| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2010-00800 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| 127 | Other Identifier | Tumor Vaccine Group |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: ONTAK may be able to help reduce the type of cells that prevent other types of immune cells from attacking the breast cancer cells.
PURPOSE: This phase I/II trial is studying the safety of ONTAK and its possible side effects to see how well it works in treating patients with advanced breast cancer that did not respond to previous treatment.
PRIMARY OBJECTIVES:
I. To evaluate the safety of ONTAK infusion in patients with advanced refractory breast cancer.
II. To evaluate the effect of ONTAK administration on peripheral blood T-regulatory cells.
SECONDARY OBJECTIVES:
I. To evaluate the incidence of IL-2R expression in tumor samples and investigate the correlation of tumor IL-2R expression and tumor response to ONTAK therapy.
II. To evaluate levels of circulating sIL-2R before and after ONTAK therapy. III. To evaluate the effect of ONTAK on endogenous tumor specific immunity. IV. To evaluate the potential anti-tumor effects of ONTAK in patients with advanced refractory breast cancer.
OUTLINE:
Patients receive ONTAK IV over 1 hour on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for 1 year.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm I | Experimental | Patients receive ONTAK IV over 1 hour on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ONTAK | Biological | Given IV |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety Evaluated by Collecting Study Related Toxicity as Assessed by CTCAE v3.0 | Subjects are monitored for the development of end organ damage by assessing adverse events with serum chemistries, liver function studies, serum albumin, complete blood counts, symptom assessment, and physical exams performed at every cycle until 3 weeks after the final dose of ONTAK. All adverse events for all systems are graded on a scale of 1-5 using CTCAE v3.0. | 7 Days after last dose of ONTAK |
| Efficacy of ONTAK in Depleting T-regulatory Cells as a Decrease in Peripheral Blood Tregs Using Flow Cytometry | The efficacy of ONTAK in depleting Tregs will be defined as a decrease in peripheral blood Tregs by 25% of each individual subject's baseline. All subjects will undergo blood draws at baseline and post ONTAK infusions at designated time points. Tregs from the peripheral blood will be quantitated using flow cytometry. | 21 days after cycle 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Interleukin-2 (IL-2) and IL-2 Receptor (IL-2R) Expression in Tumor Samples by Immunohistochemical (IHC) Analysis | The incidence of IL-2 expression and its receptor complex, IL-2R in tumor samples will be evaluated by IHC analysis. Tumor sections will be interpreted as either positive or negative. | 21 days after cycle 6 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lupe Salazar | Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Seattle | Washington | 98109 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | ONTAK | Patients receive ONTAK IV over 1 hour on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. ONTAK: Given IV flow cytometry: Correlative studies immunohistochemistry staining method: Correlative studies enzyme-linked immunosorbent assay: Correlative studies laboratory biomarker analysis: Correlative studies protein expression analysis: Correlative studies |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| flow cytometry | Other | Correlative studies |
|
| immunohistochemistry staining method | Other | Correlative studies |
|
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| enzyme-linked immunosorbent assay | Other | Correlative studies |
|
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| laboratory biomarker analysis | Other | Correlative studies |
|
| protein expression analysis | Genetic | Correlative studies |
|
| Presence of Circulating sIL-2R in the Peripheral Blood |
Evaluate levels of circulating sIL-2R (pg/ml) in the peripheral blood assessed before and after ONTAK therapy. Changes from baseline will be tabulated. |
| 21 days after cycle 6 |
| Presence of Endogenous Tumor-specific Immunity | Evaluate the effect of ONTAK on endogenous tumor specific immunity | 21 days after cycle 6 |
| Anti-tumor Effects of ONTAK Determined by Tumor Response and Progression | Anti-tumor effects of ONTAK will be determined by evaluating tumor response and progression per RECIST. An objective response to ONTAK will be defined as achieving a CR or PR. Analysis of the data will include determination of complete (CR) and partial response (PR) rates, as well as stable (SD) and progressive disease (PD). | 21 days after cycle 6 |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm I | Patients receive ONTAK IV over 1 hour on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. ONTAK: Given IV flow cytometry: Correlative studies immunohistochemistry staining method: Correlative studies enzyme-linked immunosorbent assay: Correlative studies laboratory biomarker analysis: Correlative studies protein expression analysis: Correlative studies |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||||
| Region of Enrollment | Count of Participants | Participants |
|
