| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| metastatic endometrial cancer | 
 
| Uitgezaaide baarmoeder kanker | 
 
 
 | 
| E.1.1.1 | Medical condition in easily understood language  | 
| Patients with metastatic endometrial cancer | 
 
| Patiënten met een uitgezaaide baarmoederkanker | 
 
 
 | 
| E.1.1.2 | Therapeutic area  | Diseases [C] - Female diseases of the urinary and reproductive systems and pregancy complications [C13] | 
| MedDRA Classification | 
| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
| The primary objective of this exploratory study is to show immunologic efficacy of tumor-peptide-loaded natural DC in mEC patients. The immune-monitoring will include: a) functional response and dextramer analysis of DTH infiltrating lymphocytes against tumor peptides, b) type I IFN gene expression in PBMC shortly after vaccination, and c) proliferative, effector cytokine- and humoral responses to keyhole limpet hemocyanin (KLH), an immunogenic protein providing T cell help. | 
 
Het primaire doel van dit verkennende onderzoek is het aantonen van immunologische werkzaamheid van tumor-peptide-geladen natuurlijke DC in mEC-patiënten die chemotherapie ondergaan. De immuunbewaking omvat: a) functionele respons en dextramer-analyse van DTH-infiltrerende lymfocyten tegen tumorpeptiden, b) type I IFN-genexpressie in PBMC kort na vaccinatie, en c) proliferatieve, effector cytokine- en humorale responsen op hemodonine met sleutelgatzeeslak (KLH), een immunogeen eiwit dat hulp biedt aan T-cellen. 
 | 
 
 
 | 
| E.2.2 | Secondary objectives of the trial  | 
| The secondary objectives are the safety, feasibility and quality of life of natural DC vaccinations in combination with chemotherapy. | 
 
| De secundaire doelstellingen zijn de veiligheid, haalbaarheid en kwaliteit van leven van natuurlijke DC-vaccinaties in combinatie met chemotherapie. | 
 
 
 | 
| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
	women ≥ 18 years old with histologically confirmed stage IV or metastatic carcinoma of the endometrium of the endometroid, serous or carcinosarcoma type.  •	Hormone receptor negative or o	resistant to hormonal therapy o	ineligible for hormonal therapy because of other reasons •	eligible for treatment with carboplatin paclitaxel combination chemotherapy •	Life expectancy ≥ 6 months  •	WHO/ECOG performance status 0-1 (Karnofsky index 100-70) •	WBC >2.0109/l, neutrophils >1.5109/L lymphocytes >0.8109/L, platelets >100109/L, hemoglobin >5,6 mmol/L (9.0 g/dL), serum creatinine <150 µmol/L, AST/ALT <3 x ULN, serum bilirubin <1.5 x ULN (exception: Gilbert’s syndrome is permitted) •	Expression of survivin and/or muc1 on tumor material •	Expected adequacy of follow-up •	Postmenopausal or evidence of non-childbearing status or for women of childbearing potential: negative urine or serum pregnancy test, within 28 days of study treatment and confirmed prior to treatment on day 1 •	Written informed consent | 
 
vrouwen 18 jaar en ouder met een histologisch bevestigd stadium IV of gemetastaseerd carcinoom van het endometrium van het endometroid, sereus of carcinosarcoma-type. • Hormoonreceptor negatief of o resistent tegen hormonale therapie o om andere redenen niet in aanmerking komen voor hormonale therapie • in aanmerking komt voor behandeling met carboplatine-combinatie met paclitaxelcombinatie • Levensverwachting ≥ 6 maanden • WHO / ECOG-prestatiestatus 0-1 (Karnofsky-index 100-70) • WBC> 2.0109 / l, neutrofielen> 1.5109 / L-lymfocyten> 0.8109 / L, bloedplaatjes> 100109 / L, hemoglobine> 5,6 mmol / L (9,0 g / dL), serumcreatinine < 150 μmol / L, AST / ALT <3 x ULN, serumbilirubine <1,5 x ULN (uitzondering: Gilbert-syndroom is toegestaan) • Expressie van survivin en/of muc1 op tumormateriaal • Verwachte adequaatheid van de follow-up • Postmenopauzaal of bewijs van niet-vruchtbare leeftijd of voor vrouwen in de vruchtbare leeftijd: negatieve urine- of serumzwangerschapstest, binnen 28 dagen na de onderzoeksbehandeling en bevestigd voorafgaand aan de behandeling op dag 1 • Schriftelijke geïnformeerde toestemming | 
 
