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PSMA and TARP Peptide Vaccine With Poly IC-LC Adjuvant in HLA-A2 (+) Patients With Elevated PSA After Initial Definitive Treatment

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Peptide Vaccine
Poly IC-LC
Sponsored by
H. Lee Moffitt Cancer Center and Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring vaccine, PSMA, TARP, immunology, PSA

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • History of histologically confirmed prostate cancer.
  • Competence to understand the patient information and provide written informed consent, and willingness and ability to return to H. Lee Moffitt Cancer Center for planned treatments and follow-up.
  • Absence of evidence of metastatic disease by current physical exam or by current imaging studies (computed tomography [CT] or magnetic resonance imaging [MRI] pelvis, and bone scan within 60 days of first treatment).
  • Patients not on hormone therapy (stratum "N") must meet all of these:

    1. At least 1 year after prostatectomy, definitive prostate radiation, or other definitive-intent local therapy.
    2. No testosterone suppression therapy for at least 6 months.
    3. PSA at least 1 ng/ml, on 2 measurements, at least 2 weeks apart.
    4. Testosterone level >100 ng/ml, at start ("noncastrate").
  • Patients on hormone therapy (stratum "Y") must meet all of these:

    1. On treatment with gonadotropin-releasing hormone (GnRH) agonist (or orchiectomy) at least 6 months.
    2. testosterone level <50 ng/ml, at start.
    3. PSA at least 1 ng/ml, on 2 measurements, at least 2 weeks apart.
  • Laboratory values obtained 0-14 days prior to start of therapy:

    1. White blood count (WBC) over 3,500/micro L.
    2. Platelet count over 100,000 micro L.
    3. Hemoglobin over 10.0 g/dL.
    4. Serum creatinine up to 2.0 mg/dL.
    5. Alkaline phosphatase up to 2.5 x upper limit of normal (ULN).
    6. Aspartic transaminase (AST) up to 2.5 x ULN.
  • Life expectancy at least 6 months.
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1.

Exclusion Criteria:

  • Known standard therapy for the patient's disease that is potentially curative.
  • A known immunodeficiency including HIV. Appropriate trials for individuals with HIV may be considered at a later date.
  • History of other malignancy besides prostate cancer in the last 5 years, except non-melanoma skin cancer treated with local resection only. (The effect of study treatment on other, potentially dormant malignant diseases is not known).
  • Use of oral or inhaled or parenteral corticosteroids or of other immunomodulatory drugs within the 60 days of start. [Use of steroids after start will be considered by the principal investigator (PI) on a case-by-case basis.]
  • Use of estrogens (including herbal phytoestrogens) or ketoconazole within 30 days of start, or during the study.
  • Failure to fully recover to grade 1 or better from effects of prior chemotherapy regardless of interval since last treatment.
  • Other concurrent chemotherapy, immunotherapy, radiotherapy, or investigational agent in last 30 days (one month washout to start of treatment; patients could register but not start until the washout).
  • Known hypersensitivity to one or more components of the study medication.
  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

Sites / Locations

  • H. Lee Moffitt Cancer Center & Research Institute
  • Ponce School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

A. Level 100 mcg Peptide Vaccine

B. Level 300 mcg Peptide Vaccine

C. Level 1 mg Peptide Vaccine

Arm Description

Peptide vaccine dose level 100 mcg + Poly IC-LC

Peptide vaccine dose level 300 mcg + Poly IC-LC

Peptide vaccine dose level 1 mg + Poly IC-LC

Outcomes

Primary Outcome Measures

Occurrence of Related Adverse Events - Grade 3 or Higher
Number of participants with related Grade 3 or higher adverse events. Establish the safety and toxicity of varying doses of polypeptide vaccines PSMA and TARP administered with a fixed dose of Poly IC-LC as an adjuvant.

Secondary Outcome Measures

Number of Participants With Prostatic Specific Antigen (PSA) Doubling
Number of Participants Who Had a Doubling of the PSA or Proceeded to Another Therapy. Assess the impact of the vaccine on the pattern of PSA change in patients with castrate testosterone level and in patients with non-suppressed testosterone level not on hormone therapy.
Number of Participants Who Did Not Have PSA Doubling
Number of participants who did not have a PSA doubling before their last study visit, median 458 days from baseline PSA (55-613).

