A Phase I/II Study of Recombinant Interleukin-4 in AIDS and Kaposi's Sarcoma
Study Details
Study Description
Brief Summary
To determine the safety and tolerance of interleukin-4 (IL-4) in patients with AIDS-related Kaposi's sarcoma. To determine the effects of IL-4 on tumor growth in patients with AIDS-related Kaposi's sarcoma.
IL-4 exhibits a variety of beneficial effects on the immune system and is a potent inhibitor of Kaposi's sarcoma cells in vitro.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
Phase 1 |
Detailed Description
IL-4 exhibits a variety of beneficial effects on the immune system and is a potent inhibitor of Kaposi's sarcoma cells in vitro.
Patients are stratified into two groups according to CD4 count (less than 100 cells/mm3 and greater than or equal to 100 cells/mm3) and are enrolled in cohorts of four patients at each of four dose levels of IL-4 per stratum. Within each stratum, if patients at a given dose level have received at least 2 weeks of study therapy and no more than two patients experienced grade 3 or 4 drug-related toxicity, dose escalation in subsequent patients may begin. The MTD is defined as the dose at which 50 percent of patients develop grade 3 or worse toxicity. Patients with CD4 count less than 500 cells/mm3 (per 12/30/94 amendment) must be on antiretroviral therapy during study treatment.
PER AMENDMENT 11/20/95: Group I - enrollment is closed, the objective has been defined. Group II - patients must have CD4 cells greater than or equal to 100/mm3 and less than 500/mm3.
PER AMENDMENT 11/20/95: All patients will receive antiretroviral therapy.
Study Design
Outcome Measures
Primary Outcome Measures
Eligibility Criteria
Criteria
Inclusion Criteria
Concurrent Medication:
Required:
- Antiretroviral therapy during study treatment only in patients with CD4 count < 500 cells/mm3 (per 12/30/94 amendment).
Allowed:
-
G-CSF for a second occurrence of grade 3 or 4 neutropenia (per 12/30/94 amendment).
-
Nonsteroidal anti-inflammatory agents including acetaminophen for drug-related fevers.
-
Systemic steroids for no more than 1 week in any 30-day period.
-
PCP prophylaxis with TMP/SMX, dapsone, or inhaled pentamidine, if patient has a history of PCP or a CD4 count < 250 cells/mm3.
Allowed only in patients with CD4 count < 100 cells/mm3:
-
Maintenance doses of ganciclovir, pyrimethamine/sulfa and TMP/SMX for stable, well-controlled opportunistic infections.
-
Non-myelosuppressive treatment IND medications.
Prior Medication: Required: PER AMENDMENT 11/20/95:
- Stable dose of antiretroviral therapy required for at least 21 days prior to study entry for all patients. (Changed from - Stable dose of antiretroviral therapy for at least 21 days prior to study entry in patients with CD4 count < 500 cells/mm3 (per 12/30/94 amendment).
Patients must have:
-
AIDS-related Kaposi's sarcoma.
-
PER AMENDMENT 11/20/95: CD4 lymphocyte count >= 100 but < 500 cells/mm3. (Changed from
-
HIV infection.)
-
PER AMENDMENT 11/20/95: All Patients will receive antiretroviral therapy. (Changed from - Current antiretroviral therapy IF CD4 count < 500 cells/mm3 (per 12/30/94 amendment).)
-
No active opportunistic infections requiring induction therapy.
-
Consent of parent or guardian if less than 18 years of age.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
-
Other active malignancies (except basal cell carcinoma of the skin and in situ cervical cancer).
-
Alteration in mental status that may prevent compliance.
-
Cardiac functional capacity of Class II or worse OR regional wall abnormalities or abnormal ejection fraction on two-dimensional echocardiogram, if performed.
Concurrent Medication:
Excluded:
-
Chemotherapy, interferons, or immune modulators for Kaposi's sarcoma.
-
Myelosuppressive agents such as induction doses of ganciclovir, Fansidar (pyrimethamine/sulfadoxine), or any other investigational drugs (with the exception of non-myelosuppressive treatment IND medications in specific patients).
-
GM-CSF or erythropoietin (except for a second grade 3/4 neutropenia or anemia).
-
G-CSF.
Patients with the following prior conditions are excluded:
-
History of myocardial infarction or significant arrhythmias.
-
History of symptomatic hypoglycemia.
Prior Medication:
Excluded:
- Systemic therapy (including chemotherapy, interferons, and immune modulators) for Kaposi's sarcoma within 4 weeks prior to study entry.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | UCLA CARE Center CRS | Los Angeles | California | United States | 90095 |
2 | Massachusetts General Hospital ACTG CRS | Boston | Massachusetts | United States | 02114 |
3 | Beth Israel Deaconess Med. Ctr., ACTG CRS | Boston | Massachusetts | United States | 02215 |
Sponsors and Collaborators
- National Institute of Allergy and Infectious Diseases (NIAID)
Investigators
- Study Chair: Miles S,
- Study Chair: Scadden D,
Study Documents (Full-Text)
None provided.More Information
Publications
- ACTG 224
- 11201