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Pilot Study of a Breast Cancer Vaccine Plus Poly-ICLC for Breast Cancer (Breast 41)

Primary Purpose

Breast Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
poly-ICLC
9 Peptides from Her-2/neu, CEA, & CTA
Peptide-tet
Sponsored by
Craig L Slingluff, Jr
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring breast cancer, peptide vaccine, immunotherapy

Eligibility Criteria

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

Inclusion:

  • Patients who have been diagnosed with clinical or pathologic stage I to stage IV adenocarcinoma of the breast (any subtype) who have undergone, and recovered from primary therapy (any combination of surgery, radiation, and/or chemotherapy and/or HER2-directed therapy), with their last dose/treatment (of any single or combination treatment) being between 28 days and 36 months prior to enrollment. Staging will be based on the Seventh Edition AJCC staging system. (Systemic staging with CT or PET scans is not required by AJCC and is not required or exclusionary for this trial).
  • Stage IA patients must be high risk based upon triple negative status or HER2+ status
  • Patients may or may not be receiving hormonal therapy at the time of study entry.
  • Age ≥ 18 years at the time of enrollment
  • ECOG performance status of 0 or 1
  • Ability and willingness to give informed consent
  • HLA-A1, -A2, -A3, or -A31 positive
  • Adequate organ function
  • HIV and Hepatitis C negative
  • Subjects must have a minimum of two intact lymph node basins (any combination of axillary and inguinal basins that have not undergone complete nodal dissection)

Exclusion Criteria

  • Known or suspected allergies to any component of the vaccine
  • Active infection requiring antibiotics are excluded.
  • The following medications or treatments within the 4 weeks (28 days) prior to consenting. These medication and treatments may not be re-started at any time throughout the study in order to remain eligible.

    • Breast tumor resection surgery (reconstructive surgery permitted)
    • Chemotherapy
    • Radiation therapy
    • Allergy desensitization injections
    • Growth factors (e.g., Procrit®, Aranesp®, Neulasta®)
    • Other agents with putative immunomodulating activity (with the exception of non-steroidal anti-inflammatory agents)
    • Any investigational medication
  • Tthe following medications or treatments within the 4 weeks (28 days) prior to consenting:

    • Corticosteroids, administered parenterally, orally, or inhaled (Inhaled steroids, such as: Advair®, Flovent®, Azmacort.®)
    • Topical corticosteroids are acceptable.
  • Previous vaccination with any of the synthetic peptides included in this protocol.
  • Active tuberculosis and not on active antitubercular agents
  • Pregnancy.
  • Female subjects must not be breastfeeding
  • A medical contraindication or potential problem in complying with the requirements of the protocol, in the opinion of the investigator
  • New York Heart Association classification as having Class III or IV heart disease
  • Stage IV subjects who have anticipated chemotherapy need within the 108 day treatment period for this trial.
  • Subjects that have experienced active autoimmune disorders requiring cytotoxic or immunosuppressive therapy within the 6 weeks (42 days) prior to consenting.

    • The following will not be exclusionary:

      • The presence of laboratory evidence of autoimmune disease (e.g., positive ANA titer) without symptoms
      • Clinical evidence of vitiligo
      • Other forms of depigmenting illness
      • Mild arthritis requiring NSAID medications

Sites / Locations

  • University of Virginia Health System

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

9 Peptides from Her-2/neu, CEA, & CTA, peptide-tet, poly-ICLC

Arm Description

9 class I MHC-restricted synthetic peptides (100 mcg each peptide) derived from breast cancer associated proteins, a class II MHC-restricted tetanus derived peptide (200 mcg), plus polyICLC (1 mg).

Outcomes

Primary Outcome Measures

Safety (Frequency of dose limiting adverse events)
Immune response rate
Measured as the number of IFN-gamma producing cells in the blood in response to the vaccine.

