Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| P30CA006973 | U.S. NIH Grant/Contract | View source | |
| JHOC-J0947 | |||
| NA_00024527 | |||
| GENENTECH-JHOC-J0947 | |||
| CDR0000653173 | Other Identifier | other |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
RATIONALE: Vaccines made from gene-modified tumor cells may help the body build an effective immune response to kill tumor cells. Biological therapies, such as cyclophosphamide and trastuzumab, may increase the number of immune cells and make the immune response stronger. It is not yet known whether giving cyclophosphamide together with vaccine therapy is more effective with or without trastuzumab in treating patients with metastatic breast cancer.
PURPOSE: This randomized phase II trial is studying the side effects of giving cyclophosphamide together with vaccine therapy and to see how well it works compared with giving cyclophosphamide and vaccine therapy together with trastuzumab in treating patients with metastatic breast cancer.
OBJECTIVES:
Primary
Secondary
Tertiary
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
Skin punch and lymph node biopsies are collected at baseline and on days +3 and +7 of courses 1 and 3 for biomarker analysis.
After completion of study treatment, patients are followed periodically.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cyclophosphamide and Vaccine only | Active Comparator | Patients receive cyclophosphamide IV over 30 minutes on day -1 and allogeneic GM-CSF-secreting breast cancer vaccine intradermally on day 0. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. |
|
| Cyclophosphamide, Vaccine and Trastuzumab | Experimental | Patients receive cyclophosphamide and the vaccine as in arm I and trastuzumab IV over 30-90 minutes on day -1. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| allogeneic GM-CSF-secreting breast cancer vaccine | Biological | Given intradermally |
|
| Measure | Description | Time Frame |
|---|---|---|
| Toxicity as Assessed by Number of Grade 3 or 4 Adverse Events | Number of grade 3 or 4 nonhematologic toxicity (except alopecia), or any grade 4 hematologic toxicity as defined by NCI CTCAE v3.0 | 3 years |
| Clinical Benefit (CB) as Assessed by Progression Free Survival at Six Months | Progression-free survival is measured as percentage of participants with stable disease or complete response, as defined by RECIST criteria, six months after receiving last vaccination. Progressive disease (PD) will be defined by the appearance of a new lesion, or by an increase of at least 20% in the sum of the longest diameter of target lesions, taking as a reference that smallest sum longest diameter recorded since the study intervention began. In the case of bone lesions, progressive disease will be established after eight weeks of increasing or new lesions if there is subjective progressive disease as noted by increasing bone pain or decreasing performance status. These observations must be present for at least two measurement periods separated by at least four weeks. | 6 months post-intervention |
| HER-2/Neu-specific Immune Responses as Measured by Number of Participants With Positive for Delayed-type Hypersensitivity (DTH) Response | 3 years | |
| Pharmacodynamics of Peripheral CD4+CD25+ Regulatory T Cells | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Immune Priming in In-vivo Vaccine-site Biopsies | 3 years | |
| Enumeration of CD8+ T Cells Specific for hTERT by ELISPOT | 3 years | |
| Characterization of the T-cell Memory Pool Pre- and Post-vaccination |
Not provided
DISEASE CHARACTERISTICS:
Histologically confirmed adenocarcinoma of the breast
Must not be eligible for therapy of known curative potential for metastatic breast cancer
Measurable or evaluable disease
Stable CNS disease allowed provided that it's adequately treated and not under active treatment
Hormone receptor status not specified
PATIENT CHARACTERISTICS:
Menopausal status not specified
ECOG performance status 0-1
ANC > 1,000/mm^3
Platelets > 100,000/mm^3
Serum bilirubin < 2.0 mg/dL (unless due to Gilbert syndrome)
AST and ALT < 2 times upper limit of normal (ULN)
Alkaline phosphatase < 5 times ULN
Serum creatinine < 2.0 mg/dL
Ejection fraction normal by MUGA OR ≥ 50% by echocardiogram
Not pregnant or nursing
Fertile patients must use effective contraception
HIV negative
Asthma or chronic obstructive pulmonary disease that does not require daily systemic corticosteroids allowed
No prior or concurrent autoimmune disease requiring management with systemic immunosuppression, including any of the following:
No other malignancies within the past 5 years, except carcinoma in situ of the cervix, superficial nonmelanoma skin cancer, superficial bladder cancer, or tamoxifen-related endometrial cancer that has been adequately treated
No active major medical or psychosocial problems that could be complicated by study participation
No symptomatic intrinsic lung disease or extensive tumor involvement of the lungs resulting in dyspnea at rest
No uncontrolled medical problems
No evidence of active acute or chronic infection
No known severe hypersensitivity to trastuzumab, except mild to moderate infusion reactions that are easily managed and do not recur
No allergy to corn
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
More than 28 days since prior and no other concurrent chemotherapy, radiation therapy, or biologic therapy (except trastuzumab)
More than 28 days since prior and no other concurrent participation in an investigational new drug trial
More than 28 days since prior and no other concurrent systemic oral steroids
No prior vaccination with the allogeneic GM-CSF-secreting breast tumor vaccine
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Leisha A. Emens, MD, PhD | Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore | Maryland | 21231-2410 | United States |
3 subjects were withdrawn prior to receiving intervention (2 due to development of new medical problems, 1 due to anxiety and non-compliance).
