Phase I Study Of Telomerase Peptide Vaccination For Patients With Advanced Breast Cancer
Collecte de données
Maladies du sein+2
+ Néoplasmes du sein
+ Néoplasmes par site
Étude thérapeutique
Résumé
Date de début de l'étude : 1 février 2004
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: Primary * Determine the safety of telomerase: 540-548 peptide vaccine emulsified in Montanide ISA-51 and sargramostim (GM-CSF) in patients with HLA-A2-expressing stage IV breast cancer. Secondary * Compare the generation of human telomerase reverse transcriptase (hTERT) peptide-specific vs cytomegalovirus peptide-specific cytotoxic T-lymphocyte (CTL) immunity in patients treated with this regimen. * Correlate the dose level of this regimen with the generation of hTERT-specific CTL immunity and the development of hTERT-specific autoimmunity in these patients. * Determine the tumor response in patients treated with this regimen. OUTLINE: This is a dose-escalation study of the telomerase: 540-548 peptide and CMV 495 peptide portions of the vaccine. Patients receive telomerase: 540-548 peptide and CMV 495 peptide (as an immunological control) vaccine emulsified in Montanide ISA-51 subcutaneously (SC) followed by sargramostim (GM-CSF) SC on day 1 of weeks 1, 3, 5, 7, 11, 15, 19, and 27 (for a total of 8 vaccinations). Treatment continues in the absence of disease progression or unacceptable toxicity. Cohorts of 5-8 patients receive escalating doses of telomerase: 540-548 peptide and CMV 495 peptide until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 5 or 2 of 8 patients experience dose-limiting toxicity. A total of 12 patients receive treatment at the MTD. Patients are followed within 30 days and then at 6 and 12 months. PROJECTED ACCRUAL: A total of 5-28 patients will be accrued for this study.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.28 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Tout sexe
Le sexe biologique des participants éligibles à s'inscrire.De 18 à 120 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
DISEASE CHARACTERISTICS: * Diagnosis of stage IV breast cancer * Failed at least 1 prior conventional therapy for metastatic disease * Measurable or evaluable disease by clinical, radiographic, or laboratory assessment * Measurable lesions must be at least 1 dimension * At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan * The following are not considered measurable: * Pleural effusion * Bone lesions * Tumor markers * HLA-A2-expressing disease by human leukocyte antigen typing * No CNS metastases by contrast CT scan and/or MRI * No brain metastases within the past 4 years * Hormone receptor status: * Not specified PATIENT CHARACTERISTICS: Age * 18 and over Sex * Not specified Menopausal status * Not specified Performance status * ECOG 0-1 Life expectancy * More than 6 months Hematopoietic * WBC ≥ 3,000/mm\^3 * Platelet count ≥ 75,000/mm\^3 * Hemoglobin ≥ 10 g/dL Hepatic * Bilirubin ≤ 1.5 times upper limit of normal (ULN) * ALT and AST ≤ 2.5 times ULN * Hepatitis B negative * Hepatitis C negative Renal * Creatinine ≤ 1.5 times ULN Immunologic * HIV negative * Human T-cell lymphotrophic virus-1 negative * No active infection * No major autoimmune disorder that would preclude study participation Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for 6 months after study participation * No alcohol abuse or illicit drug use within the past 12 months * No clinically significant comorbid disease or other underlying condition that would preclude study participation * No significant psychiatric disorder that would preclude giving informed consent or complying with study PRIOR CONCURRENT THERAPY: Biologic therapy * No prior allogeneic or autologous bone marrow or stem cell transplantation * More than 30 days since prior hematopoietic growth factors * More than 30 days since initiation of prior immunotherapy (e.g., trastuzumab \[Herceptin\]) * Concurrent immunotherapy (e.g., trastuzumab) allowed provided regimen was initiated more than 30 days before study entry, disease is stable or progressive, and patient plans to continue immunotherapy for the duration of study participation * No other concurrent hematopoietic growth factors Chemotherapy * More than 30 days since prior chemotherapy * No concurrent chemotherapy Endocrine therapy * More than 30 days since prior glucocorticoids * More than 30 days since initiation of prior hormonal therapy (e.g., tamoxifen, anastrozole, or letrozole) * Concurrent hormonal therapy (e.g., tamoxifen, anastrozole, or letrozole) allowed provided regimen was initiated more than 30 days before study entry, disease is stable or progressive, and patient plans to continue hormonal therapy for the duration of study participation * No concurrent glucocorticoids Radiotherapy * More than 30 days since prior radiotherapy * No concurrent radiotherapy Surgery * Not specified Other * More than 14 days since prior anticoagulants (e.g., warfarin, heparin, or enoxaparin) * Low-dose anticoagulants to maintain IV catheter patency allowed * More than 30 days since prior immunosuppressive drugs * More than 30 days since prior experimental therapy * No concurrent immunosuppressive drugs * No other concurrent investigational products
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 1 site