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Clinical Study of Personalized mRNA Vaccine Encoding Neoantigen in Patients With Advanced Esophageal Cancer and Non-small Cell Lung Cancer

Primary Purpose

Esophageal Cancer, Non Small Cell Lung Cancer

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Personalized mRNA Tumor Vaccine
Sponsored by
Stemirna Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophageal Cancer focused on measuring mRNA cancer vaccine, cancer vaccine, tumor vaccine, NSCLC, Esophageal Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients Age 18 to 75 years old (including both ends)
  2. The primary lesion was confirmed by pathology or cytology as esophageal cancer and non-small cell lung cancer;
  3. Receive a biopsy before treatment;
  4. Patients with fertility must agree to use reliable methods of contraception (hormone or barrier or abstinence) during the trial and at least 12 weeks after the last treatment;
  5. The primary lesion was confirmed by pathology or cytology as esophageal cancer and non-small cell lung cancer;
  6. Patients with unresectable or metastatic esophageal cancer (IIIC (T4bNanyM0, TanyN3M0), stage IV) and non-small cell lung cancer (stage IIIB, IV) with standard treatment failure or no standard treatment;
  7. According to the solid tumor evaluation standard RECIST (version 1.1), at least one measurable tumor lesion (spiral CT scan tumor maximum diameter ≥ 10 mm);
  8. ECOG score 0~1;
  9. The number of lymphocytes is ≥800/μL, the number of absolute neutrophils is ≥1,500/μL, hemoglobin ≥10 g/dL; WBC≥2.5×109/L, PLT≥75×109/L, MID≥1.5×109/L, LY≥0.4×109/L; serum Alb≥30 g/L; serum lipase and amylase<1.5 ULN; serum creatinine≤1.5 ULN; ALT≤2.5 ULN, AST≤2.5 ULN, alkaline phosphatase ≤ 2.5 ULN; AST, ALT and alkaline phosphatase <5 ULN in the presence of bone or liver metastasis; serum urea nitrogen ≤ 3 ULN; serum total bilirubin ≤ 1.5 ULN; prothrombin time ( PT) extended ≤ 4s;
  10. Subjects volunteered to participate and signed informed consent in writing.

Exclusion Criteria:

1. Allergic constitution or a history of allergies to biopharmaceuticals; 2. Pregnant or lactating women; 4. The tumor mutation load (TMB) is less than 2.0/Mb or the tumor neonatal antigen load (TNB) is less than 0.5/Mb or the predicted number of nascent antigens is less than 3; 5. Patients with untreated brain metastases or symptoms of brain metastases (patients with stable brain metastases can be enrolled); 6. There are a wide range of tumor lung metastases, leading to difficulty breathing; 7. Patients with tumors close to large blood vessels or nerves; 8. History of severe cardiovascular and cerebrovascular diseases, including but not limited to ventricular arrhythmias requiring clinical intervention; acute coronary syndrome, myocardial infarction, congestive heart failure, stroke or other grade III and above within 6 months Cardiovascular events; New York Heart Association (NYHA) cardiac function classification ≥ II or left ventricular ejection fraction (LVEF) < 50%; hypertension still controlled by standard treatment (systolic blood pressure > 150 mmHg, diastolic blood pressure > 90 mmHg); 9. There are currently patients with active ulcers and gastrointestinal bleeding; 10. Patients with clinically diagnosed autoimmune diseases; HIV, HCV positive; HBsAg positive; those with acute EBV or CMV infection; 11. Patients with a history of organ transplantation or waiting for an organ transplant; 12. Any uncontrollable active person; 13. Subjects with immunosuppression, including known immunodeficiency; those currently on systemic use of steroids (except those who have recently or recently used inhaled steroids); 14. Skin diseases such as psoriasis may prevent intradermal injection of vaccine into the target area; 15. Anti-tumor treatments such as chemotherapy, biotherapy, radiation therapy, endocrine therapy, and targeted therapy were administered within 28 days prior to the first administration of mRNA tumor vaccine (in which fluorouracil oral drugs such as tigio, capecitabine, and finally One oral dose may be administered at least 14 days between the first dose of mRNA tumor vaccine, or other test drug treatment, or surgery (without diagnostic biopsy); 16. Adverse reactions to previous anti-tumor treatment have not been restored to CTCAE (version 4.03) grade evaluation ≤ 1 (except for hair loss); 17. The investigator assessed that the subject was unable or unwilling to comply with the requirements of the study protocol.

18. Previous chemotherapy, severe myelosuppression

Sites / Locations

  • The First Affiliated Hospital of Zhengzhou UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Personalized mRNA Tumor Vaccine

Arm Description

Personalized mRNA Tumor Vaccine Encoding Neoantigen in Patients with advanced esophageal and non-small cell lung cancers

Outcomes

Primary Outcome Measures

Number of participants with treatment-related adverse events as assessed by CTCAE v4.03
During the trial conduction, especially within the 24 weeks of treatment phase when mRNA tumor Vaccine administered, all adverse events (including laboratory abnormality and clinical events) will be closely monitored, and all ≥ grade 3 adverse events per CTCAE will be recorded, including but not limited to the toxicities potentially suspected to relate to injection procedures and/or mRNA Tumor Vaccine therapy as listed below: Fever Chills Nausea, vomiting and other gastrointestinal symptoms Fatigue Hypotension Respiratory distress Tumor lysis syndrome Neutropenia, thrombocytopenia Liver and kidney dysfunction Neutropenia, thrombocytopenia Liver and kidney dysfunction

Secondary Outcome Measures

Disease Control Rate (DCR)
Disease Control Rate of Personalized mRNA Tumor Vaccine
Progression-free Survival (PFS)
Progression-free Survival of Personalized mRNA Tumor Vaccine
Time to Tumor Progression (TTP)
Time to Tumor Progression of Personalized mRNA Tumor Vaccine
Overall Survival (OS)
Overall Survival of Personalized mRNA Tumor Vaccine

Full Information

First Posted
April 8, 2019
Last Updated
April 11, 2023
Sponsor
Stemirna Therapeutics
Collaborators
The First Affiliated Hospital of Zhengzhou University
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1. Study Identification

Unique Protocol Identification Number
NCT03908671
Brief Title
Clinical Study of Personalized mRNA Vaccine Encoding Neoantigen in Patients With Advanced Esophageal Cancer and Non-small Cell Lung Cancer
Official Title
Clinical Trial on the Safety and Efficacy of Neoantigen Antigen mRNA Tumor Vaccine in the Treatment of Advanced Esophageal Cancer and Non-small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 18, 2019 (Actual)
Primary Completion Date
October 31, 2024 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stemirna Therapeutics
Collaborators
The First Affiliated Hospital of Zhengzhou University

