Safety and Efficacy Study of HER2/Neu (E75) Vaccine in Node-Positive Breast Cancer Patients

This study has been completed.
Sponsor:
Collaborator:
Uniformed Services University of the Health Sciences
Information provided by (Responsible Party):
COL George Peoples, MD, FACS, Walter Reed Army Medical Center
ClinicalTrials.gov Identifier:
NCT00841399
First received: February 10, 2009
Last updated: June 2, 2014
Last verified: June 2014
  Purpose

The purposes of this study are the following:

  1. To assess safety and document local and systemic toxicity to the peptide vaccine (E75)
  2. To determine maximum tolerated dose (MTD) and optimal biologic dose (OBD) for the peptide vaccine
  3. To evaluate the in vivo cellular immune response to the peptide vaccine
  4. To evaluate time to recurrence in the vaccinated patients vs. matched controls

Condition Intervention Phase
Breast Cancer
Biological: E75 + GM-CSF vaccine
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Phase Ib Trial of HER2/Neu Peptide (E75) Vaccine in Breast Cancer Patients at Risk for Recurrence After Surgical and Medical Therapies

Resource links provided by NLM:


Further study details as provided by Walter Reed Army Medical Center:

Primary Outcome Measures:
  • The primary endpoints are the safety and optimal dosing of the vaccine to induce an in vivo peptide-specific immune response. [ Time Frame: Time period needed to determine the maximum tolerated and optimal biologic doses. ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • The clinical endpoint is time to disease recurrence. [ Time Frame: 30 days after each monthly vaccine, then per standard of care for breast cancer. ] [ Designated as safety issue: Yes ]

Enrollment: 100
Study Start Date: July 2001
Study Completion Date: March 2013
Primary Completion Date: September 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: E75 + GM-CSF vaccine
The dose escalation scheme is for three patients to receive each of the doses, 100, 500, and 1,000 mcg of peptide + 250 mcg GM-CSF each month for 6 months until the maximum tolerated dose is determined. Patients who receive the vaccine are HLA-A2+ and/or HLA-A3+. Responses to the vaccine are measured via immunologic assays.
Biological: E75 + GM-CSF vaccine
Dose escalation scheme involving three patients each receiving injection of 100, 500, or 1,000 mcg E75 + GM-CSF monthly for 6 months. HLA-A2 and HLA-A3 status determined. HLA-A2+ and HLA-A3+ patients receive the vaccine; HLA-A2- and HLA-A3- enrolled to the control arm.
No Intervention: Control/observation
HLA-A2- and HLA-A3- patients do not receive the E37 + GM-CSF vaccine, but are instead enrolled to the control arm for observation.

Detailed Description:

Breast cancer is the most common malignancy and second most common cause of cancer-specific death among women in the United States. Despite advances in the diagnosis and treatment of breast cancer, one third of the women who develop the disease will die of the disease, accounting for approximately 46,300 deaths/year. While good primary therapies are available to treat early stage breast cancer, there is a substantial failure rate to these therapies in more advanced disease.

Advances in the understanding of the immune response to cancer have lead to the genesis of immunotherapeutic approaches. Specifically, the development of anti-cancer vaccines holds promise as an adjuvant and preventive therapy for patients after both primary surgical and medical treatment for breast cancer, but who are at a high risk for recurrence. Patients with greater than four lymph nodes positive have an 87% chance of recurrence post standard surgical and medical therapies at 10 years. While patients with hormone receptor positive tumors have the option to undergo hormonal therapy, recurrence is especially high among estrogen receptor/progesterone receptor (ER/PR) negative patients. For these patients, currently there is no good treatment option after completion of primary therapy; close surveillance and watchful waiting is the standard.

It is this population of patients that a vaccine strategy to induce cellular immunity would target. We propose to vaccinate these patients with an immunogenic peptide from the HER2/neu protein. If successful, this vaccine strategy could be utilized as an adjuvant to currently accepted first line therapy in future clinical trials.

  Eligibility

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

Inclusion Criteria:

  1. HER2/neu expressing tumor
  2. HLA-A2+ and/or HLA-A3+ to receive the vaccine. HLA-A2- and/or HLA-A3- patients will be eligible to be included in the control group.
  3. Immunologically intact with a good performance status
  4. Identified as being high or intermediate risk for recurrence
  5. Without evidence of disease
  6. Completion of all standard first-line therapies (but may still be on hormonal therapy)

Exclusion Criteria:

  1. Tumor does not express HER2/neu
  2. Not HLA-A2+ and/or HLA-A3+
  3. Anergic
  4. Receiving immunosuppressive therapy
  5. In poor health (Karnofsky <60%, ECOG >2 and Tbili >1.5 and creatinine>2)
  6. Pregnant (beta HCG+)
  7. Metastatic disease or have refused standard therapies
  8. Patients enrolled in other experimental protocols may enroll to this study only with the permission of the other study PI.
  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: NCT00841399

Locations
United States, Maryland
Walter Reed National Military Medical Center
Bethesda, Maryland, United States, 20889
United States, Pennsylvania
Windber Medical Center
Windber, Pennsylvania, United States, 15963
Sponsors and Collaborators
COL George Peoples, MD, FACS
Uniformed Services University of the Health Sciences
Investigators
Principal Investigator: George E Peoples, MD Cancer Vaccine Development Program
  More Information

Publications:

Responsible Party: COL George Peoples, MD, FACS, Chief, Surgical Oncology, Brooke Army Medical Center, Walter Reed Army Medical Center
ClinicalTrials.gov Identifier: NCT00841399     History of Changes
Other Study ID Numbers: 00-2005, WRAMC 20280
Study First Received: February 10, 2009
Last Updated: June 2, 2014
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by Walter Reed Army Medical Center:
Breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases

ClinicalTrials.gov processed this record on July 20, 2014