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HSPPC-96 Vaccine With Temozolomide in Patients With Newly Diagnosed GBM (HeatShock)

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HSPPC-96
Temozolomide
Standard Surgical Resection
Sponsored by
University of California, San Francisco
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring Newly Diagnosed Glioblastoma Multiforme, vaccine

Eligibility Criteria

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

Inclusion Criteria:

Pre-surgery tissue acquisition Inclusion criteria

  1. Age > or equal to 18 years old
  2. Life expectancy of greater than 12 weeks.
  3. Able to read and understand the informed consent document; must sign the informed consent
  4. Must have suspected diagnosis of Glioblastoma Multiforme with a surgical intent to resect at least 90% of enhancing disease
  5. Must be eligible for post-surgical treatment with radiotherapy and temozolomide

Post-radiation therapy/pre-vaccine eligibility Inclusion criteria

  1. Agree to use contraception or abstain from sexual activity from the time of consent through 1 month after the end of study drug administration
  2. Negative serum pregnancy test for female patients of childbearing potential
  3. Patients with histologically proven, non-progressive glioblastoma multiforme (GBM)
  4. Patient must have received standard of care radiation and temozolomide therapy
  5. Must have undergone a at least a 90% resection (determined by the principal investigator (PI)) measured by postoperative magnetic resonance imaging (MRI) scan, T1-weighted contrast scan, or CT scan if clinically indicated, performed within 72 hours after surgery
  6. All radiotherapy must be discontinued at least 2 weeks and no more than 5 weeks prior to the first planned vaccine administration
  7. Availability of at least 4 doses of vaccine (at least 4 vials for clinical administration produced from the tumor provided)
  8. Karnofsky functional status rating > or equal to 70
  9. Adequate bone marrow function including the absence of lymphopenia (ANC > 1,500/ mm3; absolute lymphocyte count (ALC) > 500/mm3 ; platelet count >100,000/mm3), adequate liver function (serum glutamic oxaloacetic transaminase/ aspartate aminotransferase (AST), alanine amino transferase (ALT), and alkaline phosphatase <2.5 times institutional upper limit of normals [IULNs] and bilirubin (total) <1.5 mg*IULN), and adequate renal function (BUN and creatinine <1.5 times IULNs

Exclusion Criteria:

Pre-surgery tissue acquisition

  1. Current diagnosis of Human Immunodeficiency Virus (HIV testing is not required per protocol)
  2. Any prior diagnosis of any other cancer or other concurrent malignancy, with the exception of adequately treated nonmetastatic in situ carcinoma of the uterine cervix or nonmetastatic nonmelanoma skin cancer unless in complete remission and off all therapy for that disease for a minimum of 5 years
  3. Any systemic autoimmune disease (e.g., Hashimoto's thyroiditis) and/or any history of primary or secondary immunodeficiency
  4. Any prior therapy for glioma
  5. Planned use or current use of other investigational therapy for the treatment of glioma

Post-radiation therapy/pre-vaccine Exclusion

  1. Inability to comply with study-related procedures
  2. Prior diagnosis of any other cancer or other concurrent malignancy, with the exception of adequately treated nonmetastatic in situ carcinoma of the uterine cervix or nonmetastatic nonmelanoma skin cancer unless in complete remission and off all therapy for that disease for a minimum of 5 years
  3. Current or active use of chemotherapy (except temozolomide) or immune therapy
  4. Contrast MRI findings (or CT scan if MRI is clinically contraindicated) consistent with progression per protocol defined modified Response assessment in neuro-oncology criteria (RANO) criteria. Progression prior to vaccination as determined by the Principal Investigator
  5. Patients with active uncontrolled infection
  6. Evidence of bleeding diathesis
  7. Unstable or severe intercurrent medical conditions
  8. Female patients who are pregnant or breastfeeding

Sites / Locations

  • University of California, San Francisco
  • University of Miami
  • Northwestern University
  • Johns Hopkins Hospital
  • The Valley Hospital
  • Northern Westchester Hospital
  • Columbia University
  • University of Oklahoma
  • University of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Protein Peptide-Complex (HSPPC-96)

Arm Description

Patients will receive 4 weekly injections of HSPPC-96 followed by a 5th vaccine injection on the same day of the start of maintenance temozolomide administered 2 weeks (+ 4 days) following vaccine administration #4 on the same day of the start of maintenance temozolomide (Day 36). Monthly vaccine injections will then begin on day 21 (+/- 7 days) of the first 28 day temozolomide cycle (Day 56 of the study), 3 weeks following vaccine administration #5 and will continue every 28 days until depletion of vaccine or progression.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-Related Adverse Events of Any Grade
Median Overall Survival
Overall survival is defined as the time from surgical resection to death of any cause.

Secondary Outcome Measures

Median Progression Free Survival (PFS)
PFS is defined as the duration of progression-free survival from the time from resection until either documented disease progression or death
Median PD-L1 Positivity in Circulating Myeloid Cells
Circulating myeloid cells (CD45+/CD11b+) obtained from patients at the time of surgery were analyzed for PD-L1 expression to determine the percent of myeloid cells positive for PD-L1 (cut off for positivity determined relative to Fluorescence Minus One (FMO) and isotype control).

Full Information

First Posted
May 18, 2009
Last Updated
March 23, 2021
Sponsor
University of California, San Francisco
Collaborators
Agenus Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00905060
Brief Title
HSPPC-96 Vaccine With Temozolomide in Patients With Newly Diagnosed GBM
Acronym
HeatShock
Official Title
PHASE 2, Multi-center, Single Arm Investigation of HSPPC-96 Vaccine With Temozolomide in Patients With Newly Diagnosed Glioblastoma Multiforme
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Completed
Study Start Date
June 29, 2009 (Actual)
Primary Completion Date
June 3, 2014 (Actual)
Study Completion Date
June 3, 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of California, San Francisco
Collaborators
Agenus Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase II trial studies the side effects and how well HSPPC-96 (vitespen) and temozolomide work in treating patients with newly diagnosed glioblastoma multiforme. Vaccines made from a person's tumor cells and heat shock protein peptide may help the body to build an effective immune response to kill tumor cells. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving HSPPC-96 (vitespen) together with temozolomide may kill more tumor cells.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate the safety profile of HSPPC-96 (vitespen) administered concurrently with temozolomide in patients with newly diagnosed glioblastoma multiforme (GBM). II. To evaluate survival in patients treated with an autologous tumor-derived heat shock protein peptide-complex (HSPPC-96) with concurrent temozolomide. SECONDARY OBJECTIVES: I. To evaluate progression-free survival (PFS) from date of surgical resection. II. To evaluate the immunologic response to vaccine treatment in a subset of evaluable patients. OUTLINE: Approximately 2-5 weeks after standard radiation therapy and temozolomide completion, patients receive vitespen intradermally (ID) on days 1, 8, 15, and 22. Beginning 2 weeks after the 4th dose of vitespen, patients receive a 5th dose of vitespen ID and maintenance temozolomide orally (PO) on days 1-5 (of 28 day courses). On day 21 of course 1, patients receive the 6th dose of vitespen ID and continue vaccinations monthly. Courses repeat every 28 days in the absence of vaccine depletion, disease progression, or unacceptable toxicity. After completion of study treatment, patients are followed up every 12 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors
Keywords
Newly Diagnosed Glioblastoma Multiforme, vaccine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Protein Peptide-Complex (HSPPC-96)
Arm Type
Experimental
Arm Description
Patients will receive 4 weekly injections of HSPPC-96 followed by a 5th vaccine injection on the same day of the start of maintenance temozolomide administered 2 weeks (+ 4 days) following vaccine administration #4 on the same day of the start of maintenance temozolomide (Day 36). Monthly vaccine injections will then begin on day 21 (+/- 7 days) of the first 28 day temozolomide cycle (Day 56 of the study), 3 weeks following vaccine administration #5 and will continue every 28 days until depletion of vaccine or progression.
Intervention Type
Biological
Intervention Name(s)
HSPPC-96
Other Intervention Name(s)
Heat Shock, Vitespen
Intervention Description
Autologous tumor-derived heat shock protein peptide-complex (HSPPC-96) administered at 25 μg per dose injected intradermally once weekly for 4 consecutive weeks and monthly following standard treatment with radiation and temozolomide.
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Other Intervention Name(s)
Temodar
Intervention Description
Maintenance temozolomide treatment is given 2 weeks after administration of the fourth vaccine at an initial dose of 150 mg per square meter (mg/m2) for 5 consecutive days in a 28-day cycle. The dose was increased to 200 mg/m2 for 5 days in subsequent cycles.
Intervention Type
Procedure
Intervention Name(s)
Standard Surgical Resection
Other Intervention Name(s)
Craniotomy
Intervention Description
Patients will undergo standard surgical resection of intracranial tumor
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-Related Adverse Events of Any Grade
Time Frame
Up to 3 years
Title
Median Overall Survival
Description
Overall survival is defined as the time from surgical resection to death of any cause.
Time Frame
Up to 3 years
Secondary Outcome Measure Information:
Title
Median Progression Free Survival (PFS)
Description