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Cyclophosphamide and Vaccine Only | Patients receive cyclophosphamide IV over 30 minutes on day -1 and allogeneic GM-CSF-secreting breast cancer vaccine intradermally on day 0. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally cyclophosphamide: Given IV |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| trastuzumab | Biological | Given IV |
|
| cyclophosphamide | Drug | Given IV |
|
| 3 years |
| FG001 | Cyclophosphamide, Vaccine and Trastuzumab | Patients receive cyclophosphamide and the vaccine as in arm I and trastuzumab IV over 30-90 minutes on day -1. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally trastuzumab: Given IV cyclophosphamide: Given IV |
| COMPLETED |
|
| NOT COMPLETED |
|
63 subjects were deemed eligible for this study. 2 were taken off-study prior to vaccination due to the development of new medical problems. 1 subject was taken off due to anxiety and non-compliance. 60 research subjects went on to receive at least 1 vaccination, where 30 subjects were randomized to Arm A and 30 subjects were randomized to Arm B.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Cyclophosphamide and Vaccine Only | Patients receive cyclophosphamide IV over 30 minutes on day -1 and allogeneic GM-CSF-secreting breast cancer vaccine intradermally on day 0. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally cyclophosphamide: Given IV |
| BG001 | Cyclophosphamide, Vaccine and Trastuzumab | Patients receive cyclophosphamide and the vaccine as in arm I and trastuzumab IV over 30-90 minutes on day -1. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally trastuzumab: Given IV cyclophosphamide: Given IV |
| BG002 | Total | Total of all reporting groups |
| 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 |
| ||||||||||||||||||
| Age, Continuous | Mean | Full Range | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | 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 | Toxicity as Assessed by Number of Grade 3 or 4 Adverse Events | Number of grade 3 or 4 nonhematologic toxicity (except alopecia), or any grade 4 hematologic toxicity as defined by NCI CTCAE v3.0 | Data was not evaluable in 2/30 participants from the cyclophosphamide and vaccine-only arm. | Posted | Number | adverse events | 3 years |
|
|
| |||||||||||||||||||||||||||||
| Primary | Clinical Benefit (CB) as Assessed by Progression Free Survival at Six Months | Progression-free survival is measured as percentage of participants with stable disease or complete response, as defined by RECIST criteria, six months after receiving last vaccination. Progressive disease (PD) will be defined by the appearance of a new lesion, or by an increase of at least 20% in the sum of the longest diameter of target lesions, taking as a reference that smallest sum longest diameter recorded since the study intervention began. In the case of bone lesions, progressive disease will be established after eight weeks of increasing or new lesions if there is subjective progressive disease as noted by increasing bone pain or decreasing performance status. These observations must be present for at least two measurement periods separated by at least four weeks. | Data was not evaluable in 2/30 participants from the cyclophosphamide and vaccine-only arm. | Posted | Number | 95% Confidence Interval | percentage of participants | 6 months post-intervention |
| ||||||||||||||||||||||||||||||
| Primary | HER-2/Neu-specific Immune Responses as Measured by Number of Participants With Positive for Delayed-type Hypersensitivity (DTH) Response | Data was not evaluable in 2/30 participants from the cyclophosphamide and vaccine-only arm. | Posted | Count of Participants | Participants | 3 years |
|
| |||||||||||||||||||||||||||||||
| Primary | Pharmacodynamics of Peripheral CD4+CD25+ Regulatory T Cells | Lab analysis could not be completed due to loss of funding, therefore data was not collected to assess this outcome measure. | Posted | 3 years |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Immune Priming in In-vivo Vaccine-site Biopsies | Lab analysis could not be completed due to loss of funding, therefore data was not collected to assess this outcome measure | Posted | 3 years |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Enumeration of CD8+ T Cells Specific for hTERT by ELISPOT | Lab analysis could not be completed due to loss of funding, therefore data was not collected to assess this outcome measure. | Posted | 3 years |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Characterization of the T-cell Memory Pool Pre- and Post-vaccination | Lab analysis could not be completed due to loss of funding, therefore data was not collected to assess this outcome measure. | Posted | 3 years |
