Ovarian Cancer Clinical Trial
Gene Therapy and Biological Therapy in Treating Patients With Ovarian Epithelial Cancer
Summary
RATIONALE: Interleukin-2 may stimulate a person's white blood cells to kill ovarian cancer cells. Interleukin-2 combined with white blood cells that are gene-modified to recognize and kill ovarian cancer cells may be an effective treatment for recurrent or residual ovarian cancer.
PURPOSE: Phase I trial to study the effectiveness of interleukin-2 plus gene-modified white blood cells in treating patients who have advanced ovarian epithelial cancer.
Full Description
OBJECTIVES:
Determine the clinical response in patients with advanced ovarian epithelial cancer treated with intravenously administered allogeneic peripheral blood mononuclear cell-stimulated, gene-modified lymphocytes (MOv-PBL).
Evaluate the ability of intravenously administered MOv-PBL to traffic to sites of ovarian cancer.
Determine the duration of survival of transduced lymphocytes in the systemic circulation and at the tumor site in these patients.
OUTLINE: This is a dose-escalation study. Patients are stratified by eligibility to receive interleukin-2 (IL-2) (yes vs no).
Patients undergo leukapheresis. The collected peripheral blood lymphocytes (PBLs) are stimulated with allogeneic peripheral blood mononuclear cells (PBMCs) followed by retroviral transduction with antiovarian cancer MOv-gamma chimeric receptor gene (MOv-PBL). MOv-PBL are then reinfused IV over 30-60 minutes followed by IL-2 IV over 15-30 minutes every 12 hours for up to 8 doses (if eligible). This course may be repeated at least once, beginning 2-3 weeks later. Patients receiving allogeneic PBMC-stimulated PBLs receive donor PBMCs subcutaneously at 1 and 8 days after each MOv-PBL infusion instead of IL-2.
Cohorts of 3-6 patients in each stratum receive escalating doses of MOv-PBL until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. An additional 10 patients receive MOv-PBL, without IL-2, followed by immunization with donor PBMCs as above.
Patients are followed at 4 and 8 weeks and then periodically for survival.
PROJECTED ACCRUAL: Approximately 13-50 patients will be accrued for this study.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically proven recurrent, resected recurrent, or residual ovarian epithelial cancer
Failed prior standard effective therapy including cisplatin/carboplatin or paclitaxel
Tumor positive for folate-binding protein by monoclonal antibody MOv18 binding
Measurable disease by CT scan, MRI, ultrasound, or physical exam OR
Minimal residual disease on laparotomy, laparoscopy, or peritoneal washings (i.e., disease not evaluable radiologically or on physical exam)
PATIENT CHARACTERISTICS:
Age:
18 and over
Performance status:
ECOG 0 or 1
Hematopoietic:
WBC greater than 3,000/mm^3
Platelet count greater than 100,000/mm^3
Hemoglobin greater than 9.0 g/dL
No coagulation disorder
Hepatic:
Bilirubin no greater than 2.0 mg/dL
Other liver function tests less than 3 times upper limit of normal
Hepatitis B antigen negative
Renal:
Creatinine no greater than 2.0 mg/dL
Cardiovascular:
No major cardiovascular illness
If history of ischemic heart disease, congestive heart failure, or cardiac arrhythmias, not eligible to receive interleukin-2
Pulmonary:
FEV_1 and DLCO greater than 70% predicted
No major respiratory illness
Immunologic:
Must have an intact immune system as evidenced by a positive reaction to Candida albicans, mumps, or tetanus toxoid skin tests on a standard anergy panel
HIV negative
No active systemic infection
Other:
Not pregnant
Negative pregnancy test
Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy:
More than 2 weeks since prior biologic therapy
Chemotherapy:
See Disease Characteristics
More than 2 weeks since prior chemotherapy
Endocrine therapy:
More than 2 weeks since prior endocrine therapy
No concurrent steroids
Radiotherapy:
More than 2 weeks since prior radiotherapy
Surgery:
See Disease Characteristics
Prior debulking allowed
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There is 1 Location for this study
Bethesda Maryland, 20892, United States
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