Secondary Outcome Measures

Safety (adverse event profile)
Immunogenicity- CD8+ T cell specificity
Characterize vaccine specific peripheral CD8+ T-cell specificity by tetramer staining and flow cytometric analysis
Immunogenicity- CD8+ cytokine production
Estimate the Tc1/Tc2 cytokine production bias of circulating vaccine-specific T cells.
Immunogenicity- immue responses among subjects treated with anti-estrogen therapies
Using the ELIspot assay, describe the frequency of immune responses among patients treated with anti-estrogen therapies

Full Information

First Posted
February 8, 2012
Last Updated
May 7, 2020
Sponsor
Craig L Slingluff, Jr
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1. Study Identification

Unique Protocol Identification Number
NCT01532960
Brief Title
Pilot Study of a Breast Cancer Vaccine Plus Poly-ICLC for Breast Cancer
Acronym
Breast 41
Official Title
A Pilot Study of the Immunogenicity of a 9-Peptide Breast Cancer Vaccine Plus Poly-ICLC in Stage I-IV Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Terminated
Why Stopped
Futility for immune responses to the vaccine. Also, a component of study drug was in short supply.
Study Start Date
July 2012 (undefined)
Primary Completion Date
September 2015 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Craig L Slingluff, Jr

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Despite advances in surgical, radiation and medical therapies of early stage breast cancer, some patients will experience disease recurrence. Because recurrence may not happen for years after definitive treatment, there is a period of time between resection and relapse when micrometastatic disease may be amenable to immune eradication or modulation. While the ultimate goal of any cancer treatment is clinical efficacy, the immediate urgency in breast immunotherapy is to define treatments that have immunologic efficacy. In this study, the investigators will determine whether a vaccine consisting of nine-class I breast specific peptides plus a class II tetanus toxoid helper peptide is immunogenic when administered with poly-ICLC to participants with stage IB to IIIA breast cancer in the adjuvant setting.
Detailed Description
The study is a single arm, open label, pilot study of safety and immune efficacy of peptide vaccination with poly-ICLC in patients with stage IB-IIIA resected breast cancer. Participants will be patients who have completed their last dose/treatment of any single treatment or combination of adjuvant surgery, radiation, chemotherapy or trastuzumab therapy between 45 days and 6 months (180 days) prior to enrollment. Each vaccination will be administered on days 1, 8, 15, 36, 57, and 78. All participants will receive 9 class I MHC-restricted synthetic peptides (restricted by HLA-A1, -A2, -A3, or -A31) and a class II MHC-restricted tetanus helper peptide mixed with 1mg poly-ICLC and administered in sterile water. The vaccine will be administered intramuscular (IM) (1 ml) and intradermally (ID) (1 ml) at vaccination sites in the arm and leg. (Each vaccine given IM and ID at one site; site to alternate between arm site opposite the breast cancer and an anterior thigh site.) Participants will be screened for HLA type and must be HLA-A1, -A2, -A3, or -A31 (80% of the Virginia population in prior studies1). Annual follow-up for progression and survival for 3 years after study withdrawal/completion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
breast cancer, peptide vaccine, immunotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
9 Peptides from Her-2/neu, CEA, & CTA, peptide-tet, poly-ICLC
Arm Type
Experimental
Arm Description
9 class I MHC-restricted synthetic peptides (100 mcg each peptide) derived from breast cancer associated proteins, a class II MHC-restricted tetanus derived peptide (200 mcg), plus polyICLC (1 mg).
Intervention Type
Biological
Intervention Name(s)
poly-ICLC
Intervention Description
poly-ICLC
Intervention Type
Biological
Intervention Name(s)
9 Peptides from Her-2/neu, CEA, & CTA
Intervention Description
9 synthetic peptides derived from Her-2/neu, CEA & CTA derived breast cancer proteins.
Intervention Type
Biological
Intervention Name(s)
Peptide-tet
Intervention Description
A class II MHC-restricted helper peptide derived from tetanus toxoid protein.
Primary Outcome Measure Information:
Title
Safety (Frequency of dose limiting adverse events)
Time Frame
30 days post-administration of the last vaccine
Title
Immune response rate
Description
Measured as the number of IFN-gamma producing cells in the blood in response to the vaccine.
Time Frame
through day 108
Secondary Outcome Measure Information:
Title
Safety (adverse event profile)
Time Frame
30 days post-administration of the last vaccine
Title
Immunogenicity- CD8+ T cell specificity
Description
Characterize vaccine specific peripheral CD8+ T-cell specificity by tetramer staining and flow cytometric analysis
Time Frame
through day 108
Title
Immunogenicity- CD8+ cytokine production
Description
Estimate the Tc1/Tc2 cytokine production bias of circulating vaccine-specific T cells.
Time Frame
through day 108
Title
Immunogenicity- immue responses among subjects treated with anti-estrogen therapies
Description
Using the ELIspot assay, describe the frequency of immune responses among patients treated with anti-estrogen therapies
Time Frame
through day 108

