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Vaccine Therapy in Treating Patients With Recurrent Prostate Cancer

Phase 2
Completed
Conditions
Recurrent Prostate Cancer
Adenocarcinoma of the Prostate
Interventions
Biological: incomplete Freund's adjuvant
Other: laboratory biomarker analysis
Registration Number
NCT00109811
Lead Sponsor
National Cancer Institute (NCI)
Brief Summary

This phase II trial is studying how well vaccine therapy works in treating patients with recurrent prostate cancer. Vaccines made from peptides may help the body build an effective immune response to kill tumor cells

Detailed Description

PRIMARY OBJECTIVES:

I. Determine the T-lymphocyte immune response in patients with recurrent adenocarcinoma of the prostate treated with prostate-specific antigen (PSA) peptide vaccine (PSA-3A; PSA: 154-163 \[155L\]) emulsified in Montanide ISA-51.

SECONDARY OBJECTIVES:

I. Determine the toxicity of this vaccine in these patients. II. Determine the effect of this vaccine on serum PSA level in these patients.

OUTLINE: This is a pilot study.

Patients receive prostate-specific antigen (PSA) peptide vaccine (PSA-3A; PSA: 154-163 \[155L\]) emulsified in Montanide ISA-51 subcutaneously once in weeks 0, 2, 4, 6, 10, 14, and 18 in the absence of disease progression\* or unacceptable toxicity.

NOTE: \*A rise in PSA alone is not considered disease progression.

After completion of study treatment, patients are followed at 1 and 4 weeks.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
32
Inclusion Criteria
  • Histologically confirmed adenocarcinoma of the prostate

  • Must have undergone radical prostatectomy ≥ 3 months ago

  • Prostate-specific antigen (PSA) level ≥ 0.6 ng/mL and rising (after radical prostatectomy) on ≥ 2 measurements separated by ≥ 3 months

  • HLA-A2-positive peripheral blood mononuclear cells by flow cytometry

  • No clinical evidence of local recurrence

    • No palpable induration or mass in prostatic fossa
  • No metastatic prostate cancer

    • No osseous metastases by bone scan
  • Performance status - ECOG 0-1

  • Performance status - Karnofsky 70-100%

  • More than 1 year

  • WBC ≥ 3,000/mm^3

  • Absolute neutrophil count ≥ 1,500/mm^3

  • Platelet count ≥ 100,000/mm^3

  • AST and ALT ≤ 2.5 times upper limit of normal

  • Bilirubin normal

  • Hepatitis B and C negative

  • Creatinine normal

  • Creatinine clearance ≥ 60 mL/min

  • No symptomatic congestive heart failure

  • No unstable angina pectoris

  • No cardiac arrhythmia

  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to study PSA peptide vaccine or Montanide ISA-51

  • No history of systemic autoimmune disease or autoimmune disease requiring anti-inflammatory or immunosuppressive therapy

    • Patients with history of autoimmune thyroiditis are eligible provided the patient requires only thyroid hormone replacement therapy AND disease has been stable for ≥ 1 year
  • No known HIV positivity

  • No ongoing or active infection

  • No primary or secondary immune deficiency

  • No psychiatric illness or social situation that would preclude study compliance

  • No history of other uncontrolled illness

  • No prior chemotherapy

  • No prior hormonal therapy

  • No concurrent systemic or ocular steroid therapy, except for any of the following:

    • Inhaled steroids for asthma
    • Limited topical steroids
    • Replacement doses of cortisone
  • More than 4 weeks since prior radiotherapy

  • No prior radiotherapy to the prostate

    • Prior radiotherapy to the pelvis after radical prostatectomy allowed
  • See Disease Characteristics

  • No other concurrent investigational agents

  • No other concurrent anticancer therapy

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatmentlaboratory biomarker analysisPatients receive PSA peptide vaccine (PSA-3A; PSA: 154-163 \[155L\]) emulsified in Montanide ISA-51 subcutaneously once in weeks 0, 2, 4, 6, 10, 14, and 18 in the absence of disease progression or unacceptable toxicity.
Treatmentincomplete Freund's adjuvantPatients receive PSA peptide vaccine (PSA-3A; PSA: 154-163 \[155L\]) emulsified in Montanide ISA-51 subcutaneously once in weeks 0, 2, 4, 6, 10, 14, and 18 in the absence of disease progression or unacceptable toxicity.
Primary Outcome Measures
NameTimeMethod
Change in frequency of CD8 T-lymphocyte precursors in peripheral blood mononuclear cells (PBMC), measured by ELISPOT assaysFrom baseline to 1 week after the last dose of study treatment

A response is defined as at least a 5 fold higher frequency of INF-gamma secreting CD8 T cells after vaccination than before. A patient also will be considered a responder if no specific PSA: 154-163(155L) response was found before vaccination and a specific PSA: 154-163(155L) response is identified after vaccination.

Secondary Outcome Measures
NameTimeMethod
Effect of treatment on serum prostate-specific antigen levelUp to 4 weeks after completion of study treatment

The PSA reduction is defined as is at least 50% fall in the serum PSA level after vaccination. The proportion of patients who showed a reduction in serum PSA will be estimated and corresponding 95% confidence intervals will be calculated.

Incidence of adverse events graded according to NCI CTCAE version 3.0Up to 4 weeks after completion of study treatment

Trial Locations

Locations (1)

University of Maryland Greenebaum Cancer Center

🇺🇸

Baltimore, Maryland, United States

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