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A Phase II Trial to Assess TroVax® Plus Chemotherapy in Patients With Malignant Pleural Mesothelioma (SKOPOS)

Primary Purpose

Malignant, Pleural, Mesothelioma

Status
Unknown status
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
TroVax®
Pemetrexed
Cisplatin
Vitamin B12
Folic Acid
Dexamethasone
Sponsored by
Wales Cancer Trials Unit
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant focused on measuring Phase II, Single arm, Vaccine

Eligibility Criteria

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

Inclusion Criteria:

  • Signed and dated written informed consent obtained from the patient in accordance with the local regulations
  • Locally advanced or metastatic, histologically or cytologically proven MPM
  • Aged 18 years or over
  • WHO performance status 0-1 (Appendix I)
  • Life expectancy > 6months
  • Haemoglobin ≥ 12 g/dl, total white cell count ≥ 3 x 10^9/L, neutrophil count > 1.5 x 10^9/L, lymphocyte count ≥1 x 10^9/L, monocyte count <0.8 x 10^9/L platelet count >100 x 10^9/L and <400 x 10^9/L. Blood transfusion is allowed.
  • Adequate renal function: Creatinine ≥ 50 mL/min as measured by EDTA or 60mL/min as measured by the Cockcroft-Gault formula
  • Adequate liver function: ALT, AST and bilirubin < 2 times the upper limit of normal
  • At least four weeks from any previous therapy including surgery, or radiotherapy
  • Able to comply with the protocol
  • Women must be either post-menopausal, or rendered surgically sterile or, if of child-bearing potential, must have a negative pregnancy test prior to trial entry. Two reliable forms of contraception (oral contraception and a barrier method) must be used by all participants while they are being treated with the TroVax® vaccine. Females must continue to use this level of contraception for 3 months following the last trial treatment, and male patients must continue for 1 month.

Exclusion Criteria:

  • Serious infections within the 28 days prior to entry to the trial.
  • Prior TroVax® treatment
  • Previous chemotherapy for MPM
  • Major surgery or radiation therapy completed ≤ 4 weeks prior to enrolment
  • Prior radiopharmaceuticals (strontium, samarium) less than 8 weeks prior to enrolment
  • Participation in any other clinical trial of a licensed or unlicensed drug within the previous 30 days
  • History of prior malignant disease unless patient has been disease-free for at least 3 years or the tumour was a non-melanoma skin cancer or early cervical cancer
  • Autoimmune disease including systemic Lupus Erythematosis, Grave's disease, Hashimoto's thyroiditis, multiple sclerosis, insulin dependent diabetes mellitus or systemic (non-joint) manifestations of rheumatoid disease
  • Clinical significant cardiac failure or a measured ejection fraction of <40%
  • Other severe acute or chronic medical or psychiatric conditions or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgement of the investigator, would make the patient inappropriate for entry into this study.
  • Chronic corticosteroid use unless prescribed as replacement therapy in the case of adrenal insufficiency, or other immunosuppressive agents. Dexamethasone is allowed as part of trial treatment.
  • Cerebral metastases
  • History of allergic response to previous vaccine vaccinations
  • Known allergy to egg proteins
  • Known to test positive for HIV or hepatitis B or C
  • Pregnancy or lactation
  • Prior history of organ transplantation

Sites / Locations

  • Velindre Cancer CentreRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TroVax®

Arm Description

In this single-arm study, all participants will receive 9 injections of the TroVax® vaccine, plus standard cisplatin and pemetrexed chemotherapy.

Outcomes

Primary Outcome Measures

Immune response to 5T4 and MVA antigens as measured by intracellular cytokine staining (ICCS)
To evaluate whether TroVax® is active in the treatment of MPM. This will be assessed by measuring the cellular or humoral anti-5T4 immune responses following treatment with TroVax® given in combination with Pem/Cis.

Secondary Outcome Measures

Safety and tolerability
To investigate the safety and tolerability of TroVax® in combination with Pem/Cis. This will be assessed from toxicity data, SAE reports and dose of chemotherapy received
Clinical activity in terms of PFS, ORR and OS
To assess secondary measures of clinical activity, including progression-free survival (PFS), objective response rate (ORR), overall survival (OS) at 6 months and 1 year
Relationship between immune response and clinical response
To explore the relationship between immune response (antibody and cellular responses against the tumour 5T4 and the MVA viral vector) and clinical response (PFS, ORR, OS).
Identify potential predictors of treatment benefit
To investigate the utility of (a) baseline platelet levels, (b) baseline monocyte levels and (c) baseline haemoglobin as predictors of treatment benefit.

