Vaccination with Autologous Dendritic Cells Loaded with Autologous Tumour Homogenate After Curative Resection for Stage IV Colorectal Cancer.

NCT02919644 | Recruiting Phase 2 DMC

• 2 other identifiers: IRST153.042015-000894-11
• Study Type: interventional
• Target: 19
• Locations: 1 country
• Sites: 2

Brief Summary

Single-arm, monocentric trial to assess safety and immunological efficacy of adjuvant vaccination with autologous dendritic cells loaded with autologous tumour homogenate after curative resection for stage IV colorectal cancer

Conditions

Stage IV Colorectal Cancer; Curative Resection

Keywords

vaccination; autologous dendritic cells; autologous tumour homogenate; curative resection; stage IV colorectal cancer

Outcome Measures

Primary Outcomes (2)

• Incidence of Treatment-Emergent Adverse Events

  To characterize the safety of the study drugs all adverse events observed during the study will be collected and assessed using the CTCAE v 4.03 criteria . Type, incidence, and severity of the adverse events will be reported and analyzed using descriptive statistics. All patients who received at least one treatment cycle will be considered evaluable for this primary endpoint.

  up to 24 months

• immunological efficacy

  Immunological efficacy will be assessed by quantifying circulating immune effectors specific for a selected panel of tumour antigens using interferon (IFN) - γELISPOT analysis . The assay determines the proportion of peptide-reactive T lymphocytes from peripheral blood mononuclear cells (PBMC) expressed as number of spot-forming Cells

  up to 24 months

Secondary Outcomes (8)

• Relapse Free Survival (RFS)

  up to 7 years

• Overall Survival (OS)

  up to 7 years

• Positive Delayed Type Hypersensitivity (DTH) skin test

  up 24 months

• Antitumor Immune response

  up to 7 years

• evaluation of the prognostic or predictive role of the enhancement of a specific immune response

  up to 7 years

Study Arms (1)

vaccine + Interleukin -2 (IL2)

EXPERIMENTAL

autologous dendritic cells loaded with autologous tumour homogenate given by intradermal injection (day 1), followed by IL-2 given by subcutaneous injection daily for five days (days 3-7)

Biological: autologous dendritic cells loaded with autologous tumour homogenate; Drug: IL2

Interventions

autologous dendritic cells loaded with autologous tumour homogenate BIOLOGICAL

Each vaccine dose consists of 10\_7 autologous dendritic cells loaded with autologous tumor homogenate

vaccine + Interleukin -2 (IL2)

IL2 DRUG

Each vaccine dose is followed, after two days, by IL-2 as adjuvant, at a dose of 3 MU daily for five consecutive days

vaccine + Interleukin -2 (IL2)

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients must have histologically confirmed stage IV colorectal cancer surgically treated with radical intent.
• The autologous surgical specimen must have been collected and sent to the Somatic Cell Therapy Lab of Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST IRCCS) and must fulfil all the acceptance criteria prescribed by the Good Manufacturing practise (GMP) procedures.
• The patient must be disease-free, as assessed by CT scan or MRI of the chest, abdomen, pelvis performed within 60 days before enrolment. If the resected lesions had occurred in other sites, these must be also included in the baseline CT scan and in all the subsequent evaluations.
• The patient must have recovered (grade 1 or less by CTCAE 4.0) from all the adverse events related to previous surgery.
• Age \>18 years.
• Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
• Patient must have acceptable organ function, defined as:
• Haemoglobin \>10 g/dl
• White blood cells ≥4000/μl.
• Absolute neutrophil count \>1500/μl.
• Platelets ≥100000/μl.
• aspartate aminotransferase (AST) and Alanine Aminotransferase (ALT) \<3 times the upper institutional reference level.
• Total bilirubin \<1.5 times the upper institutional reference level.
• Serum creatinine \<1.5 times the upper institutional reference level.
• Patients aged 70 years or older must have left ventricular ejection fraction not lower than 55% as assessed by echocardiography.

You may not qualify if:

• Patients with residual disease after surgery. Marginal resection of any lesion in the absence of clinically evident residual disease is acceptable.
• Patients who relapsed within 6 months since primary treatment of stage I-III colorectal cancer. If adjuvant chemotherapy had been administered, the term must be computed since last chemotherapy dose.
• Patient who completed surgery more than 60 days before study enrolment.
• History of other neoplastic diseases in the previous 5 years, except basal cell carcinoma of the skin and in situ carcinoma of the cervix uteri treated with curative surgery.
• History of congenital or acquired immunodeficiency, including history of organ transplantation.
• Any positivity for the serologic markers of hepatitis B virus (HBV) (including at least anti-HBs antibodies and anti-hepatitis B core (HBc) antibodies), hepatitis C virus (HCV), HIV or Treponema pallidum. The serologic tests must have been performed within 30 days before any GMP-regulated activity (i.e. surgical resection and leukapheresis). The sole positivity for antibodies against the HBV S antigen (i.e. with all other HBV markers negative) is indicative of previous HBV vaccination and therefore is acceptable.
• Female patients who are pregnant or nursing.
• Patients undergone surgery after preoperatory chemotherapy with a fluoropyrimidine plus oxaliplatin, unless they are not candidate for postoperatory chemotherapy with the same schedule in the opinion of the Investigator (e.g. for unacceptable toxicity) or refuse completion of the perioperatory treatment.
• Participation in another clinical trial with any investigational agent within 30 days prior to study screening.
• Any active inflammatory or autoimmune disease requiring systemic steroids or other immunomodulatory agents as detailed in section 6.4, or potentially requiring such treatments during the study treatment in the judgement of the Investigator.
• Any clinical condition that, in the opinion of the Investigator or the Transfusion Medicine specialist, is a contraindication to leukapheresis. In addition, all patients aged 70 or older must be evaluated by a cardiology specialist before the procedure to exclude any clinically relevant cardiac condition and any grade 3-4 cardiac arrhythmia, even if asymptomatic.
• Any clinical condition that, in the opinion of the Investigator, contraindicates the subcutaneous administration of low-dose IL-2 as per protocol (see section 6.2 for details).
• Any uncontrolled serious intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations potentially impacting patient safety and compliance in the opinion of the Investigator.
• Refusal of giving written informed consent.

Sponsors & Collaborators

• Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS: lead

Study Sites (2)

UO Immunoterapia e Laboratorio TCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) S.r.l IRCCS

Meldola, FC, 47014, Italy

RECRUITING

CRO-IRCCS Aviano

Aviano, Italy

NOT YET RECRUITING

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

Interleukin-2

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases

Intervention Hierarchy (Ancestors)

Interleukins; Cytokines; Intercellular Signaling Peptides and Proteins; Peptides; Amino Acids, Peptides, and Proteins; Lymphokines; Proteins; Biological Factors

Study Officials

• Francesco De Rosa, MD

  UO Immunoterapia e Laboratorio TCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) S.r.l IRCCS

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Oriana Nanni, PhD

CONTACT

+390543739266; oriana.nanni@irst.emr.it

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: September 28, 2016
• First Posted: September 29, 2016
• Study Start: December 2, 2016
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2031
• Last Updated: September 19, 2024

Record last verified: 2024-09

Locations

IT (2)