A Safety and Efficacy Trial of Lethally Irradiated Allogeneic Pancreatic Tumor Cells Transfected With the GM-CSF Gene in Combination With Adjuvant Chemoradiotherapy for the Treatment of Adenocarcinoma of the Pancreas
GVAX pancreatic cancer vaccine
Adenocarcinoma+9
+ Carcinoma
+ Digestive System Diseases
Treatment Study
Summary
Study start date: January 1, 2002
Actual date on which the first participant was enrolled.OBJECTIVES: Primary * Determine overall and disease-free survival of patients with resected stage I or II adenocarcinoma of the pancreas treated with adjuvant chemoradiotherapy in combination with GVAX pancreatic cancer vaccine. Secondary * Correlate specific in vivo parameters of immune response (post-vaccination delayed-type hypersensitivity reactions to autologous tumor, mesothelin-specific T-cell response, and the degree of local eosinophil, macrophage, and T-cell infiltration at the vaccine site) with clinical responses in patients treated with this regimen. * Determine the toxic effects associated with intradermal injections of this vaccine in these patients. OUTLINE: This is an open-label study. * Post surgery vaccination: Within 8-10 weeks after pancreaticoduodenectomy, patients receive GVAX pancreatic cancer vaccine intradermally (ID) on day 0. * Adjuvant chemoradiotherapy: Within 16-28 days after the first vaccination, patients receive fluorouracil (5-FU) IV continuously for 3 weeks. Approximately 1-2 weeks after completion of 5-FU, patients receive chemoradiotherapy comprising radiotherapy daily and 5-FU IV continuously for 26-28 weeks. Approximately 3-5 weeks after completion of chemoradiotherapy, patients receive 5-FU IV continuously for 4 weeks. 5-FU repeats every 6 weeks for 2 courses. * Post chemoradiotherapy vaccination: Within 4-8 weeks after the completion of chemoradiotherapy, patients receive GVAX pancreatic cancer vaccine ID on days 0, 28, 56, and 196. Treatment continues in the absence of unacceptable toxicity. Patients are followed every 3 months for 1 year and then every 6 months thereafter. PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.60 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: * Histologically confirmed invasive ductal adenocarcinoma of the head, neck, and uncinate process of the pancreas * Mixed adenocarcinoma tumors allowed if the predominant invasive component of the tumor is adenocarcinoma * Stage I or II (clinical stage T1-3, N0-1, M0) disease * Has undergone pancreaticoduodenectomy at the Johns Hopkins Hospital within the past 8-10 weeks * Completely resected (R0) or microscopic residual (R1) disease * No diagnosis other than ductal adenocarcinoma, including any of the following: * Adenosquamous * Squamous cell * Colloid * Islet cell * Non-invasive intraductal papillary mucinous neoplasms * Serous or mucinous cystadenoma or cystadenocarcinoma * Carcinoid * Small or large cell carcinoma * Intraductal oncocytic papillary neoplasms * Osteoclast-like giant cell tumors * Acinar cell carcinoma * Pancreatoblastoma * Solid pseudopapillary tumors * Undifferentiated small cell carcinoma * Non-epithelial tumors (sarcoma, gastrointestinal stromal tumor, or lymphoma) * Adenocarcinoma of the ampulla * Adenocarcinoma of the distal bile duct * Adenocarcinoma of the duodenum * No recurrent disease * No metastatic disease, including peritoneal implants or liver and/or lung involvement PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count \>/= 1,500/mm\^3 * Platelet count \>/= 100,000/mm\^3 * Hemoglobin \>/= 10 g/dL Hepatic * Bilirubin \</= 2 mg/dL * AST/ALT \</= 2 times upper limit of normal (ULN) * Alkaline phosphatase \</= 5 times ULN Renal * Creatinine \</= 2 mg/dL Pulmonary * No asthma or chronic obstructive pulmonary disease requiring systemic corticosteroids Immunologic * HIV negative * No active infection * No prior or concurrent autoimmune disease requiring treatment with systemic immunosuppressants, including any of the following: * Inflammatory bowel disease * Systemic vasculitis * Scleroderma * Psoriasis * Multiple sclerosis * Hemolytic anemia or immune thrombocytopenia * Rheumatoid arthritis * Systemic lupus erythematosus * Sjogren's syndrome * Sarcoidosis * Negative results to viral delayed-type hypersensitivity serology testing if autologous tumor cells are available Other * No postoperative complications (e.g., inability to take oral nutrition \>/= 1,500 calories/day, ongoing requirement for long-term biliary stenting, or persistence of wound infection) * No other malignancy within the past 5 years except nonmelanoma skin cancer * No uncontrolled medical conditions that would preclude study participation * No other major active medical or psychosocial problem that could be exacerbated by study treatment * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for at least 4 weeks after study participation PRIOR CONCURRENT THERAPY: Biologic therapy * More than 1 month since prior biologic therapy * No other concurrent biologic therapy, immunotherapy, or gene therapy for pancreatic cancer Chemotherapy * More than 1 month since prior chemotherapy * No other concurrent chemotherapy for pancreatic cancer Endocrine therapy * More than 28 days since prior systemic steroids * No concurrent systemic corticosteroids Radiotherapy * More than 1 month since prior radiotherapy * No other concurrent radiotherapy for pancreatic cancer Surgery * See Disease Characteristics * Recovered from prior surgery Other * More than 1 month since prior participation in an investigational new drug trial * No other concurrent investigational therapy for pancreatic cancer
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location