Finding studies
Finding studies
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Lead
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
With
OBJECTIVES: Primary * To evaluate the safety of cyclophosphamide-modulated vaccination with vs without trastuzumab in patients with breast cancer that does not overexpress HER-2/neu. * To compare the clinical benefit of cyclophosphamide-modulated vaccination with vs without trastuzumab in these patients. * To measure HER-2/neu-specific CD4+ and CD8+ T-cell immunity by delayed-type hypersensitivity (DTH) and ELISPOT. * To measure the pharmacodynamics of CD4+CD25+ regulatory T cells by flow cytometry. Secondary * To assess the impact of trastuzumab on immune priming in vivo by immunohistochemistry of vaccine-site biopsies at day +3 and day +7 of courses 1 and 3 on the two study arms, comparing cellular infiltrates to those seen in previous preclinical and clinical models. * To measure hTERT-specific CD8+ T-cell immunity by ELISPOT. * To characterize the peripheral-memory T-cell pool. Tertiary * To determine baseline and change in vaccine site-draining lymph node immunohistology and gene expression profile. * To develop the tandem tetramer/CD107a cytotoxicity assay for HER-2/neu-specific CD8+ T cells. * To measure novel T-cell responses induced by trastuzumab and cyclophosphamide-modulated vaccination. OUTLINE: Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive cyclophosphamide IV over 30 minutes on day -1 and allogeneic GM-CSF-secreting breast cancer vaccine intradermally on day 0. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. * Arm II: Patients receive cyclophosphamide and the vaccine as in arm I and trastuzumab IV over 30-90 minutes on day -1. Courses repeat every 4-6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive a fourth vaccination at 6-8 months. Skin punch and lymph node biopsies are collected at baseline and on days +3 and +7 of courses 1 and 3 for biomarker analysis. After completion of study treatment, patients are followed periodically.
Age
18–120
Sex
ALL
Healthy volunteers
Not accepted
