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Monoclonal Antibody and Sargramostim in Treating Patients With Metastatic Prostate Cancer
This study is ongoing, but not recruiting participants.

First Received on July 8, 2003.   Last Updated on January 26, 2011   History of Changes
Sponsor: University of California, San Francisco
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00064129
  Purpose

RATIONALE: Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Colony-stimulating factors such as sargramostim may increase the number of immune cells found in bone marrow or peripheral blood and may help a person's immune system kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of monoclonal antibody when given with sargramostim in treating patients with metastatic prostate cancer.


Condition Intervention Phase
Prostate Cancer
Biological: ipilimumab
Biological: sargramostim
Other: immunoenzyme technique
Other: pharmacological study
Phase I

Study Type: Interventional
Study Design: Primary Purpose: Treatment
Official Title: A Phase I Study of Repetitive Dosing of Anti-CTLA-4 Antibody (MDX-010) in Combination With GM-CSF in Patients With Metastatic, Androgen-Independent Prostate Cancer

Resource links provided by NLM:


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

Estimated Enrollment: 36
Study Start Date: November 2009
Estimated Primary Completion Date: November 2013 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010) administered with sargramostim (GM-CSF) in patients with metastatic androgen-independent prostate cancer. (Phase I)
  • Determine the safety of this regimen in these patients. (Phase I)
  • Evaluate the efficacy as measured by reduction in PSA associated with combining GM-CSF with CTLA-4 blockade with ipilimumab at a dosage of 3 mg/kg given monthly x 6 doses (d1 of courses 1-6). (Cohort Expansion)

Secondary

  • Determine the T-cell immunity and T-cell response in patients treated with this regimen. (Phase I)
  • Determine the pharmacokinetics of MDX-010 in these patients. (Phase I)
  • Determine the prostate-specific antigen and/or objective responses in patients treated with this regimen. (Phase I)
  • Determine the percentages of activated, naive, and memory T-cells. (Cohort Expansion)
  • Determine the measurement of T-cell response to describe epitopes from prostate antigens including PSA, PSMA, and PAP. (Cohort Expansion)
  • Quantitate T-cell response to antigens in patients with relevant HLA allele using HLA*0201 tetramers. (Cohort Expansion)
  • Evaluate the toxicity of this regimen in these patients. (Cohort Expansion)
  • Determine the initial efficacy as measured by reduction in PSA associated with combining GM-CSF with CTLA-4 blockade with ipilimumab at a dosage of 3 mg/kg given monthly x 6 doses (d1 of courses 1-6). (Cohort Expansion)
  • Determine objective response by post-therapy measurable disease changes using RECIST criteria. (Cohort Expansion)

OUTLINE: This is a multicenter, dose-escalation study of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010).

Patients receive MDX-010 IV over 90 minutes on day 1 and sargramostim (GM-CSF) subcutaneously on days 1-14. Treatment repeats every 28 days for 4-6 courses. GM-CSF continues beyond 4 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of MDX-010 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Some patients undergo blood sample collection periodically for laboratory and pharmacokinetic studies. Samples are analyzed for human anti-human antibodies, IgG antibodies to MDX-010 via semi-quantitative ELISA assay, and plasma concentrations of MDX-CTL4A via quantitative ELISA assay.

Patients are followed at 30 days.

PROJECTED ACCRUAL: A total of 18-36 patients will be accrued for this study within 6-7 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed prostate cancer

    • Metastatic disease
  • Progressive disease after prior androgen deprivation as defined by at least 1 of the following criteria:

    • Patients with measurable disease must have an increase of at least 20% in the sum of the longest diameter of target lesions OR the appearance of 1 or more new lesions
    • Patients with nonmeasurable disease must have a positive bone scan and a prostate-specific antigen (PSA) level of at least 5 ng/mL, which has risen on at least 2 successive occasions at least 2 weeks apart*

      • At least 1 PSA level must be obtained at least 4 weeks after flutamide (6 weeks after bicalutamide or nilutamide) NOTE: *An additional PSA level is required if the confirmatory PSA is not greater than the screening PSA
  • Testosterone no greater than 50 ng/dL

    • Patients with no prior orchiectomy must continue luteinizing hormone-releasing hormone agonist therapy
  • No history or radiologic evidence of CNS metastases

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • At least 12 weeks

Hematopoietic

  • Absolute neutrophil count greater than 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 8 g/dL

Hepatic

  • Bilirubin less than 1.5 times upper limit of normal (ULN)
  • SGOT and SGPT no greater than 2.5 times ULN

Renal

  • Creatinine no greater than 1.5 times ULN

Cardiovascular

  • No significant cardiovascular disease
  • No New York Heart Association class III or IV congestive heart failure
  • No active angina pectoris
  • No myocardial infarction within the past 6 months

Other

  • Not pregnant or nursing
  • Fertile patients must use effective contraception prior to, during, and for 3 months after study participation
  • No history of autoimmune disease including, but not limited to, any of the following:

    • Autoimmune hemolytic anemia
    • Ulcerative and hemorrhagic colitis
    • Endocrine disorders (e.g., thyroiditis, hyperthyroidism, hypothyroidism of immune etiology, autoimmune hypophysitis/hypopituitarism, or adrenal insufficiency)
    • Sarcoid granuloma
    • Myasthenia gravis
    • Polymyositis
    • Guillain-Barre syndrome
    • Systemic lupus erythematosis
    • Rheumatoid arthritis
    • Inflammatory bowel disease
  • No other medical or psychiatric illness that would preclude study participation or giving informed consent
  • No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or stage I or II cancer currently in complete remission

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior immunotherapy (e.g., vaccines or investigational)
  • No other concurrent colony-stimulating factors

Chemotherapy

  • No prior chemotherapy
  • No concurrent chemotherapy

Endocrine therapy

  • See Disease Characteristics
  • At least 4 weeks since prior systemic corticosteroids
  • At least 4 weeks since other prior hormonal therapy, including megestrol and finasteride
  • No concurrent systemic steroid therapy except inhaled or topical steroids
  • No other concurrent hormonal therapy

    • Hormones administered for nondisease-related conditions (e.g., insulin for diabetes) allowed

Radiotherapy

  • At least 4 weeks since prior radiotherapy and recovered
  • More than 8 weeks since prior radiopharmaceuticals (e.g., strontium chloride Sr 89 and samarium Sm 153 lexidronam pentasodium)
  • Prior irradiation of a symptomatic lesion or one that may produce disability (e.g., unstable femur) allowed
  • No concurrent palliative radiotherapy

Surgery

  • See Disease Characteristics

Other

  • At least 4 weeks since prior herbal products known to decrease PSA levels (e.g., PC-SPES or saw palmetto)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00064129

Locations
United States, California
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
Veterans Affairs Medical Center - San Francisco
San Francisco, California, United States, 94121
Sponsors and Collaborators
University of California, San Francisco
Investigators
Study Chair: Eric J. Small, MD University of California, San Francisco
  More Information

Additional Information:
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
ClinicalTrials.gov Identifier: NCT00064129     History of Changes
Other Study ID Numbers: CDR0000309054, UCSF-02558, NCI-6032
Study First Received: July 8, 2003
Last Updated: January 26, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent prostate cancer
stage IV prostate cancer

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Genital Diseases, Male
Prostatic Diseases

ClinicalTrials.gov processed this record on February 09, 2012