Breast Cancer Clinical Trial
Vaccine Therapy in Treating Patients With HER2/Neu Positive or Negative Stage IV Breast Cancer or Other HER2/Neu Positive Cancers
Summary
RATIONALE: Vaccines made from gene-modified tumor cells may make the body build an immune response to kill tumor cells. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop tumor cells from dividing so they stop growing or die. Interferon alfa may interfere with the growth of tumor cells. Combining vaccine therapy with cyclophosphamide and interferon alfa may kill more tumor cells.
PURPOSE: Phase I trial to study the effectiveness of combining vaccine therapy with interferon alfa and cyclophosphamide in treating patients who have stage IV breast cancer.
Full Description
OBJECTIVES:
Determine the safety, tolerability, and feasibility of vaccine therapy comprising an allogeneic (non-self) tumor cell line transfected with the sargramostim (GM-CSF) gene combined with low-dose interferon alfa and low-dose cyclophosphamide in patients with stage IV breast cancer or other solid tumors.
Determine the clinical response, time to progression, and survival of patients treated with this regimen.
Correlate clinical response with immunological response in patients treated with this regimen.
OUTLINE: Patients receive low-dose cyclophosphamide IV once 2-3 days before each tumor vaccine. Patients then receive tumor vaccine comprising HER2/neu-positive allogeneic (non-self) breast cancer cells transfected with the sargramostim (GM-CSF) gene intradermally (ID) on day 1. Patients also receive low-dose interferon alfa ID approximately 48 and 96 hours after each tumor vaccine. Treatment repeats every 2 weeks for 3 vaccinations and then monthly for 3 vaccinations in the absence of disease progression or unacceptable toxicity.
Patients are followed at 2 weeks and then every 3 months thereafter.
PROJECTED ACCRUAL: A total of 9-24 patients will be accrued for this study.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically confirmed breast cancer meeting 1 of the following criteria:
Recurrent and/or metastatic lesions that are HER2/neu-positive or negative
Recurrent or progressive cancer of the lung, ovary, pancreas, prostate, bladder, or other primary site associated with HER2/neu-positive tumor by histochemistry
Bone-only metastatic breast cancer, cytologically confirmed malignant effusions, histologically confirmed marrow involvement, or other evaluable (but non-measurable) metastatic disease allowed
Failed prior first-line chemotherapy (e.g., anthracycline- or taxane-based therapy) with or without adjuvant chemotherapy or hormonal therapy
No curative or reliably effective palliative surgery, radiotherapy, or medical therapy available
Stable brain metastases allowed provided the following criteria are met*:
Previously treated
No concurrent requirement for corticosteroids
No radiological or clinical deterioration within the past 6 weeks NOTE: *Patients who had recent treatment with gamma knife or intensity-modulated radiotherapy for brain metastases are eligible provided there has been recovery from known or anticipated toxic effects
Patients with no HLA-A2 allele are eligible
Hormone receptor status:
Not specified
PATIENT CHARACTERISTICS:
Age
18 and over
Sex
Female or male
Menopausal status
Not specified
Performance status
ECOG 0-2
Life expectancy
At least 4 months
Hematopoietic
Absolute granulocyte count ≥ 1,000/mm^3
Platelet count ≥ 100,000/mm^3
Hepatic
Bilirubin ≤ 2 mg/dL
Alkaline phosphatase ≤ 5 times upper limit of normal (ULN)
ALT and AST ≤ 2 times ULN
Renal
BUN ≤ 30 mg/dL
Creatinine ≤ 2 mg/dL
≤ 1 g protein on 24-hour urine collection OR
≤ 1+ proteinuria on urinalysis
Cardiovascular
Hypertension controlled by agents (except beta-blockers) allowed
Other
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
HIV negative
No history of anaphylactic reaction to any known or unknown antigen
No history of clinical hypersensitivity to sargramostim (GM-CSF), interferon, yeast, beef, or to any components used in preparation of study vaccine
No clinical or laboratory features indicative of AIDS
No rheumatological, psychiatric, or other clinically progressive major medical problems requiring treatment
No other malignancy within the past 2 years
PRIOR CONCURRENT THERAPY:
Biologic therapy
More than 3 weeks since prior biological therapy, including trastuzumab (Herceptin^®)
More than 3 weeks since prior immunotherapy
No concurrent immunotherapy
Chemotherapy
See Disease Characteristics
More than 3 weeks since prior chemotherapy (8 weeks for nitrosoureas or mitomycin)
No concurrent chemotherapy
Endocrine therapy
See Disease Characteristics
More than 3 weeks since prior hormonal therapy
No concurrent hormonal therapy
No concurrent systemic steroids
Concurrent inhalation steroids for respiratory hypersensitivity (e.g., triamcinolone nasal or pulmonary inhalers) allowed
Radiotherapy
See Disease Characteristics
More than 3 weeks since prior radiotherapy
No concurrent radiotherapy
Surgery
More than 3 weeks since prior major surgery with general anesthesia
No concurrent major surgery
Other
Recovered from prior therapy
Patients receiving pamidronate, bisphosphonates, or other supportive measures must continue therapy during study participation
No concurrent anticoagulants
No concurrent beta-blockers for control of mild hypertension or other indications
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There are 3 Locations for this study
Glendale California, 91204, United States
Los Angeles California, 90027, United States
Los Angeles California, 90057, United States
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