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SGN-00101 Vaccine in Treating Human Papillomavirus in Patients Who Have Abnormal Cervical Cells

Primary Purpose

Atypical Squamous Cells of Undetermined Significance, Cervical Cancer, High-grade Squamous Intraepithelial Lesion

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HspE7
placebo
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Atypical Squamous Cells of Undetermined Significance

Eligibility Criteria

18 Years - 50 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Meets criteria for 1 of the following groups: Prospective group, meeting the following criteria: Evidence of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL) by Pap test Human papillomavirus (HPV)-16-positive by polymerase chain reaction (PCR) and PGMY09/PGMY11 oligonucleotide primers viral load assay Medical records-based group, meeting the following criteria: Medical-record evidence of ASCUS or LSIL by Pap test within the past 6-12 months Meets 1 of the following criteria: Liquid-cytology findings of ASCUS or LSIL Colposcopic evidence of a LSIL by the Reid Index score of 1-5 Historically persistent HPV-16-infection by PCR and HPV reverse transcription (RT)-PCR No evidence of high-grade squamous intraepithelial lesions (HSIL) by colposcopy (Reid Index ≥ 6) Reports no sex partner change since last index Pap screening test Specimen-based group, meeting the following criteria: Medical-record evidence of ASCUS or LSIL by Pap test within the past 6-12 months Liquid-based cytology specimen available Meets 1 of the following criteria: Liquid-cytology findings of ASCUS or LSIL Colposcopic evidence of a LSIL by the Reid Index score of 1-5 Historically persistent HPV-16-infection by PCR and, where measurable, HPV RT-PCR showing no greater than 3-fold reduction over the index liquid-cytology specimen No evidence of HSIL by colposcopy (Reid Index ≥ 6) Menstrual period occurred at least once within the past 52 weeks No HSIL by Pap test within the past year Performance status - ECOG 0 No severe or unstable coagulation Hepatitis B surface antigen negative Hepatitis C antibody negative No angina No heart failure No other cardiac condition No respiratory condition No asthma No immunological disorders (e.g., lupus, diabetes, multiple sclerosis, or myasthenia gravis) Not immunocompromised, suggestive of severe immune deficiency HIV negative No AIDS No active infection, defined as fever > 100° F No syphilis No severe allergic reactions (anaphylactic response) to drugs or any other allergen No history of allergy to any vaccine constituents, including cell- or tissue-system elements used to prepare the vaccine (e.g., bread products, yeast, or recombinant DNA technology using yeast systems) Must agree to use effective form of contraception throughout vaccination period Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during vaccination period and for 5 months after study treatment No sexual intercourse within 48 hours of virus specimen collection during study visits No objects (e.g., tampons, douche, suppositories, fingers, or toes) within the vagina or rectum within 48 hours of virus specimen collection during study visits No prior malignancy except nonmelanoma skin cancer No medical or psychiatric illness than would preclude study participation or compliance No other disorders requiring medical intervention that would preclude study participation No prior HPV vaccine More than 30 days since prior investigational vaccine More than 30 days since prior systemic steroid therapy No prior splenectomy More than 30 days since prior investigational drug More than 72 hours since prior antibiotic therapy for active infection

Sites / Locations

  • University of California Medical Center At Irvine-Orange Campus

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm I (SGN-00101)

Arm II (placebo)

Arm Description

Patients receive SGN-00101 vaccine SC on day 1 of weeks 1, 4, and 8 for a maximum of 3 injections in the absence of unacceptable toxicity or the development of an invasive malignancy or serious illness.

Patients receive placebo vaccine SC on day 1 of weeks 1, 4, and 8 for a maximum of 3 injections in the absence of unacceptable toxicity or the development of an invasive malignancy or serious illness.

Outcomes

Primary Outcome Measures

HPV-16 viral load
Following the univariate modeling, multivariate logistic regression models will be constructed by adding the demographic factors, baseline viral load, and type of cellular atypia to the model. The univariate logistic regression model for infection resolution is equivalent to a chi-square test.
Natural history of HPV 16 viral load
A repeated measures version of the zero-inflated log-normal model will be constructed.
Natural history of HPV 16 viral load
A repeated measures version of the zero-inflated log-normal model will be constructed.
Natural history of HPV 16 viral load
A repeated measures version of the zero-inflated log-normal model will be constructed.
Regression or non-regression of the cellular atypia
The analysis for this will employ logistic regression models. A multivariate logistic regression model will be constructed. . A two group continuity corrected chi squared test with a 0.050 two-sided significance level will be used.

