Lung Cancer Clinical Trial
Monoclonal Antibody Therapy in Treating Patients With Relapsed or Refractory Small Cell Lung Cancer
Summary
RATIONALE: Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells.
PURPOSE: Phase I trial to study the effectiveness of monoclonal antibody therapy in treating patients who have relapsed or refractory small cell lung cancer.
Full Description
OBJECTIVES:
Determine the dose limiting toxicity and maximum tolerated dose of yttrium Y 90 anti-CEA monoclonal antibody MN-14 in patients with relapsed or refractory small cell lung cancer.
Determine the dosimetric and pharmacokinetic properties of this treatment regimen in the blood, normal organs, and tumors of these patients.
Determine the stability and complexation with circulating carcinoembryonic antigen of this radioantibody in the plasma of these patients.
Determine the antibody response of these patients treated with this regimen.
Determine the antitumor effects of this treatment regimen in these patients.
OUTLINE: This is a dose escalation study of yttrium Y 90 anti-CEA monoclonal antibody MN-14 (90Y-hMN-14). Patients are stratified according to prior radiotherapy (yes vs no).
Patients undergo pretherapy imaging with indium In 111 anti-CEA monoclonal antibody MN-14 IV over 30-40 minutes on day -7 or -6 followed by external scintigraphy on days -7 or -6 to 0.
Patients who show positive localization of at least one documented tumor site receive 90Y-hMN-14 IV over 30-40 minutes on day 0.
Cohorts of 3-6 patients receive escalating doses of 90Y-hMN-14 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose limiting toxicity.
Patients are followed at 2, 4, 8, and 12 weeks; every 3 months for 2 years; and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 15-30 patients will be accrued for this study within 10-14 months.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed small cell lung cancer (SCLC)
Must have received at least one prior course of standard chemotherapy and, if indicated, up to 6,900 cGy of thoracic radiotherapy
Patients who received prior radiotherapy must show evidence of progressive disease
Patients who received no prior radiotherapy to the primary tumor must show evidence of stable or progressive disease
Measurable disease
Must have evidence of carcinoembryonic antigen (CEA) production or expression documented by one of the following:
Serum CEA at least 10 ng/mL
Positive immunohistology of either the primary tumor or a metastasis with CEA specific monoclonal antibody
Must have unilateral bone marrow biopsy with less than 25% tumor involvement
No known, active brain metastases
PATIENT CHARACTERISTICS:
Age:
18 and over
Performance status:
Karnofsky 70-100%
ECOG 0-2
Life expectancy:
At least 3 months
Hematopoietic:
WBC at least 3,000/mm^3
Granulocyte count at least 1,500/mm^3
Platelet count at least 100,000/mm^3
Hepatic:
Bilirubin no greater than 2 mg/dL
AST no greater than 2 times upper limit of normal (ULN)
No hepatitis B or C
No other serious liver abnormality
Renal:
Creatinine no greater than 1.5 times ULN
No urinary incontinence
Cardiovascular:
Ejection fraction at least 50%
Pulmonary:
FEV_1 and FVC at least 60%
DLCO at least 50% predicted
Other:
No severe anorexia, nausea, or vomiting
No other significant medical problems
No prisoners
No reactivity to humanized MN-14 (in patients with prior exposure to chimeric or humanized antibody)
HIV negative
No active HIV-related disease
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for at least 3 months following study participation
PRIOR CONCURRENT THERAPY:
Biologic therapy:
See Chemotherapy
No concurrent growth factors (e.g., filgrastim [G-CSF])
Chemotherapy:
See Disease Characteristics
At least 4 weeks since prior chemotherapy
No prior high dose chemotherapy with stem cell transplantation
Endocrine therapy:
Not specified
Radiotherapy:
See Disease Characteristics
At least 4 weeks since prior radiotherapy
Prior radiotherapy to less than 30% of red marrow (including standard chest x-ray for limited stage SCLC) allowed
Surgery:
At least 4 weeks since prior major surgery
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There is 1 Location for this study
Belleville New Jersey, 07109, United States
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