Vaccine Therapy Combined With Adjuvant Chemoradiotherapy in Treating Patients With Resected Stage I or Stage II Adenocarcinoma (Cancer) of the Pancreas

NCT00084383 | Completed Phase 2 Results DMC

• 4 other identifiers: J9988R01CA088058P30CA006973JHOC-J9988
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

RATIONALE: Vaccines made from gene-modified pancreatic cancer cells may make the body build an immune response to kill tumor cells. Drugs used in chemotherapy, such as fluorouracil, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving vaccine therapy together with chemotherapy and radiation therapy after surgery may kill any remaining tumor cells. PURPOSE: This phase II trial is studying how well giving vaccine therapy together with adjuvant chemoradiotherapy works in treating patients with resected stage I or stage II adenocarcinoma (cancer) of the pancreas.

Conditions

Pancreatic Cancer

Keywords

stage I pancreatic cancer; stage II pancreatic cancer; duct cell adenocarcinoma of the pancreas

Outcome Measures

Primary Outcomes (2)

• Overall Survival

  Overall survival in patients treated with adjuvant chemoradiotherapy in sequence with the irradiated allogeneic GM-CSF transfected pancreatic tumor cell lines. Overall survival is defined as time from surgery until death, regardless of cause.

  Participants were followed for the duration of the study, an average of 2 years

• Disease-free Survival

  Disease-free Survival in Patients Treated With Adjuvant Chemoradiotherapy in Sequence With the Irradiated Allogeneic GM-CSF Transfected Pancreatic Tumor Cell Lines. DFS is defined as time from surgery until clinical evidence of disease (eg, CT scan) or death due to any cause.

  Participants were followed for the duration of the study, an average of 2 years

Secondary Outcomes (2)

• To Further Identify and Characterize Toxicities Associated With Intradermal Injections of the Vaccine That Were Initially Reported in the Phase 1 Trial.

  4 years

• Estimate the Association of Specific in Vivo Parameters of Immune Response With Clinical Responses in Patients Treated With Combination Chemoradiotherapy Together With the Irradiated Allogeneic GM-CSF Transfected Pancreatic Tumor Cell Lines.

  Continuous

Study Arms (1)

GVAX pancreatic cancer vaccine

EXPERIMENTAL

5E8 vaccine cells. The first vaccination is administered 6-8 weeks after surgery. Four to eight weeks following the completion of the last cycle of adjuvant radiation and chemotherapy (chemo-radiation therapy is standard of care and not part of the protocol) eligible patients will receive three additional vaccinations at one month intervals. Patients who continue to remain disease-free will receive a fifth "booster" vaccination, six months following the fourth vaccination

Biological: GVAX pancreatic cancer vaccine

Interventions

GVAX pancreatic cancer vaccine BIOLOGICAL

Patients will receive vaccinations consisting of 5E8 vaccine cells. The first vaccination is administered 6-8 weeks after surgery. Four to eight weeks following the completion of the last cycle of adjuvant radiation and chemotherapy (chemo-radiation therapy is standard of care and not part of the protocol) eligible patients will receive three additional vaccinations at one month intervals. Patients who continue to remain disease-free will receive a fifth "booster" vaccination, six months following the fourth vaccination.

