Lymphocyte Therapy in Treating Patients With Kidney Cancer

Study Overview
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Brief Summary
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RATIONALE: Treating a person's lymphocytes with interleukin-2 and monoclonal antibody may help them kill more cancer cells when they are put back in the body. PURPOSE: This phase II trial is studying how well lymphocyte therapy works in treating patients with stage III or stage IV kidney cancer.

Detailed Description
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OBJECTIVES: Evaluate the ability of autologous lymphocyte therapy (ALT) given as adjuvant therapy following nephrectomy and/or complete surgical resection of any metastatic disease to delay or prevent metastatic recurrence in patients with high-risk renal cell carcinoma. Determine the incidence of tumor recurrence and the survival of these patients treated with this regimen. Determine the toxicity/morbidity of this regimen in these patients. Explore the relationship between clinical response and in vitro autologous lymphocyte characteristics, including lytic activity, cytokine production, response to cytokines, and phenotypic profile in these patients treated with this regimen. Assess patient immune status before, during, and after therapy. OUTLINE: Patients are stratified according to postnephrectomy interval (less than 3 months vs more than 3 months), extent of lymph node involvement (N1 vs N2-N3), interleukin-1 concentration in initial autologous lymphocyte culture (less than 500 pg/mL vs greater than 500 pg/mL), and prenephrectomy treatment. Mononuclear cells are collected by apheresis on day 1 and cultured with interleukin-2 and monoclonal antibody OKT3. After cellular production, the autologous lymphocytes are reinfused over at least 30 minutes. Treatment repeats monthly for 6 months and then every 3 months for 6 months in the absence of unacceptable toxicity. Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then annually for 5 years. PROJECTED ACCRUAL: A total of 10-90 patients will accrued for this study within 3 years.

Official Title
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Adjuvant Autolymphocyte Therapy (ALT) For Patients With Non-Metastatic Renal Cell Carcinoma

Conditions
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Kidney Cancer

Intervention / Treatment
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* Biological: aldesleukin
* Biological: muromonab-CD3
* Biological: therapeutic autologous lymphocytes
* Procedure: adjuvant therapy


Participation Criteria
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Eligibility Criteria
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DISEASE CHARACTERISTICS: Histologically documented and completely resected stage III or stage IV renal cell carcinoma, clinically staged within 2 months prior to initiation of therapy No evidence of nephrotic syndrome PATIENT CHARACTERISTICS: Age: Over 16 Performance status: ECOG 0-2 Hematopoietic: WBC at least 3,000/mm^3 Granulocyte count at least 1,500/mm^3 Platelet count 50,000/mm3 to 500,000/mm^3 Hemoglobin at least 10 g/dL No hematologic abnormalities Hepatic: PT no greater than 1.5 times control PTT less than 1.5 times control Hepatitis B surface antigen negative Renal: Creatinine no greater than 4.0 mg/dL Calcium no greater than 12 mg/dL No symptomatic hypercalcemia Cardiovascular: No uncontrolled or severe cardiac disease, e.g.: No myocardial infarction within 6 months No congestive heart failure Other: HIV negative No significant organ dysfunction No other serious medical illness that would limit life expectancy No significant CNS disease including uncontrolled or untreated psychiatric or seizure disorders No uncontrolled bacterial, viral, or fungal infection No active peptic or duodenal ulcer Adequate peripheral venous access required No prior malignancy within past 5 years except inactive nonmelanoma skin cancer or carcinoma in situ of the cervix Not pregnant Negative pregnancy test PRIOR CONCURRENT THERAPY: No other concurrent postnephrectomy adjuvant therapy Biologic therapy: No concurrent immunotherapy Chemotherapy: No concurrent chemotherapy Endocrine therapy: More than 1 week since prior corticosteroids (except as inhalation therapy for respiratory ailments or replacement for adrenal insufficiency) No concurrent therapy with the following: Estrogens (except as postmenopausal replacement therapy) Androgens Progestins Antiestrogens Antiandrogens LHRH analogues or antagonists Other hormones Radiotherapy: Not specified Surgery: See Disease Characteristics No prior solid organ allograft More than 3 weeks since major surgery, including nephrectomy

Ages Eligible for Study
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Minimum Age: 16 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 |
| --- |
|Biological: aldesleukin|nan|
|Biological: muromonab-CD3|nan|
|Biological: therapeutic autologous lymphocytes|nan|
|Procedure: adjuvant therapy|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival as measured by Kaplan-Meier method at 5 years |  |  | 
| Onset of recurrence as measured by Kaplan-Meier method at 5 years |  |  | 
| Safety as measured by NCI Common Toxicity Criteria at completion of study |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stage III renal cell cancer, stage IV renal cell cancer, recurrent renal cell cancer