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Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors

Primary Purpose

Non Small Cell Lung Cancer, Urothelial Carcinoma, Malignant Melanoma

Status
Completed
Phase
Phase 1
Locations
Denmark
Study Type
Interventional
Intervention
ARG1-18,19,20
Sponsored by
Herlev Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Small Cell Lung Cancer focused on measuring Arginase 1

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 18
  2. The patient has metastatic solid tumors (NSCLC, colorectal cancer, urothelial cancer, breast cancer, ovarian cancer, malignant melanoma or HNSCC); progressive or recurrent disease on or following treatment with standard of care agents
  3. At least one measurable parameter according to RECIST 1.1.
  4. The patient has an ECOG performance status of 0 or 1
  5. Life expectancy of at least 3 months
  6. Prior PD1/PD-L1 allowed
  7. The patient is a female of childbearing potential with negative pregnancy test
  8. For fertile women: Agreement to use contraceptive methods with a failure rate of < 1 % per year during the treatment period and for at least 150 days 12 weeks after the treatment. Safe contraceptive methods for women are birth control pills, intrauterine device, contraceptive injection, contraceptive implant, contraceptive patch or contraceptive vaginal ring.
  9. For men: Agreement to use contraceptive measures and agreement to refrain from donating sperm
  10. The patient has met the following hematological and biochemical criteria:

    1. AST and ALT ≤2,5 X ULN or ≤5 X ULN with liver metastases
    2. Serum total bilirubin ≤1,5 X ULN or direct bilirubin ≤ ULN for patient with total bilirubin level > 1,5 ULN
    3. Serum creatinine ≤1,5 X ULN
    4. ANC (Absolute Neutrophil Count) ≥1,000/mcL
    5. Platelets ≥ 75,000 /mcL
    6. Hemoglobin ≥ 9 g/dL or ≥ 5.6 mmol/L
  11. Mandatory provision of archival tissue and blood for biomarker testing at baseline
  12. Mandatory provision of blood for biomarker testing during the study
  13. Signed declaration of consent after oral and written information about the protocol

Exclusion Criteria:

  1. The patient has not recovered from surgery or is less than 4 weeks from major surgery
  2. The patient has a history of life-threatening or severe immune related adverse events on treatment with another immunotherapy and is considered to be at risk of not recovering
  3. The patient is expected to require any other form of systemic antineoplastic therapy or radiation therapy while receiving the treatment. However, radiation therapy treatment of non target lesion is allowed.
  4. The patient has a history of severe clinical autoimmune disease
  5. The patient has a history of pneumonitis, organ transplant, human immunodeficiency virus positive, active hepatitis B or hepatitis C
  6. The patient requires systemic steroids for management of immune-related adverse events experienced on another immunotherapy
  7. The patient has any condition that will interfere with patient compliance or safety (including but not limited to psychiatric or substance abuse disorders)
  8. The patient is pregnant or breastfeeding
  9. The patient is unable to voluntarily agree to participate by signed informed consent or assent
  10. The patient has an active infection requiring systemic therapy
  11. The patient has received a live virus vaccine within 30 days of planned start of therapy
  12. Significant medical disorder according to investigator; e.g. severe asthma or chronic obstructive lung disease, dysregulated heart disease or dysregulated diabetes mellitus
  13. Concurrent treatment with other experimental drugs
  14. Concurrent treatment with Valproate or Xanthin Oxidase inhibitors
  15. Known side effects to Montanide ISA-51
  16. Any active autoimmune diseases e.g. autoimmune neutropenia, thrombocytopenia or hemolytic anemia, systemic lupus erythematosus, scleroderma, myasthenia gravis, autoimmune glomerulonephritis, autoimmune adrenal deficiency, autoimmune thyroiditis etc.
  17. Severe allergy or anaphylactic reactions earlier in life

Sites / Locations

  • Center for Cancer Immune Therapy Dept. of Hematology/oncology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ARG1-18,19,20 peptide vaccine

Arm Description

One ARG1-vaccine every third week for 45 weeks.

