Vaccine Therapy Plus Interleukin-12 in Treating Patients With Metastatic Prostate Cancer That Has Not Responded to Hormone Therapy

Phase II Study of Immunization With PSMA Peptide-Pulsed Autologous PBMC Plus rhIL-12 in Patients With Metastatic Prostate Cancer

RATIONALE: Vaccines made from a patient's white blood cells may make the body build an immune response to kill cancer cells. Interleukin-12 may kill cancer cells by stopping blood flow to the tumor and by stimulating a person's white blood cells to kill cancer cells. Combining vaccine therapy with interleukin-12 may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of vaccine therapy combined with interleukin-12 in treating patients who have metastatic prostate cancer that has not responded to hormone therapy.

OBJECTIVES:

• Determine whether immunization with prostate-specific membrane antigen-pulsed autologous peripheral blood mononuclear cells and interleukin-12 can promote specific T-cell priming in patients with metastatic hormone-refractory prostate cancer.
• Determine the clinical response in patients treated with this regimen.

OUTLINE: Patients receive prostate-specific membrane antigen-pulsed autologous peripheral blood mononuclear cells subcutaneously (SC) on day 1 and interleukin-12 SC on days 1, 3, and 5. Treatment repeats every 21 days for 3-9 courses in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 12-37 patients will be accrued for this study within 37 weeks.

DISEASE CHARACTERISTICS:

• Histologically confirmed metastatic adenocarcinoma of the prostate

• HLA-A2 positive

• Progressive measurable systemic disease

  • PSA at least 5 ng/mL with 2 consecutive rising PSA levels at least 1 week apart and no measurable disease OR
  • Objective evidence of disease progression by a 20% increase in the sum of longest diameter of all target lesions or evidence of new lesions by CT or bone scan regardless of PSA status
  • Lesions must be at least 1 cm to be considered measurable
  • Progressive systemic disease after discontinuation of anti-androgen therapy

• Previously treated with orchiectomy (testosterone less than 50 ng/mL) OR luteinizing hormone-releasing hormone (LHRH) analogue therapy with or without anti-androgens

  • If on LHRH analogue therapy, must continue therapy during study

• Brain metastases allowed if previously treated, clinically stable, and weaned from prior corticosteroids

PATIENT CHARACTERISTICS:

Age:

• Over 18

Performance status:

• Karnofsky 70-100%

Life expectancy:

• At least 12 weeks

Hematopoietic:

• Absolute neutrophil count greater than 1,500/mm^3
• Hemoglobin greater than 9 g/dL
• Platelet count greater than 100,000/mm^3
• No active gastrointestinal bleeding

Hepatic:

• Bilirubin less than 1.5 times upper limit of normal (ULN)
• SGPT normal
• Hepatitis B surface antigen negative

Renal:

• Creatinine less than 1.5 times ULN
• Calcium less than 11 mg/dL

Cardiovascular:

• No significant cardiovascular disease
• No cardiac arrhythmia requiring therapy

Other:

• Fertile patients must use effective barrier contraception
• No intrinsic immunosuppression
• HIV negative
• No serious concurrent infection
• No psychiatric illness that would preclude study compliance
• No clinically significant autoimmune disease
• No uncontrolled peptic ulcer disease
• No history of inflammatory bowel disease

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• At least 4 weeks since prior biologic therapy

Chemotherapy:

• Not specified

Endocrine therapy:

• See Disease Characteristics
• At least 4 weeks since prior flutamide
• At least 6 weeks since prior bicalutamide or nilutamide
• No concurrent systemic corticosteroids except physiologic replacement doses

Radiotherapy:

• Not specified

Surgery:

• See Disease Characteristics

Other:

• No concurrent immunosuppressive drugs (e.g., cyclosporine)