External Beam Radiation With Intratumoral Injection of Dendritic Cells As Neo-Adjuvant Treatment for Sarcoma

Inclusion Criteria

• Intermediate or high grade sarcoma as determined by pathology review
• Musculoskeletal tumor in extremities, trunk or chest wall.
• Primary tumor or isolated locally recurrent tumor greater than 5 cm in diameter.
• Clinical Stage T2N0M0 (AJCC 6th edition)
• Patient is not a candidate for neoadjuvant chemotherapy.
• Performance status Eastern Cooperative Oncology Group (ECOG) 0 or 1.
• No steroid therapy within 4 weeks of first dendritic cell administration.
• No coagulation disorder.
• Patient's written informed consent.
• No contraindication to resection.
• Adequate organ function (measured within a week of beginning treatment).
• White blood count (WBC) > 3, 000/mm to the third power and absolute neutrophil count (ANC) >1500/mm to the third power
• Platelets > 100, 000/mm to the third power
• Hematocrit > 25%
• Bilirubin 60 mL/min
• Radiation Oncologist must confirm that a 2-3 cm strip of skin can be spared from radiation.

Exclusion Criteria

• Retroperitoneal location.
• Gastrointestinal stromal tumor (GIST).
• Demonstrated metastatic disease.
• Prior radiation therapy if the current tumor is locally recurrent after prior resection.
• Concurrent treatment with any anticancer agent other than radiation as dictated by the protocol.
• Bleeding disorder.
• H.I.V. infection or other primary immunodeficiency disorder.
• Ongoing systemic therapy with immunosuppressant drugs (e.g. corticosteroids, azathioprine, cyclosporin, methotrexate).
• Any serious ongoing infection.
• Pregnant or lactating women -- Patients in reproductive age must agree to use contraceptive methods for the duration of the study (a pregnancy test will be obtained before treatment).
• ECOG performance status of 2, 3 or 4.