Vaccine Therapy in Treating Patients With Recurrent B-Cell Lymphoma

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier:
NCT00561756
First received: November 20, 2007
Last updated: June 26, 2013
Last verified: June 2013
  Purpose

RATIONALE: Vaccines made from mouse DNA may help the body build an effective immune response to kill cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of mouse DNA vaccine in treating patients with recurrent B-cell lymphoma.


Condition Intervention Phase
Lymphoma
Biological: plasmid DNA vaccine therapy
Other: flow cytometry
Other: immunoenzyme technique
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I Trial to Assess Safety and Immunogenicity of Xenogeneic CD20 DNA Vaccination With Patients With B-Cell Lymphoma

Resource links provided by NLM:


Further study details as provided by Memorial Sloan-Kettering Cancer Center:

Primary Outcome Measures:
  • Safety and immunogenicity [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Antibody and T-cell responses against CD20 [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Antitumor response [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 18
Study Start Date: October 2007
Estimated Study Completion Date: October 2014
Estimated Primary Completion Date: October 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Vaccine Therapy
This single arm, open-label, phase I clinical trial of xenogeneic CD20 DNA vaccination is designed to evaluate its safety in patients with B cell lymphoma. The study is a dose escalation study at three test doses, 0.5 mg, 2 mg and 4 mg of purified plasmid DNA per injection. There will be an initial cohort of three patients receiving a pre-level 1 dose of 0.1 mg/vaccination before proceeding to the three test doses.
Biological: plasmid DNA vaccine therapy Other: flow cytometry Other: immunoenzyme technique

Detailed Description:

OBJECTIVES:

Primary

  • To evaluate the safety and feasibility of intramuscular DNA vaccination with a plasmid DNA vector expressing the mouse extracellular domain of CD20, namely pINGmminiCD20. Doses of pING-mminiCD20 will be escalated by group to determine the optimal biological dose.

Secondary

  • To evaluate antibody and T-cell responses to CD20 after vaccination.
  • To observe patients for evidence of any antitumor response generated after vaccination.

OUTLINE: The entire immunization schedule comprises five injections administered every three weeks (for a total of approximately four and one half months). After the second injection, blood will be drawn for assessment of antibody and T-cell responses. After the fifth and final injection, blood will again be drawn for assessment of antibody and T-cell responses.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have a functional immune system as determined by the following tests:
  • Serum proteins immunoelectrophoresis (serum IgG levels ≥ 0.5 g/dL are required)
  • No evidence of anergy as shown by positive skin test with tetanus toxoid, mumps or Candida. OR
  • Circulating T-cells as measured by flow cytometry (serum CD4+ and CD8+ T-cell counts ≥ 250 and 150 cells/μL, respectively) Patients must have histologically proven (and confirmed at MSKCC) B-cell lymphoma of any histology, excluding Burkitt's lymphoma, Lymphoblastic lymphoma (due to their aggressiveness and low likelihood of response to immune therapy).
  • CD20 surface expression must be confirmed by immunohistochemical staining or flow.
  • Measurable disease is not a pre-requisite for enrollment in the study. However, if a patient does have measurable disease as evidenced by imaging studies, these have to be done within eight weeks of starting treatment.
  • Patients must have a Karnofsky performance status ≥ 70%.
  • Patients with evidence of active disease, progression of disease or relapsed disease following one or more prior regimens of chemotherapy, immunotherapy or radiation therapy (including autologous stem cell transplants), not requiring immediate cytoreductive chemotherapy. All treatment must be completed at least four weeks prior to administration of the first vaccination, except immunotherapy and radioimmunotherapy, which must be completed at least 90 days prior to receiving the first vaccination. Active disease includes patients with minor or partial responses after therapy as evidenced by FDG-avid disease or biopsy.
  • Age ≥ 18.
  • Adequate contraception during study enrollment.
  • Avoidance of breast-feeding their infants during the study enrollment.
  • Patients must have adequate organ and marrow function as defined below:
  • Absolute Neutrophil Count ≥ 1,000/uL
  • Platelets ≥ 75,000/uL
  • Total bilirubin ≤ 2.5 times institutional upper limit
  • AST/ALT ≤ 2.5 times institutional upper limit
  • Creatinine ≤ 2 mg/dL
  • PT/PTT ≤ 1.5 times institutional upper limit
  • Patients must have no signs of congestive heart failure according to the New York Heart Failure Guidelines Class III/IV.

Exclusion Criteria:

  • Patients who have had chemotherapy or radiation therapy within 4 weeks prior to entering the study.
  • Patients who have undergone an allogeneic stem cell transplant at any time.
  • Patients who have not recovered from adverse events due to agents administered more than 4 weeks earlier.
  • Patients who have received immunotherapy (i.e. rituximab) or radioimmuno therapy (i.e. tositumomab or ibritumomab) within the past 90 days.

Patients who display signs of anergy as indicated by skin testing.

  • Patients with Burkitt's lymphoma and Lymphoblastic Lymphoma.
  • Patients who have been previously immunized with any type of DNA vaccine.
  • Patients who have positive anti-DS-DNA antibodies.
  • Patients with life expectancy less than 3 months from the time of enrollment.
  • Patients with serious underlying medical conditions, active infections requiring the use of antimicrobial drugs or active bleeding.
  • Patients with active Hepatitis C (HC) or Hepatitis B (HB) infection, the latter defined as a positive test for HBsAg or measurable viral load. In patients who are HBsAg negative but HBsAg positive (regardless of HBsAb status), a HB viral load will be performed and if positive the subject will be excluded. If the subject is HBsAg negative, HBcAb positive (regardless of HBsAb status) but with negative HBV viral load, the subject may be included but must undergo HBV DNA PCR testing at least every two months from the start of treatment during the routine study visits for as long as the subject remains on study. Prophylactic antiviral therapy, in addition to the monitoring described above, may be initiated at the discretion of the investigator.

Patients with documented HIV infection or other immunodeficiency disorder or on chronic steroids treatment.

  • Patients with autoimmune diseases such as but not limited to rheumatoid arthritis, Sjogren disease, ulcerative colitis, autoimmune hepatitis.
  • Pregnant or nursing women. Women of child-bearing age will be tested for qualitative β-HCG within 2 weeks of immunization.
  • Patients receiving other investigational drug.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00561756

Locations
United States, New York
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10065
Sponsors and Collaborators
Memorial Sloan-Kettering Cancer Center
Investigators
Principal Investigator: M. Lia Palomba, MD Memorial Sloan-Kettering Cancer Center
Principal Investigator: Andrew D. Zelenetz, MD, PhD Memorial Sloan-Kettering Cancer Center
Principal Investigator: Alan N. Houghton, MD Memorial Sloan-Kettering Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier: NCT00561756     History of Changes
Other Study ID Numbers: 07-100, MSKCC-07100
Study First Received: November 20, 2007
Last Updated: June 26, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Memorial Sloan-Kettering Cancer Center:
cutaneous B-cell non-Hodgkin lymphoma
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
recurrent grade 3 follicular lymphoma
extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
recurrent marginal zone lymphoma
recurrent mantle cell lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult diffuse mixed cell lymphoma

Additional relevant MeSH terms:
Lymphoma
Lymphoma, B-Cell
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin

ClinicalTrials.gov processed this record on April 17, 2014