Outcomes

Primary Outcome Measures

Adverse Events Evaluated by CTCAE 4.0
Patients were evaluated according to Common Terminology Criteria for Adverse Events (CTCEA). An adverse event (AE) is an abnormal clinical finding. Each participant was assessed from start of treatment until 6 months after the last vaccine.

Secondary Outcome Measures

Immune Responses
To evaluate the immunological impact of the ARG1-18,19,20 peptide vaccines using blood samples and tumor biopsies.
Overall Survival
Overall Survival (OS) defined as time from treatment initiation to death, will be described with use of Kaplan Meier curve.
4.Progression Free Survival
Progression free survival (PFS) defined as the time from treatment initiation to disease progression, relapse or death due to any cause, which ever comes first, will be described with Kaplan Meier curve. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Full Information

First Posted
September 27, 2018
Last Updated
February 19, 2023
Sponsor
Herlev Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03689192
Brief Title
Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors
Official Title
Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
December 17, 2018 (Actual)
Primary Completion Date
January 19, 2022 (Actual)
Study Completion Date
January 19, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Herlev Hospital

4. Oversight

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

5. Study Description

Brief Summary
In this phase I first-in-humans-study a vaccine consisting of arginase-1 (ARG1) peptides and the adjuvant Montanide ISA-51 will be tested in ten patients with metastatic solid tumors. Patients will be treated with an ARG1 vaccine every third week for 45 weeks.
Detailed Description
Arginase-1 (ARG1) is an enzyme that converts the amino acid arginine into urea and ornithine. ARG1 is mainly expressed in hepatocytes but different myeloid cells are also capable of ARG1-expression. An ARG1-induced arginine depletion suppresses T cell function through the impairment of the T cell receptor (TCR)-complex. A research group from the Center for Cancer Immune Therapy (CCIT) have identified spontaneous T cell reactivity against ARG1 peptides in peripheral blood mononuclear cells of cancer patients and healthy donors. The theoretic background for an ARG1 peptide vaccine is to activate ARG1-specific T cells to infiltrate the tumor microenvironment and eliminate ARG1-expressing immunosuppressive cells. The aim is to treat 10 patients with progressive solid tumors following treatment with standard of care agents. Patients will receive ARG1 vaccinations administered subcutaneously every third week for 45 weeks. The primary endpoint is to evaluate safety and toxicity. Immune responses will be assessed using blood- and tumor tissue samples and clinical responses are evaluated using RECIST 1.1.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Small Cell Lung Cancer, Urothelial Carcinoma, Malignant Melanoma, Ovarian Cancer, Colorectal Cancer, Breast Cancer, Squamous Cell Carcinoma of the Head and Neck, Metastatic Cancer
Keywords
Arginase 1

