Vaccination of Patients with Ovarian Cancer with Dendritic Cell/Tumor Fusions with GM-CSF and Imiquimod

This research study is evaluating the effect (good and bad) of a dendritic cell/tumor
fusion vaccine in combination with the laboratory made agents GM-CSF and imiquimod on the
participants immune system. Another purpose of this study is to determine the type and
severity of any side effects associated with this new study vaccine. We will also be
evaluating what effect the vaccine has on the participants cancer. Dendritic cell
vaccines have already been tested in clinical trials involving participants with many
different types of cancer. Dendritic cells are powerful immune-stimulating cells that are
normally found in small amounts in the body and are responsible for immune responses
against "foreign" substances that enter the body.

Inclusion criteria at time of initial enrollment:

- Patients must have undergone therapeutic debulking surgery for independent clinical
indications and have tissue frozen and stored under sterile conditions as part of
protocol 07-319 (Study of Primary Tumor Harvest for the Purpose of Possible Use in a
Future Clinical Trial in Patients with Ovarian, Fallopian Tube, or Primary
Peritoneal Cancer)

- Patients with histologically proven stage III or IV ovarian, fallopian tube or
primary peritoneal serous carcinoma (or patients of any stage with recurrent
disease) who demonstrate lack of disease progression as determined by clinical
assessment as well as CA-125 levels and/or radiographic assessment

- Patients must have ECOG performance status of 0-2 with greater than six week life
expectancy.

- All patients must be informed of the investigational nature of this study and must
give written informed consent in accordance with institutional and federal
guidelines.

- Laboratories:WBC > 2.0 X 103/uL, Platelets > 50,000/uL, Bilirubin < 2.0 mg/dL,
Creatinine <2.0 mg/dL, AST/ALT < 2.5 x ULN

Eligibility criteria prior to first vaccination

At a maximum of twelve weeks after the last dose of chemotherapy, patients must fulfill
the following criteria:

- Complete clinical response after first-line chemotherapy for newly-diagnosed
patients, or after second-line chemotherapy for relapsed patients who require
secondary cytoreduction.**

- Asymptomatic, low volume disease not requiring further chemotherapy prior to
initiating vaccination

** Complete clinical response is defined as normal exam, normal CT scan, and normal
CA-125 level. Tumor tissue for relapsed patients would be obtained under informed
consent at the time of a secondary surgical debulking, which would be performed as
part of standard relapse management in appropriate patients.

- Resolution of all chemotherapy related grade III-IV toxicity

- Laboratories:WBC > 2.0 X 103/uL, Platelets > 50,000/uL, Bilirubin < 2.0 mg/dL
Creatinine <2.0 mg/dL, AST/ALT < 2.5 x ULN

Exclusion Criteria:

- Patient with progressive disease during first line chemotherapy with a
platinum/taxane combination will be excluded.

- Patients must not have clinically significant autoimmune disease that requires
treatment with immunosuppressant medications.

- Because of compromised cellular immunity and limited capacity to respond to
vaccination, patients who are HIV+ will be excluded.

- Patients must not have serious intercurrent illness such as infection requiring IV
antibiotics, or significant cardiac disease characterized by significant arrhythmia,
unstable ischemic coronary disease or congestive heart failure.

- Pregnant and/or lactating women will be excluded. Premenopausal patients will
undergo pregnancy testing when indicated. Women will practice effective birth
control while receiving protocol treatment.

- Patients with a history of clinically significant venous thromboembolism will be
excluded.

- Active second malignancy, aside from basal cell or squamous cell carcinoma of the
skin (i.e. malignancy not treated with curative intent or diagnosis within the past
2 years)