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| Sponsor: | National Cancer Institute (NCI) |
|---|---|
| Information provided by: | National Institutes of Health Clinical Center (CC) |
| ClinicalTrials.gov Identifier: | NCT00393029 |
Purpose
Background:
The p53 gene normally suppresses tumor growth, but when it is mutated, or damaged, tumors can grow unchecked.
In cancers where the p53 gene has mutated, an increased level of p53(overexpression of p53) can be measured in the tumor.
Objectives To determine whether advanced cancers that overexpress p53 can be treated effectively with lymphocytes (white blood cells) that have been genetically engineered to contain an anti-p53 protein.
Eligibility Patients 18 years of age and older with metastatic cancer (cancer that has spread beyond the original site) Patient's tumor overexpresses p53 Patient's leukocyte antigen type is HLA-A 0201 Design
Patients undergo the following procedures:
Leukapheresis (on two occasions). This is a method of collecting large numbers of white blood cells. The cells obtained in the first leukapheresis procedure are grown in the laboratory, and the anti-p53 protein is inserted into the cells using an inactivated (harmless)virus in a process called transduction. Cells collected in the second leukapheresis procedure are used to evaluate the effectiveness of the study treatment.
Chemotherapy. Patients are given chemotherapy through a vein (intravenously, IV) for 1 week to suppress the immune system so that the patients immune cells do not interfere with the treatment.
Treatment with anti-p53 cells. Patients receive an IV infusion of the transduced cells containing anti-p53 protein, followed by infusions of a drug called IL-2, which helps boost the effectiveness of the transduced white cells.
Patients may undergo a tumor biopsy (removal of a small piece of tumor tissue). Patients are evaluated with laboratory tests and imaging tests, such as computed tomography (CT) scans 4 to 6 weeks after treatment and then once a month 3 to 4 months to determine the response to treatment.
Patients have blood tests at 1, 3, 6 and 12 months and then annually for the next 10 years.
| Condition | Intervention | Phase |
|---|---|---|
|
Anti-p53 TCR-Gene |
Biological: anti-protein 53 or tumor protein 53 (p53) T-cell receptor transduced peripheral blood lymphocytes Biological: aldesleukin Biological: filgrastim Drug: cyclophosphamide Drug: fludarabine phosphate |
Phase II |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Study of Metastatic Cancer That Overexpresses p53 Using Lymphodepleting Conditioning Followed by Infusion of Anti-p53 T Cell Receptor (TCR)-Gene Engineered Lymphocytes |
Response Evaluation Criteria In Solid Tumors (RECIST).
See the protocol Link module for full criteria if desired.
| Enrollment: | 12 |
| Study Start Date: | October 2006 |
| Study Completion Date: | November 2008 |
| Primary Completion Date: | November 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Patients with metastatic melanoma
Melanoma is a serious form of skin cancer that develops in the skin cells that make our skin color (melanocytes).
|
Biological: anti-protein 53 or tumor protein 53 (p53) T-cell receptor transduced peripheral blood lymphocytes
Peripheral blood lymphocytes are harvested by lymphapheresis and engineered to express a T cell receptor that binds to P53.
Other Names:
Biological: aldesleukin
720,000 IU/kg intravenously over 15 minutes every 8 hours for up to 5 days
Other Names:
Biological: filgrastim
Beginning on day 1 or 2, administered subcutaneously at a dose of 5 mcg/kg/day (not to exceed 300 mcg/day); continue daily until neutrophil count > 1.0 x 10^9/L x 3 days or > 5.0 x 10^9/L.
Other Names:
Drug: cyclophosphamide
60 mg/kg/day x 2 days intravenously in 250ml dextrose 5% in water (D5W) with mesna 15 mg/kg/day x 2 days over 1 hour.
Other Names:
Drug: fludarabine phosphate
25 mg/m2/day intravenously piggyback (IVPB) daily over 30 minutes for 5 days.
Other Names:
|
| Experimental: Patients with other metastatic cancers |
Biological: anti-protein 53 or tumor protein 53 (p53) T-cell receptor transduced peripheral blood lymphocytes
Peripheral blood lymphocytes are harvested by lymphapheresis and engineered to express a T cell receptor that binds to P53.
Other Names:
Biological: aldesleukin
720,000 IU/kg intravenously over 15 minutes every 8 hours for up to 5 days
Other Names:
Biological: filgrastim
Beginning on day 1 or 2, administered subcutaneously at a dose of 5 mcg/kg/day (not to exceed 300 mcg/day); continue daily until neutrophil count > 1.0 x 10^9/L x 3 days or > 5.0 x 10^9/L.
Other Names:
Drug: cyclophosphamide
60 mg/kg/day x 2 days intravenously in 250ml dextrose 5% in water (D5W) with mesna 15 mg/kg/day x 2 days over 1 hour.
Other Names:
Drug: fludarabine phosphate
25 mg/m2/day intravenously piggyback (IVPB) daily over 30 minutes for 5 days.
Other Names:
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Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contacts and Locations
More Information
| Responsible Party: | Steven A. Rosenberg, M.D., Ph.D., National Cancer Institute, National Institutes of Health |
| ClinicalTrials.gov Identifier: | NCT00393029 History of Changes |
| Other Study ID Numbers: | 070003, 070003, 07-C-0003 |
| Study First Received: | October 25, 2006 |
| Results First Received: | June 1, 2011 |
| Last Updated: | August 10, 2011 |
| Health Authority: | United States: Food and Drug Administration; United States: Federal Government |
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Tumor Regression In Vivo Cell Survival Toxicity Profile |
Metastatic Renal Cell Cancer Cancer Metastatic Cancer |
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Neoplasm Metastasis Neoplasms Neoplasms, Second Primary Neoplastic Processes Pathologic Processes Cyclophosphamide Fludarabine monophosphate Fludarabine Aldesleukin Interleukin-2 Lenograstim Vidarabine Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs |
Pharmacologic Actions Antirheumatic Agents Therapeutic Uses Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Myeloablative Agonists Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Antimetabolites, Antineoplastic Antimetabolites |