Colon Cancer Clinical Trial
Biological Therapy and Chemotherapy in Treating Patients With Metastatic Kidney Cancer or Colorectal Cancer
Summary
RATIONALE: Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining biological therapy with chemotherapy may kill more tumor cells.
PURPOSE: Phase I/II trial to study the effectiveness of biological therapy combined with chemotherapy in treating patients who have metastatic kidney cancer or colorectal cancer.
Full Description
OBJECTIVES:
Determine the safety of a repeat course of interleukin-12-primed activated T cells (12ATC) in combination with fluorouracil, sargramostim (GM-CSF), and interferon alfa-2b in patients with metastatic renal cell or colorectal carcinoma.
Determine the clinical responses of patients treated with this regimen.
Determine the efficacy of 12ATC in these patients.
Determine whether there are changes in immunologic parameters related to 12ATC as measured by lymphocyte phenotype and cytokine secretion in these patients.
Determine the correlation between clinical responses in patients treated with this regimen and in vitro immune functions of lymphocytes.
OUTLINE: Patients are stratified according to disease type (renal cell carcinoma vs colorectal carcinoma).
Patients receive sargramostim (GM-CSF) subcutaneously (SC) daily on days 1-5 and then undergo collection of autologous peripheral blood mononuclear cells (PBMC) on days 6 and 7 of week 1. The PBMC are treated ex vivo to form interleukin-12-primed activated T cells (12ATC).
Patients receive fluorouracil IV over 24 hours on day 6 of week 2 and interferon alfa-2b SC and GM-CSF SC 3 times weekly on weeks 3-5. Patients receive 12ATC IV over 15-30 minutes twice weekly and interferon alfa-2b SC (at least 24 hours after 12ATC infusion) once weekly on weeks 6-8. Patients with complete or partial response or stable disease at 3 weeks after the last 12ATC infusion may receive an additional 8-week course as above.
Patients are followed every 2-3 months for 1 year and then every 6 months for 2 years or at any time when the physical examination or symptoms are suspicious for tumor progression.
PROJECTED ACCRUAL: A total of 60 patients (30 per stratum) will be accrued for this study within 2-3 years.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed metastatic renal cell carcinoma or colorectal carcinoma, meeting 1 of the following criteria:
Obtained no benefit from prior standard or salvage therapy
Ineligible for standard therapy because of concurrent illness
Declined standard therapy
At least 1 site of measurable disease that can be measured in at least 1 dimension
At least 20 mm with conventional techniques OR at least 10 mm with spiral CT scan
No untreated or unstable, treated brain metastasis
PATIENT CHARACTERISTICS:
Age:
18 and over
Performance status:
ECOG 0-2
Life expectancy:
More than 3 months
Hematopoietic:
WBC at least 4,000/mm^3
Granulocyte count at least 2,000/mm^3
Platelet count at least 100,000/mm^3
Hemoglobin at least 10 g/dL
No coagulation disorders
Hepatic:
Bilirubin no greater than 2.5 mg/dL*
ALT/AST less than 3 times upper limit of normal*
PT no greater than 1.5 times control (unless therapeutically anticoagulated)
PTT less than 1.5 times control (unless therapeutically anticoagulated) NOTE: *Patients whose cancer has led to values that do not fall within the above ranges may be eligible at the discretion of the investigators
Renal:
Creatinine no greater than 2.0 mg/dL* NOTE: *Patients whose cancer has led to values that do not fall within the above range may be eligible at the discretion of the investigators
Cardiovascular:
No symptomatic congestive heart failure
No unstable angina pectoris
No cardiac arrhythmia
No thrombophlebitis
Pulmonary:
FEV_1 and FVC at least 65% predicted
No uncontrolled pulmonary embolism
Other:
No other malignancy within the past 5 years except resected basal cell skin cancer or carcinoma in situ of the cervix
No prior allergic reactions attributed to compounds of similar chemical or biologic composition to interleukin-12-primed activated T cells or other study agents
No active autoimmune disease
No uncontrolled thyroid abnormalities
No ongoing or active infection
No other uncontrolled concurrent illness
No psychiatric illness or social situations that would preclude study compliance
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for up to 2 years after study participation
PRIOR CONCURRENT THERAPY:
Biologic therapy:
More than 4 weeks since prior immunotherapy
Chemotherapy:
More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
Endocrine therapy:
At least 4 weeks since prior steroid therapy or steroid-containing compounds
At least 2 weeks since prior topical or inhaled steroids
Radiotherapy:
More than 4 weeks since prior radiotherapy and recovered
Surgery:
More than 4 weeks since prior major surgery
Other:
No other concurrent investigational agents
No other concurrent commercial anticancer agents
No concurrent combination antiretroviral therapy for HIV-positive patients
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There is 1 Location for this study
Milwaukee Wisconsin, 53215, United States
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