SGN-00101 in Preventing Anal Cancer in Patients With HIV Who Have Anal Neoplasia

Study Overview
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Brief Summary
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Phase I/II trial to study the effectiveness of SGN-00101 in preventing anal cancer in HIV-positive patients who have high-grade anal neoplasia. Chemoprevention therapy is the use of certain drugs to try to prevent the development of cancer. SGN-00101 may be effective in preventing anal cancer.

Detailed Description
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OBJECTIVES: I. Determine the safety and maximum tolerated dose of SGN-00101 in HIV-positive patients with high-grade anal squamous intraepithelial lesions. II. Determine clinical response and histologic/cytologic regression in patients treated with this drug. III. Determine immune response in patients treated with this drug. IV. Determine the effect of this drug on HIV viral load and CD4 level in these patients. OUTLINE: This is a dose-escalation study. Patients receive SGN-00101 subcutaneously once on weeks 0, 4, and 8. Treatment continues in the absence of disease progression or unacceptable toxicity. Cohorts of 5-6 patients receive escalating doses of SGN-00101 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which no more than 1 of 6 patients experience dose-limiting toxicity. Patients are followed at 1, 4, and 10 months.

Official Title
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A Phase I/II Trial of SGN-00101 in the Treatment of High-Grade Anal Intraepithelial Neoplasia (AIN) in HIV-Positive Individuals

Conditions
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Anal Cancer

Intervention / Treatment
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* Biological: HspE7


Participation Criteria
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Eligibility Criteria
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DISEASE CHARACTERISTICS: Histologically confirmed high-grade anal squamous intraepithelial lesions (HSIL) with residual HSIL of the anal canal or margin by high-resolution anoscopy Declined routine surgery or not a candidate for surgical excision of HSIL Documented evidence of HIV infection by one of the following methods: Serologic (ELISA or western blot) Culture Quantitative polymerase chain reaction or bDNA assays HIV RNA no greater than 500 copies/mL CD4 at least 200 x 10^6/L Must have received stable highly active antiviral therapy (HAART) for at least 4 weeks before study HAART defined as 3 or more agents, including a protease inhibitor or nonnucleoside reverse transcriptase inhibitor that is approved or available through expanded access combination antiviral therapy No prior history of invasive anal or cervical cancer No concurrent untreated cervical HSIL PATIENT CHARACTERISTICS: Age 18 and over Life expectancy At least 12 months Hematopoietic Hemoglobin at least 10 g/dL Platelet count at least 75,000/mm^3 Absolute neutrophil count at least 1,000/mm^3 Hepatic AST and ALT no greater than 3 times upper limit of normal (ULN) Renal Creatinine no greater than 1.5 times ULN Immunologic No prior severe allergic reactions (i.e., anaphylactic response) to drugs or any other allergen No history of collagen-vascular or autoimmune disorder requiring treatment within the past 5 years No other concurrent illness that compromises the immune system No active serious opportunistic infection Other Not pregnant or nursing Negative pregnancy test Fertile patients must use 2 forms of effective contraception during and for 3 months after study No concurrent participation in a conception process (e.g., active attempt to become pregnant or impregnate, sperm donation, or in vitro fertilization) No other concurrent medical or psychiatric illness that would preclude study PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent immunostimulants (including interferon or interleukin-12) Chemotherapy More than 1 year since prior chemotherapy for cancer Endocrine therapy No concurrent steroids that compromise immune function Concurrent topical corticosteroids allowed if dose determined not to suppress immune function Radiotherapy More than 1 year since prior radiotherapy for cancer Other More than 30 days since other prior investigational agents No concurrent medications that suppress immune function

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: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm I<br>Patients receive SGN-00101 subcutaneously once on weeks 0, 4, and 8. Treatment continues in the absence of disease progression or unacceptable toxicity. Cohorts of 5-6 patients receive escalating doses of SGN-00101 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which no more than 1 of 6 patients experience dose-limiting toxicity. | Biological: HspE7<br> <br> |

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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anal cancer