A Phase II Study on Adjuvant Vaccination with Dendritic Cells Loaded with Autologous Tumor Homogenate in Resected Stage IV Rare Cancers.

NCT04166006 | Recruiting Phase 2

• 1 other identifier: IRST100.42
• Study Type: interventional
• Target: 51
• Locations: 1 country
• Sites: 1

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 rare cancers (In Head/Neck tumors (H\&N), NEuroendocrine Tumors (NET) and Soft Tissue Sarcomas (STS).

Conditions

Head Neck Tumors; Neuroendocrine Tumors; Soft Tissue Sarcoma; Rare Cancer; Vaccination

Keywords

Head Neck Tumors; Neuroendocrine Tumors; Soft Tissue Sarcoma; rare cancer; vaccination; autologous dendritic cells; adjuvant; Interleukin-2

Outcome Measures

Primary Outcomes (2)

• Incidence of Treatment-Emergent Adverse Events

  Incidence, type and severity of adverse events occurred during treatment will be reported and graded according to NCI CTCAE 5.0 criteria

  from the day of the leukapheresis up to 30 days after the last dose

• Immunological efficacy

  immunological efficacy will be assessed as a proportion of tumor-specific circulating immune effectors determined by IFNgamma ELISPOT

  at 4 months, after at least 3 vaccinations

Secondary Outcomes (3)

• Overall Survival (OS)

  Up to 7 years

• Relapse Free Survival (RFS)

  Up to 7 years

• Predictive role of Delayed-Type Hypersensitivity (DTH) skin test

  Up to 7 years

Study Arms (1)

Experimental

EXPERIMENTAL

7-14×106 autologous dendritic cells loaded with autologous tumour homogenate given by intradermal injection (day 1), followed by Interleukin (IL) - 2 (IL-2), at a dose of 3 Million Units (MU), given by subcutaneous injection daily for five days (days 3-7). This constitutes a treatment cycle. Treatment cycles are repeated every 28 days up to a maximum of six cycles.

Biological: Autologous DC vaccine; Drug: Interleukin-2

Interventions

Autologous DC vaccine BIOLOGICAL

7-14×106 autologous dendritic cells loaded with autologous tumour homogenate given by intradermal injection (day 1)

Experimental

Interleukin-2 DRUG

Autologous DC vaccine is followed by IL-2, at a dose of 3 MU, given by subcutaneous injection daily for five days (days 3-7).

Experimental

Eligibility Criteria

• Age: 18 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 Head\&Neck Squamous Cell Carcinoma (HNSCC), NeuroEndocrine Tumors (NET) or Soft Tissue Sarcoma (STS) surgically treated with radical intent.
• The autologous surgical specimen must have been collected and sent to the Somatic Cell Therapy Lab and must fulfil all the acceptance criteria prescribed by the Good Manufactory Practice (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 occurred in other sites, these must be also included in the baseline CT scan and in all the subsequent evaluations.
• Patients disease-free candidates for only observation as per clinical practice (no standard treatment is available after surgery)
• The patient must have recovered from all the adverse events related to previous surgery.
• Age ≥18 years.
• Performance status Eastern Cooperative Oncology Group (ECOG) 0 or 1.
• Patient must have acceptable organ function, defined as:
• Haemoglobin \>10 g/dl
• White blood cells ≥3000/μl.
• Absolute neutrophil count ≥1500/μl.
• Platelets≥75000/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.

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.
• Patient who completed surgery more than 90 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- Hepatitis B surface antibodies (HBs) and 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 surface 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.
• 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 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 (1)

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)

Meldola, FC, 47014, Italy

RECRUITING

MeSH Terms

Conditions

Head and Neck Neoplasms; Neuroendocrine Tumors; Sarcoma

Interventions

Interleukin-2

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms, Nerve Tissue; Neoplasms, Connective and Soft Tissue

Intervention Hierarchy (Ancestors)

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

Study Officials

• Laura Ridolfi, MD

  Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)

  STUDY CHAIR

Central Study Contacts

Oriana Nanni, DR

CONTACT

+39 0543739266; 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: November 14, 2019
• First Posted: November 18, 2019
• Study Start: December 12, 2019
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): December 1, 2031
• Last Updated: September 19, 2024

Record last verified: 2024-09

Locations

IT (1)