A Phase II Study on Adjuvant Vaccination with Dendritic Cells Loaded with Autologous Tumor Homogenate in Resected Stage IV Rare Cancers.

Launched by ISTITUTO ROMAGNOLO PER LO STUDIO DEI TUMORI DINO AMADORI IRST S.R.L. IRCCS · Nov 14, 2019

Keywords

ClinConnect Summary

This clinical trial is testing a new type of treatment for patients with advanced rare cancers, specifically head and neck tumors, neuroendocrine tumors, and soft tissue sarcomas. The trial aims to see if using a special vaccine made from the patient's own immune cells (called dendritic cells) that have been mixed with their own tumor tissue can help improve their recovery after surgery. Participants will be followed to check the safety of this treatment and how well it works in boosting their immune response against any remaining cancer cells.

To be eligible for this trial, participants must be adults aged 18 or older who have had surgery for stage IV cancer and are currently free of disease, meaning no signs of cancer are detected on recent scans. They should also have recovered well from their surgery and meet certain health requirements, such as having good organ function. If you join this study, you can expect to receive the vaccine treatment after your surgery and will be monitored closely for any side effects or improvements in your health. This trial is currently recruiting participants, so it could be an important option for those looking for new ways to fight their cancer.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Patients must have histologically confirmed stage IV Head\&Neck Squamous Cell Carcinoma (HNSCC), NeuroEndocrine Tumors (NET) or Soft Tissue Sarcoma (STS) surgically treated with radical intent.
• • 2. The autologous surgical specimen must have been collected and sent to the Somatic Cell Therapy Lab and must fulfil all the acceptance criteria prescribed by the Good Manufactory Practice (GMP) procedures.
• • 3. The patient must be disease-free, as assessed by CT scan or MRI of the chest, abdomen, pelvis performed within 60 days before enrolment. If the resected lesions occurred in other sites, these must be also included in the baseline CT scan and in all the subsequent evaluations.
• • 4. Patients disease-free candidates for only observation as per clinical practice (no standard treatment is available after surgery)
• • 5. The patient must have recovered from all the adverse events related to previous surgery.
• • 6. Age ≥18 years.
• • 7. Performance status Eastern Cooperative Oncology Group (ECOG) 0 or 1.
• 8. Patient must have acceptable organ function, defined as:
• • 1. Haemoglobin \>10 g/dl
• • 2. White blood cells ≥3000/μl.
• • 3. Absolute neutrophil count ≥1500/μl.
• • 4. Platelets≥75000/μl.
• • 5. aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \<3 times the upper institutional reference level.
• • 6. Total bilirubin \<1.5 times the upper institutional reference level.
• • 7. Serum creatinine \<1.5 times the upper institutional reference level.
• • 9. Patients aged 70 years or older must have left ventricular ejection fraction not lower than 55% as assessed by echocardiography.
• • 10. Female patients of childbearing potential and all male patients must accept and be compliant with an highly effective contraceptive method (i.e. with a failure rate of \<1% per year: double barrier method, one barrier method plus spermicidal, intrauterine device, or oral contraception) from informed consent signature and up to three months after end of study. For this purpose are considered of childbearing potential all female subjects after puberty unless they are post-menopausal for at least two years or are surgically sterile. Complete abstinence from sexual intercourses is acceptable if patients' lifestyle guarantees his/her strict compliance with this prescription in the judgement of the Investigator.
• • 11. The patient is willing and able to give written informed consent for the study.
• Exclusion Criteria:
• • 1. Patients with residual disease after surgery. Marginal resection of any lesion in the absence of clinically evident residual disease is acceptable.
• • 2. Patient who completed surgery more than 90 days before study enrolment.
• • 3. History of other neoplastic diseases in the previous 5 years, except basal cell carcinoma of the skin and in situ carcinoma of the cervix uteri treated with curative surgery.
• • 4. History of congenital or acquired immunodeficiency, including history of organ transplantation.
• • 5. Any positivity for the serologic markers of hepatitis B virus (HBV) (including at least anti- Hepatitis B surface antibodies (HBs) and hepatitis B core (HBc) antibodies, hepatitis C virus (HCV), HIV or Treponema pallidum. The serologic tests must have been performed within 30 days before any GMP-regulated activity (i.e. surgical resection and leukapheresis). The sole positivity for antibodies against the HBV surface antigen (i.e.
• • with all other HBV markers negative) is indicative of previous HBV vaccination and therefore is acceptable.
• • 6. Female patients who are pregnant or nursing.
• • 7. Participation in another clinical trial with any investigational agent within 30 days prior to study screening.
• • 8. Any active inflammatory or autoimmune disease requiring systemic steroids or other immunomodulatory agents as detailed in section 6.4, or potentially requiring such treatments during the study treatment in the judgement of the Investigator.
• • 9. Any clinical condition that, in the opinion of the Investigator or the Transfusion Medicine specialist, is a contraindication to leukapheresis. In addition, all patients aged 70 or older must be evaluated by a cardiology specialist before the procedure to exclude any clinically relevant cardiac condition and any grade 3-4 cardiac arrhythmia, even if asymptomatic.
• • 10. Any uncontrolled serious intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations potentially impacting patient safety and compliance in the opinion of the Investigator.
• • 11. Refusal of giving written informed consent.