This phase I trial is studying the side effects and best dose of decitabine when given together with pegylated liposomal doxorubicin hydrochloride and vaccine therapy in treating patients with recurrent ovarian epithelial cancer, fallopian tube cancer, or peritoneal cancer. Drugs used in chemotherapy, such as decitabine and pegylated liposomal doxorubicin hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Vaccines made from a peptide or antigen may help the body build an effective immune response to kill tumor cells. Giving combination chemotherapy together with vaccine therapy may kill more tumor cells
PRIMARY OBJECTIVES: I. To determine the safety of 5-aza-2'-deoxycytidine (decitabine) in combination with immunization with NYESO-I protein mixed with montanide and granulocyte-macrophage colony stimulating factor (GM-CSF) in patients scheduled to receive liposomal doxorubicin for recurrent epithelial ovarian, fallopian tube or primary peritoneal carcinoma. SECONDARY OBJECTIVES: I. To evaluate NY-ESO-l specific cellular and humoral immunity by determination of NY-ESO-I specific antibody, CD8+ and CD4+ T-cells following immunization with NY-ESO-l protein mixed with montanide and GM-CSF in combination with 5-aza-2' -deoxycytidine (decitabine) in patients receiving liposomal doxorubicin for recurrent epithelial ovarian, fallopian tube or primary peritoneal carcinoma. II. To determine the impact of 5-aza-2'-deoxycytidine on NY-ESO-I specific expression, NY-ESO-l promoter methylation, and global DNA methylation. III. To compare the time to progression (ttp) for the proposed therapy with the ttp for standard therapy (historical studies). OUTLINE: This is a dose escalation study of decitabine. Patients receive decitabine intravenously (IV) over 3 hours on day 1, pegylated liposomal doxorubicin hydrochloride IV on day 8, and NY-ESO-1 peptide vaccine emulsified in incomplete Freund's adjuvant and sargramostim subcutaneously on day 15. Treatment repeats every 28 days for 4 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 6 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Given IV
Given SC
Given IV
Given SC
Given SC
Correlative studies
Correlative studies
Correlative studies
Correlative studies
Correlative studies
Correlative studies
Correlative studies
Roswell Park Cancer Institute
Buffalo, New York, United States
Toxicity as assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v3.0
Estimated with a one-sided, 95%, Wilson score binomial confidence interval.
Time frame: Up to 6 months
NY-ESO-1 specific cellular and humoral immunity as assessed by NY-ESO-1-specific CD8+ and CD4+ T cells and antibodies and frequency of CD4+ CD25+ FOXP3+ regulatory T cells
Will be summarized by quartiles. Also, confidence intervals will be constructed for the median and the mean.
Time frame: Up to 6 months
NY-ESO-l expression using Q-RT-PCR and IHC
Time frame: Days 1, 8, 15, 36, 43, 64, 71, 92, and 99
Time to progression
Summarized by a Kaplan-Meier survival curve.
Time frame: Up to 6 months
NY-ESO-l promoter DNA methylation using pyrosequencing
Time frame: Days 1, 8, 15, 36, 43, 64, 71, 92, and 99
Global genomic DNA methylation using liquid chromatography-mass spectrometry (LC-MS) and LINE-l pyrosequencing
Time frame: Days 1, 8, 15, 36, 43, 64, 71, 92, and 99
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