Vaccine treatment for metastatic neuroendocrine tumors

A Phase I Study of Safety and Immunogenicity of Survivin Long Peptide Vaccine (SurVaxM) in Patients With Metastatic Neuroendocrine Tumors (NETs)

This study is testing a new vaccine to see if it can help people with advanced neuroendocrine tumors by boosting their immune system to fight the cancer.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 14 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Roswell Park Cancer Institute (Academic / other)
• Drugs / interventions: immunotherapy
• Locations: 1 site (Buffalo, New York)
• Trial ID: NCT03879694 on ClinicalTrials.gov

What this trial studies

This phase I trial evaluates the safety and effectiveness of the survivin long peptide vaccine in patients with metastatic neuroendocrine tumors. The vaccine aims to stimulate the immune system to target and attack tumor cells expressing survivin proteins. Participants will receive the vaccine along with sargramostim and octreotide acetate, with assessments of clinical benefit and immune response over time. The study will also explore immune markers associated with treatment responses.

Who should consider this trial

Good fit: Ideal candidates include patients with confirmed metastatic neuroendocrine tumors that express survivin and have experienced disease progression.

Not a fit: Patients without survivin expression in their tumors or those with significant comorbidities may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could enhance the immune response against metastatic neuroendocrine tumors, potentially improving patient outcomes.

How similar studies have performed: While this approach is innovative, similar immunotherapy strategies have shown promise in other cancer types, suggesting potential for success.

Eligibility criteria

Inclusion Criteria:

* Have a Karnofsky performance status \>= 70 or Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (i.e. the patient must be able to care for himself/ herself with occasional help from others).
* Pathologically confirmed diagnosis of neuroendocrine tumor of gastrointestinal, pancreatic or lung origin.
* Patients who have been on somatostatin analogues (SSA) may continue to take SSA while on study treatment.
* Patients must have documented progression within the last six months on CT or MRI scans performed at least four weeks apart per RECIST v1.1 criteria. In the case of retreatment, progression may be defined by the treating provider (e.g., clinical, radiographic, biochemical).
* Archival neuroendocrine tumor tissue must test positive for survivin presence by clinical immunohistochemistry prior to study enrollment
* Absolute neutrophil count (ANC) \>= 1.5 x 10\^9/L (obtained within 14 days prior to enrollment).
* Platelets \>= 100 x 10\^9/L (obtained within 14 days prior to enrollment).
* Hemoglobin (Hgb) \> 9g/dL (obtained within 14 days prior to enrollment).
* Plasma total bilirubin: =\< 1.5 x upper limit of normal (ULN) (obtained within 14 days prior to enrollment).
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 4 x ULN (obtained within 14 days prior to enrollment).
* Patients on full-dose anticoagulants (e.g., warfarin or low molecular weight \[LMW\] heparin) must meet the following criteria:

  * No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices, which carries a significant risk of bleeding in investigator's opinion).
* Creatinine =\< 1.8 mg/dL (obtained within 14 days of enrollment).
* Participants of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry and, have a negative pregnancy test prior to starting study treatment. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
* Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure.

Exclusion Criteria:

* The patient must not have received any immunotherapy for any malignancy,as long as it was \> 3 months prior to study start.
* Patients with serious concurrent infection or medical illness, which in the treating physicians' opinion would jeopardize the ability of the patient to receive the treatment outlined in this protocol with reasonable safety.
* Patients who are pregnant or breast-feeding.
* Patients with a concurrent or prior malignancy are ineligible unless they are patients with curatively treated carcinoma-in-situ or basal cell carcinoma of the skin. Patients who have been free of disease (any prior malignancy) for at least 3 years are eligible for this study.
* Known history of an autoimmune disorder.
* Known human immunodeficiency virus (HIV) positivity or acquired immunodeficiency syndrome (AIDS) related illness or other serious medical illness.
* Previous local therapy (e.g. chemo-embolization, bland, or radio-embolization) is allowed if completed \> 6 weeks prior to randomization. For subjects who received local therapy prior to randomization, there must be documented growth of measurable disease within the embolization field prior to study.
* Unwilling or unable to follow protocol requirements.
* Systemic corticosteroid therapy \> 2 mg of dexamethasone or equivalent per day at study entry.
* Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive study drug.
* Received an investigational agent within 30 days prior to enrollment.
* Clinically significant cardiac arrhythmia, bradycardia, tachycardia that would compromise patient safety or the outcome of the study.

Where this trial is running

Buffalo, New York

• Roswell Park Cancer Institute — Buffalo, New York, United States (Recruiting)

Study contacts

• Principal investigator: Renuka V Iyer — Roswell Park Cancer Institute

Conditions Lung Atypical Carcinoid Tumor; Lung Typical Carcinoid Tumor; Metastatic Pancreatic Neuroendocrine Tumor