rCSP/AP10-602 [GLA-LSQ] Vaccine Trial
Plasmodium Falciparum Infection
About this trial
This is an interventional prevention trial for Plasmodium Falciparum Infection focused on measuring AP 10-602 [GLA-LSQ], Challenge, Healthy adults, Malaria, P. falciparum, rCSP, Vaccine
Eligibility Criteria
Inclusion Criteria:
- Healthy adults (males and non-pregnant, non-lactating females) between the ages of 18 and 45 years, inclusive
- Able and willing to participate for the duration of the study
- Able and willing to provide written (not proxy) informed consent
- Provides informed consent and correctly answers > / = 70 percent on the post consent quiz before any study procedures and is available for all study visits
Females of childbearing potential and males must agree to practice highly effective contraception*
*Contraception must be practiced from 30 days before the time of enrollment until at least 30 days following the third vaccine dose for groups 1, 2 and 3, and the malaria challenge event for groups 4, 4B, 5 and 6 (such as double barrier methods (condoms plus foam or spermicide, diaphragm plus foam or spermicide), licensed intrauterine devices (IUDs), intravaginal or intra/transdermal or oral hormonal methods initiated at least 30 days before inoculation or challenge, documented surgical sterilization via tubal ligation the essure procedure or hysterectomy, abstinence or a vasectomized partner). The contraceptive method should remain unchanged throughout the study participation
Is in good health, as determined by vital signs (heart rate, blood pressure, oral temperature); medical history; laboratory values* that do not meet toxicity grading criteria, except when Grade 1 and clinically insignificant; and a physical examination
*Laboratory values include: hemoglobin, white blood cell count, platelet count, glucose (random), serum alanine aminotransferase (ALT), serum creatinine, urine protein and urine blood
- Agree not to travel to a malaria endemic region during the entire course of the trial
- Willing to avoid non-study related blood donation for the duration of participation in the study or until at least 1 year after receiving the last investigational vaccine, whichever is longer
- Able to understand and comply with planned study procedures including daily outpatient follow-up visits beginning 5 days after malaria challenge (groups 4, 4B, 5 and 6 only)
- Willing to avoid non-study related blood donation for 3 years following P. falciparum challenge (groups 4, 4B, 5 and 6 only)
Exclusion Criteria:
- Any history of malaria infection, or travel to a malaria endemic region within 6 months before first vaccination
- History of long-term residence (> / = 5 years) in an area known to have significant transmission of P. falciparum
- Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg)
- Positive sickle cell screening test or known hemoglobinopathy (groups 4, 4B, 5 and 6 only)
- Current or recent (within the last four weeks) treatment with parenteral or oral corticosteroids (intranasal or inhaled steroids are acceptable), or other immunosuppressive agents, or chemotherapy
- History of splenectomy
Participants who have a clinically significant (as determined by the PI or designee) baseline Grade 1 or greater toxicity, or any Grade 2 or greater toxicity (regardless of clinical significance) by the toxicity table, except hematuria > 1+ detected during menses for females*
* For females who are menstruating, urinalysis frequently tests positive for blood and is not an indicator of poor health status or increased risk.