| 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 | Safety Evaluated by Collecting Study Related Toxicity as Assessed by CTCAE v3.0 | Subjects are monitored for the development of end organ damage by assessing adverse events with serum chemistries, liver function studies, serum albumin, complete blood counts, symptom assessment, and physical exams performed at every cycle until 3 weeks after the final dose of ONTAK. All adverse events for all systems are graded on a scale of 1-5 using CTCAE v3.0. | Posted | Count of Participants | Participants | 7 Days after last dose of ONTAK |
|
|
| |||||||||||||||||||||||||||
| Primary | Efficacy of ONTAK in Depleting T-regulatory Cells as a Decrease in Peripheral Blood Tregs Using Flow Cytometry | The efficacy of ONTAK in depleting Tregs will be defined as a decrease in peripheral blood Tregs by 25% of each individual subject's baseline. All subjects will undergo blood draws at baseline and post ONTAK infusions at designated time points. Tregs from the peripheral blood will be quantitated using flow cytometry. | 14 patients equals patients that had repeat blood draws taken but did not complete the treatment except for 4 patients who completed the study | Posted | Count of Participants | Participants | 21 days after cycle 6 |
|
| |||||||||||||||||||||||||||
| Secondary | Incidence of Interleukin-2 (IL-2) and IL-2 Receptor (IL-2R) Expression in Tumor Samples by Immunohistochemical (IHC) Analysis | The incidence of IL-2 expression and its receptor complex, IL-2R in tumor samples will be evaluated by IHC analysis. Tumor sections will be interpreted as either positive or negative. | Posted | Count of Participants | Participants | 21 days after cycle 6 |
|
| ||||||||||||||||||||||||||||
| Secondary | Presence of Circulating sIL-2R in the Peripheral Blood | Evaluate levels of circulating sIL-2R (pg/ml) in the peripheral blood assessed before and after ONTAK therapy. Changes from baseline will be tabulated. | 4/14 patients had peripheral blood available before and after ONTAK treatment. | Posted | Median | Full Range | pg/ml | 21 days after cycle 6 |
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| ||||||||||||||||||||||||||
| Secondary | Presence of Endogenous Tumor-specific Immunity | Evaluate the effect of ONTAK on endogenous tumor specific immunity | Posted | Count of Participants | Participants | 21 days after cycle 6 |
|
| ||||||||||||||||||||||||||||
| Secondary | Anti-tumor Effects of ONTAK Determined by Tumor Response and Progression | Anti-tumor effects of ONTAK will be determined by evaluating tumor response and progression per RECIST. An objective response to ONTAK will be defined as achieving a CR or PR. Analysis of the data will include determination of complete (CR) and partial response (PR) rates, as well as stable (SD) and progressive disease (PD). | Posted | Count of Participants | Participants | 21 days after cycle 6 |
|
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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 receive ONTAK IV over 1 hour on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. ONTAK: Given IV flow cytometry: Correlative studies immunohistochemistry staining method: Correlative studies enzyme-linked immunosorbent assay: Correlative studies laboratory biomarker analysis: Correlative studies protein expression analysis: Correlative studies | 1 | 15 | 15 | 15 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Severe Nausea and Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Allergic Reaction/Hypersensitivity | Investigations | CTCAE (3.0) | Systematic Assessment |
| |
| Tinnitus | Ear and labyrinth disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Other - Ringing in Ear | Ear and labyrinth disorders | CTCAE (3.0) | Systematic Assessment |
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| Hemoglobin Abnormal | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Lymphopenia | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
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| Platelets Abnormal | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Leukocytes Abnormal | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| ANC/AGC Abnormal | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Blood and Lymphatic System Disorders - Other | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | RBC Low |
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| Blood and Lymphatic System Disorders - Other | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | MCV and MCH High |
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| Blood and Lymphatic System Disorders - Other | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | HCT Low |
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| Cardiac Arrhythmia | Cardiac disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Hypotension | Vascular disorders | CTCAE (3.0) | Systematic Assessment |
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| Hypertension | Cardiac disorders | CTCAE (3.0) | Systematic Assessment |
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| Fatigue | General disorders | CTCAE (3.0) | Systematic Assessment |
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| Rigors/Chills | General disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Insomnia | Psychiatric disorders | CTCAE (3.0) | Systematic Assessment |
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| Fever | General disorders | CTCAE (3.0) | Systematic Assessment |
