Temozolomide and Survivin Long Peptide Vaccine (SurVaxM) for the Treatment of Patients With Progressing Metastatic Neuroendocrine Tumors

Launched by ROSWELL PARK CANCER INSTITUTE · Dec 29, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment approach for patients with metastatic neuroendocrine tumors (NET), which are cancers that start in the hormone-producing cells of the digestive system, lungs, or pancreas and have spread to other parts of the body. The trial compares the effects of a medication called temozolomide, which helps kill cancer cells, with a vaccine called SurVaxM that aims to boost the immune system's ability to fight tumors. Together, they may work better than temozolomide alone, especially for patients whose cancer is worsening.

To be eligible for the trial, participants must be at least 18 years old, have a confirmed diagnosis of NET, and show that their cancer has progressed despite previous treatments. They should also have a good level of physical function, meaning they can take care of themselves with minimal assistance. Participants can expect to receive regular monitoring and care throughout the study, and they will need to provide informed consent before starting any study-related procedures. It’s important to note that this trial is not yet recruiting participants, so it may take some time before enrollment begins.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age ≥ 18 years of age
• • Have a Karnofsky performance status ≥ 80 or Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 (i.e. the patient must be able to care for himself/ herself with occasional help from others)
• • Measurable, pathologically confirmed diagnosis of neuroendocrine tumor of gastrointestinal, pancreatic, or lung origin
• • Patients must have documented radiographic progression, determined as clinically significant by the treating provider, within the last twelve months on CT or MRI scans performed at least four weeks apart per RECIST v1.1 criteria. In the case of retreatment, progression may be defined by the treating provider (e.g., clinical, radiographic, biochemical)
• • Patients must have failed at least one prior systemic therapy (e.g. lanreotide, octreotide, everolimus, sunitinib, or lutetium Lu 177 dotatate)
• • Patients who have been on somatostatin analogues (SSA) may continue to take SSA while on study treatment
• • Archival neuroendocrine tumor tissue must test positive for survivin presence by clinical immunohistochemistry prior to study enrollment
• • Absolute neutrophil count (ANC) ≥ 1.5 x 10\^9/L (obtained within 14 days prior to enrollment)
• • Platelets ≥ 100 x 10\^9/L (obtained within 14 days prior to enrollment)
• • Hemoglobin (Hgb) \> 9g/dL (obtained within 14 days prior to enrollment)
• • Plasma total bilirubin: ≤ 1.5 x upper limit of normal (ULN) (obtained within 14 days prior to enrollment)
• • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 4 x ULN (obtained within 14 days prior to enrollment)
• • Creatinine clearance ≥ 60 mL/min (per Cockroft-Gault equation) (obtained within 14 days prior to enrollment)
• * Patients on full-dose anticoagulants (e.g., warfarin or low molecular weight \[LMW\] heparin) must meet the following criteria:
• • No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices, which carries a significant risk of bleeding in investigator's opinion)
• • Participants of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
• • Participant must understand the investigational nature of this study and sign an independent ethics committee/institutional review board approved written informed consent form prior to receiving any study related procedure
• Exclusion Criteria:
• • Patients who have received temozolomide in the advanced disease setting either alone or as part of a combination therapy will be excluded
• • Has received prior treatment with SurVaxM
• • Received an investigational agent within 30 days prior to enrollment
• • Participants who have received checkpoint inhibitors within 3 months prior to study enrollment or, those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
• • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, bradycardia, tachycardia or psychiatric illness/social situations that would limit compliance with study requirements and, which in the treating physicians' opinion would jeopardize the ability of the patient to receive the treatment outlined in this protocol with reasonable safety
• • Patients with a concurrent or prior malignancy are ineligible unless they are patients with curatively treated carcinoma-in-situ or basal cell carcinoma of the skin. Patients who have been free of disease (any prior malignancy) for at least 3 years are eligible for this study
• • Known history of an autoimmune disorder
• • Known human immunodeficiency virus (HIV) positivity or acquired immunodeficiency syndrome (AIDS) related illness or other serious medical illness
• • Systemic corticosteroid therapy \> 2mg of dexamethasone or equivalent per day at study entry
• • Pregnant or nursing female participants
• • Unwilling or unable to follow protocol requirements
• • Any condition which in the Investigator's opinion deems the participant an unsuitable candidate to receive study drug
• • Patients with Hepatitis B or Hepatitis C or HIV may be included if there are adequately controlled viral titers and no drug-drug interactions