Biological Therapy Following Surgery and Chemotherapy in Treating Patients With Stage III or Stage IV Breast Cancer
RATIONALE: Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Combining different types of biological therapies may kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of biological therapy following surgery and chemotherapy in treating patients who have stage III or stage IV breast cancer.
Biological: autologous tumor cell vaccine
Biological: therapeutic autologous lymphocytes
Procedure: surgical procedure
|Study Design:||Primary Purpose: Treatment|
|Official Title:||Immunotherapy for Breast Carcinoma - Phase II Trial of Autologous Cancer Antigen Specific Immunotherapy|
|Study Start Date:||June 1997|
|Primary Completion Date:||February 2004 (Final data collection date for primary outcome measure)|
- Determine the efficacy of immunotherapy with irradiated autologous tumor cell vaccine and sargramostim (GM-CSF) followed by monoclonal antibody OKT3- activated T lymphocytes and interleukin-2 in combination with standard therapy in terms of response rate in patients with stage III or IV breast cancer.
- Determine the immunogenicity of breast cancer in this patient population.
OUTLINE: Patients are stratified according to extent of disease at the time of immunotherapy, extent of antigen specific response to vaccination, performance status (0 vs 1), prior therapy (yes vs no), and gender.
Patients undergo surgical debulking of tumor on week 1 followed by adjuvant chemotherapy. Within 2-4 weeks of chemotherapy, patients are vaccinated with irradiated autologous tumor cells and sargramostim (GM-CSF), then receive GM-CSF alone intradermally at vaccination sites daily for 4 days. Patients are revaccinated 2 weeks later.
Patients undergo peripheral blood mononuclear cell collection two weeks after the second vaccination. Peripheral blood mononuclear cells are stimulated with anti-CD3 monoclonal antibody (OKT3) and interleukin-2, producing activated T lymphocytes. The activated T lymphocytes are infused IV over 1-6 hours followed by 5 doses of interleukin-2 IV every other day over 10 days. Treatment continues in the absence of disease progression or unacceptable toxicity.
Patients may receive one additional course of immunotherapy as above.
Patients are followed every 3 months for 2 years, then every 6 months thereafter.
PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study.
|United States, Michigan|
|Barbara Ann Karmanos Cancer Institute|
|Detroit, Michigan, United States, 48201|
|Study Chair:||Roy D. Baynes, MD, PhD, FACP||Barbara Ann Karmanos Cancer Institute|