Vaccine Therapy in Treating Patients With Advanced or Recurrent Cancer

Sponsor

National Cancer Institute (NCI) (NIH)

Overall Status

Completed

CT.gov ID

NCT00019110

Collaborator

(none)

Locations

Study Details

Study Description

Brief Summary

RATIONALE: Vaccines made from certain human papillomaviruses may be able to help the body to kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of human papillomavirus vaccine therapy in treating patients who have advanced or recurrent cancer of the cervix, vagina, penis, anus, esophagus, or head and neck.

Condition or Disease	Intervention/Treatment	Phase
Anal Cancer Cervical Cancer Esophageal Cancer Head and Neck Cancer Penile Cancer Vulvar Cancer	Biological: human papillomavirus 16 E7 peptide Biological: synthetic human papillomavirus 16 E6 peptide	Phase 1

Detailed Description

OBJECTIVES:

Determine whether endogenous cellular immunity to the viral oncoproteins human papilloma virus 16 (HPV16) E6 and E7 is present in patients with advanced or recurrent carcinoma of the cervix or other carcinomas that carry HPV16.
Determine whether vaccination with antigen-presenting cells pulsed with synthetic peptide corresponding to the tumor's HPV16 E6 or E7 peptide can induce or boost patient cellular immunity to that particular peptide.
Determine the type and characteristics of the cellular immunity generated in patients treated with this regimen.
Determine the toxicity of this regimen in these patients.
Determine the tumor response in patients treated with this regimen.
Determine whether in vivo T cells generated specifically against HPV16 E6 or E7 peptide can be cloned and expanded in vitro against the corresponding peptide.

OUTLINE: Patients are stratified according to disease category as defined by the following:

Stratum A: Stage III cervical cancer not previously treated with appropriate radiotherapy; stage IV or recurrent cervical cancer; or other advanced tumors that harbor human papilloma virus 16 (HPV16) such as anogenital, esophageal, or head and neck cancers.
Stratum B: Stage III cervical cancer previously treated with standard therapy with no evidence of residual disease. Vaccination in this group is given as adjuvant therapy.

Patients are assigned to receive HPV E6 or E7 peptide by the principal investigator. Peripheral blood mononuclear cells (PBMC) (antigen presenting cells) are harvested and treated in vitro with sargramostim (GM-CSF) and pulsed with HPV16 E6 or E7. Patients receive vaccination with HPV16 E6 or E7 pulsed PBMC IV over 1-2 minutes during weeks 1, 3, 7, and 11 for a total of 4 vaccinations. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients who achieve complete response (CR) continue treatment for a maximum of 1 year past CR.

Patients are followed at 1 month.

PROJECTED ACCRUAL: A total of 40-46 patients (at least 28 patients for stratum A and 12 for stratum B) will be accrued for this study within 1-2 years.

Study Design

Study Type:

Interventional

Primary Purpose:

Treatment

Official Title:

VACCINE THERAPY AND DETECTION OF IMMUNOLOGIC RESPONSES WITH HUMAN PAPILLOMAVIRUS 16 E6 AND E7 PEPTIDES IN PATIENTS WITH METASTATIC OR LOCALLY ADVANCED CERVICAL CANCER

Study Start Date :

Nov 1, 1995

Outcome Measures

Primary Outcome Measures

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

Female

Accepts Healthy Volunteers:

DISEASE CHARACTERISTICS:

Histologically proven stage III, IV, or recurrent carcinoma of the cervix or other tumor that carries human papilloma virus 16 (HPV16) such as other anogenital (vulvar, penile, and anal), esophageal, and head and neck cancers
HLA-A2.1 positive
Patients with tumors other than cervical cancer must have no other therapeutic options
Fresh tissue or paraffin block available for HPV genome detection and typing (optional for cervical cancer)
No history of CNS metastases

PATIENT CHARACTERISTICS:

Age:

Over 18

Performance status:

ECOG 0-1

Life expectancy:

More than 3 months

Hematopoietic:

WBC at least 2,000/mm^3
Platelet count at least 100,000/mm^3

Hepatic:

Bilirubin no greater than 2.0 mg/dL
SGPT no greater than 4 times normal

Renal:

Creatinine no greater than 2.0 mg/dL

Cardiovascular:

No myocardial infarction within the past 6 months
No New York Heart Association class III or IV heart disease

Immunologic:

No autoimmune disease, e.g.:
Systemic lupus erythematosus
Multiple sclerosis
Ankylosing spondylitis
HIV negative
Responsive to 1 of the following skin test antigens:
Mumps Trichophyton
Candida Tetanus

Other:

No active infection requiring antibiotics
No weight loss greater than 20% within the past 6 months
No other active malignancy except basal cell skin cancer
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

At least 4 weeks since prior immunotherapy and recovered

Chemotherapy:

At least 4 weeks since prior chemotherapy and recovered

Endocrine therapy:

At least 4 weeks since prior steroids and recovered

Radiotherapy:

At least 4 weeks since prior radiotherapy and recovered

Surgery:

Not specified

Other:

Recovered from the toxic effects of prior therapy

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support	Bethesda	Maryland	United States	20892-1182
2	Center for Cancer Research	Bethesda	Maryland	United States	20892
3	Massachusetts General Hospital Cancer Center	Boston	Massachusetts	United States	02114-2617
4	Brigham and Women's Hospital	Boston	Massachusetts	United States	02115
5	Morristown Memorial Hospital	Morristown	New Jersey	United States	07962-1956
6	University of Texas Medical Branch	Galveston	Texas	United States	77555-0587