Secondary Outcome Measures

HPV-16 viral load
Following the univariate modeling, multivariate logistic regression models will be constructed by adding the demographic factors, baseline viral load, and type of cellular atypia to the model. The univariate logistic regression model for infection resolution is equivalent to a chi-square test.
Time to infection resolution
Kaplan Meier curves will be constructed.
Time to disease resolution
Kaplan Meier curves will be constructed.

Full Information

First Posted
September 7, 2004
Last Updated
May 31, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00091130
Brief Title
SGN-00101 Vaccine in Treating Human Papillomavirus in Patients Who Have Abnormal Cervical Cells
Official Title
An Exploratory Study to Evaluate the Effect of HPV 16 Vaccine on the Reduction of Viral Load in HPV 16 Positive Women With Persistent Viral Infection, But Low Grade Disease (ASCUS/LSIL)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
September 2004 (undefined)
Primary Completion Date
June 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
This randomized phase II trial is studying how well SGN-00101 vaccine works compared to a placebo in treating human papillomavirus and preventing cervical cancer in patients with abnormal cervical cells. Vaccines, such as SGN-00101, may make the body build an immune response to kill human papillomavirus and abnormal cervical cells and may be effective in preventing cervical cancer
Detailed Description
PRIMARY OBJECTIVES: I. Compare the effectiveness of SGN-00101 vaccine vs placebo in reducing the human papillomavirus (HPV)-16 viral load in patients with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL) of the cervix with persistent HPV-16 infection who are at increased risk for developing a high-grade squamous intraepithelial lesion or invasive cervical cancer. II. Compare the natural history of HPV-16 viral load in patients treated with these regimens. III. Compare the effect of HPV-16 variants on viral load response in patients treated with these regimens. IV. Compare the relative effectiveness of these regimens on the regression of cervical cellular atypias (based on Pap test results), in terms of the regression of cytologic findings of LSIL and ASCUS to normal findings and resolution or regression of colposcopically defined cervicovaginal lesions, in these patients. OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive SGN-00101 vaccine subcutaneously (SC) on day 1 of weeks 1, 4, and 8 for a maximum of 3 injections in the absence of unacceptable toxicity or the development of an invasive malignancy or serious illness. ARM II: Patients receive placebo vaccine SC on day 1 of weeks 1, 4, and 8 for a maximum of 3 injections in the absence of unacceptable toxicity or the development of an invasive malignancy or serious illness. Patients are followed at 12, 24, and 52 weeks after the last vaccination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atypical Squamous Cells of Undetermined Significance, Cervical Cancer, High-grade Squamous Intraepithelial Lesion, Low-grade Squamous Intraepithelial Lesion

