Dendritic Cells for Immunotherapy of Metastatic Endometrial Cancer Patients
DECENDO
An Exploratory Study: Dendritic Cells for Immunotherapy of Metastatic Endometrial Cancer Patients
1 other identifier
interventional
8
1 country
1
Brief Summary
Prevention of infectious diseases through immunization is one of the greatest achievements of modern medicine. Nonetheless, considerable challenges remain for improving the efficacy of existing vaccines for therapeutic immunizations for diseases such as cancer. The investigators were amongst the first groups worldwide that introduced tumor antigen-loaded dendritic cell (DC)-based vaccines in the clinic1-3. Effective immune responses and favorable clinical outcomes have indeed been observed4-7. Thus far, mainly conventional in vitro generated monocyte-derived DCs (moDC) have been used in clinical trials worldwide. In the past 14 years the investigators have treated more than 375 patients and proven that DC therapy is feasible and non-toxic. The investigators observed that long lasting tumor specific T cell-mediated immunological responses are clearly linked to increased progression free survival as well as overall survival8. In conclusion, based on all these observations the investigators are convinced that pDC and myDC employ different, and probably more optimal mechanisms to combat cancer. In addition, based on in vitro data and preclinical studies that suggest that blood pDC and myDC act synergistically, the investigators hypothesize that the combination of myDC and pDC may induce stronger anti-tumor immune responses as compared to pDC or myDC alone, or moDC.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_2
Started Apr 2019
1 active site
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
Study Start
First participant enrolled
April 8, 2019
CompletedFirst Submitted
Initial submission to the registry
November 20, 2019
CompletedFirst Posted
Study publicly available on registry
December 27, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
March 9, 2021
CompletedStudy Completion
Last participant's last visit for all outcomes
March 9, 2021
CompletedJanuary 11, 2024
December 1, 2020
1.9 years
November 20, 2019
January 9, 2024
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Immunologic efficacy of tumor-peptide loaded nDC in mEC patients
Immunomonitoring including: a) functional response and tetramer analysis of DTH infiltrating lymphocytes against tumor peptides
1 year
Secondary Outcomes (2)
toxicity: Adverse Events
study start till week 26
Health- related Quality of Life
Baseline, week 15 and week 26
Other Outcomes (1)
Assessment of T cell responses against tumor peptides
Baseline, week 8, week 17 and week 24 and week 26
Study Arms (1)
exploratory
EXPERIMENTALsingle arm exploratory, single-centre study
Interventions
Our study population consists of 8 mEC patients who receive carboplatin / paclitaxel chemotherapy in a weekly schedule on weeks 1, 2, 3 and weeks 5,6 and 7. In week 8, myeloid and plasmacytoid DC (nDC) are loaded with tumor lysate and MUC1 and survivin PepTivators, injected intranodally. An extensive immuno-motoring will be performed on all patients. Patients who show stable disease, partial response, or full response continue with extended three-week chemotherapy regimens with intranodal injections of nDC at weeks 17, 20, and 23.
Eligibility Criteria
You may qualify if:
- women ≥ 18 years old with histologically confirmed stage IV or metastatic carcinoma of the endometrium of the endometroid, serous or carcinosarcoma type.
- Hormone receptor negative or
- resistant to hormonal therapy
- ineligible for hormonal therapy because of other reasons
- eligible for treatment with carboplatin paclitaxel combination chemotherapy
- Life expectancy ≥ 6 months
- WHO/ECOG performance status 0-1 (Karnofsky index 100-70)
- WBC \>2.0 -109/l, neutrophils \>1.5-109/L lymphocytes \>0.8-109/L, platelets \>100-109/L, hemoglobin \>5,6 mmol/L (9.0 g/dL), serum creatinine \<150 µmol/L, AST/ALT \<3 x ULN, serum bilirubin \<1.5 x ULN (exception: Gilbert's syndrome is permitted)
- Expression of survivin and/or muc1 on tumor material
- Expected adequacy of follow-up
- Postmenopausal or evidence of non-childbearing status or for women of childbearing potential: negative urine or serum pregnancy test, within 28 days of study treatment and confirmed prior to treatment on day 1
- Postmenopausal is defined as:
- Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments;
- Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the post menopausal range for women under 50,
- radiation-induced oophorectomy with last menses \>1 year ago,
- +3 more criteria
You may not qualify if:
- Uncontrolled hypercalcemia
- History of any second malignancy in the previous 5 years, with the exception of adequately treated basal cell carcinoma
- Known allergy to shell fish
- Heart failure (NYHA class III/IV)
- Serious active infections
- Active hepatitis B, C or HIV infection
- Active syphilis infection
- Autoimmune diseases (exception: vitiligo is permitted)
- Organ allografts
- An uncontrolled co-morbidity, e.g. psychiatric or social conditions interfering which participation
- Concurrent use of systemic corticosteroids \> 10 mg daily prednisone equivalent
- Any serious clinical condition that may interfere with the safe administration of DC vaccinations
- Unable to undergo a tumor biopsy
- Pregnancy or insufficient anti-conception if reproduction is still possible
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Radboud University Medical Center
Nijmegen, 6500 HB, Netherlands
Related Publications (76)
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PMID: 16600979BACKGROUNDCoosemans A, Moerman P, Verbist G, Maes W, Neven P, Vergote I, Van Gool SW, Amant F. Wilms' tumor gene 1 (WT1) in endometrial carcinoma. Gynecol Oncol. 2008 Dec;111(3):502-8. doi: 10.1016/j.ygyno.2008.08.032. Epub 2008 Oct 16.
