Vaccine Therapy and Interleukin-2 in Treating Young Patients With Relapsed or Refractory Ewing's Sarcoma or Neuroblastoma

Study Overview
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Brief Summary
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RATIONALE: Vaccines made from a person's tumor cells and white blood cells may make the body build an effective immune response to kill tumor cells. Interleukin-2 (IL-2) may stimulate the white blood cells to kill tumor cells. Biological therapies, such as cellular adoptive immunotherapy, stimulate the immune system and stop tumor cells from growing. Giving vaccine therapy with IL-2 may be a more effective treatment for Ewing's sarcoma or neuroblastoma. PURPOSE: This phase I trial is studying the side effects of vaccine therapy when given with IL-2 in treating young patients with relapsed or refractory Ewing's sarcoma or neuroblastoma.

Detailed Description
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OBJECTIVES: Determine the safety of vaccination comprising autologous tumor cells fused with Epstein-Barr virus-transformed B-lymphoblastoid cells followed by interleukin-2 (IL-2) in children with relapsed or refractory Ewing's sarcoma or neuroblastoma. Determine antitumor immunity by examining cell phenotype and function in patients treated with this vaccine and cytotoxic T lymphocytes (CTL). Determine the safety of CTL and IL-2 in these patients. OUTLINE: This is a pilot study. Tumor cells and blood cells are collected from patients and expanded in vitro. Tumor cells and Epstein-Barr virus-transformed B-lymphoblastoid cells (derived from blood cells) are fused together to produce the vaccine. Vaccination: Patients receive vaccine comprising autologous tumor cells fused with Epstein-Barr virus-transformed B-lymphoblastoid cells subcutaneously (SC) once on days 0, 14, and 28 and interleukin-2 (IL-2) SC twice daily on days 1-7, 15-21, and 29-35. Cytotoxic T lymphocytes (CTL): After vaccination, patients with evidence of antitumor immunity undergo leukapheresis to collect white blood cells for CTL expansion. Some of these patients then receive CTL IV once on days 0, 14, and 28 and IL-2 SC twice daily on days 1-7, 15-21, and 29-35. Patients are followed weekly for 2 weeks, every 2 weeks for 1 month, monthly for 3 months, and then every 2 months for up to 1 year post-vaccination. Patients who receive CTL are also followed annually for survival. PROJECTED ACCRUAL: A total of 10 patients will be accrued for this study within 3 years.

Official Title
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A Phase I Pilot Study of Tumor Cell - B Lymphoblastoid Cell Line Vaccination in Pediatric Subjects With Relapsed Ewing's Sarcoma and Neuroblastoma

Conditions
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Neuroblastoma, Sarcoma

Intervention / Treatment
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* Biological: aldesleukin
* Biological: autologous EBV-transformed B lymphoblastoid-tumor fusion cell vaccine
* Biological: therapeutic autologous lymphocytes


Participation Criteria
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Eligibility Criteria
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DISEASE CHARACTERISTICS: Diagnosis of Ewing's sarcoma OR neuroblastoma Relapsed or refractory disease Epstein-Barr virus positive PATIENT CHARACTERISTICS: Age 1 to 30 Performance status Lansky 70-100% OR ECOG 0-2 Life expectancy At least 8 weeks Hepatic Bilirubin < 2.0 mg/dL AST and ALT < 2.5 times normal (in the absence of liver metastases) Patients without evidence of an obvious relationship between AST/ALT and disease activity are not eligible Hepatitis B antigen and core antibody negative Hepatitis C antibody negative Renal Creatinine clearance > 50 mL/min Immunologic HIV 1 and 2 negative HTLV 1 and 2 negative Other Not pregnant Negative pregnancy test Fertile patients must use effective contraception No other moribund condition PRIOR CONCURRENT THERAPY: Biologic therapy At least 3 months since prior autologous stem cell transplantation Chemotherapy Not specified Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 30 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: autologous EBV-transformed B lymphoblastoid-tumor fusion cell vaccine|nan|
|Biological: therapeutic autologous lymphocytes|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 neuroblastoma, recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor