Monoclonal Antibody Therapy in Treating Patients With Relapsed or Refractory Small Cell Lung Cancer

Study Overview
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Brief Summary
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RATIONALE: Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. PURPOSE: Phase I trial to study the effectiveness of monoclonal antibody therapy in treating patients who have relapsed or refractory small cell lung cancer.

Detailed Description
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OBJECTIVES: Determine the dose limiting toxicity and maximum tolerated dose of yttrium Y 90 anti-CEA monoclonal antibody MN-14 in patients with relapsed or refractory small cell lung cancer. Determine the dosimetric and pharmacokinetic properties of this treatment regimen in the blood, normal organs, and tumors of these patients. Determine the stability and complexation with circulating carcinoembryonic antigen of this radioantibody in the plasma of these patients. Determine the antibody response of these patients treated with this regimen. Determine the antitumor effects of this treatment regimen in these patients. OUTLINE: This is a dose escalation study of yttrium Y 90 anti-CEA monoclonal antibody MN-14 (90Y-hMN-14). Patients are stratified according to prior radiotherapy (yes vs no). Patients undergo pretherapy imaging with indium In 111 anti-CEA monoclonal antibody MN-14 IV over 30-40 minutes on day -7 or -6 followed by external scintigraphy on days -7 or -6 to 0. Patients who show positive localization of at least one documented tumor site receive 90Y-hMN-14 IV over 30-40 minutes on day 0. Cohorts of 3-6 patients receive escalating doses of 90Y-hMN-14 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose limiting toxicity. Patients are followed at 2, 4, 8, and 12 weeks; every 3 months for 2 years; and then every 6 months for 3 years. PROJECTED ACCRUAL: A total of 15-30 patients will be accrued for this study within 10-14 months.

Official Title
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Phase I Non-Myeloablative Trial With 90Y-Humanized MN-14 (Anti-CEA) Antibody for Relapsed or Refractory Small Cell Lung Cancer (SCLC)

Conditions
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Lung Cancer

Intervention / Treatment
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* Radiation: indium In 111 monoclonal antibody MN-14
* Radiation: yttrium Y 90 monoclonal antibody MN-14


Participation Criteria
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Eligibility Criteria
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DISEASE CHARACTERISTICS: Histologically or cytologically confirmed small cell lung cancer (SCLC) Must have received at least one prior course of standard chemotherapy and, if indicated, up to 6,900 cGy of thoracic radiotherapy Patients who received prior radiotherapy must show evidence of progressive disease Patients who received no prior radiotherapy to the primary tumor must show evidence of stable or progressive disease Measurable disease Must have evidence of carcinoembryonic antigen (CEA) production or expression documented by one of the following: Serum CEA at least 10 ng/mL Positive immunohistology of either the primary tumor or a metastasis with CEA specific monoclonal antibody Must have unilateral bone marrow biopsy with less than 25% tumor involvement No known, active brain metastases PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 70-100% ECOG 0-2 Life expectancy: At least 3 months Hematopoietic: WBC at least 3,000/mm^3 Granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hepatic: Bilirubin no greater than 2 mg/dL AST no greater than 2 times upper limit of normal (ULN) No hepatitis B or C No other serious liver abnormality Renal: Creatinine no greater than 1.5 times ULN No urinary incontinence Cardiovascular: Ejection fraction at least 50% Pulmonary: FEV_1 and FVC at least 60% DLCO at least 50% predicted Other: No severe anorexia, nausea, or vomiting No other significant medical problems No prisoners No reactivity to humanized MN-14 (in patients with prior exposure to chimeric or humanized antibody) HIV negative No active HIV-related disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 3 months following study participation PRIOR CONCURRENT THERAPY: Biologic therapy: See Chemotherapy No concurrent growth factors (e.g., filgrastim [G-CSF]) Chemotherapy: See Disease Characteristics At least 4 weeks since prior chemotherapy No prior high dose chemotherapy with stem cell transplantation Endocrine therapy: Not specified Radiotherapy: See Disease Characteristics At least 4 weeks since prior radiotherapy Prior radiotherapy to less than 30% of red marrow (including standard chest x-ray for limited stage SCLC) allowed Surgery: At least 4 weeks since prior major surgery

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment


Arms and Interventions

| Intervention/Treatment |
| --- |
|Radiation: indium In 111 monoclonal antibody MN-14|nan|
|Radiation: yttrium Y 90 monoclonal antibody MN-14|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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recurrent small cell lung cancer