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| ID | Type | Description | Link |
|---|---|---|---|
| BAMC-C.2007.098 | Other Identifier | BAMC Institutional Review Board | |
| WRNMMC-20225 | Other Identifier | WRNMMC Institutional Review Board |
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| Name | Class |
|---|---|
| NuGenerex Immuno-Oncology | INDUSTRY |
| Norwell, Inc. | INDUSTRY |
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RATIONALE: Vaccines made from peptides may help the body build an effective immune response to kill tumor cells that express HER2/neu. Biological therapies, such as GM-CSF, may stimulate the immune system in different ways and stop tumor cells from growing. It is not yet known whether vaccine therapy is more effective than GM-CSF in treating breast cancer.
PURPOSE: This randomized phase II trial is studying vaccine therapy to see how well it works compared with GM-CSF in treating patients with breast cancer.
OBJECTIVES:
OUTLINE: This is a multicenter study. Patients are stratified according to nodal status. Patients are randomized to 1 of 4 treatment arms.
After completion of study therapy, patients are followed every 3 months for the first 24 months and then every 6 months for an additional 36 months.
Booster inoculations are administered at 12, 18, 24, and 30 months from the date of patients' enrollment into the study. One booster inoculation is administered at each timepoint (+/- 2 weeks) and will be the same inoculation (vaccine or GM-CSF only) as what patients received during their regular inoculation series.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm I | Experimental | HLA-A2-positive patients receive GP2 peptide + GM-CSF vaccine intradermally (ID) every 3-4 weeks for a total of up to 6 inoculations. |
|
| Arm II | Active Comparator | HLA-A2-positive patients receive GM-CSF ID every 3-4 weeks for a total of up to 6 inoculations. |
|
| Arm III | Experimental | HLA-A2-negative patients receive AE37 peptide/GM-CSF vaccine ID every 3-4 weeks for a total of up to 6 inoculations. |
|
| Arm IV | Active Comparator | HLA-A2-negative patients receive GM-CSF ID ID every 3-4 weeks for a total of up to 6 inoculations |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GP2 peptide + GM-CSF vaccine | Biological | Given intradermally every 3-4 weeks for a total of up to 6 inoculations |
|
| Measure | Description | Time Frame |
|---|---|---|
| Disease recurrence | The following will be compared:
| Five years (from date of enrollment to the study through the end of the follow-up period) |
| Measure | Description | Time Frame |
|---|---|---|
| Safety | Inoculations will be immediately halted if any serious adverse reactions occur which, when based upon appropriate judgment of the PI, are determined to jeopardize the patient or require medical or surgical intervention. Any death or grade 4 adverse drug experience found to be directly related to the experimental vaccine will result in suspension of patient enrollment to the study. | Local and systemic reactions to each inoculation will be monitored every six months during the regular inoculation series and the booster series. |
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DISEASE CHARACTERISTICS:
Inclusion criteria:
Lymph node-positive breast cancer or high-risk lymph node-negative breast cancer. The latter is defined by any one of the following criteria:
HER2/neu-expressing tumor (IHC 1-3+ and or positive FISH >1.2)
Completion of primary standard of care breast cancer therapies (i.e., surgery, chemotherapy, immunotherapy and radiation therapy as appropriate per standard of care for patients' specific cancer)
Clinically cancer-free (no evidence of disease)
Patients may be enrolled between 1-6 months from completion of standard primary breast cancer therapies
Good performance status (as defined in Exclusion Criteria)
Capable of informed consent
Exclusion criteria:
PATIENT CHARACTERISTICS:
Inclusion criteria:
Exclusion criteria:
PRIOR CONCURRENT THERAPY:
Inclusion criteria:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Elizabeth A Mittendorf, MD, FACS | UT M.D. Anderson Cancer Center | Principal Investigator |
| George E Peoples, MD, FACS | Cancer Vaccine Development Program, Department of Surgery, Brooke Army Medical Center | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sibley Memorial Hospital | Washington D.C. | District of Columbia | 20016 | United States | ||
| University of Hawaii Cancer Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21692698 | Background | Mittendorf EA, Alatrash G, Xiao H, Clifton GT, Murray JL, Peoples GE. Breast cancer vaccines: ongoing National Cancer Institute-registered clinical trials. Expert Rev Vaccines. 2011 Jun;10(6):755-74. doi: 10.1586/erv.11.59. | |
| 21895539 | Result | Sears AK, Perez SA, Clifton GT, Benavides LC, Gates JD, Clive KS, Holmes JP, Shumway NM, Van Echo DC, Carmichael MG, Ponniah S, Baxevanis CN, Mittendorf EA, Papamichail M, Peoples GE. AE37: a novel T-cell-eliciting vaccine for breast cancer. Expert Opin Biol Ther. 2011 Nov;11(11):1543-50. doi: 10.1517/14712598.2011.616889. Epub 2011 Sep 6. |
| Label | URL |
|---|---|
| Clinical trial summary from the National Cancer Institute's PDQ® database | View source |
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| GM-CSF (sargramostim) | Biological | GM-CSF given intradermally very 3-4 weeks for a total of up to 6 inoculations |
|
| AE37 + GM-CSF vaccine | Biological | Given intradermally every 3-4 weeks for a total of up to 6 inoculations |
|
|
| GM-CSF (sargramostim) | Biological | Given intradermally every 3-4 weeks for a total of up to 6 inoculations |
|
| Immune Response | Immune response will be measured by proliferation assays, dimer assays, and ELISPOT. Delayed type hypersensitivity reactions will be compared between the vaccinated group and GM-CSF-only group. | Immune response will be measured after every monthly inoculation in the regular inoculation series and after each inoculation in the booster series |
| Honolulu |
| Hawaii |
| 96813 |
| United States |
| MedStar Union Memorial Hospital | Baltimore | Maryland | 21218 | United States |
| MedStar Good Samaritan Hospital Cancer Center | Baltimore | Maryland | 21239 | United States |
| Walter Reed National Military Medical Center | Bethesda | Maryland | 20889 | United States |
| Wake Forest University Comprehensive Cancer Center | Winston-Salem | North Carolina | 27157-1096 | United States |
| Carl R. Darnall Army Medical Center | Fort Hood | Texas | 76544-4752 | United States |
| San Antonio Army Medical Center | Fort Sam Houston | Texas | 78234-6200 | United States |
| University of Texas MD Anderson Cancer Center | Houston | Texas | 77030-4009 | United States |
| STOH Clinical Research | San Antonio | Texas | 78229 | United States |
| Madigan Army Medical Center - Tacoma | Tacoma | Washington | 98431-5000 | United States |
| Landstuhl Regional Medical Center | Landstuhl | Kirchberg | 66849 | Germany |
| Saint Savas Cancer Hospital of Athens | Athens | 11522 | Greece |
| 30025819 | Derived | Jackson DO, Trappey FA, Clifton GT, Vreeland TJ, Peace KM, Hale DF, Litton JK, Murray JL, Perez SA, Papamichail M, Mittendorf EA, Peoples GE. Effects of HLA status and HER2 status on outcomes in breast cancer patients at risk for recurrence - Implications for vaccine trial design. Clin Immunol. 2018 Oct;195:28-35. doi: 10.1016/j.clim.2018.06.008. Epub 2018 Jul 17. |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D018567 | Breast Neoplasms, Male |
| 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 |
|---|---|
| D016178 | Granulocyte-Macrophage Colony-Stimulating Factor |
| C081222 | sargramostim |
| ID | Term |
|---|---|
| D003115 | Colony-Stimulating Factors |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D016298 | Hematopoietic Cell Growth Factors |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
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