Decitabine, Vaccine Therapy, and Pegylated Liposomal Doxorubicin Hydrochloride in Treating Patients With Recurrent Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Peritoneal Cancer

NCT01673217CompletedPHASE1INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Roswell Park Cancer Institute

Enrollment

18

Start Date

2009-04-01

Completion Date

2011-10-01

Study Type

INTERVENTIONAL

Official Title

A Phase I Clinical Trial of NY-ESO-1 Protein Immunization in Combination With 5-AZA-2'-Deoxycytidine (Decitabine) in Patients Receiving Liposomal Doxorubicin for Recurrent Epithelial Ovarian or Primary Peritoneal Carcinoma

Interventions

decitabineNY-ESO-1 peptide vaccinepegylated liposomal doxorubicin hydrochloridesargramostimincomplete Freund's adjuvantimmunohistochemistry staining methodliquid chromatographymass spectrometryreverse transcriptase-polymerase chain reactionlaboratory biomarker analysisDNA methylation analysisenzyme-linked immunosorbent assay

Conditions

Recurrent Fallopian Tube CancerRecurrent Ovarian Epithelial CancerRecurrent Primary Peritoneal Cavity Cancer

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

* Subjects with relapsed epithelial ovarian cancer (including fallopian tube and primary peritoneal cancer) who will receive liposomal doxorubicin as salvage therapy for recurrent disease
* Patients may have received up to four previous lines of chemotherapy
* The relapse may be defined by an increase in CA125; there may or may not be either measurable or symptomatic disease
* Any human leukocyte antigen (HLA) type
* No requirement for tumor expression of NY-ESO-1
* Karnofsky performance status of \> 70%
* Not previously treated with doxorubicin
* Life expectancy \>= 6 months
* Hematology and biochemistry laboratory results within the limits normally expected for the patient population, without evidence of major organ failure
* No immunodeficiency
* Have been informed of other treatment options
* Able and willing to give valid written informed consent
* Neutrophil count \>= 1.5 x 10\^9
* Platelet count \>= 100 x 10\^9
* Serum creatinine =\< 2.1 mg/dL
* Serum bilirubin =\< 2 mg/dL
* Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 2.6 x upper limit of normal (ULN) (normal ranges: AST 15-46 U/L; ALT 11-66 U/L)

Exclusion Criteria:

* Metastatic disease to the central nervous system for which other therapeutic options, including radiotherapy, may be available
* Other serious illnesses (e.g., serious infections requiring antibiotics, bleeding disorders)
* History of autoimmune disease (e.g., thyroiditis, lupus) except vitiligo
* Concomitant systemic treatment with corticosteroids, anti-histamine or non-steroidal anti-inflammatory drugs; specific CQX-2 inhibitors are permitted
* Chemotherapy, radiation therapy, or immunotherapy within 4 weeks prior to first dosing of study agent (6 weeks for nitrosoureas)
* Known human immunodeficiency virus (HIV) positivity
* Known allergy or history of life threatening reaction to GM-CSF
* Myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack, chest pain or shortness of breath with activity, or other heart conditions being treated by a doctor
* Participation in any other clinical trial involving another investigational agent within 4 weeks prior to first dosing of study agent
* Mental impairment that may compromise the ability to give informed consent and comply with the requirements of the study
* Lack of availability of a patient for immunological and clinical follow-up assessment

Outcome Measures

Primary Outcomes

Toxicity as assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v3.0

Estimated with a one-sided, 95%, Wilson score binomial confidence interval.

Time frame: Up to 6 months

Secondary Outcomes

NY-ESO-1 specific cellular and humoral immunity as assessed by NY-ESO-1-specific CD8+ and CD4+ T cells and antibodies and frequency of CD4+ CD25+ FOXP3+ regulatory T cells

Will be summarized by quartiles. Also, confidence intervals will be constructed for the median and the mean.

Time frame: Up to 6 months

NY-ESO-l expression using Q-RT-PCR and IHC

Time frame: Days 1, 8, 15, 36, 43, 64, 71, 92, and 99

Time to progression

Summarized by a Kaplan-Meier survival curve.

Time frame: Up to 6 months

NY-ESO-l promoter DNA methylation using pyrosequencing

Time frame: Days 1, 8, 15, 36, 43, 64, 71, 92, and 99

Global genomic DNA methylation using liquid chromatography-mass spectrometry (LC-MS) and LINE-l pyrosequencing

Time frame: Days 1, 8, 15, 36, 43, 64, 71, 92, and 99

Locations

Roswell Park Cancer Institute, Buffalo, United States