Full Information

First Posted
March 28, 2012
Last Updated
March 11, 2013
Sponsor
Wales Cancer Trials Unit
Collaborators
Velindre NHS Trust, June Hancock Mesothelioma Research Fund, Velindre Cancer Centre Stepping Stones Appeal
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1. Study Identification

Unique Protocol Identification Number
NCT01569919
Brief Title
A Phase II Trial to Assess TroVax® Plus Chemotherapy in Patients With Malignant Pleural Mesothelioma
Acronym
SKOPOS
Official Title
A Phase II Trial to Assess the Safety, Immunological Activity of TroVax® Plus Pemetrexed/Cisplatin in Patients With Malignant Pleural Mesothelioma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Unknown status
Study Start Date
December 2012 (undefined)
Primary Completion Date
June 2014 (Anticipated)
Study Completion Date
December 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wales Cancer Trials Unit
Collaborators
Velindre NHS Trust, June Hancock Mesothelioma Research Fund, Velindre Cancer Centre Stepping Stones Appeal

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is for patients with malignant mesothelioma of the lung lining (called pleura) who are planning to have pemetrexed-cisplatin chemotherapy. We are investigating whether giving a vaccine called TroVax® with pemetrexed-cisplatin chemotherapy is both safe and potentially beneficial in patients with mesothelioma. This vaccine has been used in combination with chemotherapy in other types of cancer and has been shown to be safe. Cancer vaccines work by stimulating the person's immune system to fight the disease, in a similar way to the immune system fighting infection. In laboratory experiments, the vaccine has been shown to stimulate an immune response to a particular protein widely found on mesothelioma cells called 5T4. In patients with mesothelioma it is hoped that the vaccine will stimulate the immune system to attack mesothelioma cells carrying the 5T4 protein. Pemetrexed-cisplatin chemotherapy is currently seen as the best treatment for patients with mesothelioma, and this is why we plan to combine it with the vaccine. It is hoped that the combination of the TroVax® vaccine and chemotherapy is more beneficial than chemotherapy alone. Pemetrexed-cisplatin will be given into a vein in the arm (intravenously) every 3 weeks. The TroVax® vaccine will be given as an injection into the shoulder muscle (intramuscularly) 3 weeks before chemotherapy starts, one week before chemotherapy starts, then every 3 weeks. Each participant will receive 4 chemotherapy and 9 vaccine treatments if they complete the planned trial schedule. We aim to recruit 26 patients into the trial over a two year period. If this study shows that pemetrexed-cisplatin chemotherapy plus the TroVax® vaccine is safe and beneficial in terms of stimulating the immune system, the combination will be tested further in larger clinical trials.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant, Pleural, Mesothelioma
Keywords
Phase II, Single arm, 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
26 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TroVax®
Arm Type
Experimental
Arm Description
In this single-arm study, all participants will receive 9 injections of the TroVax® vaccine, plus standard cisplatin and pemetrexed chemotherapy.
Intervention Type
Biological
Intervention Name(s)
TroVax®
Intervention Description
Dose of 1 x 10^9 TCID 50/ml, in 1ml, given on day 1 of weeks 1, 3, 6, 9, 12, 15, 18, 21, 24.
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Intervention Description
500 mg/m^2 over 10 mins, given on day 3 of weeks 4, 7, 10, 13.
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
75mg/m^2 over 1 hour, given on day 3 of weeks 4, 7, 10, 13
Intervention Type
Dietary Supplement
Intervention Name(s)
Vitamin B12
Intervention Description
1000μg intramuscular, Day 2 of weeks 3 and 12
Intervention Type
Dietary Supplement
Intervention Name(s)
Folic Acid
Intervention Description
400μg oral daily from Day 2 of week 3 to Day 2 of week 16
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
4mg BD, Days 2-6 of weeks 4, 7, 10, 13
Primary Outcome Measure Information:
Title
Immune response to 5T4 and MVA antigens as measured by intracellular cytokine staining (ICCS)
Description
To evaluate whether TroVax® is active in the treatment of MPM. This will be assessed by measuring the cellular or humoral anti-5T4 immune responses following treatment with TroVax® given in combination with Pem/Cis.
Time Frame
34 weeks
Secondary Outcome Measure Information:
Title