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| Weight Gain | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Weight Loss | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Rash/Desquamation | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Rash: Acne/Acneiform | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Flushing | Vascular disorders | CTCAE (3.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Anorexia | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Gastritis | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
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| Taste Alteration (dysgeusia) | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Infection - Toe | Infections and infestations | CTCAE (3.0) | Systematic Assessment |
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| Edema: Limb | Vascular disorders | CTCAE (3.0) | Systematic Assessment |
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| AST Abnormal | Investigations | CTCAE (3.0) | Systematic Assessment |
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| ALT Abnormal | Investigations | CTCAE (3.0) | Systematic Assessment |
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| Hypocalcemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Hypoalbuminemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Hypokalemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Creatinine Abnormal | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Alkaline Phosphatase Abnormal | Investigations | CTCAE (3.0) | Systematic Assessment |
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| Hypoglycemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Hypoproteinemia | Investigations | CTCAE (3.0) | Systematic Assessment |
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| Hyponatremia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Alkalosis (metabolic or respiratory) | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Hyperbilirubinemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Chloride High | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Muscle Weakness | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Leg Cramps | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Neuropathy: Sensory | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Mood Alteration | Psychiatric disorders | CTCAE (3.0) | Systematic Assessment |
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| Confusion | Psychiatric disorders | CTCAE (3.0) | Systematic Assessment |
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| Ataxia (incoordination) | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Neuropathy: Motor | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Loss of Acuity Related to Illness | Eye disorders | CTCAE (3.0) | Systematic Assessment |
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| Vitreous Detachment | Eye disorders | CTCAE (3.0) | Systematic Assessment |
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| Vision Blurred - Vision | Eye disorders | CTCAE (3.0) | Systematic Assessment |
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| Watery Eye | Eye disorders | CTCAE (3.0) | Systematic Assessment |
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| Headache | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Pain - Chest Wall | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain - Back | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain - Muscle | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain - Bone | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Abdomen NOS | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Extremity | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain - Arm | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain - Musculoskeletal - Extremity | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain - Rib | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
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| Throat/Pharynx/Larynx | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Pain - Tightness in Shoulders Secondary to Benadryl IV | General disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Dyspnea (Shortness of Breath) | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Rhinitis | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Pleural Effusion (non-malignant) | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Pulmonary Fibrosis (radiologic changes) | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Flu-Like Syndrome | General disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Acute Vascular Leak Syndrome | Vascular disorders | CTCAE (3.0) | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Principal Investigator | University of Washington | TrialTVG@medicine.washington.edu |
| ID | Term |
|---|---|
| D018567 | Breast Neoplasms, Male |
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C078456 | denileukin diftitox |
| D005434 | Flow Cytometry |
| D007150 | Immunohistochemistry |
| D004797 | Enzyme-Linked Immunosorbent Assay |
| ID | Term |
|---|---|
| D002469 | Cell Separation |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D003592 | Cytophotometry |
| D005470 | Fluorometry |
| D008163 | Luminescent Measurements |
| D010783 | Photometry |
| D002623 | Chemistry Techniques, Analytical |
| D008919 | Investigative Techniques |
| D006651 | Histocytochemistry |
| D006652 | Histological Techniques |
| D007158 | Immunologic Techniques |
| D007124 | Immunoenzyme Techniques |
| D007118 | Immunoassay |
| D007163 | Immunosorbent Techniques |
| D015336 | Molecular Probe Techniques |
Not provided
Not provided
| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
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