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| ID | Type | Description | Link |
|---|---|---|---|
| DUMC-5883-04-6RO | Other Identifier | Legacy Duke IRB Number | |
| CDR000041079 | Other Identifier | NCI |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Vaccines made from a gene-modified virus and a person's white blood cells may make the body build an effective immune response to kill tumor cells. Biological therapies, such as Granulocyte-macrophage colony-stimulating factor (GM-CSF), may stimulate the immune system in different ways and stop tumor cells from growing. Combining different types of biological therapies may kill more tumor cells.
PURPOSE: This randomized phase II trial is studying giving vaccine therapy together with dendritic cells to see how well it works compared to giving vaccine therapy together with GM-CSF in treating patients with liver or lung metastases from colorectal cancer removed by surgery.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a randomized study. Patients are randomized to 1 of 2 treatment arms.
After completion of study treatment, patients are followed for 2 years.
PROJECTED ACCRUAL: A total of 72 patients (36 per treatment arm) will be accrued for this study within 2 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PANVAC-V + PANVAC-F + DC | Experimental | Patients undergo leukapheresis to obtain leukocytes for generation of autologous dendritic cells (DC). Patients then receive autologous DC loaded with vaccinia-CEA-MUC-1-TRICOM (PANVAC-V) vaccine subcutaneously (SC) and intradermally (ID) on day 1 and autologous DC loaded with fowlpox-CEA-MUC-1-TRICOM (PANVAC-F) vaccine SC and ID on days 28, 56, and 84. |
|
| PANVAC-V + PANVAC-F + GM-CSF | Experimental | Patients receive PANVAC-V SC on day 1 and PANVAC-F SC on days 28, 56, and 84. Patients also receive sargramostim (GM-CSF) SC into the same injection site once daily on days 0-3, 28-31, 56-59, and 84-87. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| falimarev | Biological | Given subcutaneously and intradermally |
|
| Measure | Description | Time Frame |
|---|---|---|
| Recurrence-free Survival at 2 Years | Recurrence-free survival for randomized patients receiving dendritic cells (DC) loaded with PANVAC or PANVAC plus Granulocyte-macrophage colony-stimulating factor (GM-CSF) measured from the date of metastasectomy, with relapse defined as documented disease recurrence at any site. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Positive Immune Response as Measured by (Enzyme-linked Immunosorbent Spot) ELISpot Assay | CEA-Specific Immune Responders by enzyme-linked immunosorbent spot (ELISpot). The ELISPOT assay is considered positive for a subject if the mean number of spots with CEA exceeds the number of spots with control by a magnitude of 10 and the difference between CEA and control is statistically significant at a level of p=0.05 by the t-test. |
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DISEASE CHARACTERISTICS:
Histologically confirmed hepatic or pulmonary metastases secondary to adenocarcinoma of the colon and rectum
Must have undergone complete resection of hepatic or pulmonary metastases with curative intent
Must have received at least 2 months of perioperative systemic chemotherapy (including preoperative and/or postoperative chemotherapy) that was completed at least 1 month ago
PATIENT CHARACTERISTICS:
Age
Performance status
Life expectancy
Hematopoietic
Hepatic
Renal
Cardiovascular
Pulmonary
Immunologic
No history of autoimmune disease, including, but not limited to, any of the following:
No human immunodeficiency virus (HIV) infection by enzyme-linked immunosorbent assay (ELISA) and western blot
Not immunocompromised (by disease or therapy)
No allergy to eggs or any component of the study vaccine
No history of allergy or untoward reaction to prior vaccinia (smallpox) vaccination
No allergy or untoward reaction to sargramostim (GM-CSF)
No active acute or chronic infection, including urinary tract infection within the past 72 hours
No inflammatory bowel conditions, including, but not limited to, the following:
