Vaccine Therapy and Celecoxib in Treating Patients With Metastatic Nasopharyngeal Cancer

The recruitment status of this study is unknown because the information has not been verified recently.
Verified December 2008 by National Cancer Institute (NCI).
Recruitment status was  Active, not recruiting
Sponsor:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00589186
First received: December 20, 2007
Last updated: December 17, 2013
Last verified: December 2008
  Purpose

RATIONALE: Vaccines made from a gene-modified virus and a person's dendritic cells may help the body build an effective immune response to kill tumor cells. Celecoxib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving vaccine therapy together with celecoxib may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving vaccine therapy together with celecoxib works in treating patients with metastatic nasopharyngeal cancer.


Condition Intervention Phase
Head and Neck Cancer
Biological: Ad5F35-LMP1/LMP2-transduced autologous dendritic cells
Drug: celecoxib
Other: flow cytometry
Other: immunoenzyme technique
Other: laboratory biomarker analysis
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Clinical Trial of Tumour Vaccination By Intradermal Delivery of Autologous Dendritic Cells Transduced With Adenoviral Vector (AD5F35) Expressing Latent Membrane Protein-1 (LMP-1) and Latent Membrane Protein-2 (LMP-2) Genes in Combination With Celecoxib in Patient With Metastatic Nasopharyngeal Carcinoma

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Clinical benefit rate (CBR) (complete response [CR], partial response [PR], and stable disease [SD] for ≥ 14 weeks) as defined by RECIST criteria [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response rate (CR and PR) [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Toxicity profile [ Designated as safety issue: Yes ]

Estimated Enrollment: 35
Study Start Date: November 2007
Estimated Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To evaluate the clinical benefit rate (complete response, partial response, and stable disease for ≥ 14 weeks) in patients with metastatic nasopharyngeal carcinoma treated with autologous dendritic cells (DC) transduced with AD5F35 expressing LMP-1 and LMP-2 when administered in combination with celecoxib.

Secondary

  • To evaluate the toxicities of this regimen in these patients.
  • To evaluate the specific T-cell response against LMP-1 and LMP-2 as measured by HLA tetramer technology, ELISPOT assay, and delayed-type hypersensitivity in patients treated with this regimen.
  • To evaluate the surrogate tumor marker response plasma EBV DNA by real-time PCR in these patients.
  • To evaluate and characterize immunological cell types and tumor characteristics in biopsy specimens of patients treated with this DC vaccine and compare it with pre-vaccine biopsy specimens.
  • To evaluate progression-free survival and overall survival of patients who show initial clinical benefit to DC vaccine.

OUTLINE: Patients undergo blood collection for the preparation of the autologous dendritic cell (DC) vaccine. Immature DCs are transduced with latent membrane protein-1 (LMP-1) and latent membrane protein-2 (LMP-2) using the adenoviral vector 5F35. Beginning 1 week after blood collection, patients receive vaccination with autologous DCs transduced with AD5F35-LMP-1/LMP-2 intradermally every 2 weeks for a total of 5 vaccinations. Patients also receive celecoxib twice a day beginning 1 week before the first vaccination and continuing for up to 6 weeks after completion of the last vaccination.

Patients who demonstrate clinical benefit after completion of 5 courses of vaccination may continue to receive the DC vaccine alone off study every 2 weeks until disease progression (based on CT scan findings) or at the investigator's discretion.

Patients undergo blood and tumor tissue sample collection periodically for laboratory studies. Blood samples are analyzed using MHC tetramer analysis; enzyme-linked immunospot (ELISPOT) analysis; EBV DNA titers to assess response; and flow cytometry to assess lymphocyte kinetics. Tumor tissue samples are used for immunological studies. Delayed-type hypersensitivity is also assessed.

After completion of study treatment, patients are followed monthly for up to 1 year.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed nasopharyngeal carcinoma (NPC)

    • Metastatic disease
    • WHO type II/III disease
  • Measurable disease
  • Meets 1 of the following criteria:

    • Progression on one or more lines of polychemotherapy for treatment of metastatic disease
    • Failed non-myeloablative hematopoietic stem cell transplant
  • No active CNS metastases

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy > 3 months
  • Hemoglobin ≥ 8.5 g/dL
  • Serum bilirubin ≤ 1.5 times upper limit of normal
  • ALT or AST ≤ 5 times normal
  • Creatinine clearance ≥ 40 mL/min
  • Left ventricular ejection fraction ≥ 45% by MUGA
  • Corrected DLCO > 50% of predicted
  • No active or prior gastrointestinal bleeding
  • No history of adverse reaction to NSAIDs or sensitivity to celecoxib
  • No cardiac disease, including any of the following:

    • Symptomatic congestive heart failure
    • Active angina pectoris
    • High-risk uncontrolled arrhythmia
    • Uncontrolled hypertension
  • No pulmonary disease, including any of the following:

    • Severe chronic obstructive lung disease
    • Uncontrolled large pleural effusion
    • Severe restrictive lung disease
  • No cerebrovascular accident
  • No transient ischemic attack
  • No HIV positivity
  • No active uncontrolled infection
  • No symptomatic leukoencephalopathy or other neuropsychiatric abnormalities
  • Not pregnant or nursing
  • Negative pregnancy test

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Prior celecoxib allowed
  • At least 28 days since prior chemotherapy
  • At least 100 days since prior non-myeloablative hematopoietic stem cell transplant
  • At least 2 months since prior donor lymphocyte infusions
  • More than 28 days since prior participation in another clinical trial with any investigational drugs
  • No other concurrent experimental drugs
  • No other concurrent anticancer therapy
  • No concurrent anticoagulation with warfarin or low molecular weight heparin
  • No other concurrent nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00589186

Locations
Singapore
National Cancer Centre - Singapore
Singapore, Singapore, 169610
Sponsors and Collaborators
National Cancer Centre, Singapore
Investigators
Study Chair: Toh Han Chong, MD, MBBS, MRCP National Cancer Centre, Singapore
  More Information

Additional Information:
No publications provided

ClinicalTrials.gov Identifier: NCT00589186     History of Changes
Other Study ID Numbers: CDR0000579355, SINGAPORE-NCC-07-11-NPC
Study First Received: December 20, 2007
Last Updated: December 17, 2013
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage IV squamous cell carcinoma of the nasopharynx
stage IV lymphoepithelioma of the nasopharynx
recurrent squamous cell carcinoma of the nasopharynx
recurrent lymphoepithelioma of the nasopharynx

Additional relevant MeSH terms:
Head and Neck Neoplasms
Neoplasms by Site
Neoplasms
Celecoxib
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Therapeutic Uses
Antirheumatic Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on September 18, 2014