Full Information

First Posted
June 4, 2008
Last Updated
October 2, 2019
Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
National Institutes of Health (NIH)
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1. Study Identification

Unique Protocol Identification Number
NCT00694551
Brief Title
PSMA and TARP Peptide Vaccine With Poly IC-LC Adjuvant in HLA-A2 (+) Patients With Elevated PSA After Initial Definitive Treatment
Official Title
Pilot Immunotherapy Study of Combination PSMA and TARP Peptide With Poly IC-LC Adjuvant in HLA-A2 (+) Patients With Elevated PSA After Initial Definitive Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
December 2, 2008 (Actual)
Primary Completion Date
February 28, 2013 (Actual)
Study Completion Date
December 6, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
National Institutes of Health (NIH)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Pilot Immunotherapy Study of Combination Prostate Specific Membrane Antigen (PSMA) and T-cell receptor γ alternate reading frame protein (TARP) Peptide With Poly IC-LC Adjuvant in Human Leukocyte Antigens (HLA)-A2 (+) Patients With Elevated prostatic specific antigen (PSA) After Initial Definitive Treatment The purpose of the study is to see if the PSMA/TARP proteins in the vaccine, along with the Hiltonol, can arouse and train the immune system to kill the prostate cancer cells. Prostate cancer is the most common cancer and is the second leading cause of cancer deaths in U.S. males. It is curable when it is confined to the prostate (kept from spreading) using surgery or radiation treatments. In some patients the cancer can come back after these treatments. Treatment options for prostate cancer that comes back include procedures or medications which may have significant risks and side effects. Another plan is being looked at that uses the body's immune system to attack prostate cancer cells. A vaccine has been developed that has proteins found in prostate cancer cells. One of the proteins is called PSMA and the other is called TARP. In addition to these proteins, another substance called Poly IC-LC (Hiltonol) will be added to the vaccine to boost its ability to start the immune system.
Detailed Description
Detailed Objectives: Estimate the frequency of immunological efficacy of the vaccine by comparison of the in vitro enzyme-linked immunosorbent spot (ELISpot) test results, for each antigen (PSMA, TARP) from peripheral blood specimens collected during the periods of time defined as "before", "during" and "after" vaccination. Study the safety and toxicity of varying doses of polypeptide vaccines: PSMA27-35-PSMA687-701 (VLAGGFFLLYRHVIYAPSSHNKYA) and TARP13-35 (LQLLKQSSRRLEHTFMFLRNFSL) administered with a fixed dose of Poly IC-LC (2 mg total/treatment) as adjuvant. Describe the impact of the vaccine on the pattern of PSA change in 2 subsets of patients: with castrate testosterone; with non-suppressed testosterone level/not on hormone therapy. Identify if there is a basis for selection of a dose of the PSMA and the TARP polypeptide vaccines for future phase II development of this vaccination strategy, considering the dose range tested.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
vaccine, PSMA, TARP, immunology, PSA

