Biological Therapy Following Chemotherapy and Peripheral Stem Cell Transplantation in Treating Patients With Cancer

Cancer Treatment Centers of America

Status and phase: Completed; Phase 2

Conditions: Breast Cancer; Neuroblastoma; Gestational Trophoblastic Tumor; Chronic Myeloproliferative Disorders; Ovarian Cancer; Leukemia; Myelodysplastic Syndromes; Multiple Myeloma and Plasma Cell Neoplasm; Sarcoma; Kidney Cancer; Lymphoma; Testicular Germ Cell Tumor

Treatments: Biological: aldesleukin; Biological: recombinant interferon alfa; Biological: sargramostim

Study type: Interventional

Funder types: Other

Identifiers

NCT00003408

MRMC-CTCA-9801

CDR0000066418

NCI-V98-1449

Details and patient eligibility

About

RATIONALE: Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Combining chemotherapy and peripheral stem cell transplantation with biological therapy may kill more cancer cells.

PURPOSE: Phase II trial to study the effectiveness of biological therapy with sargramostim, interleukin-2, and interferon alfa following chemotherapy and peripheral stem cell transplantation in treating patients who have cancer.

Full description

OBJECTIVES:

• Determine the feasibility of therapy with sargramostim (GM-CSF), interleukin-2 and interferon alfa following high dose chemotherapy and autologous stem cell rescue in patients with high risk cancer.
• Determine the effect of this regimen on long-term leukocyte and platelet recovery following high dose chemotherapy and stem cell rescue in these patients.
• Determine the cellular response to this regimen in these patients.
• Assess progression free and overall survival rates in these patients.

OUTLINE: This is a dose escalation study of interleukin-2 and interferon alfa.

Beginning 14 days after the autologous stem cell transplant, patients receive daily subcutaneous injections of sargramostim (GM-CSF) on days 1-7 and daily intravenous interleukin-2 on days 3-7, followed by 1 week of rest. Patients then receive a subcutaneous injection of interferon alfa three times a week for 3 weeks followed by one more week of rest. Treatment is repeated for four courses.

Cohorts of 10 patients each receive escalating doses of interleukin-2 and interferon alfa until a maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which no more than 3 of 10 patients experience dose limiting toxicity. Intrapatient dose escalation occurs in courses 2-4, in the absence of dose limiting toxicity.

PROJECTED ACCRUAL: A maximum of 40 patients will be accrued for this study.

Enrollment: 40 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

• Diagnosis of one of the following cancers and undergoing high dose chemotherapy with autologous stem cell rescue (ASCR):

  • Metastatic breast cancer
  • Multiple myeloma
  • Hodgkin's disease
  • Recurrent or refractory low, intermediate, or high grade non-Hodgkin's lymphoma
  • Acute myelogenous leukemia beyond first remission
  • Acute lymphoblastic leukemia beyond first remission
  • Ovarian cancer
  • Refractory malignancy and measurable or evaluable disease (at time of ASCR)

• Hormone receptor status:

  • Not specified

• A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

Age:

• Not specified

Menopausal status:

• Not specified

Performance status:

• Not specified

Hematopoietic:

• Not specified

Hepatic:

• Not specified

Renal:

• Not specified

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• See Disease Characteristics

Chemotherapy:

• See Disease Characteristics

Endocrine therapy:

• Not specified

Radiotherapy:

• Not specified

Surgery:

• Not specified