NCT01943188

Brief Summary

This pilot phase I trial studies the side effects and best way to give stereotactic body radiation therapy and T-cell infusion in treating patients with metastatic kidney cancer. Giving total body irradiation before a T-cell infusion stops the growth of cancer cells by stopping them from dividing or killing them. After treatment, stem cells are collected from the patient's blood and stored. Chemotherapy is given to prepare the bone marrow for the stem cell transplant. The stem cells are then returned to the patient to replace the blood-forming cells that were destroyed by the radiation therapy.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2

participants targeted

Target at below P25 for phase_1

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 11, 2013

Completed
5 days until next milestone

First Posted

Study publicly available on registry

September 16, 2013

Completed
8 months until next milestone

Study Start

First participant enrolled

May 1, 2014

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2016

Completed
Last Updated

March 15, 2017

Status Verified

March 1, 2017

Enrollment Period

1.8 years

First QC Date

September 11, 2013

Last Update Submit

March 13, 2017

Conditions

Outcome Measures

Primary Outcomes (1)

  • Frequency of treatment-related grade 3-5 toxicities, graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Adverse events will be tabulated by type and grade at each follow-up interval.

    Within 30 days after infusion of PBMCs

Secondary Outcomes (2)

  • Overall survival (OS)

    1 year

  • Progression-free survival (PFS)

    The duration from SBRT treatment to documented disease progression or death, assessed at 1 year

Other Outcomes (2)

  • Level of circulating tumor cells (CTCs)

    Up to 2 years

  • Changes in signaling as measured by NIA

    Up to 2 years

Study Arms (1)

Treatment (SBRT, autologous PBMC infusion)

EXPERIMENTAL

SBRT: Patients undergo standard of care SBRT over 1-2 weeks according to tumor volume and location. LYMPHODEPLETION: Beginning 3 weeks later, patients receive cyclophosphamide PO BID for 3 days. REINFUSION OF PBMC: Within 3-14 days of completing lymphodepletion with cyclophosphamide , patients undergo autologous PBMC infusion.

Radiation: stereotactic body radiation therapyDrug: cyclophosphamideBiological: therapeutic autologous lymphocytesOther: laboratory biomarker analysis

Interventions

Undergo SBRT

Also known as: SBRT, stereotactic radiation therapy, stereotactic radiotherapy
Treatment (SBRT, autologous PBMC infusion)

Given PO

Also known as: CPM, CTX, Cytoxan, Endoxan, Endoxana
Treatment (SBRT, autologous PBMC infusion)

Undergo autologous PBMC infusion

Also known as: AL, Autologous Lymphocytes, autologous T cells
Treatment (SBRT, autologous PBMC infusion)

Correlative studies

Treatment (SBRT, autologous PBMC infusion)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Histologically confirmed carcinoma of the kidney (clear-cell predominance)
  • Have had at least 2 prior systemic treatments for renal cell carcinoma (RCC)
  • Have at least 1 extracranial metastasis that is amenable to radiation and at least 1 other site of disease that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST)
  • Subjects must provide written informed consent prior to performance of study-specific procedures or assessments, and must be willing to comply with treatment and follow up
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2
  • Absolute neutrophil count (ANC) \>= 0.75 x 10\^9/L
  • Absolute lymphocyte count (ALC) \>= 0.5 X 10\^9/L
  • Hemoglobin \>= 8 g/dL
  • Platelets \>= 50 X 10\^9/L
  • Total bilirubin =\< 3 X upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 3 X ULN
  • Serum creatinine =\< 2.1 X ULN (or creatinine clearance of \> 50 cc/min)

You may not qualify if:

  • History of other malignancies within 5 years prior to enrollment except for tumors with a negligible risk for metastasis or death, such as adequately controlled basal cell carcinoma, squamous-cell carcinoma of the skin, carcinoma in situ of the cervix, early-stage bladder cancer, or low-grade endometrial cancer
  • Malignancies that have undergone a putative surgical cure (i.e., localized prostate cancer post-prostatectomy) within 5 years prior to enrollment may be discussed with the lead primary investigator
  • History or clinical evidence of central nervous system (CNS) metastases or leptomeningeal carcinomatosis, except for individuals who have previously-treated CNS metastases, are asymptomatic, and have had no requirement for steroids or anti-seizure medication for more than 1 week within 6 months prior enrollment
  • Presence of uncontrolled infection
  • Evidence of active bleeding or bleeding diathesis; any medical condition requiring systemic anticoagulation (including anti-platelet agents)
  • Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subject's safety, provision of informed consent, or compliance to procedures
  • Pregnant and breastfeeding women are excluded; as well as women of child-bearing potential who are unwilling or unable to use an acceptable method of birth control (hormonal or barrier method of birth control; abstinence) to avoid pregnancy for the duration of the study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Stanford University Hospitals and Clinics

Stanford, California, 94305, United States

Location

MeSH Terms

Conditions

Carcinoma, Renal Cell

Interventions

RadiosurgeryCyclophosphamide

Condition Hierarchy (Ancestors)

AdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasmsKidney NeoplasmsUrologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesKidney DiseasesUrologic DiseasesMale Urogenital Diseases

Intervention Hierarchy (Ancestors)

RadiotherapyTherapeuticsStereotaxic TechniquesNeurosurgical ProceduresSurgical Procedures, OperativeInvestigative TechniquesPhosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedHydrocarbonsOrganic ChemicalsPhosphoramidesOrganophosphorus Compounds

Study Officials

  • Sandy Srinivas

    Stanford University Hospitals and Clinics

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Medicine

Study Record Dates

First Submitted

September 11, 2013

First Posted

September 16, 2013

Study Start

May 1, 2014

Primary Completion

March 1, 2016

Last Updated

March 15, 2017

Record last verified: 2017-03

Locations