PFS is defined as the duration of progression-free survival from the time from resection until either documented disease progression or death
Time Frame
Up to 3 years
Title
Median PD-L1 Positivity in Circulating Myeloid Cells
Description
Circulating myeloid cells (CD45+/CD11b+) obtained from patients at the time of surgery were analyzed for PD-L1 expression to determine the percent of myeloid cells positive for PD-L1 (cut off for positivity determined relative to Fluorescence Minus One (FMO) and isotype control).
Time Frame
Up to 53 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pre-surgery tissue acquisition Inclusion criteria Age > or equal to 18 years old Life expectancy of greater than 12 weeks. Able to read and understand the informed consent document; must sign the informed consent Must have suspected diagnosis of Glioblastoma Multiforme with a surgical intent to resect at least 90% of enhancing disease Must be eligible for post-surgical treatment with radiotherapy and temozolomide Post-radiation therapy/pre-vaccine eligibility Inclusion criteria Agree to use contraception or abstain from sexual activity from the time of consent through 1 month after the end of study drug administration Negative serum pregnancy test for female patients of childbearing potential Patients with histologically proven, non-progressive glioblastoma multiforme (GBM) Patient must have received standard of care radiation and temozolomide therapy Must have undergone a at least a 90% resection (determined by the principal investigator (PI)) measured by postoperative magnetic resonance imaging (MRI) scan, T1-weighted contrast scan, or CT scan if clinically indicated, performed within 72 hours after surgery All radiotherapy must be discontinued at least 2 weeks and no more than 5 weeks prior to the first planned vaccine administration Availability of at least 4 doses of vaccine (at least 4 vials for clinical administration produced from the tumor provided) Karnofsky functional status rating > or equal to 70 Adequate bone marrow function including the absence of lymphopenia (ANC > 1,500/ mm3; absolute lymphocyte count (ALC) > 500/mm3 ; platelet count >100,000/mm3), adequate liver function (serum glutamic oxaloacetic transaminase/ aspartate aminotransferase (AST), alanine amino transferase (ALT), and alkaline phosphatase <2.5 times institutional upper limit of normals [IULNs] and bilirubin (total) <1.5 mg*IULN), and adequate renal function (BUN and creatinine <1.5 times IULNs Exclusion Criteria: Pre-surgery tissue acquisition Current diagnosis of Human Immunodeficiency Virus (HIV testing is not required per protocol) Any prior diagnosis of any other cancer or other concurrent malignancy, with the exception of adequately treated nonmetastatic in situ carcinoma of the uterine cervix or nonmetastatic nonmelanoma skin cancer unless in complete remission and off all therapy for that disease for a minimum of 5 years Any systemic autoimmune disease (e.g., Hashimoto's thyroiditis) and/or any history of primary or secondary immunodeficiency Any prior therapy for glioma Planned use or current use of other investigational therapy for the treatment of glioma Post-radiation therapy/pre-vaccine Exclusion Inability to comply with study-related procedures Prior diagnosis of any other cancer or other concurrent malignancy, with the exception of adequately treated nonmetastatic in situ carcinoma of the uterine cervix or nonmetastatic nonmelanoma skin cancer unless in complete remission and off all therapy for that disease for a minimum of 5 years Current or active use of chemotherapy (except temozolomide) or immune therapy Contrast MRI findings (or CT scan if MRI is clinically contraindicated) consistent with progression per protocol defined modified Response assessment in neuro-oncology criteria (RANO) criteria. Progression prior to vaccination as determined by the Principal Investigator Patients with active uncontrolled infection Evidence of bleeding diathesis Unstable or severe intercurrent medical conditions Female patients who are pregnant or breastfeeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jennifer Clarke, MD
Organizational Affiliation
University of California, San Francisco
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
The Valley Hospital
City
Paramus
State/Province
New Jersey
ZIP/Postal Code
07652
Country
United States
Facility Name
Northern Westchester Hospital
City
Mount Kisco
State/Province
New York
ZIP/Postal Code
10549
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
University of Oklahoma
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28193626
Citation
Bloch O, Lim M, Sughrue ME, Komotar RJ, Abrahams JM, O'Rourke DM, D'Ambrosio A, Bruce JN, Parsa AT. Autologous Heat Shock Protein Peptide Vaccination for Newly Diagnosed Glioblastoma: Impact of Peripheral PD-L1 Expression on Response to Therapy. Clin Cancer Res. 2017 Jul 15;23(14):3575-3584. doi: 10.1158/1078-0432.CCR-16-1369. Epub 2017 Feb 13.
Results Reference
result

Learn more about this trial

HSPPC-96 Vaccine With Temozolomide in Patients With Newly Diagnosed GBM

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