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Vaccine Therapy for Treating Patients With Previously Untreated Chronic Lymphocytic Leukemia (CLL)

Primary Purpose

Chronic Lymphocytic Leukemia (CLL)

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Oncoquest-CLL vaccine
Sponsored by
XEME Biopharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Lymphocytic Leukemia (CLL) focused on measuring Cancer vaccine, Chronic lymphocytic leukemia, CLL, Autologous vaccine, B cell leukemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must have histologically confirmed B-CLL with low or intermediate risk disease as defined by the modified Rai criteria.
  2. Patients must have lymphocytosis with white blood cells between 30,000-100,000/microliters (uL) in order to collect adequate leukemia cells for vaccine production.
  3. Patients must have evidence of disease progression as demonstrated by an increase of more than 50% in lymphocytosis since diagnosis and/or lymphadenopathy and a lymphocyte doubling time of more than 6 months. Patients must have had at least 3 months of observation since diagnosis.
  4. Patients must be age 18 years or older
  5. Patients must exhibit an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  6. Patients must have adequate renal and hepatic function:

    • Serum creatinine less than or equal to 2.0 mg/deciliter (dL)
    • Total Bilirubin less than or equal to 2.0 mg/dL
    • Serum glutamic-oxaloacetic transaminase/serum glutamate pyruvate transaminase (SGOT/SGPT) less than or equal to 2.5 x upper limit of normal (ULN)
  7. Females of childbearing potential and sexually active males must consent to use of effective contraception. Child-bearing potential is defined as any female (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:

    • Has not undergone a hysterectomy or bilateral oophorectomy; OR
    • Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding consecutive 12 months).
  8. All patients must have given signed, informed consent prior to registration on study.

Exclusion Criteria:

  1. Patients who meet any of the NCI Working Group criteria to initiate treatment for CLL are NOT eligible for participation
  2. Patients who have had or are currently receiving any treatment for CLL, including chemotherapy, corticosteroids, biologic therapy, or immunotherapy are NOT eligible for participation.
  3. Patients who are actively receiving steroids or non-steroidal antiinflammatory drugs (NSAIDs) on a chronic basis and who are unwilling and/or unable to discontinue while on study therapy are NOT eligible for participation. NOTE: Patients must have discontinued steroids or NSAIDs for 1 week prior to registration to be considered eligible for participation.
  4. Patients who are receiving cyclosporine, tacrolimus, or other chronic immunosuppressive agents are NOT eligible for participation.
  5. Patients who exhibit any active or ongoing autoimmune processes including, but not limited to, autoimmune hemolytic anemia or immune thrombocytopenia purpura, are NOT eligible for participation.
  6. Although rare, the only exception to this would be patients with Hashimoto's thyroiditis who ARE eligible for participation.
  7. Patients who demonstrate the presence of antibodies to HIV or hepatitis C or presence of hepatitis B surface antigen or other active infectious process that could suppress the immune system and potentially interfere with the development of an immune response to the tumor antigen are NOT eligible for participation.
  8. Patients who have a previous or concomitant malignancy are NOT eligible for participation EXCEPT for the following:

    • Patients with curatively treated squamous or basal cell carcinoma of the skin or effectively treated carcinoma in situ of the cervix ARE eligible for participation.
    • Patient who had a stage 1 solid tumor which has been adequately treated with curative intent, and has been in remission for more than 1 year.
    • Patients with a prior solid tumor who have been in remission more than 5 years ARE eligible for participation.
  9. Patients who exhibit any significant concurrent, uncontrolled medical or psychiatric condition that in the opinion of the investigator would compromise the patient's ability to tolerate this treatment are NOT eligible for participation.
  10. Patients who are pregnant or lactating are NOT eligible for participation.

Sites / Locations

  • Robert H. Lurie Comprehensive Cancer Center at Northwestern University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Oncoquest-CLL vaccine treatment

Arm Description

Patients receive Oncoquest-CLL vaccine subcutaneously on Day 1 and 15, and then monthly for 3 months in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Incidence of adverse events graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
Safety data will be tabulated for all patients and include vital signs, laboratory parameters, and adverse events. Toxicities will be summarized descriptively by type and attribution.
Feasibility in terms of vaccine production.
The rate of successful production of the vaccine will be calculated. Successful production (feasibility) will be dichotomous. Dichotomous outcomes will be summarized using proportions and exact 95% binomial confidence intervals.
Feasibility in terms of vaccine delivery.
The rate of successful delivery of the vaccine will be calculated. Successful delivery (feasibility) will be dichotomous. Dichotomous outcomes will be summarized using proportions and exact 95% binomial confidence intervals.

