Cyclophosphamide or Denileukin Diftitox Followed By Expanding a Patient's Own T Cells in the Laboratory in Treating Patients With HER-2/Neu Overexpressing Metastatic Breast Cancer, Ovarian Cancer, or Non-Small Cell Lung Cancer Previously Treated With HER-2/Neu Vaccine

NCT ID: NCT00228358

Last Updated: 2014-11-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

8 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-06-30

Brief Summary

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This phase I trial studies the safety and the ability to expand laboratory-treated T cells when given together with cyclophosphamide or denileukin diftitox in treating patients with human epidermal growth factor receptor (HER)-2/neu overexpressing metastatic breast cancer, ovarian cancer, or non-small cell lung cancer previously treated with HER-2/neu vaccine. Laboratory-expanded T cells may help the immune system in different ways and stop tumor cells from growing. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Biological therapy, such as denileukin diftitox, may stimulate the immune system in different ways and stop tumor cells from growing. Giving laboratory-treated T cells together with cyclophosphamide or denileukin diftitox may allow the immune system to kill more tumor cells

Detailed Description

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PRIMARY OBJECTIVES:

I. To assess the feasibility of expanding HER2 specific T cells ex vivo for infusion into subjects who have advanced HER2 overexpressing cancer.

II. To assess the toxicity associated with infusing autologous HER2 specific T cells into patients using either a single dose of cyclophosphamide or ONTAK (denileukin diftitox) prior to T cell infusion.

SECONDARY OBJECTIVES:

I. To investigate to what extent HER2 specific T cell immunity can be boosted in individuals treated with a single dose of cyclophosphamide of ONTAK followed by infusion of autologous HER2 specific T cells.

II. To investigate the potential anti-tumor effects of HER2 specific T cells in patients with HER2 overexpressing advanced-stage cancers.

III. To evaluate how long tumor antigen specific T cell immune augmentation persists in vivo after a single dose of cyclophosphamide or ONTAK followed by infusion of autologous HER2 specific T cells.

OUTLINE: This is a dose-escalation study of ex vivo-expanded HER2-specific T cells. Patients are assigned to 1 of 2 treatment groups.

GROUP A: Patients receive low-dose cyclophosphamide intravenously (IV) on day -1 and 3 escalating doses of autologous ex vivo-expanded HER2-specific T cells IV over 30 minutes on days 1, 10, and 20.

GROUP B: Patients receive ONTAK (denileukin diftitox) IV over 1 hour on day -1 and 3 escalating doses of autologous ex vivo-expanded HER2-specific T cells IV over 30 minutes on days 1, 10, and 20.

After completion of study treatment, patients are followed periodically.

Conditions

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HER2-positive Breast Cancer Recurrent Breast Cancer Recurrent Non-small Cell Lung Cancer Recurrent Ovarian Epithelial Cancer Recurrent Ovarian Germ Cell Tumor Stage IV Breast Cancer Stage IV Non-small Cell Lung Cancer Stage IV Ovarian Epithelial Cancer Stage IV Ovarian Germ Cell Tumor

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A (cellular infusions after cyclophosphamide)

Patients receive low-dose cyclophosphamide IV on day -1 and 3 escalating doses of autologous ex vivo-expanded HER2-specific T cells IV over 30 minutes on days 1, 10, and 20.

Group Type EXPERIMENTAL

ex vivo-expanded HER2-specific T cells

Intervention Type DRUG

Laboratory-expanded T cells, given IV

cyclophosphamide

Intervention Type DRUG

Given IV

flow cytometry

Intervention Type OTHER

Intracellular cytokine staining (correlative study)

immunoenzyme technique

Intervention Type OTHER

ELIspot assay (correlative study)

Group B (cellular infusions after ONTAK conditioning)

Patients receive denileukin diftitox IV over 1 hour on day -1 and 3 escalating doses of autologous ex vivo-expanded HER2-specific T cells IV over 30 minutes on days 1, 10, and 20.