Safety and tolerability
Description
To investigate the safety and tolerability of TroVax® in combination with Pem/Cis. This will be assessed from toxicity data, SAE reports and dose of chemotherapy received
Time Frame
34 weeks
Title
Clinical activity in terms of PFS, ORR and OS
Description
To assess secondary measures of clinical activity, including progression-free survival (PFS), objective response rate (ORR), overall survival (OS) at 6 months and 1 year
Time Frame
1 year
Title
Relationship between immune response and clinical response
Description
To explore the relationship between immune response (antibody and cellular responses against the tumour 5T4 and the MVA viral vector) and clinical response (PFS, ORR, OS).
Time Frame
1 year
Title
Identify potential predictors of treatment benefit
Description
To investigate the utility of (a) baseline platelet levels, (b) baseline monocyte levels and (c) baseline haemoglobin as predictors of treatment benefit.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated written informed consent obtained from the patient in accordance with the local regulations Locally advanced or metastatic, histologically or cytologically proven MPM Aged 18 years or over WHO performance status 0-1 (Appendix I) Life expectancy > 6months Haemoglobin ≥ 12 g/dl, total white cell count ≥ 3 x 10^9/L, neutrophil count > 1.5 x 10^9/L, lymphocyte count ≥1 x 10^9/L, monocyte count <0.8 x 10^9/L platelet count >100 x 10^9/L and <400 x 10^9/L. Blood transfusion is allowed. Adequate renal function: Creatinine ≥ 50 mL/min as measured by EDTA or 60mL/min as measured by the Cockcroft-Gault formula Adequate liver function: ALT, AST and bilirubin < 2 times the upper limit of normal At least four weeks from any previous therapy including surgery, or radiotherapy Able to comply with the protocol Women must be either post-menopausal, or rendered surgically sterile or, if of child-bearing potential, must have a negative pregnancy test prior to trial entry. Two reliable forms of contraception (oral contraception and a barrier method) must be used by all participants while they are being treated with the TroVax® vaccine. Females must continue to use this level of contraception for 3 months following the last trial treatment, and male patients must continue for 1 month. Exclusion Criteria: Serious infections within the 28 days prior to entry to the trial. Prior TroVax® treatment Previous chemotherapy for MPM Major surgery or radiation therapy completed ≤ 4 weeks prior to enrolment Prior radiopharmaceuticals (strontium, samarium) less than 8 weeks prior to enrolment Participation in any other clinical trial of a licensed or unlicensed drug within the previous 30 days History of prior malignant disease unless patient has been disease-free for at least 3 years or the tumour was a non-melanoma skin cancer or early cervical cancer Autoimmune disease including systemic Lupus Erythematosis, Grave's disease, Hashimoto's thyroiditis, multiple sclerosis, insulin dependent diabetes mellitus or systemic (non-joint) manifestations of rheumatoid disease Clinical significant cardiac failure or a measured ejection fraction of <40% Other severe acute or chronic medical or psychiatric conditions or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgement of the investigator, would make the patient inappropriate for entry into this study. Chronic corticosteroid use unless prescribed as replacement therapy in the case of adrenal insufficiency, or other immunosuppressive agents. Dexamethasone is allowed as part of trial treatment. Cerebral metastases History of allergic response to previous vaccine vaccinations Known allergy to egg proteins Known to test positive for HIV or hepatitis B or C Pregnancy or lactation Prior history of organ transplantation
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hayley Clements, BSc
Phone
+442920687500
Email
skopos@cardiff.ac.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Angela Casbard, MSc
Phone
+442920687500
Email
skopos@cardiff.ac.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jason F Lester, FRCR, MRCP
Organizational Affiliation
Velindre Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Velindre Cancer Centre
City
Cardiff
State/Province
South Wales
ZIP/Postal Code
CF14 2TL
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mick Button

12. IPD Sharing Statement

Learn more about this trial

A Phase II Trial to Assess TroVax® Plus Chemotherapy in Patients With Malignant Pleural Mesothelioma

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