No acute, chronic, or exfoliative skin disorders, including any of the following:
Other
Not pregnant or nursing
Fertile patients must use effective contraception
Able to avoid close contact or household contact for 3 weeks after each vaccination with the following individuals:
No medical or psychological condition that would preclude study compliance
No extensive eczema
No other serious chronic or acute illness that would preclude study participation
No other malignancy within the past 5 years except nonmelanoma skin cancer, controlled superficial bladder cancer, or previously treated carcinoma in situ of the cervix
PRIOR CONCURRENT THERAPY:
Biologic therapy
Chemotherapy
Endocrine therapy
Radiotherapy
Surgery
Other
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| Name | Affiliation | Role |
|---|---|---|
| Michael A. Morse, MD | Duke Cancer Institute | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lombardi Comprehensive Cancer Center at Georgetown University Medical Center | Washington D.C. | District of Columbia | 20007 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23657083 | Derived | Morse MA, Niedzwiecki D, Marshall JL, Garrett C, Chang DZ, Aklilu M, Crocenzi TS, Cole DJ, Dessureault S, Hobeika AC, Osada T, Onaitis M, Clary BM, Hsu D, Devi GR, Bulusu A, Annechiarico RP, Chadaram V, Clay TM, Lyerly HK. A randomized phase II study of immunization with dendritic cells modified with poxvectors encoding CEA and MUC1 compared with the same poxvectors plus GM-CSF for resected metastatic colorectal cancer. Ann Surg. 2013 Dec;258(6):879-86. doi: 10.1097/SLA.0b013e318292919e. |
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The study was designed to treat 72 subjects. Total number of enrollment is 74 because enrollment reflects the number of subjects that signed consent and were randomized to the study but did not necessarily receive study drug or complete study drug.
This was a 7 site study where patients were recruited from medical clinics and the patient's primary oncologist and study team approached the patient about the study. Patients were recruited for this study from January 2005 and September 2009.
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| ID | Title | Description |
|---|---|---|
| FG000 | PANVAC-V + PANVAC-F + DC | Patients undergo leukapheresis to obtain leukocytes for generation of autologous dendritic cells (DC). Patients then receive autologous DC loaded with vaccinia-CEA-MUC-1-TRICOM (PANVAC-V) vaccine subcutaneously (SC) and intradermally (ID) on day 1 and autologous DC loaded with fowlpox-CEA-MUC-1-TRICOM (PANVAC-F) vaccine SC and ID on days 28, 56, and 84. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| inalimarev | Biological | Given subcutaneously and intradermally |
|
| sargramostim | Biological | Given subcutaneously |
|
| therapeutic autologous dendritic cells | Biological | Given subcutaneously and intradermally |
|
| 13 weeks |
| H. Lee Moffitt Cancer Center and Research Institute at University of South Florida | Tampa | Florida | 33612-9497 | United States |
| Duke Comprehensive Cancer Center | Durham | North Carolina | 27710 | United States |
| Wake Forest University Baptist Medical Center | Winston-Salem | North Carolina | 27157 | United States |
| Providence Cancer Center at Providence Portland Medical Center | Portland | Oregon | 97213-2967 | United States |
| Hollings Cancer Center at Medical University of South Carolina | Charleston | South Carolina | 29425 | United States |
| FG001 | PANVAC-V + PANVAC-F + GM-CSF | Patients receive PANVAC-V SC on day 1 and PANVAC-F SC on days 28, 56, and 84. Patients also receive sargramostim (GM-CSF) SC into the same injection site once daily on days 0-3, 28-31, 56-59, and 84-87. |
| COMPLETED |
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| NOT COMPLETED |
|
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37 PANVAC-V + PANVAC-F + DC arm patients and 37 PANVAC-V + PANVAC-F + GM-CSF arm. One participant in PANVAC-V + PANVAC-F + DC Arm was consented and contributed baseline data, but was not considered to have started or enrolled in the study patients signed consent.