Group Type EXPERIMENTAL

ex vivo-expanded HER2-specific T cells

Intervention Type DRUG

Laboratory-expanded T cells, given IV

denileukin diftitox

Intervention Type BIOLOGICAL

Given IV

flow cytometry

Intervention Type OTHER

Intracellular cytokine staining (correlative study)

immunoenzyme technique

Intervention Type OTHER

ELIspot assay (correlative study)

Interventions

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ex vivo-expanded HER2-specific T cells

Laboratory-expanded T cells, given IV

Intervention Type DRUG

cyclophosphamide

Given IV

Intervention Type DRUG

denileukin diftitox

Given IV

Intervention Type BIOLOGICAL

flow cytometry

Intracellular cytokine staining (correlative study)

Intervention Type OTHER

immunoenzyme technique

ELIspot assay (correlative study)

Intervention Type OTHER

Other Intervention Names

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CPM CTX Cytoxan Endoxan Endoxana DAB389 interleukin-2 DAB389 interleukin-2 immunotoxin DAB389-IL2 DABIL2 immunoenzyme techniques

Eligibility Criteria

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Inclusion Criteria

* Patients with progressive HER2/neu overexpressing metastatic breast, ovarian, or non-small cell lung cancer not considered curable by conventional therapies, including trastuzumab

* Extra-skeletal disease that can be accurately measured \>= 10 mm by standard imaging techniques that can include but not limited to computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI)
* Skeletal or bone-only disease which is measurable by Fludeoxyglucose F 18 (FDG) PET imaging will also be allowed
* Patients with ovarian cancer may have measurable disease; however, their only indication of progression may be an abnormal CA-125
* Patients must have documented HER-2/neu overexpression in their tumor (either primary or metastasis) as was required per the eligibility criteria of their original vaccination protocol
* Patients must have received HER2-specific vaccinations while enrolled on a HER2 vaccine protocol approved at the University of Washington Human Subjects Division
* Patients must have undergone leukapheresis after vaccination through a protocol approved at the University of Washington Human Subjects Division and have product stored for clinical use
* Subjects must have a Performance Status Score (Zubrod/Eastern Cooperative Oncology Group \[ECOG\] Scale) = 0 or 1
* Patients can be currently receiving trastuzumab and/or lapatinib and/or hormonal therapy and/or bisphosphonate therapy

* Patients on trastuzumab and/or lapatinib must have adequate cardiac function as demonstrated by multi gated acquisition (MUGA) scan or echocardiogram (ECHO) within 90 days of eligibility determination
* Patients must be off all immunosuppressive treatments, and/or systemic steroid therapy, for at least 14 days prior to initiation of study treatment
* Patients must be off chemotherapy and trastuzumab for at least 1 week prior to the first infusion of T cells
* Men and women of reproductive ability must agree to contraceptive use during the study and for one month after the final T cell infusion
* Patients with a history of brain metastases must have a stable head imaging study within 30 days of enrollment
* White blood cells (WBC) \>= 3000/mm\^3
* Absolute neutrophil count (ANC) \>= 1000/mm\^3
* Hemoglobin (Hgb) \>= 10 mg/dl
* Platelets \>= 75,000mm\^3
* Serum creatinine =\< 2.0 mg/dl or creatinine clearance \> 60 ml/min
* Total bilirubin =\< 2.5 mg/dl
* Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) =\< 3 times ULN

Exclusion Criteria

* Concurrent enrollment in other treatment studies
* Patients with any of the following cardiac conditions:

* Symptomatic restrictive cardiomyopathy
* Unstable angina within the last 4 months prior to enrollment
* New York Heart Association functional class III-IV heart failure on active treatment
* Patients with any clinically significant autoimmune disease uncontrolled with treatment
* Pregnant or breast-feeding women
* Known history of hypersensitivity to diphtheria toxin or interleukin (IL)-2 (only for subjects enrolled in Group B)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mary Disis

Role: PRINCIPAL_INVESTIGATOR

Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Locations

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Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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NCI-2009-01547

Identifier Type: REGISTRY

Identifier Source: secondary_id

6223

Identifier Type: -

Identifier Source: org_study_id