Phase I/II Study of Aerosol Interleukin-2 for Pulmonary Metastases
Trial Snapshot
- Phase
- Phase 1
- Status
- Active, not recruiting
- Sponsor
- M.D. Anderson Cancer Center
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- Maximum tolerated dose, defined as the highest dose level with six patients with at most one dose limiting toxicity, using the CTCAE v4.0 (Phase I)
Study Overview
Brief Summary
This phase I/II trial studies the side effects and best dose of aerosolized aldesleukin and to see how well it works in treating patients with cancer that has spread from the original tumor to the lungs. Biological therapies, such as aerosolized aldesleukin, may stimulate or suppress the immune system in different ways and stop tumor cells from growing.
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate toxicity in patients with lung metastases during aerosol interleukin (IL)-2 (aldesleukin) therapy using self-report, remote spirometry and pulse oximetry.
SECONDARY OBJECTIVES:
I. To determine dose and schedule of an acceptable aerosol IL-2 regimen and correlate with absolute lymphocyte count (ALC).
II. To determine serum IL-2 levels on day 1 of therapy for evidence of spillover into circulation and correlate with absence or presence of toxicity.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 12 Years to 50 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with diagnosis of advanced cancer with lung metastases; patients with no prior therapy are eligible if there is no known superior alternative medical therapy; for phase Ib expansion cohort diagnosis of osteosarcoma, lung metastases will be required
- •Willing to comply with protocol therapy and required safety monitoring (self-report, pulse oximetry, remote spirometry, labs)
- •Creatinine =< 2 x upper limit of normal (ULN)
- •Bilirubin =< 5 x ULN
- •Aspartate aminotransferase (AST) =< 5 x ULN
- •Forced vital capacity (FVC) >= 50% predicted
- •Oxygen (O2) saturation at rest >= 90% (off supplementary oxygen)
- •Eastern Cooperative Oncology Group (ECOG) performance status =< 1 for ages >= 16 or Lansky play >= 80% for ages =< 15
- •Patients must have recovered to =< grade 1 toxicity (except alopecia and hearing loss) from any prior chemotherapy, other investigational therapy, hormonal, biological, targeted agents
- •No radiotherapy within 2 weeks: exception: patients may receive palliative low dose radiotherapy (30 Gy or less) for lesions outside the lung at the discretion of the treating physician; palliative radiotherapy could be given before aerosol treatment is started if necessary
- •Subjects have to be able to read and understand English
- •Patients with advanced cancer with resectable lung metastases
- •Patients with sarcoma, renal cell carcinoma, or melanoma or with known disease outside the lungs and/or thorax
Exclusion Criteria
- •Currently being treated with bronchodilators or corticosteroids
- •Females: pregnant or breast feeding and if of child bearing potential (e.g. female of childbearing age that has not been amenorrheic for at least 12 consecutive month or surgically sterilized) not willing to use effective contraception
- •Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, bradycardia, related to cardiac disease, bundle branch block, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- •Subjects with baseline symptoms of fever and/or cough and/or shortness of breath and/or wheezing and/or fatigue grade >= 2 (Common Terminology Criteria for Adverse Events [CTCAE] version [v] 4.0)
- •Patients with unresectable lung metastases
- •Patients without sarcoma, renal cell carcinoma, or melanoma
Arms & Interventions
Treatment (aerosolized aldesleukin)
Patients receive aerosolized aldesleukin QD on days 1-21. Courses repeat every 28 days in the absence of disease progression of unacceptable toxicity.
Intervention: Laboratory Biomarker Analysis (Other)
Treatment (aerosolized aldesleukin)
Patients receive aerosolized aldesleukin QD on days 1-21. Courses repeat every 28 days in the absence of disease progression of unacceptable toxicity.
Intervention: Aerosolized Aldesleukin (Biological)
Outcomes
Primary Outcomes
Maximum tolerated dose, defined as the highest dose level with six patients with at most one dose limiting toxicity, using the CTCAE v4.0 (Phase I)
Time Frame: 28 days
The dose escalation will be conducted via the accelerated titration method for the first 2 dose levels.
Incidence of adverse events (AE)s, using the CTCAE v4.0 (Phase II)
Time Frame: Up to 4 years
AEs will be summarized by severity according to the worst grade experienced over the number of patients at risk.
Response of measurable lesions to aerosol aldesleukin using modified RECIST (Phase II)
Time Frame: Up to 4 years
Response analysis will be performed on intent-to-treat, that is, any patient who enrolled into the expansion cohort. Patients who withdraw before the end of 2 months without responding will be considered non-responders. The two-sided 95% Clopper-Pearson confidence intervals will be calculated for the proportion of patients with responses.
Secondary Outcomes
- IL-2 levels in serum(Day 1 of therapy)
- Changes in biomarker levels(Baseline to 8 weeks)