GVAX pancreatic cancer vaccine

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

DISEASE CHARACTERISTICS: * Histologically confirmed invasive ductal adenocarcinoma of the head, neck, and uncinate process of the pancreas * Mixed adenocarcinoma tumors allowed if the predominant invasive component of the tumor is adenocarcinoma * Stage I or II (clinical stage T1-3, N0-1, M0) disease * Has undergone pancreaticoduodenectomy at the Johns Hopkins Hospital within the past 8-10 weeks * Completely resected (R0) or microscopic residual (R1) disease * No diagnosis other than ductal adenocarcinoma, including any of the following: * Adenosquamous * Squamous cell * Colloid * Islet cell * Non-invasive intraductal papillary mucinous neoplasms * Serous or mucinous cystadenoma or cystadenocarcinoma * Carcinoid * Small or large cell carcinoma * Intraductal oncocytic papillary neoplasms * Osteoclast-like giant cell tumors * Acinar cell carcinoma * Pancreatoblastoma * Solid pseudopapillary tumors * Undifferentiated small cell carcinoma * Non-epithelial tumors (sarcoma, gastrointestinal stromal tumor, or lymphoma) * Adenocarcinoma of the ampulla * Adenocarcinoma of the distal bile duct * Adenocarcinoma of the duodenum * No recurrent disease * No metastatic disease, including peritoneal implants or liver and/or lung involvement PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count \>/= 1,500/mm\^3 * Platelet count \>/= 100,000/mm\^3 * Hemoglobin \>/= 10 g/dL Hepatic * Bilirubin \</= 2 mg/dL * AST/ALT \</= 2 times upper limit of normal (ULN) * Alkaline phosphatase \</= 5 times ULN Renal * Creatinine \</= 2 mg/dL Pulmonary * No asthma or chronic obstructive pulmonary disease requiring systemic corticosteroids Immunologic * HIV negative * No active infection * No prior or concurrent autoimmune disease requiring treatment with systemic immunosuppressants, including any of the following: * Inflammatory bowel disease * Systemic vasculitis * Scleroderma * Psoriasis * Multiple sclerosis * Hemolytic anemia or immune thrombocytopenia * Rheumatoid arthritis * Systemic lupus erythematosus * Sjogren's syndrome * Sarcoidosis * Negative results to viral delayed-type hypersensitivity serology testing if autologous tumor cells are available Other * No postoperative complications (e.g., inability to take oral nutrition \>/= 1,500 calories/day, ongoing requirement for long-term biliary stenting, or persistence of wound infection) * No other malignancy within the past 5 years except nonmelanoma skin cancer * No uncontrolled medical conditions that would preclude study participation * No other major active medical or psychosocial problem that could be exacerbated by study treatment * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for at least 4 weeks after study participation PRIOR CONCURRENT THERAPY: Biologic therapy * More than 1 month since prior biologic therapy * No other concurrent biologic therapy, immunotherapy, or gene therapy for pancreatic cancer Chemotherapy * More than 1 month since prior chemotherapy * No other concurrent chemotherapy for pancreatic cancer Endocrine therapy * More than 28 days since prior systemic steroids * No concurrent systemic corticosteroids Radiotherapy * More than 1 month since prior radiotherapy * No other concurrent radiotherapy for pancreatic cancer Surgery * See Disease Characteristics * Recovered from prior surgery Other * More than 1 month since prior participation in an investigational new drug trial * No other concurrent investigational therapy for pancreatic cancer

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, 21231, United States

Location

Related Publications (1)

• Lutz E, Yeo CJ, Lillemoe KD, Biedrzycki B, Kobrin B, Herman J, Sugar E, Piantadosi S, Cameron JL, Solt S, Onners B, Tartakovsky I, Choi M, Sharma R, Illei PB, Hruban RH, Abrams RA, Le D, Jaffee E, Laheru D. A lethally irradiated allogeneic granulocyte-macrophage colony stimulating factor-secreting tumor vaccine for pancreatic adenocarcinoma. A Phase II trial of safety, efficacy, and immune activation. Ann Surg. 2011 Feb;253(2):328-35. doi: 10.1097/SLA.0b013e3181fd271c.

  PMID: 21217520 DERIVED

MeSH Terms

Conditions

Pancreatic Neoplasms

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Endocrine Gland Neoplasms; Digestive System Diseases; Pancreatic Diseases; Endocrine System Diseases

Results Point of Contact

• Title: Dr. Daniel Laheru
• Organization: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

laherda@jhmi.edu

410-955-8974

Study Officials

• Daniel A. Laheru, MD

  Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 10, 2004
• First Posted: June 11, 2004
• Study Start: January 1, 2002
• Primary Completion: December 1, 2005
• Study Completion: July 1, 2006
• Last Updated: July 22, 2013
• Results First Posted: July 15, 2013

Record last verified: 2013-07

Locations

US (1)