- Vaccination with a live vaccine within the past 30 days or with a nonreplicating, inactivated, or subunit vaccine within the last 14 days
- Known hypersensitivity to components of the vaccine for groups 1, 2, 3, 4, 4B and 5; or to the adjuvant for groups 1, 2, 4, 4B and 5
- History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, nervous system, or other metabolic or autoimmune/inflammatory conditions
- History of anaphylaxis or severe hypersensitivity reaction
- History of Guillain-Barre syndrome or severe adverse reaction to any vaccination
- Severe asthma, as defined by an emergency room visit or hospitalization within the last 12 months
- Pregnant or breastfeeding women or women who plan to become pregnant before day 115 in groups 1, 2 and 3; or before 30 days post-malaria challenge in groups 4, 4B, 5 and 6
- Concurrent participation in other investigational protocols prior to Day 141 or receipt of an investigational product within the previous 30 days
- Planned receipt of an investigational product within 28 days following the last vaccination dose or malaria challenge
- Any condition that, in the opinion of the investigator, would affect a participant's ability to understand or comply with the study protocol or would jeopardize a participant's safety or rights
- History of previous receipt of a candidate malaria vaccine or a vaccine containing the GLA-LSQ adjuvant
Use or planned use of any drug with anti-malarial* activity 30 days before, or after malaria challenge (groups 4, 4B, 5 and 6 only)
*Medications with antimalarial activity include trimethoprim-sulfamethoxazole, azithromycin, erythromycin, tetracycline, doxycycline, minocycline, clindamycin, ciprofloxacin, levofloxacin, norfloxacin and rifampin
- Planned surgery 30 days before or after vaccination or malaria challenge
- History of drug or alcohol abuse within the last five years
- Receipt of blood or blood products in the previous six months or donation of a unit of blood within two months before screening
History of schizophrenia, bipolar disorder or other psychiatric condition that makes study compliance difficult*
* Subjects with psychoses or history of suicide attempt or gesture in the 3 years before study entry, ongoing risk for suicide
- History of diabetes mellitus with the exception of pregnancy-induced diabetes that has resolved
Has evidence of increased cardiovascular disease risk* (defined as > 10 percent, 5 year risk) as determined by the method of Gaziano (groups 4, 4B, 5 and 6 only)
* Risk factors include sex, age (years), systolic blood pressure (mm Hg), smoking status, body mass index (BMI, kg / mm^2), reported diabetes status, and blood pressure
Abnormal screening ECG* (groups 4, 4B, 5, and 6 only)
* Pathologic Q wave and significant ST-T wave changes, left ventricular hypertrophy, non-sinus rhythm except isolated premature atrial or ventricular contractions, right of left bundle branch block, advanced A-V heart block (secondary or tertiary), QT/QTc interval > 450 ms
- Known hypersensitivity to mosquito bites, artemether-lumefantrine or atovaquone-proguanil (groups 4, 4B, 5 and 6 only)
- Anticipated medication use during the 28-day post-challenge period that are known to interact with artemether/lumefantrine or atovaquone/proguanil, such as cimetidine, metoclopramide, antacids, and kaolin (groups 4, 4B, 5 and 6 only)
- Previous participation in a CHMI study
Sites / Locations
- University of Maryland, School of Medicine, Center for Vaccine Development and Global Health
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Other
Group 1
Group 2
Group 3
Group 4
Group 4B
Group 5
Group 6
10 subjects receive 10 mcg rCSP + AP 10-602 [GLA-LSQ] (5 mcg GLA - 2 mcg LSQ) intramuscularly (IM) on days 1, 29 and 85.
10 subjects receive 30 mcg rCSP + AP 10-602 [GLA-LSQ] (5 mcg GLA - 2 mcg LSQ) intramuscularly (IM) on days 1, 29 and 85.
10 subjects receive 30 mcg rCSP intramuscularly (IM) on days 1, 29 and 85.
9 subjects receive 60 mcg rCSP + AP 10-602 [GLA-LSQ] (5 mcg GLA - 2 mcg LSQ) intramuscularly (IM) on days 1 and 85. Subjects will then receive CHMI challenge with P. falciparum parasites of the NF54/3D7 strain on day 113.
10 subjects receive 60 mcg rCSP + AP 10-602 [GLA-LSQ] (5 mcg GLA - 2 mcg LSQ) intramuscularly (IM) on days 1, 29 and 85. Subjects will then receive CHMI challenge with P. falciparum parasites of the NF54/3D7 strain on day 113.
10 subjects receive 10 mcg or 30 mcg rCSP + AP 10-602 [GLA-LSQ] (5 mcg GLA - 2 mcg LSQ) intramuscularly (IM) on days 1, 29 and 85 if immunogenicity analysis conducted 28 days post-2nd dose in Groups 1, 2, and 3 show promise (at least fourfold increase in geometric mean anti-CSP antibody or geometric mean anti-CSP titer of 20). Otherwise, subjects will receive 60 mcg rCSP + AP 10-602 [GLA-LSQ] (5 mcg GLA - 2 mcg LSQ). Subjects will then receive CHMI challenge with P. falciparum parasites of the NF54/3D7 strain on day 113.
6 subjects receive CHMI challenge with P. falciparum parasites of the NF54/3D7 strain.