NIH Clinical Research Studies

Protocol Number: 99-H-0064

Active Accrual, Protocols Recruiting New Patients

Title:
Exploratory Study of Non-Myeloablative Allogeneic Stem Cell Transplantation and Donor Lymphocyte Infusions for Metastatic Neoplasms Refractory to Standard Therapy
Number:
99-H-0064
Summary:
The goal of this research study is to identify other types of cancer (malignant neoplasms) that may be treatable with stem cell transplantation (allogenic peripheral blood stem cell transplantation.

Patients with a variety of different types of cancerous tumors that have spread (metastasized) and whose conditions have not improved with stand therapy, will be eligible to participate. Those patients selected to participate in the study will undergo a procedure known as a "mini-transplant". The mini-transplant is a transplantation of stem-cells collected from a sibling (brother or sister) of the patient. Unlike traditional bone marrow transplants, the mini-transplant does not require intense chemotherapy or radiation therapy. Because of this, patients experience fewer and less severe side effects.

This study is open to patients diagnosed with a variety of metastatic solid tumors including esophageal, gastric (stomach), colon, rectal, liver tumors (hepatoma), cancer of the biliary system (cholangiocarcinoma), cancer of the pancreas, lung, breast, prostate, bone (sarcoma), adrenal basal cell, bladder, and adenocarcinomas of unk primary origin.

Sponsoring Institute:
National Heart, Lung and Blood Institute (NHLBI)
Recruitment Detail
Type: Active Accrual Of New Subjects
Gender: Male & Female
Referral Letter Required: No
Population Exclusion(s): None

Eligibility Criteria:
INCLUSION CRITERIA:

PATIENTS:

Patients with metastatic solid tumors (adrenal, basal cell, breast, transitional cell carcinoma of the bladder or uroepitheleum, cholangiocarcinoma, small intestine/colon/rectal, adenocarcinoma, esophageal/gastric, hepatocellular, ovarian, pancreatic, prostate, bony/soft tissue sarcomas, small cell lung cancer, non small cell lung cancer, and adenocarcinomas of unknown primary origin) which are histologically confirmed, progressive and incurable.

Age greater than or equal to 10 to less than or equal to 80.

No known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy.

Metastatic disease, which is bi-dimensionally evaluable radiographically.

No prior treatment for neoplasm within 30 days.

Ability to comprehend the investigational nature of the study and provide informed consent.

Availability of HLA identical or single HLA-locus mismatched family donor.

Willingness and availability to return to the NIH for scheduled follow-ups.

DONOR:

HLA identical or single HLA-locus mismatched family donor.

Age greater than or equal to 10 up to 80 years old.

Ability to comprehend the investigational nature of the study and provide informed consent.

EXCLUSION CRITERIA:

PATIENT:

Pregnant or lactating.

Age less than 10 or greater than 80 years.

ECOG performance status of 3 or more.

Psychiatric disorder or mental deficiency severe as to make compliance with the BMT treatment unlikely, and making informed consent impossible.

Major anticipated illness or organ failure incompatible with survival from PBSC transplant.

DLCO: less than 40% predicted.

Left ventricular ejection fraction: less than 30%.

Serum creatinine greater than 2.5mg/dl or creatinine clearance less than 50 cc/min by 24 hr urine collection.

Serum bilirubin greater than 4 mg/dl

Transaminases greater than 5x upper limit of normal.

Oral intake less than 1,200 calories/day.

Recent weight loss of greater than or equal to 10% of actual body weight.

Life expectancy less than 3 months

Therapy for malignancy within 4 weeks of beginning protocol.

CNS metastatic disease associated with intracranial bleeding, uncontrolled seizure disorder or significant intracranial mass effect.

Other malignant diseases liable to relapse or progress within 5 years.

Uncontrolled infection.

DONOR:

Pregnant or lactating.

Donor unfit to receive G-CSF and undergo apheresis. (Uncontrolled hypertension, history of congestive heart failure or unstable angina, thrombocytopenia).

Age less than 10 or greater than 80 years.

HIV positive. Donors who are positive for HBV, HCV or HTLV-I may be used at the discretion of the investigator following counseling and approval from the recipient.

Special Instructions: Currently Not Provided
Keywords:
Graft-Versus-Tumor
Peripheral Blood Stem Cells
Non-Myeloablative Bone Marrow Transplantation
Metastatic Solid Tumors
Engraftment
Graft-versus-host Disease
Cyclophosphamide
Fludarabine
Donor Apheresis
Recruitment Keywords:
Cancer
Tumor
Conditions:
Cholangiocarcinoma
Colon/Rectal Ca
Bladder Ca
Breast Ca
Basal Cell Ca
Adrenal Ca
Esophageal/Gastric Ca
Hepatocellular Ca
Ovarian Ca
Prostate Ca
Small Cell Lung Ca
Non Small Cell Lung Ca
Adenocarcinoma, Unk origin
Pancreatic Ca
Bony/Soft Tissue Sarcoma
Investigational Drug(s):
None
Investigational Device(s):
None

Contacts:
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:
Evidence for a graft-versus-tumor effect in a patient treated with marrow ablative chemotherapy and allogeneic bone marrow transplantation for breast cancer

Allogeneic cell-mediated immunotherapy for breast cancer after autologous stem cell transplantation: a clinical pilot study

Allogeneic periperal-blood progenitor-cell transplantation for poor-risk patients with metastatic breast cancer

Active Accrual, Protocols Recruiting New Patients

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