Laboratory-Treated Autologous Lymphocytes and Aldesleukin After Cyclophosphamide and Fludarabine in Treating Patients With Metastatic Melanoma
| Status: | Archived |
|---|---|
| Conditions: | Skin Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
| Start Date: | February 2009 |
A Phase II Study Using Short-Term Cultured Anti-Tumor Autologous Lymphocytes Following a Non-Myeloablative Lymphocyte Depleting Chemotherapy Regimen in Metastatic Melanoma
RATIONALE: Treating lymphocytes in the laboratory may help the lymphocytes kill more tumor
cells when they are put back in the body. Aldesleukin may stimulate the lymphocytes to kill
tumor cells. Drugs used in chemotherapy, such as cyclophosphamide and fludarabine, work in
different ways to stop the growth of tumor cells, either by killing the cells or by stopping
them from dividing. Giving laboratory-treated lymphocytes and aldesleukin together with
cyclophosphamide and fludarabine may kill more tumor cells.
PURPOSE: This phase II trial is studying how well laboratory-treated autologous lymphocytes
and aldesleukin work when given after cyclophosphamide and fludarabine in treating patients
with metastatic melanoma.
OBJECTIVES:
Primary
- Determine the ability of treatment with short-term cultured autologous
tumor-infiltrating lymphocytes (TIL) in combination with high-dose aldesleukin after a
nonmyeloablative lymphocyte-depleting preparative regimen comprising cyclophosphamide
and fludarabine phosphate to mediate tumor regression in patients with metastatic
melanoma.
- Determine the toxicity of this treatment regimen.
Secondary
- Determine the rate of repopulation of the young TIL cells.
- Establish in vitro immunological correlates that predict in vivo persistence and
clinical response.
OUTLINE:
- Conditioning regimen: Patients receive cyclophosphamide IV over 1 hour on days -7 and
-6 and fludarabine phosphate IV over 30 minutes on days -5 to -1.
- Tumor-infiltrating lymphocyte (TIL) infusion and high-dose aldesleukin: Patients
receive short-term cultured autologous TIL IV over 20-30 minutes on day 0. Patients
also receive high-dose aldesleukin IV over 15 minutes every 8 hours on days 0-4.
Patients with stable disease, partial response, or recurrent disease after initial response
may receive 1 additional course of treatment (as above) beginning 8 weeks after completion
of aldesleukin.
Blood samples are collected at baseline, at 1 week and 1 month after TIL infusion, and then
periodically thereafter for research studies. Samples are analyzed for differences in
function and phenotype prior to and after TIL infusion. The immunological correlates of
treatment are also evaluated using FACS, cytokine release assays, ELISPOT assays, flow
cytometry, and PCR. TIL that are cryopreserved at the time of infusion are analyzed to
determine cell phenotype and function; correlation of in vitro characteristics of the
infused cells with in vivo antitumor activity; and the activity, specificity, and telomere
length using flow FISH.
After completion of study treatment, patients are followed at 4-6 weeks, every 3 months for
1 year, every 6 months for 2 years, and then annually for 2 years.
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