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
139 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I (SGN-00101)
Arm Type
Experimental
Arm Description
Patients receive SGN-00101 vaccine SC on day 1 of weeks 1, 4, and 8 for a maximum of 3 injections in the absence of unacceptable toxicity or the development of an invasive malignancy or serious illness.
Arm Title
Arm II (placebo)
Arm Type
Placebo Comparator
Arm Description
Patients receive placebo vaccine SC on day 1 of weeks 1, 4, and 8 for a maximum of 3 injections in the absence of unacceptable toxicity or the development of an invasive malignancy or serious illness.
Intervention Type
Biological
Intervention Name(s)
HspE7
Other Intervention Name(s)
HPV 16 E7/HSP65 Vaccine, HPV E7 Peptide Epitope Vaccine, SGN-00101
Intervention Description
Given SC
Intervention Type
Other
Intervention Name(s)
placebo
Other Intervention Name(s)
PLCB
Intervention Description
Given SC
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
HPV-16 viral load
Description
Following the univariate modeling, multivariate logistic regression models will be constructed by adding the demographic factors, baseline viral load, and type of cellular atypia to the model. The univariate logistic regression model for infection resolution is equivalent to a chi-square test.
Time Frame
6 months
Title
Natural history of HPV 16 viral load
Description
A repeated measures version of the zero-inflated log-normal model will be constructed.
Time Frame
Baseline
Title
Natural history of HPV 16 viral load
Description
A repeated measures version of the zero-inflated log-normal model will be constructed.
Time Frame
3 months
Title
Natural history of HPV 16 viral load
Description
A repeated measures version of the zero-inflated log-normal model will be constructed.
Time Frame
6 months
Title
Regression or non-regression of the cellular atypia
Description
The analysis for this will employ logistic regression models. A multivariate logistic regression model will be constructed. . A two group continuity corrected chi squared test with a 0.050 two-sided significance level will be used.
Time Frame
Up to 52 weeks
Secondary Outcome Measure Information:
Title
HPV-16 viral load
Description
Following the univariate modeling, multivariate logistic regression models will be constructed by adding the demographic factors, baseline viral load, and type of cellular atypia to the model. The univariate logistic regression model for infection resolution is equivalent to a chi-square test.
Time Frame
3 months
Title
Time to infection resolution
Description
Kaplan Meier curves will be constructed.
Time Frame
Up to 52 weeks
Title
Time to disease resolution
Description
Kaplan Meier curves will be constructed.
Time Frame
Up to 52 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Meets criteria for 1 of the following groups: Prospective group, meeting the following criteria: Evidence of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL) by Pap test Human papillomavirus (HPV)-16-positive by polymerase chain reaction (PCR) and PGMY09/PGMY11 oligonucleotide primers viral load assay Medical records-based group, meeting the following criteria: Medical-record evidence of ASCUS or LSIL by Pap test within the past 6-12 months Meets 1 of the following criteria: Liquid-cytology findings of ASCUS or LSIL Colposcopic evidence of a LSIL by the Reid Index score of 1-5 Historically persistent HPV-16-infection by PCR and HPV reverse transcription (RT)-PCR No evidence of high-grade squamous intraepithelial lesions (HSIL) by colposcopy (Reid Index ≥ 6) Reports no sex partner change since last index Pap screening test Specimen-based group, meeting the following criteria: Medical-record evidence of ASCUS or LSIL by Pap test within the past 6-12 months Liquid-based cytology specimen available Meets 1 of the following criteria: Liquid-cytology findings of ASCUS or LSIL Colposcopic evidence of a LSIL by the Reid Index score of 1-5 Historically persistent HPV-16-infection by PCR and, where measurable, HPV RT-PCR showing no greater than 3-fold reduction over the index liquid-cytology specimen No evidence of HSIL by colposcopy (Reid Index ≥ 6) Menstrual period occurred at least once within the past 52 weeks No HSIL by Pap test within the past year Performance status - ECOG 0 No severe or unstable coagulation Hepatitis B surface antigen negative Hepatitis C antibody negative No angina No heart failure No other cardiac condition No respiratory condition No asthma No immunological disorders (e.g., lupus, diabetes, multiple sclerosis, or myasthenia gravis) Not immunocompromised, suggestive of severe immune deficiency HIV negative No AIDS No active infection, defined as fever > 100° F No syphilis No severe allergic reactions (anaphylactic response) to drugs or any other allergen No history of allergy to any vaccine constituents, including cell- or tissue-system elements used to prepare the vaccine (e.g., bread products, yeast, or recombinant DNA technology using yeast systems) Must agree to use effective form of contraception throughout vaccination period Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during vaccination period and for 5 months after study treatment No sexual intercourse within 48 hours of virus specimen collection during study visits No objects (e.g., tampons, douche, suppositories, fingers, or toes) within the vagina or rectum within 48 hours of virus specimen collection during study visits No prior malignancy except nonmelanoma skin cancer No medical or psychiatric illness than would preclude study participation or compliance No other disorders requiring medical intervention that would preclude study participation No prior HPV vaccine More than 30 days since prior investigational vaccine More than 30 days since prior systemic steroid therapy No prior splenectomy More than 30 days since prior investigational drug More than 72 hours since prior antibiotic therapy for active infection
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frank Meyskens
Organizational Affiliation
University of California Medical Center At Irvine-Orange Campus
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California Medical Center At Irvine-Orange Campus
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States

12. IPD Sharing Statement

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SGN-00101 Vaccine in Treating Human Papillomavirus in Patients Who Have Abnormal Cervical Cells

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