Vaccine Therapy in Treating Patients With Epstein-Barr Virus-Related Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed malignancy of a type typically associated with Epstein-Barr virus (EBV) latent infection meeting the following criteria:
• •* The presence of EBV within the malignant cells has been demonstrated by immunohistochemistry for viral antigens or by EBER (EBV early RNA) in situ hybridization
• •Patients in remission from disease or with disease for which no standard treatment is appropriate, as defined by 1 of the following groups:
• •* Have achieved a continuing complete response (CR) or unconfirmed CR
• •* Residual masses at the site of treated disease that are not progressing (i.e., stable disease) and for which no standard therapy is recognized
• •* Residual or recurrent disease that is low-volume and causing minimal or no symptoms and for which no standard therapy is recognized
• •Completed standard therapy for malignancy ≥ 12 weeks before trial entry
• •* No more than 1 course of chemotherapy as treatment for EBV+ malignancy
• •No ongoing toxic manifestations of prior treatment, except alopecia or certain grade 1 toxicities at the discretion of the investigator and Cancer Research UK
• •No patients with active EBV+ cancer for whom evidence-based active treatment is available and likely to be offered to prolong life or relieve symptoms within 14 weeks of the first vaccination
• •PATIENT CHARACTERISTICS:
• •WHO performance status 0 or 1
• •Life expectancy ≥ 4 months
• •Lymphocyte count must satisfy 1 of the following criteria:
• •* Greater than lower limit of the reference range in the investigator site
• •* Greater than or equal to 0.5 x 10\^9/L AND recovery from nadir of lymphocyte numbers following primary treatment for EBV+ malignancy, judged by no successive rises in lymphocyte count measured up to 3 successive occasions 3 weeks apart
• •Hemoglobin \> 10.0 g/dL
• •Absolute neutrophil count ≥ 1.5 x 10\^9/L
• •Platelet count ≥ 100 x 10\^9/L
• •Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
• •Serum alkaline phosphatase \< 1.5 times ULN
• •ALT and/or AST \< 1.5 times ULN
• •Calculated creatinine clearance \> 50 mL/min (uncorrected value) OR isotope clearance measurement \> 50 mL/min
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception during study and for 6 months after completion of study treatment
• •No known chronic active infection with hepatitis B, hepatitis C, or HIV
• •No history of anaphylaxis or severe allergy to vaccinations
• •No allergy to eggs or egg products
• •No ongoing active infection
• •No known splenic dysfunction
• •No concurrent active autoimmune disease
• •No prior NYHA class III or IV cardiac disease or concurrent congestive heart failure
• •No concurrent active skin diseases requiring therapy (i.e., psoriasis, eczema)
• •No other condition that, in the Investigator's opinion, would make the patient not a good candidate for this clinical trial
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics
• •No prior myeloablative therapy followed by an autologous or allogeneic hematopoietic stem cell transplant
• •More than 12 weeks since prior and no concurrent chemotherapy or radiotherapy
• •No splenectomy or splenic irradiation
• •No concurrent immunosuppressive medication, including corticosteroids
• •* Long-term prophylactic use of inhaled corticosteroids allowed
• •No major thoracic and/or abdominal surgery within the past 4 weeks from which the patient has not yet recovered
• •No other concurrent anticancer or investigational drugs