Secondary Outcome Measures

Clinical response evaluated using IWCLL2008 guidelines.
Clinical response to vaccination will be evaluated by parameters of reduction in leukemia cell count, lymph node size, liver and spleen size, and reduction in amount of disease in bone marrow) and improved hematologic parameters (including hemoglobin and platelet count).
In vitro immune response evaluated using T-cell and B-cell immune responses.
T-cell and B-cell responses will be summarized using medians and nonparametric confidence intervals.
Progression-free survival.
Change in absolute lymphocyte count.
Change in lymphocyte doubling time.

Full Information

First Posted
October 29, 2013
Last Updated
April 7, 2021
Sponsor
XEME Biopharma Inc.
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01976520
Brief Title
Vaccine Therapy for Treating Patients With Previously Untreated Chronic Lymphocytic Leukemia (CLL)
Official Title
NU 13H05: A Phase Ib Trial of Oncoquest-CLL Vaccine for Treatment-Naive Patients With Chronic Lymphocytic Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 2013 (undefined)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
January 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
XEME Biopharma Inc.
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Phase I trial studies the safety and efficacy of vaccine therapy in treating patients with previously untreated chronic lymphocytic leukemia. Liposome-based vaccines containing an extract of a person's cancer cells and the immunostimulant interleukin-2 may help the body to build an effective immune response to kill cancer cells.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate the safety of vaccination with Oncoquest-Chronic Lymphocytic Leukemia (CLL) vaccine (autologous tumor cell extract vaccine). II. To evaluate the feasibility of Oncoquest-CLL production and administration to previously untreated patients with CLL. SECONDARY OBJECTIVES: I. To evaluate the clinical response [as defined by the International Workshop on Chronic Lymphocytic Leukemia 2008 (iwCLL2008)] of the Oncoquest-CLL vaccine in treatment-naive patients with CLL. II. To evaluate the T and B cell immune responses against autologous leukemia cells induced with Oncoquest-CLL vaccine. III. To measure the progression-free survival of patients treated with the Oncoquest-CLL vaccine. IV. To evaluate the change in absolute lymphocyte count and lymphocyte doubling time before and after vaccine administration and correlate this with immune response. OUTLINE: Patients receive autologous tumor vaccine subcutaneously (SC) on Study Day 1 and 15, and then monthly for 3 months in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up monthly for 3 months, and then every 3 months for up to 1 year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia (CLL)
Keywords
Cancer vaccine, Chronic lymphocytic leukemia, CLL, Autologous vaccine, B cell leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Oncoquest-CLL vaccine treatment
Arm Type
Experimental
Arm Description
Patients receive Oncoquest-CLL vaccine subcutaneously on Day 1 and 15, and then monthly for 3 months in the absence of disease progression or unacceptable toxicity.
Intervention Type
Biological
Intervention Name(s)
Oncoquest-CLL vaccine
Other Intervention Name(s)
ATCE Vaccine, ATCEV, Autologous Tumor Vaccine, Oncoquest-CLL
Intervention Description
Comparison of 4 different dose levels of Oncoquest-CLL vaccine: 100 micrograms (mcg)/0.2 milliliters (mL), 200 mcg/0.4 mL, 375 mcg/0.75 mL, and 500 mcg/mL. Patients will receive a total of 5 doses of vaccines; the first 2 doses separated by 2 week intervals and the last 3 doses by 1 month intervals. Vaccine will be given by sc injections in 2 sites in upper arms or legs.
Primary Outcome Measure Information:
Title
Incidence of adverse events graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
Description
Safety data will be tabulated for all patients and include vital signs, laboratory parameters, and adverse events. Toxicities will be summarized descriptively by type and attribution.
Time Frame
Up to 30 days post-vaccination
Title
Feasibility in terms of vaccine production.
Description
The rate of successful production of the vaccine will be calculated. Successful production (feasibility) will be dichotomous. Dichotomous outcomes will be summarized using proportions and exact 95% binomial confidence intervals.
Time Frame
Up to 4 weeks.
Title
Feasibility in terms of vaccine delivery.
Description
The rate of successful delivery of the vaccine will be calculated. Successful delivery (feasibility) will be dichotomous. Dichotomous outcomes will be summarized using proportions and exact 95% binomial confidence intervals.
Time Frame
Up to 15 weeks.
Secondary Outcome Measure Information:
Title
Clinical response evaluated using IWCLL2008 guidelines.
