Vaccine Therapy With or Without Sargramostim in Treating Patients With Advanced or Metastatic Cancer

Inclusion Criteria:

Histologically confirmed adenocarcinoma that failed standard curative options and for which no standard palliative options are required within the next 8weeks

Advanced or metastatic disease
Recurrent or unresectable disease
Microscopic metastatic disease confirmed by surgical exploration allowed
CEA expression by immunohistochemistry
Circulating CEA greater than 5 ng/mL

HLA phenotyping required

HLA phenotyping must be repeated for patients who have undergone allogeneic bone marrow transplantation

No clinically symptomatic brain metastases

Patients with brain metastases who have completed palliative radiotherapy and have discontinued steroids are eligible

Hormone receptor status:

Not specified
Male or female
Performance status - ECOG 0-1
WBC at least 3,000/mm^3
Platelet count at least 100,000/mm^3
Bilirubin less than 1.5 times upper limit of normal (ULN)
AST and ALT less than 3 times ULN
PT and PTT less than 1.5 times ULN (unless therapeutically anticoagulated)
Creatinine less than 1.5 mg/dL
Creatinine clearance greater than 60 mL/min
Proteinuria or hematuria less than +2 on urinalysis*
Urine protein less than 1,000 mg/24-hour collection, if proteinuria greater than +1
No frequent vomiting or severe anorexia
No more than 10% weight loss within the past 3 months
No inflammatory bowel disease, Crohn's disease, ulcerative colitis, or active diverticulitis
No uncontrolled seizure disorders
No encephalitis
No multiple sclerosis
No allergy to eggs
No HIV-associated opportunistic infection

No autoimmune diseases, including the following:

Systemic lupus erythematosus
Sjögren's syndrome
Scleroderma
Myasthenia gravis
Goodpasture syndrome
Addison's disease
Hashimoto's thyroiditis
Graves' disease
Antinuclear antibody positive status allowed if no evidence of an autoimmune disease

No direct contact of vaccination site with the following persons for at least 72 hours after each vaccination:

Children under 1 year of age
Pregnant women
Individuals with eczema or other open skin condition
Immunocompromised individuals
No other concurrent serious medical illness that would preclude study entry
No other malignancy within the past 2 years except excised basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception for at least 1 month before (female patients only), during, and for at least 3 months after study participation
See Disease Characteristics
No prior CEA-directed active immunotherapy
Prior CEA-directed antibody therapy allowed
At least 4 weeks since prior immunotherapy and recovered
No other concurrent antineoplastic biologic therapy or immunotherapy
At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
No concurrent antineoplastic chemotherapy
See Disease Characteristics
No concurrent antineoplastic hormonal therapy
No concurrent systemic steroids (inhaled steroids allowed)
Concurrent systemic mineralocorticoids (e.g., megestrol for appetite stimulation or fludrocortisone) allowed
Concurrent birth control pills allowed
See Disease Characteristics
At least 4 weeks since prior radiotherapy and recovered
No prior radiotherapy to more than 50% of all nodal groups
See Disease Characteristics
Recovered from prior surgery
No prior splenectomy
Concurrent non-steroidal anti-inflammatory drugs allowed
No other concurrent anti-cancer therapy