Vaccine Therapy and Sargramostim With or Without Docetaxel in Treating Patients With Metastatic Lung Cancer or Metastatic Colorectal Cancer
RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. Colony-stimulating factors such as sargramostim increase the number of immune cells found in bone marrow and peripheral blood. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining vaccine therapy and sargramostim with docetaxel may kill more tumor cells.
PURPOSE: This randomized phase II trial is studying how well giving vaccine therapy together with sargramostim and docetaxel works compared to vaccine therapy and sargramostim alone in treating patients with metastatic lung cancer or metastatic colorectal cancer.
Drug: recombinant fowlpox-CEA(6D)/TRICOM vaccine
Drug: recombinant vaccinia-CEA(6D)-TRICOM vaccine
Procedure: biological therapy
Procedure: colony-stimulating factor therapy
Procedure: cytokine therapy
Procedure: non-specific immune-modulator therapy
Procedure: recombinant viral vaccine
Procedure: vaccine therapy
|Study Design:||Allocation: Randomized
Primary Purpose: Treatment
|Official Title:||Randomized Single Institution Pilot Study of Vaccinia-CEA (6D)-Tricomand Fowlpox CEA(6D)-Tricom With GM-CSF in Combination With Docetaxel in Patients With CEA-Bearing Cancers|
- Change in immune response as assessed by T-cells monthly
|Study Start Date:||June 2004|
- Determine the recommended dose and schedule of docetaxel when given in combination with recombinant vaccinia-CEA-TRICOM vaccine, recombinant fowlpox-CEA-TRICOM vaccine, and sargramostim (GM-CSF), defined by best immune response with acceptable toxicity, in patients with carcinoembryonic antigen (CEA)-expressing metastatic lung or colorectal cancer.
- Compare the effect of varying doses and schedules of docetaxel on CEA-specific T-cell immune responses by ELISPOT assay in patients treated with these regimens.
- Compare objective antitumor response in patients treated with these regimens.
OUTLINE: This is a 2-part, randomized, pilot study. Patients are randomized to 1 of 6 treatment arms: arms I, II, and III in part I (lung cancer and colorectal cancer patients) and arms IV, V, and VI in part II (lung cancer patients only). Patients are stratified according to disease site and HLA-A2 positivity (positive vs negative). At least 6 of 10 patients must be HLA-A2 positive for each of the treatment arms.
- Vaccinia-CEA-TRICOM vaccine (parts I and II): In all treatment arms, patients receive vaccinia-CEA-TRICOM vaccine intradermally on day 1 and sargramostim (GM-CSF) subcutaneously (SC) into the vaccine site on days 1-4.
Fowlpox-CEA-TRICOM vaccine and concurrent chemotherapy:
Part I (lung cancer and colorectal cancer patients):
- Arm I: Three weeks after treatment with vaccinia-CEA-TRICOM vaccine, patients receive fowlpox-CEA-TRICOM vaccine SC on day 1 and GM-CSF SC into each vaccination site on days 1-4.
- Arm II: Patients receive fowlpox-CEA-TRICOM vaccine and GM-CSF as as in arm I and lower-dose docetaxel IV over 30 minutes on days 1 and 8.
- Arm III: Patients receive fowlpox-CEA-TRICOM vaccine and GM-CSF as in arm I and standard-dose docetaxel IV over 30 minutes on days 1 and 8.
Part II (lung cancer patients only):
- Arm IV: Patients receive fowlpox-CEA-TRICOM vaccine and GM-CSF as in arm I and full-dose docetaxel IV over 1 hour on day 1.
- Arm V: Patients receive full-dose docetaxel IV over 1 hour on day 1, fowlpox-CEA-TRICOM vaccine SC on day 8, and GM-CSF SC into each vaccination site on days 8-11.
- Arm VI: Patients receive full-dose docetaxel as in arm V, fowlpox-CEA-TRICOM vaccine SC on day 15, and GM-CSF SC into each vaccination site on days 15-18.
Treatment in all arms repeats every 21 days for a total of 4 courses in the absence of disease progression or unacceptable toxicity. Patients who do not have significant disease progression or unacceptable toxicity after 4 courses of treatment may receive additional fowlpox-CEA-TRICOM vaccine and docetaxel according to the treatment arm on which they were enrolled at study entry.
Patients are followed every 6 months for 2 years and then annually for 13 years.
PROJECTED ACCRUAL: A total of 60 patients (10 per treatment arm) will be accrued for this study within 10 months.
|United States, District of Columbia|
|Lombardi Comprehensive Cancer Center at Georgetown University Medical Center|
|Washington, District of Columbia, United States, 20007|
|Study Chair:||John L. Marshall, MD||Lombardi Cancer Research Center|