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ARG1-18,19,20 peptide vaccine
Arm Type
Experimental
Arm Description
One ARG1-vaccine every third week for 45 weeks.
Intervention Type
Biological
Intervention Name(s)
ARG1-18,19,20
Intervention Description
300 ug ARG1-18,19,20 peptide in water mixed with 500ul montanide
Primary Outcome Measure Information:
Title
Adverse Events Evaluated by CTCAE 4.0
Description
Patients were evaluated according to Common Terminology Criteria for Adverse Events (CTCEA). An adverse event (AE) is an abnormal clinical finding. Each participant was assessed from start of treatment until 6 months after the last vaccine.
Time Frame
0 - 75 weeks
Secondary Outcome Measure Information:
Title
Immune Responses
Description
To evaluate the immunological impact of the ARG1-18,19,20 peptide vaccines using blood samples and tumor biopsies.
Time Frame
project blood samples were taken at baseline and every 3 months for a maximum of 1,5 year. Tumor biopsies were taken at baseline and after 3 months if possible.
Title
Overall Survival
Description
Overall Survival (OS) defined as time from treatment initiation to death, will be described with use of Kaplan Meier curve.
Time Frame
0 - 75 weeks
Title
4.Progression Free Survival
Description
Progression free survival (PFS) defined as the time from treatment initiation to disease progression, relapse or death due to any cause, which ever comes first, will be described with Kaplan Meier curve. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time Frame
0 - 75 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 The patient has metastatic solid tumors (NSCLC, colorectal cancer, urothelial cancer, breast cancer, ovarian cancer, malignant melanoma or HNSCC); progressive or recurrent disease on or following treatment with standard of care agents At least one measurable parameter according to RECIST 1.1. The patient has an ECOG performance status of 0 or 1 Life expectancy of at least 3 months Prior PD1/PD-L1 allowed The patient is a female of childbearing potential with negative pregnancy test For fertile women: Agreement to use contraceptive methods with a failure rate of < 1 % per year during the treatment period and for at least 150 days 12 weeks after the treatment. Safe contraceptive methods for women are birth control pills, intrauterine device, contraceptive injection, contraceptive implant, contraceptive patch or contraceptive vaginal ring. For men: Agreement to use contraceptive measures and agreement to refrain from donating sperm The patient has met the following hematological and biochemical criteria: AST and ALT ≤2,5 X ULN or ≤5 X ULN with liver metastases Serum total bilirubin ≤1,5 X ULN or direct bilirubin ≤ ULN for patient with total bilirubin level > 1,5 ULN Serum creatinine ≤1,5 X ULN ANC (Absolute Neutrophil Count) ≥1,000/mcL Platelets ≥ 75,000 /mcL Hemoglobin ≥ 9 g/dL or ≥ 5.6 mmol/L Mandatory provision of archival tissue and blood for biomarker testing at baseline Mandatory provision of blood for biomarker testing during the study Signed declaration of consent after oral and written information about the protocol Exclusion Criteria: The patient has not recovered from surgery or is less than 4 weeks from major surgery The patient has a history of life-threatening or severe immune related adverse events on treatment with another immunotherapy and is considered to be at risk of not recovering The patient is expected to require any other form of systemic antineoplastic therapy or radiation therapy while receiving the treatment. However, radiation therapy treatment of non target lesion is allowed. The patient has a history of severe clinical autoimmune disease The patient has a history of pneumonitis, organ transplant, human immunodeficiency virus positive, active hepatitis B or hepatitis C The patient requires systemic steroids for management of immune-related adverse events experienced on another immunotherapy The patient has any condition that will interfere with patient compliance or safety (including but not limited to psychiatric or substance abuse disorders) The patient is pregnant or breastfeeding The patient is unable to voluntarily agree to participate by signed informed consent or assent The patient has an active infection requiring systemic therapy The patient has received a live virus vaccine within 30 days of planned start of therapy Significant medical disorder according to investigator; e.g. severe asthma or chronic obstructive lung disease, dysregulated heart disease or dysregulated diabetes mellitus Concurrent treatment with other experimental drugs Concurrent treatment with Valproate or Xanthin Oxidase inhibitors Known side effects to Montanide ISA-51 Any active autoimmune diseases e.g. autoimmune neutropenia, thrombocytopenia or hemolytic anemia, systemic lupus erythematosus, scleroderma, myasthenia gravis, autoimmune glomerulonephritis, autoimmune adrenal deficiency, autoimmune thyroiditis etc. Severe allergy or anaphylactic reactions earlier in life
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Inge Marie Svane, Prof., MD
Organizational Affiliation
CCIT-DK
Official's Role
Study Director
Facility Information:
Facility Name
Center for Cancer Immune Therapy Dept. of Hematology/oncology
City
Copenhagen
State/Province
Herlev
ZIP/Postal Code
2730
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36330525
Citation
Lorentzen CL, Martinenaite E, Kjeldsen JW, Holmstroem RB, Mork SK, Pedersen AW, Ehrnrooth E, Andersen MH, Svane IM. Arginase-1 targeting peptide vaccine in patients with metastatic solid tumors - A phase I trial. Front Immunol. 2022 Oct 17;13:1023023. doi: 10.3389/fimmu.2022.1023023. eCollection 2022.
Results Reference
derived

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Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors

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