Description
Clinical response to vaccination will be evaluated by parameters of reduction in leukemia cell count, lymph node size, liver and spleen size, and reduction in amount of disease in bone marrow) and improved hematologic parameters (including hemoglobin and platelet count).
Time Frame
Up to 1 year.
Title
In vitro immune response evaluated using T-cell and B-cell immune responses.
Description
T-cell and B-cell responses will be summarized using medians and nonparametric confidence intervals.
Time Frame
Up to 1 year.
Title
Progression-free survival.
Time Frame
Up to 1 year.
Title
Change in absolute lymphocyte count.
Time Frame
Baseline to up to 1 year.
Title
Change in lymphocyte doubling time.
Time Frame
Baseline to up to 1 year.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically confirmed B-CLL with low or intermediate risk disease as defined by the modified Rai criteria. Patients must have lymphocytosis with white blood cells between 30,000-100,000/microliters (uL) in order to collect adequate leukemia cells for vaccine production. Patients must have evidence of disease progression as demonstrated by an increase of more than 50% in lymphocytosis since diagnosis and/or lymphadenopathy and a lymphocyte doubling time of more than 6 months. Patients must have had at least 3 months of observation since diagnosis. Patients must be age 18 years or older Patients must exhibit an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients must have adequate renal and hepatic function: Serum creatinine less than or equal to 2.0 mg/deciliter (dL) Total Bilirubin less than or equal to 2.0 mg/dL Serum glutamic-oxaloacetic transaminase/serum glutamate pyruvate transaminase (SGOT/SGPT) less than or equal to 2.5 x upper limit of normal (ULN) Females of childbearing potential and sexually active males must consent to use of effective contraception. Child-bearing potential is defined as any female (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria: Has not undergone a hysterectomy or bilateral oophorectomy; OR Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding consecutive 12 months). All patients must have given signed, informed consent prior to registration on study. Exclusion Criteria: Patients who meet any of the NCI Working Group criteria to initiate treatment for CLL are NOT eligible for participation Patients who have had or are currently receiving any treatment for CLL, including chemotherapy, corticosteroids, biologic therapy, or immunotherapy are NOT eligible for participation. Patients who are actively receiving steroids or non-steroidal antiinflammatory drugs (NSAIDs) on a chronic basis and who are unwilling and/or unable to discontinue while on study therapy are NOT eligible for participation. NOTE: Patients must have discontinued steroids or NSAIDs for 1 week prior to registration to be considered eligible for participation. Patients who are receiving cyclosporine, tacrolimus, or other chronic immunosuppressive agents are NOT eligible for participation. Patients who exhibit any active or ongoing autoimmune processes including, but not limited to, autoimmune hemolytic anemia or immune thrombocytopenia purpura, are NOT eligible for participation. Although rare, the only exception to this would be patients with Hashimoto's thyroiditis who ARE eligible for participation. Patients who demonstrate the presence of antibodies to HIV or hepatitis C or presence of hepatitis B surface antigen or other active infectious process that could suppress the immune system and potentially interfere with the development of an immune response to the tumor antigen are NOT eligible for participation. Patients who have a previous or concomitant malignancy are NOT eligible for participation EXCEPT for the following: Patients with curatively treated squamous or basal cell carcinoma of the skin or effectively treated carcinoma in situ of the cervix ARE eligible for participation. Patient who had a stage 1 solid tumor which has been adequately treated with curative intent, and has been in remission for more than 1 year. Patients with a prior solid tumor who have been in remission more than 5 years ARE eligible for participation. Patients who exhibit any significant concurrent, uncontrolled medical or psychiatric condition that in the opinion of the investigator would compromise the patient's ability to tolerate this treatment are NOT eligible for participation. Patients who are pregnant or lactating are NOT eligible for participation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shuo Ma, MD, PhD
Organizational Affiliation
Northwestern University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Vaccine Therapy for Treating Patients With Previously Untreated Chronic Lymphocytic Leukemia (CLL)

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