PMID: 18929401BACKGROUNDCoosemans A, Vanderstraeten A, Tuyaerts S, Verschuere T, Moerman P, Berneman ZN, Vergote I, Amant F, VAN Gool SW. Wilms' Tumor Gene 1 (WT1)--loaded dendritic cell immunotherapy in patients with uterine tumors: a phase I/II clinical trial. Anticancer Res. 2013 Dec;33(12):5495-500.
PMID: 24324087BACKGROUNDResnick MB, Sabo E, Kondratev S, Kerner H, Spagnoli GC, Yakirevich E. Cancer-testis antigen expression in uterine malignancies with an emphasis on carcinosarcomas and papillary serous carcinomas. Int J Cancer. 2002 Sep 10;101(2):190-5. doi: 10.1002/ijc.10585.
PMID: 12209997BACKGROUNDHoos A, Parmiani G, Hege K, Sznol M, Loibner H, Eggermont A, Urba W, Blumenstein B, Sacks N, Keilholz U, Nichol G; Cancer Vaccine Clinical Trial Working Group. A clinical development paradigm for cancer vaccines and related biologics. J Immunother. 2007 Jan;30(1):1-15. doi: 10.1097/01.cji.0000211341.88835.ae.
PMID: 17198079BACKGROUNDHoos A, Eggermont AM, Janetzki S, Hodi FS, Ibrahim R, Anderson A, Humphrey R, Blumenstein B, Old L, Wolchok J. Improved endpoints for cancer immunotherapy trials. J Natl Cancer Inst. 2010 Sep 22;102(18):1388-97. doi: 10.1093/jnci/djq310. Epub 2010 Sep 8.
PMID: 20826737BACKGROUNDHoos A. Evolution of end points for cancer immunotherapy trials. Ann Oncol. 2012 Sep;23 Suppl 8:viii47-52. doi: 10.1093/annonc/mds263.
PMID: 22918928BACKGROUNDCoulie PG, Karanikas V, Colau D, Lurquin C, Landry C, Marchand M, Dorval T, Brichard V, Boon T. A monoclonal cytolytic T-lymphocyte response observed in a melanoma patient vaccinated with a tumor-specific antigenic peptide encoded by gene MAGE-3. Proc Natl Acad Sci U S A. 2001 Aug 28;98(18):10290-5. doi: 10.1073/pnas.161260098. Epub 2001 Aug 21.
PMID: 11517302BACKGROUNDCoulie PG, Connerotte T. Human tumor-specific T lymphocytes: does function matter more than number? Curr Opin Immunol. 2005 Jun;17(3):320-5. doi: 10.1016/j.coi.2005.03.002.
PMID: 15886124BACKGROUNDDiamond MS, Kinder M, Matsushita H, Mashayekhi M, Dunn GP, Archambault JM, Lee H, Arthur CD, White JM, Kalinke U, Murphy KM, Schreiber RD. Type I interferon is selectively required by dendritic cells for immune rejection of tumors. J Exp Med. 2011 Sep 26;208(10):1989-2003. doi: 10.1084/jem.20101158. Epub 2011 Sep 19.
PMID: 21930769BACKGROUNDde Vries IJ, Castelli C, Huygens C, Jacobs JF, Stockis J, Schuler-Thurner B, Adema GJ, Punt CJ, Rivoltini L, Schuler G, Coulie PG, Lucas S. Frequency of circulating Tregs with demethylated FOXP3 intron 1 in melanoma patients receiving tumor vaccines and potentially Treg-depleting agents. Clin Cancer Res. 2011 Feb 15;17(4):841-8. doi: 10.1158/1078-0432.CCR-10-2227. Epub 2010 Dec 21.
PMID: 21177412BACKGROUNDBol KF, Aarntzen EH, Hout FE, Schreibelt G, Creemers JH, Lesterhuis WJ, Gerritsen WR, Grunhagen DJ, Verhoef C, Punt CJ, Bonenkamp JJ, de Wilt JH, Figdor CG, de Vries IJ. Favorable overall survival in stage III melanoma patients after adjuvant dendritic cell vaccination. Oncoimmunology. 2015 Jun 5;5(1):e1057673. doi: 10.1080/2162402X.2015.1057673. eCollection 2016.
PMID: 26942068BACKGROUNDAarntzen EH, Srinivas M, Bonetto F, Cruz LJ, Verdijk P, Schreibelt G, van de Rakt M, Lesterhuis WJ, van Riel M, Punt CJ, Adema GJ, Heerschap A, Figdor CG, Oyen WJ, de Vries IJ. Targeting of 111In-labeled dendritic cell human vaccines improved by reducing number of cells. Clin Cancer Res. 2013 Mar 15;19(6):1525-33. doi: 10.1158/1078-0432.CCR-12-1879. Epub 2013 Feb 4.
PMID: 23382117BACKGROUNDHoos A, Ibrahim R, Korman A, Abdallah K, Berman D, Shahabi V, Chin K, Canetta R, Humphrey R. Development of ipilimumab: contribution to a new paradigm for cancer immunotherapy. Semin Oncol. 2010 Oct;37(5):533-46. doi: 10.1053/j.seminoncol.2010.09.015.
PMID: 21074069BACKGROUNDWolchok JD, Hoos A, O'Day S, Weber JS, Hamid O, Lebbe C, Maio M, Binder M, Bohnsack O, Nichol G, Humphrey R, Hodi FS. Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria. Clin Cancer Res. 2009 Dec 1;15(23):7412-20. doi: 10.1158/1078-0432.CCR-09-1624. Epub 2009 Nov 24.
PMID: 19934295BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Jolanda de Vries, Prof. Dr.
Radboud Umiversity Medical Center
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 20, 2019
First Posted
December 27, 2019
Study Start
April 8, 2019
Primary Completion
March 9, 2021
Study Completion
March 9, 2021
Last Updated
January 11, 2024
Record last verified: 2020-12
Data Sharing
- IPD Sharing
- Will not share