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CPG 7909 Oligodeoxynucleotides (ODNS) After Autologous Transplantation to Enhance Immune Reconstitution


Phase 1
18 Years
N/A
Not Enrolling
Both
Germ Cell Tumor, Leukemia, Lymphoma, Multiple Myeloma and Plasma Cell Neoplasm

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Trial Information

CPG 7909 Oligodeoxynucleotides (ODNS) After Autologous Transplantation to Enhance Immune Reconstitution


OBJECTIVES:

Primary

- Determine whether CpG 7909 enhances immune function, as measured by the response to
keyhole limpet hemocyanin (neo-antigen) and tetanus toxoid (memory antigen), in
patients who have undergone autologous stem cell transplantation.

Secondary

- Determine if dose escalation of CpG 7909, within a range of previously tested safe
doses of CpG 7909, impacts upon the primary immune readouts.

OUTLINE: This is a non-randomized, dose-escalation study of CpG 7909.

Patients receive CpG 7909 subcutaneously (SC) on days 1, 7, and 14. Patients receive keyhole
limpet hemocyanin SC and tetanus toxoid SC on day 7.

Cohorts of 3-6 patients receive escalating doses of Cp6 7909 until the maximum tolerated
dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2
of 6 patients experience dose-limiting toxicity. A total of 10 patients are treated at the
MTD.

Blood is collected at baseline and at approximately day 40 for immunological studies,
including immunoenzyme techniques, antibody response assays, and immunophenotyping.

After completion of study treatment, patients are followed every 3 months for 1 year.


Inclusion Criteria:



- Patients must have undergone autologous transplantation for non-Hodgkin's lymphoma
(NHL), Hodgkin's disease, acute myelogenous leukemia (AML), germ cell tumors, or
multiple myeloma.

- Patients must be eligible for and consent to participate in study MT1999 06 -
Vaccination with tetanus toxoid and Keyhole Limpet Hemocyanin (KLH) to assess antigen
specific immune responses (BB-IND 10430).

- Patients will be eligible to receive CpG 7909 and vaccines on or after day 60 post
transplant. No patients are eligible for this protocol beyond day 74 post
transplant. Therefore, all patients will start therapy on this protocol between days
60-74 post transplant to allow for patient scheduling flexibility.

- Patients must have engraftment and be independent of transfusion support or growth
factor support.

- Patients must not have received platelet or red-cell transfusions in the previous
week.

- Patients must have been continuously off all growth factors for at least 1 week.

- Unsupported counts must be:

- platelets ≥ 50,000/ml

- Hgb ≥ 9 gm/ul

- Absolute neutrophil count ≥ 1000/µL

- Absolute lymphocyte count ≥ 500/µL

- Patients must have a current performance status of 0-1 (Eastern Cooperative Oncology
Group) or 70-100% (Karnofsky.

- Patients must be afebrile, off antibiotics therapeutic (not prophylactic), and free
of evidence of active infection. Patients must be off intravenous (IV)
hyperalimentation and IV fluids.

- Minimum laboratory values within 2 weeks of entry: Creatinine ≤ 2.0 mg/dl or CrCl ≥
50 ml/min, Bilirubin, ALT ≤ 2 x normal

- Age >18 years

- Patients receiving or scheduled to receive planned radiation therapy, growth factor
therapy, or steroid therapy during the study period will be ineligible. Patients
must have completed all planned post-transplant radiation therapy if applicable.

- Patients must be able to give written informed consent and agree to comply with the
study parameters

- Patients must agree to use contraception during the study.

Exclusion Criteria:

Patients with one or more of the following:

- Active infection, or fever >38.2˚C

- Significant nonmalignant disease including documented HIV infection, uncontrolled
hypertension (diastolic blood presses >115 mmHg), unstable angina, congestive heart
failure (NY Class II), poorly controlled diabetes, coronary angioplasty within 6
months, myocardial infarction with the last 6 months, or uncontrolled atrial or
ventricular cardiac arrhythmias.

- Hematopoietic growth factors administered within 1 week of study entry.

- Expected to require additional cytotoxic therapy within 30 days of study

- Receiving other post-transplant investigational agents

- Patients with a history of autoimmune diseases will be ineligible for this protocol

- It is unknown whether CpG 7909 may exacerbate autoimmune disorders by its
immunomodulatory effects. Therefore, subjects with a history of autoimmune disease
should not receive CpG 7909. Controlled thyroid disease is permissible.

- Systemic corticosteroids or other immunosuppressants

- Pregnant or lactating (It is unlikely and probably unwise that a women of
childbearing potential become pregnant this early after transplant, however; if any
suspicion, a pregnancy test should be done)

- Not meeting one or more of the eligibility criteria, as listed above

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Enhanced immune function as measured by response to keyhole limpet hemocyanin and tetanus toxoid

Outcome Description:

anti-KLH IgG

Outcome Time Frame:

1 Month after vaccine

Safety Issue:

No

Principal Investigator

Marcie Tomblyn, MD, MS

Investigator Role:

Principal Investigator

Investigator Affiliation:

Masonic Cancer Center, University of Minnesota

Authority:

United States: Food and Drug Administration

Study ID:

2003LS014

NCT ID:

NCT00369291

Start Date:

September 2003

Completion Date:

May 2010

Related Keywords:

  • Germ Cell Tumor
  • Leukemia
  • Lymphoma
  • Multiple Myeloma and Plasma Cell Neoplasm
  • Neoplasms
  • Leukemia
  • Lymphoma
  • Multiple Myeloma
  • Neoplasms, Plasma Cell
  • Plasmacytoma
  • Neoplasms, Germ Cell and Embryonal

Name

Location

Masonic Cancer Center at University of Minnesota Minneapolis, Minnesota  55455