Clinical Trial: T-Lymphocytes in Treating Patients With Epstein-Barr Virus-Positive Nasopharyngeal Cancer, NPC

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Administration of EBV-Specific T-Lymphocytes to Patients With EBV-Positive Nasopharyngeal Carcinoma

Brief Summary:

Patients have a type of cancer called nasopharyngeal cancer. This cancer has come back or not gone away or is at high risk for coming back after treatment (including the best treatment we know for nasopharyngeal cancer). We are asking patients to volunteer to be in a research study using special immune system cells called EBV-specific cytotoxic T lymphocytes, a new experimental therapy.

Most patients with nasopharyngeal cancer show evidence of infection with the virus that causes infectious mononucleosis, Epstein Barr virus (EBV), before or at the time of their diagnosis of nasopharyngeal cancer. EBV is found in the cancer cells of most patients with nasopharyngeal cancer, suggesting that it may play a role in causing this cancer. The cancer cells infected by EBV are able to hide from the body's immune system and escape destruction. We want to see if special white blood cells (called T cells) that have been trained to kill EBV-infected cells can survive in the patient's blood and affect the tumor.

We have treated other patients with different EBV positive cancers and have had variable results. Some patients have had some response to the treatment. Some patients have been cured by the treatment. It is not possible for us to predict if this treatment will work for nasopharyngeal cancer.

The purposes of this study are to find the largest safe dose of EBV specific cytotoxic T cells, to learn what the side effects are, and to see whether this therapy might help patients with nasopharyngeal cancer.

Detailed Summary:

We will first test a biopsy of the tumor (that has already been done) to see if your tumor cells are EBV positive. If the patient is eligible, we will then take 60-70 ml (12-14 teaspoons) of blood from them. We will use this blood to grow more of the T cells in the laboratory. We will first grow an EBV-infected cell line by infecting the blood with EBV virus. This line will then be irradiated so it cannot grow and used to stimulate the T cells. This stimulation will train the T cells to kill cells with EBV on their surface. We will then grow these EBV-specific CTLs by more stimulation with EBV infected cells and a growth factor called Interleukin 2. Next, we will test the T cells to make sure that they kill the EBV-infected cells. If the number of T cells produced is low, we may need to obtain additional blood samples to make these cells.

The cells (which are the patient's own T cells) will be injected into them over 10 minutes, after pretreatment with Tylenol and Benadryl. A total of two doses will be given two weeks apart. All of the Treatments will be given by the Center for Cell and Gene Therapy at Texas Children's Hospital or the Methodist Hospital.

We will follow the patient in the clinic after the injections. To learn more about the way the T cells are working and how long they last in the body, an extra 10-60 mls (2-12 teaspoons) of blood will be taken before the infusion and 3-4 days after the infusion (this is optional). Up to 40 ml (8 teaspoons) of blood will also be drawn at 1, 2, 4 and 6 weeks post-infusion, and then at 3, 6, 9, and 12 months. The blood may be drawn from the patient's central line at the time of the regular blood tests. We will use this blood to look at the immune response to the patient's cancer. Over the course of the study, up to 29 tablespoons of blood will be drawn.

Patients will be enrolled at the first dose level and followed for six weeks after the second dose (which will constitute a course) for evaluation of any critical toxicity