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Therapeutic Autologous Lymphocytes, Aldesleukin, and Denileukin Diftitox in Treating Patients With Stage III-IV Melanoma

Information source: Fred Hutchinson Cancer Research Center
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Recurrent Melanoma; Stage III Melanoma; Stage IV Melanoma

Intervention: therapeutic autologous lymphocytes (Biological); aldesleukin (Biological); denileukin diftitox (Biological); biopsy (Procedure); immunohistochemistry staining method (Other); laboratory biomarker analysis (Other); polymerase chain reaction (Genetic)

Phase: Phase 1/Phase 2

Status: Terminated

Sponsored by: Fred Hutchinson Cancer Research Center

Official(s) and/or principal investigator(s):
Sylvia Lee, Principal Investigator, Affiliation: Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Summary

RATIONALE: White blood cells that have been treated in a laboratory may be able to kill tumor cells in patients with melanoma. Aldesleukin and denileukin diftitox may stimulate the white blood cells to kill melanoma cells. Giving therapeutic autologous lymphocyte therapy together with aldesleukin and denileukin diftitox may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects of giving therapeutic autologous lymphocytes together with aldesleukin and denileukin diftitox and to see how well it works in treating patients with stage III-IV melanoma

Clinical Details

Official title: Phase I/II Study To Evaluate The Safety Of Cellular Adoptive Immunotherapy Using Autologous CD8+ Antigen-Specific T Cell Clones Following CD25 Lymphodepletion For Patients With Metastatic Melanoma

Study design: Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: In vivo survival of CD8+ transferred T-clones

Detailed description: PRIMARY OBJECTIVES: I. Assess the safety of cellular adoptive immunotherapy in melanoma patients using autologous CD8+ antigen-specific T-cell clones following CD25 lymphodepletion. II. Determine the influence of CD25 lymphodepletion on the duration of in vivo persistence of adoptively transferred CD8+ antigen-specific cytotoxic T-cell (CTL) clones. SECONDARY OBJECTIVES: I. Assess the anti-tumor efficacy of cellular adoptive immunotherapy in melanoma patients using autologous CD8+ antigen-specific T cell clones following CD25 lymphodepletion. II. Evaluate the induction of T cells to non-targeted tumor-associated antigens (antigen-spreading) following adoptive transfer of CD8+ antigen-specific CTL and CD25 lymphodepletion. OUTLINE: This is a phase I study followed by a phase II study. Patients receive autologous T-cell intravenously (IV) over 30-60 minutes on days 0 and 28 and low-dose aldesleukin subcutaneously (SC) twice daily on days 0 to 13 and 28 to 41. Beginning 4-6 days before second T- cell infusion, patients receive denileukin diftitox IV over 30 minutes on days 1-3. Treatment continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 4 weeks, 8 weeks, and then every 3 months thereafter.

Eligibility

Minimum age: 18 Years. Maximum age: 75 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Histopathological documentation of melanoma

- Expression of human leukocyte antigen (HLA)-A2 or B44 as determined by HLA typing lab

- Patients whose tumor expresses targeted antigen and restricting allele against which

CD8 T cell clones can be generated

- Karnofsky Performance status of at least 80% and an expected survival of greater than

6 months

- Bi-dimensionally measurable disease by palpation on clinical exam, or radiographic

imaging (X-ray, computed tomography [CT] scan)

- Normal cardiac stress test (treadmill, echocardiogram, or myocardial perfusion scan)

within 182 days prior to enrollment is required of patients with a history of cardiac disease

- Pulse > 45 or < 120

- Weight >= 45 kg

- Temperature =< 38C (< 100. 4 F)

- White blood cells (WBC) >= 3,000

- Hematocrit (HCT) >= 30%

- Platelets >= 100,000

- Patients must be willing and able to discontinue the use of all antihypertensive

medications 24 hours prior to and during IL2 therapy Exclusion Criteria:

- Pregnant women, nursing mothers, or women of reproductive ability who are unwilling

to use effective contraception or abstinence

- Serum creatinine > 1. 6mg/dL

- Creatinine clearance < 75 ml/min

- Aspartate aminotransferase (AST) > 2. 5 x upper limit of normal

- Alanine aminotransferase (ALT) > 2. 5 x upper limit of normal

- Bilirubin > 1. 6 or international normalized ratio (INR) > 1. 5 due to hepatic

dysfunction

- Albumin < 3. 0g/dL

- Clinically significant pulmonary dysfunction, as determined by medical history and

physical exam; patients so identified will undergo pulmonary functions testing and those with Forced expiratory volume in one second (FEV1) < 80% predicted or diffusing capacity of the lung for carbon monoxide (DLco) (corr for hemoglobin [Hgb]) < 75% will be excluded

- Significant cardiovascular abnormalities as defined by any one of the following:

congestive heart failure, symptoms of coronary artery disease

- Symptomatic central nervous system (CNS) metastases greater than 1 cm at time of

therapy; patients with 1-2 asymptomatic, less than 1cm brain/CNS metastases without significant edema may be considered for treatment

- Patients with active infections or oral temperature > 38. 2 C within 48 hours of study

entry or systemic infection requiring chronic maintenance or suppressive therapy

- Chemotherapeutic agents (standard or experimental), radiation therapy, or other

immunosuppressive therapies less than 3 weeks prior to T cell therapy)

- Concurrent treatment with steroids

- Patients must not be receiving any other experimental drugs within 3 weeks of the

initiation of the protocol and must have recovered from all side effects of such therapy

- The following agents are not allowed while on study: systemic corticosteroids (except

as outlined for management of toxicity of nontransduced CTL), immunotherapy (for example, interleukins, interferons, melanoma vaccines, intravenous immunoglobulin, expanded polyclonal TIL or LAK therapy), pentoxifylline, or other investigational agents

Locations and Contacts

Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium, Seattle, Washington 98109, United States
Additional Information

Starting date: July 2009
Last updated: December 2, 2011

Page last updated: August 23, 2015

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