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| ID | Title | Description |
|---|---|---|
| BG000 | Experimental PANVAC-V + PANVAC-F + DC | Patients undergo leukapheresis to obtain leukocytes for generation of autologous dendritic cells (DC). Patients then receive autologous DC loaded with vaccinia-Carcinoembryonic antigen (CEA)-Mucin 1 (MUC-1)-TRIad of COstimulatory Molecules (TRICOM) (PANVAC-V) vaccine subcutaneously (SC) and intradermally (ID) on day 1 and autologous DC loaded with fowlpox-CEA-MUC-1-TRICOM (PANVAC-F) vaccine subcutaneous (SC) and intradermally (ID) on days 28, 56, and 84. |
| BG001 | Experimental PANVAC-V + PANVAC-F + GM-CSF | Patients receive PANVAC-V SC on day 1 and PANVAC-F SC on days 28, 56, and 84. Patients also receive sargramostim (Granulocyte-macrophage colony-stimulating factor or GM-CSF) subcutaneous (SC) into the same injection site once daily on days 0-3, 28-31, 56-59, and 84-87. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| |||||||||||||||
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||
| Sites of metastasis | Number | participants |
| ||||||||||||||||
| Number of nodules | Number | participants |
| ||||||||||||||||
| Carcinoembryonic antigen (CEA) | Mean | Full Range | mcg/L |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Recurrence-free Survival at 2 Years | Recurrence-free survival for randomized patients receiving dendritic cells (DC) loaded with PANVAC or PANVAC plus Granulocyte-macrophage colony-stimulating factor (GM-CSF) measured from the date of metastasectomy, with relapse defined as documented disease recurrence at any site. | Posted | Number | participants | 2 years |
|
|
| ||||||||||||||||||||||||||||||
| Secondary | Positive Immune Response as Measured by (Enzyme-linked Immunosorbent Spot) ELISpot Assay | CEA-Specific Immune Responders by enzyme-linked immunosorbent spot (ELISpot). The ELISPOT assay is considered positive for a subject if the mean number of spots with CEA exceeds the number of spots with control by a magnitude of 10 and the difference between CEA and control is statistically significant at a level of p=0.05 by the t-test. | Posted | Number | participants | 13 weeks |
|
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Adverse Events were only collected/assessed for participants who received at least one dose of intervention
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Arm I | Patients undergo leukapheresis to obtain leukocytes for generation of autologous dendritic cells (DC). Patients then receive autologous DC loaded with vaccinia-CEA-MUC-1-TRICOM (PANVAC-V) vaccine subcutaneously (SC) and intradermally (ID) on day 1 and autologous DC loaded with fowlpox-CEA-MUC-1-TRICOM (PANVAC-F) vaccine SC and ID on days 28, 56, and 84. | 0 | 35 | 35 | 35 | ||
| EG001 | Arm II | Patients receive PANVAC-V SC on day 1 and PANVAC-F SC on days 28, 56, and 84. Patients also receive sargramostim (GM-CSF) SC into the same injection site once daily on days 0-3, 28-31, 56-59, and 84-87. | 0 | 36 | 35 | 36 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hematologic Adverse Events | Blood and lymphatic system disorders | Non-systematic Assessment | Hematologic Adverse Events |
| |
| Cardiac | Cardiac disorders | Cardiac | Systematic Assessment | Cardiac |
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| CONSTITUTIONAL SYMPTOMS | General disorders | CONSTITUTIONAL SYMPT | Systematic Assessment | CONSTITUTIONAL SYMPTOMS |
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| Skin | Skin and subcutaneous tissue disorders | Skin | Systematic Assessment | Skin |
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| Endocrine | Endocrine disorders | Endocrine | Systematic Assessment | Endocrine |
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| GI | Gastrointestinal disorders | GI | Systematic Assessment | GI |
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| Infection | Infections and infestations | Infection | Systematic Assessment | Infection |
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| Metabolic | Metabolism and nutrition disorders | Metabolic | Systematic Assessment |
| |
| MUSCULOSKELETAL/SOFT TISSUE | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| NEUROLOGY | Nervous system disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Michael Morse | Duke University Medical Center | 919-684-5705 | michael.morse@dm.duke.edu |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D009362 | Neoplasm Metastasis |
| D003110 | Colonic Neoplasms |
| D012004 | Rectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C081222 | sargramostim |
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| Between 18 and 65 years |
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| >=65 years |
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| Male |
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| Lung |
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| 2-4 nodules |
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| >4 nodules |
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| unknown |
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