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