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
29 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A. Level 100 mcg Peptide Vaccine
Arm Type
Experimental
Arm Description
Peptide vaccine dose level 100 mcg + Poly IC-LC
Arm Title
B. Level 300 mcg Peptide Vaccine
Arm Type
Experimental
Arm Description
Peptide vaccine dose level 300 mcg + Poly IC-LC
Arm Title
C. Level 1 mg Peptide Vaccine
Arm Type
Experimental
Arm Description
Peptide vaccine dose level 1 mg + Poly IC-LC
Intervention Type
Biological
Intervention Name(s)
Peptide Vaccine
Other Intervention Name(s)
Hiltonol, poly IC-LC, PSMA peptide vaccine, TARP peptide vaccine
Intervention Description
Peptide vaccine (PSMA and TARP peptide vaccine with Poly IC-LC adjuvant). Pilot study using three treatment arms of increasing peptide dose levels (100 mcg, 300 mcg, and 1 mg) with a fixed dose of Poly IC-LC as an adjuvant. Patients were randomly assigned to one of the 3 arms upon enrollment.
Intervention Type
Drug
Intervention Name(s)
Poly IC-LC
Other Intervention Name(s)
Hiltonol, NSC-301463
Intervention Description
Administered subcutaneously, one 2 mg/ml vial,(divided into two equal portions for each injection site).
Primary Outcome Measure Information:
Title
Occurrence of Related Adverse Events - Grade 3 or Higher
Description
Number of participants with related Grade 3 or higher adverse events. Establish the safety and toxicity of varying doses of polypeptide vaccines PSMA and TARP administered with a fixed dose of Poly IC-LC as an adjuvant.
Time Frame
Up to 48 months
Secondary Outcome Measure Information:
Title
Number of Participants With Prostatic Specific Antigen (PSA) Doubling
Description
Number of Participants Who Had a Doubling of the PSA or Proceeded to Another Therapy. Assess the impact of the vaccine on the pattern of PSA change in patients with castrate testosterone level and in patients with non-suppressed testosterone level not on hormone therapy.
Time Frame
Up to 48 months
Title
Number of Participants Who Did Not Have PSA Doubling
Description
Number of participants who did not have a PSA doubling before their last study visit, median 458 days from baseline PSA (55-613).
Time Frame
Up to 48 months

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: History of histologically confirmed prostate cancer. Competence to understand the patient information and provide written informed consent, and willingness and ability to return to H. Lee Moffitt Cancer Center for planned treatments and follow-up. Absence of evidence of metastatic disease by current physical exam or by current imaging studies (computed tomography [CT] or magnetic resonance imaging [MRI] pelvis, and bone scan within 60 days of first treatment). Patients not on hormone therapy (stratum "N") must meet all of these: At least 1 year after prostatectomy, definitive prostate radiation, or other definitive-intent local therapy. No testosterone suppression therapy for at least 6 months. PSA at least 1 ng/ml, on 2 measurements, at least 2 weeks apart. Testosterone level >100 ng/ml, at start ("noncastrate"). Patients on hormone therapy (stratum "Y") must meet all of these: On treatment with gonadotropin-releasing hormone (GnRH) agonist (or orchiectomy) at least 6 months. testosterone level <50 ng/ml, at start. PSA at least 1 ng/ml, on 2 measurements, at least 2 weeks apart. Laboratory values obtained 0-14 days prior to start of therapy: White blood count (WBC) over 3,500/micro L. Platelet count over 100,000 micro L. Hemoglobin over 10.0 g/dL. Serum creatinine up to 2.0 mg/dL. Alkaline phosphatase up to 2.5 x upper limit of normal (ULN). Aspartic transaminase (AST) up to 2.5 x ULN. Life expectancy at least 6 months. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1. Exclusion Criteria: Known standard therapy for the patient's disease that is potentially curative. A known immunodeficiency including HIV. Appropriate trials for individuals with HIV may be considered at a later date. History of other malignancy besides prostate cancer in the last 5 years, except non-melanoma skin cancer treated with local resection only. (The effect of study treatment on other, potentially dormant malignant diseases is not known). Use of oral or inhaled or parenteral corticosteroids or of other immunomodulatory drugs within the 60 days of start. [Use of steroids after start will be considered by the principal investigator (PI) on a case-by-case basis.] Use of estrogens (including herbal phytoestrogens) or ketoconazole within 30 days of start, or during the study. Failure to fully recover to grade 1 or better from effects of prior chemotherapy regardless of interval since last treatment. Other concurrent chemotherapy, immunotherapy, radiotherapy, or investigational agent in last 30 days (one month washout to start of treatment; patients could register but not start until the washout). Known hypersensitivity to one or more components of the study medication. Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mayer Fishman, M.D., Ph.D.
Organizational Affiliation
H. Lee Moffitt Cancer Center and Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
H. Lee Moffitt Cancer Center & Research Institute
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Ponce School of Medicine
City
Ponce
ZIP/Postal Code
00716
Country
Puerto Rico

12. IPD Sharing Statement

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PSMA and TARP Peptide Vaccine With Poly IC-LC Adjuvant in HLA-A2 (+) Patients With Elevated PSA After Initial Definitive Treatment

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