 
 | 
| E.4 | Principal exclusion criteria | 
•Eligible for hormonal therapy 	 •Uncontrolled hypercalcemia •History of any second malignancy in the previous 5 years, with the exception of adequately treated basal cell carcinoma  •Known allergy to shell fish  •Heart failure (NYHA class III/IV) •Serious active infections •Active hepatitis B, C or HIV infection •Active syphilis infection •Autoimmune diseases (exception: vitiligo is permitted)   •Organ allografts •An uncontrolled co-morbidity, e.g. psychiatric or social conditions interfering which participation  •Concurrent use of systemic corticosteroids > 10 mg daily prednisone equivalent •Any serious clinical condition that may interfere with the safe administration of DC vaccinations •Unable to undergo a tumor biopsy  •Pregnancy or insufficient anti-conception if reproduction is still possible | 
 
• In aanmerking komend voor hormonale therapie • Ongecontroleerde hypercalciëmie • Voorgeschiedenis van een tweede maligniteit in de afgelopen 5 jaar, met uitzondering van adequaat behandeld basaalcelcarcinoom • Bekende allergie voor schaaldieren • Hartfalen (NYHA klasse III / IV) • Ernstige actieve infecties • Actieve hepatitis B-, C- of HIV-infectie • Actieve syfilisinfectie • Auto-immuunziekten (uitzondering: vitiligo is toegestaan) • Orgaallotransplantaten • Een ongecontroleerde co-morbiditeit, b.v. psychiatrische of sociale omstandigheden die deelname verstoren • Gelijktijdig gebruik van systemische corticosteroïden> prednison-equivalent van 10 mg per dag • Elke ernstige klinische aandoening die het veilig toedienen van DC-vaccinaties kan verstoren • Kan geen tumorbiopsie ondergaan  • Zwangerschap of onvoldoende anticonceptie als reproductie nog steeds mogelijk is | 
 
 
 | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| The primary endpoint of the study is to evaluate the immune responses towards tumor peptide-loaded nDC in mEC patients. We will study: a) functional responses and tetramer analysis of DTH infiltrating lymphocytes against tumor peptides and b) type I IFN gene expression in PBMC shortly after vaccination, and c) proliferative, effector cytokine- and humoral responses.  | 
 
| Het primaire eindpunt van de studie is om de immuunresponsen tegen tumorpeptide beladen nDC bij mEC-patiënten te evalueren. We bestuderen: a) functionele responsen en tetrameer-analyse van DTH infiltrerende lymfocyten tegen tumorpeptiden en b) type I IFN genexpressie in PBMC kort na vaccinatie, en c) proliferatieve, effector cytokine- en humorale responsen.  | 
 
 
 | 
| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| After every round of vaccination, immunological response will be measured in DTH biopsies and in blood. | 
 
| Na elke vaccinatie ronde zal de afweer response gemeten worden in de biopten die genomen zijn van de DTH sites en in het bloed. | 
 
 
 | 
| E.5.2 | Secondary end point(s) | 
| The secondary objectives are the safety, feasibility and quality of life of nDC vaccinations in combination with chemotherapy. | 
 
| De secundaire doelstellingen zijn de veiligheid, haalbaarheid en kwaliteit van leven van natuurlijke DC-vaccinaties in combinatie met chemotherapie. | 
 
 
 | 
| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
| Q of L before, after 3 vaccinations and end of study | 
 
| Q of L voor start studie, na 3 vaccinaties en bij het einde van de studie. | 
 
 
 | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  Yes  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  Yes  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  No  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  No  | 
| E.8.1.1 | Randomised |  No  | 
| E.8.1.2 | Open |  Yes  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  No  | 
| E.8.1.5 | Parallel group |  No  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  No  | 
| E.8.2.3 | Other |  No  | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  Yes  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  No  | 
| E.8.5 | The trial involves multiple Member States |  No  | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  No  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  No  | 
| E.8.7 | Trial has a data monitoring committee |  No  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
| LVLS | 
 
| Laatste bezoek van de laatste patient | 
 
 
 | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 3 | 
| E.8.9.1 | In the Member State concerned months | 0 | 
| E.8.9.1 | In the Member State concerned days | 0 |