|
|
up to 6 months post-intervention
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cyclophosphamide and Vaccine Only | Patients receive cyclophosphamide IV over 30 minutes on day -1 and allogeneic GM-CSF-secreting breast cancer vaccine intradermally on day 0. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally cyclophosphamide: Given IV | 0 | 30 | 0 | 30 | 30 | 30 |
| EG001 | Cyclophosphamide, Vaccine and Trastuzumab | Patients receive cyclophosphamide and the vaccine as in arm I and trastuzumab IV over 30-90 minutes on day -1. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally trastuzumab: Given IV cyclophosphamide: Given IV | 0 | 30 | 0 | 30 | 30 | 30 |
Not provided
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Erythema/swelling of vaccine sites | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Pain/soreness/tenderness of vaccine sites | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Pruritus of vaccine sites | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Rash around vaccine sites | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Blister at vaccine site | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Ecchymosis at vaccine site | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Hyperpigmentation at vaccine site | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Warmth at vaccine site | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Anorexia | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Aphthus Ulcers | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Arthralgia | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
| ||
| Bruising | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Chills | General disorders | Non-systematic Assessment |
| ||
| Constipation | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Dermatographism | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Dizziness | Nervous system disorders | Non-systematic Assessment |
| ||
| Dry throat | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Eczema | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Erythema | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Fatigue | General disorders | Non-systematic Assessment |
| ||
| Fever | General disorders | Non-systematic Assessment |
| ||
| Flatulence | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Flu-like symptoms | General disorders | Non-systematic Assessment |
| ||
| Headache | Nervous system disorders | Non-systematic Assessment |
| ||
| Hypotension | Cardiac disorders | Non-systematic Assessment |
| ||
| Indigestion | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Infection, Herpes | Infections and infestations | Non-systematic Assessment |
| ||
| Insomnia | Psychiatric disorders | Non-systematic Assessment |
| ||
| Lymphadenopathy | Blood and lymphatic system disorders | Non-systematic Assessment |
| ||
| Malaise | General disorders | Non-systematic Assessment |
| ||
| Mucositis | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Myalgia | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Neck stiffness | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
| ||
| Pain, bone | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
| ||
| Pain, hip/groin | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
| ||
| Pruritis | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Rash | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Sweats | General disorders | Non-systematic Assessment |
| ||
| Urticaria | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Vaccine flare | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Vomiting | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Hives | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
|
Not provided
Not provided
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Leisha Emens, MD, PhD | Johns Hopkins University | emensle@jhmi.edu |
| 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 |
Not provided
Not provided
| ID | Term |
|---|---|
| D000068878 | Trastuzumab |
| D003520 | Cyclophosphamide |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
Not provided
Not provided
| >=65 years |
|
| Male |
|
Patients receive cyclophosphamide and the vaccine as in arm I and trastuzumab IV over 30-90 minutes on day -1. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. allogeneic GM-CSF-secreting breast cancer vaccine: Given intradermally trastuzumab: Given IV cyclophosphamide: Given IV |
|
|
| Participants |
|
|
|
|
|