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion: Patients who have been diagnosed with clinical or pathologic stage I to stage IV adenocarcinoma of the breast (any subtype) who have undergone, and recovered from primary therapy (any combination of surgery, radiation, and/or chemotherapy and/or HER2-directed therapy), with their last dose/treatment (of any single or combination treatment) being between 28 days and 36 months prior to enrollment. Staging will be based on the Seventh Edition AJCC staging system. (Systemic staging with CT or PET scans is not required by AJCC and is not required or exclusionary for this trial). Stage IA patients must be high risk based upon triple negative status or HER2+ status Patients may or may not be receiving hormonal therapy at the time of study entry. Age ≥ 18 years at the time of enrollment ECOG performance status of 0 or 1 Ability and willingness to give informed consent HLA-A1, -A2, -A3, or -A31 positive Adequate organ function HIV and Hepatitis C negative Subjects must have a minimum of two intact lymph node basins (any combination of axillary and inguinal basins that have not undergone complete nodal dissection) Exclusion Criteria Known or suspected allergies to any component of the vaccine Active infection requiring antibiotics are excluded. The following medications or treatments within the 4 weeks (28 days) prior to consenting. These medication and treatments may not be re-started at any time throughout the study in order to remain eligible. Breast tumor resection surgery (reconstructive surgery permitted) Chemotherapy Radiation therapy Allergy desensitization injections Growth factors (e.g., Procrit®, Aranesp®, Neulasta®) Other agents with putative immunomodulating activity (with the exception of non-steroidal anti-inflammatory agents) Any investigational medication Tthe following medications or treatments within the 4 weeks (28 days) prior to consenting: Corticosteroids, administered parenterally, orally, or inhaled (Inhaled steroids, such as: Advair®, Flovent®, Azmacort.®) Topical corticosteroids are acceptable. Previous vaccination with any of the synthetic peptides included in this protocol. Active tuberculosis and not on active antitubercular agents Pregnancy. Female subjects must not be breastfeeding A medical contraindication or potential problem in complying with the requirements of the protocol, in the opinion of the investigator New York Heart Association classification as having Class III or IV heart disease Stage IV subjects who have anticipated chemotherapy need within the 108 day treatment period for this trial. Subjects that have experienced active autoimmune disorders requiring cytotoxic or immunosuppressive therapy within the 6 weeks (42 days) prior to consenting. The following will not be exclusionary: The presence of laboratory evidence of autoimmune disease (e.g., positive ANA titer) without symptoms Clinical evidence of vitiligo Other forms of depigmenting illness Mild arthritis requiring NSAID medications
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick M Dillon, MD
Organizational Affiliation
University of Virginia
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Virginia Health System
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29157306
Citation
Dillon PM, Petroni GR, Smolkin ME, Brenin DR, Chianese-Bullock KA, Smith KT, Olson WC, Fanous IS, Nail CJ, Brenin CM, Hall EH, Slingluff CL Jr. A pilot study of the immunogenicity of a 9-peptide breast cancer vaccine plus poly-ICLC in early stage breast cancer. J Immunother Cancer. 2017 Nov 21;5(1):92. doi: 10.1186/s40425-017-0295-5.
Results Reference
derived

Learn more about this trial

Pilot Study of a Breast Cancer Vaccine Plus Poly-ICLC for Breast Cancer

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