Monoclonal Antibody Therapy in Treating Patients With Ovarian Epithelial Cancer, Melanoma, Acute Myeloid Leukemia, Myelodysplastic Syndrome, or Non-Small Cell Lung Cancer
Study Details
Study Description
Brief Summary
This phase I trial is studying the side effects of monoclonal antibody therapy in treating patients with ovarian epithelial cancer, melanoma, acute myeloid leukemia, myelodysplastic syndrome, or non-small cell lung cancer. Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells
Detailed Description
PRIMARY OBJECTIVES:
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To determine the safety of MDX-CTLA-4 in patients previously and not previously vaccinated with GM-CSF-based vaccines using lethally irradiated, autologous melanoma, ovarian cancer, acute myelogenous leukemia/myelodysplasia or lung cancer cells.
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To identify preliminary evidence of biologic activity and efficacy.
OUTLINE:
Patients receive anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody IV over 90 minutes on day 1. Courses repeat every 2 months in the absence of disease progression or unacceptable toxicity.
Patients are followed monthly until disease progression.
PROJECTED ACCRUAL: A total of 48 patients (12 per disease type; 36 previously treated with a sargramostim (GM-CSF)-expressing autologous tumor cell vaccine and 12 not previously treated with this vaccine) will be accrued for this study.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Treatment (ipilimumab) Patients receive anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody IV over 90 minutes on day 1. Courses repeat every 2 months in the absence of disease progression or unacceptable toxicity. |
Biological: ipilimumab
Given IV
Other Names:
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Outcome Measures
Primary Outcome Measures
- Toxicities of ipilimumab, based on the National Cancer Institute Common Toxicity Criteria (NCI CTC) v2.0 [Up to 6 years]
Secondary Outcome Measures
- Overall clinical response rate (complete response [CR] plus partial response [PR]) based on the Response Evaluation Criteria in Solid Tumors (RECIST) [Up to 6 years]
90% confidence intervals will be estimated.
- Proportion of patients who mount a brisk immune response, graded as absent, non-brisk, and brisk as described by Mihm [Up to 2 months post-treatment]
90% confidence intervals will be estimated.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients previously vaccinated with GM-CSF-based vaccines using lethally irradiated, autologous melanoma, ovarian cancer, acute myelogenous leukemia/myelodysplasia, or non-small cell lung cancer cells; patients with acute myelogenous leukemia/myelodysplasia or non-small cell lung cancer who have not been vaccinated with an autologous, GM-CSF based vaccine
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= 4 weeks since treatment (chemo-, radiation, hormone, immuno-, etc., therapy)
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Patients must have recovered from any acute toxicity associated with prior therapy
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Measurable epithelial ovarian cancer, melanoma, AML/MDS, or non-small cell lung cancer
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No standard curative treatment options
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Not require immediate palliative therapy
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Patients with epithelial ovarian cancer must have persistent or recurrent disease following primary surgery and primary chemotherapy
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Patients with melanoma must be stage IV disease
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Patients with AML/MDS, but without MDS, must be: a) in second relapse or b) first relapse with no option for bone marrow transplant or c) not a candidate for immunosuppressive chemotherapy due to age or comorbid disease
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Patients with non-small cell lung cancer must be not curable by standard surgery, chemotherapy, and/or radiation
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Life expectancy >= 12 weeks
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ECOG performance status of 0, 1 or 2
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Written informed consent
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Due to the unknown effects of MDX-CTLA-4 on the fetus or nursing infant, pregnant or nursing women should not be included; women should be either: post-menopausal for at least 1 year; surgically incapable of bearing children; or utilizing an intrauterine device, and/or spermicide and barrier, for contraception; during the study, use of oral contraception alone is not acceptable; women of childbearing potential must have a negative serum beta-HCG pregnancy test conducted during screening, and a negative urinary beta-HCG pregnancy test conducted within 24 hours prior to treatment; due to the unknown effects of MDX-CTLA-4 on the fetus, men should not father children during the study
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WBC > 1,000 cells/mm^3 (except for AML/MDS patients)
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Serum creatinine < 2 mg/dL
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Platelets > 75,000 cells/mm^3 (except for AML/MDS patients)
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AST and ALT < 2 x UNL
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Total bilirubin < 2 x UNL
Exclusion Criteria:
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Active infection
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Autoimmune disease requiring immunosuppressive treatment
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Any underlying medical condition which, in the principal investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of adverse events
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Any concurrent medical condition requiring the use of systemic steroids (use of inhaled or topical steroids is acceptable)
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CNS metastases, unless previously treated and stable for at least three months
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Patients who have received prior treatment with MDX-CTLA-4
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Dana-Farber Cancer Institute | Boston | Massachusetts | United States | 02115 |
Sponsors and Collaborators
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: Frank Hodi, Dana-Farber Cancer Institute
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- NCI-2012-03144
- 01-228
- R21CA105776
- CDR0000069349