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
A single arm, open-label pilot study is designed to determine the safety, tolerability and effectiveness of personalized mRNA tumor vaccine encoding neoantigen in Patients with advanced esophageal cancer and non-small cell lung cancer
Detailed Description
Primary objectives: Assessing the safety and tolerability of mRNA personalized tumor vaccines encoding neoantigen for unresectable or metastatic advanced esophageal and non-small cell lung cancers with standard treatment failure or no standard treatment. Secondary objectives: Preliminary observation of the efficacy of mRNA personalized tumor vaccines encoding neoantigen for unsurgically resected or metastatic advanced esophageal and non-small cell lung cancers with standard treatment failure or no standard treatment. Time of tumor progression (TTP); Disease Control Rate (DCR); Objective Remission Rate (ORR); Overall Survival (OS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Cancer, Non Small Cell Lung Cancer
Keywords
mRNA cancer vaccine, cancer vaccine, tumor vaccine, NSCLC, Esophageal Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Personalized mRNA Tumor Vaccine
Arm Type
Experimental
Arm Description
Personalized mRNA Tumor Vaccine Encoding Neoantigen in Patients with advanced esophageal and non-small cell lung cancers
Intervention Type
Biological
Intervention Name(s)
Personalized mRNA Tumor Vaccine
Intervention Description
subcutaneous injection with personalized mRNA tumor vaccine
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.03
Description
During the trial conduction, especially within the 24 weeks of treatment phase when mRNA tumor Vaccine administered, all adverse events (including laboratory abnormality and clinical events) will be closely monitored, and all ≥ grade 3 adverse events per CTCAE will be recorded, including but not limited to the toxicities potentially suspected to relate to injection procedures and/or mRNA Tumor Vaccine therapy as listed below: Fever Chills Nausea, vomiting and other gastrointestinal symptoms Fatigue Hypotension Respiratory distress Tumor lysis syndrome Neutropenia, thrombocytopenia Liver and kidney dysfunction Neutropenia, thrombocytopenia Liver and kidney dysfunction
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Disease Control Rate (DCR)
Description
Disease Control Rate of Personalized mRNA Tumor Vaccine
Time Frame
1.5 years
Title
Progression-free Survival (PFS)
Description
Progression-free Survival of Personalized mRNA Tumor Vaccine
Time Frame
2 years
Title
Time to Tumor Progression (TTP)
Description
Time to Tumor Progression of Personalized mRNA Tumor Vaccine
Time Frame
2 years
Title
Overall Survival (OS)
Description
Overall Survival of Personalized mRNA Tumor Vaccine
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged between 18 and 75 (including both ends), with no gender limit; The primary lesion was confirmed by histopathology or cytology as esophageal carcinoma (ⅢC (T4bNanyM0, TanyN3M0), and stage Ⅳ) or non-small cell lung cancer (stage ⅢB-Ⅳ). Patients who have metastatic or locally advanced tumor but failed instandard treatments or not suitable for standard treatments; According to RECIST (V1.1), the efficacy evaluation criteria for solid tumors, there is at least one measurable lesion. Participants with Performance Scale (PS) of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) PS Participants must have at least 1 lesion amenable to the mandatory fresh tumor biopsy at study entry Fertile patients must agree to use a reliable contraceptive methods (hormonal or barrier methods or abstinence) during the trial and for at least 12 weeks after the last treatment; The subject voluntarily participates and signs ICF (Informed consent forms). Exclusion Criteria: Any clinical research drugs, anti-cancer monoclonal antibodies, anti-cancer therapeutic vaccines, immunostimulants (such as IL-2) or using previous investigational drugs within 7 days of the first treatment with mRNA-personalized tumor vaccine or carrelizumab. Patients who have allergies or previous history of biological drug allergy; Patients who are in pregnant or breast-feeding; Patients who are expected to survive less than 3 months during the screening period; Tumor mutation load (TMB) is less than 2.0/Mb or tumor neogenic antigen load (TNB) is less than 0.5/Mb or the number of predicted neoantigen is less than 3; Patients who underwent major surgery or suffered significant trauma within 4 weeks prior to the enrollment (blood collection), or who are expected to undergo major surgery during the study period; Patients with symptoms of brain metastases (Patients with stable brain metastases can be included) Extensive lung metastases from tumors, causing breathing difficulties; Patients who have tumors close to large blood vessels or nerves; A history of severe cardiovascular and cerebrovascular diseases, including but not limited to ventricular arrhythmia requiring clinical intervention; Acute coronary syndrome, myocardial infarction, congestive heart failure, stroke or other grade III and above cardiovascular events within 6 months; New York Heart Association (NYHA) cardiac function grade≥Grade II or left ventricular ejection fraction (LVEF) <50%; Poorly controlled hypertension after standard treatment (systolic blood pressure> 150 mmHg and diastolic blood pressure> 90 mmHg); Patients with active ulcers and gastrointestinal bleeding; Patients with clinically confirmed autoimmune disease have received systemic treatment in the past 2 years; HIV, HCV positive; HBV-DNA≥1×103 copies/mL (or 2×102 IU/mL); Acute EBV or CMV virus infection; Patients with previous history of non-infectious pneumonia requiring steroid therapy or acute lung cancer; Participants with a history of interstitial lung disease; Patients who have a history of organ transplantation or are waiting for organ transplantation; Have any uncontrolled active infection; Immunosuppressed subjects, including those with known immunodeficiency; those who are currently using steroids systemically (except those who are using inhaled steroids recently or currently); Skin diseases (such as psoriasis) may prevent intradermal vaccines from reaching the target area; Who have received chemotherapy, biotherapy, radiotherapy, endocrine therapy, targeted therapy and other tumor treatments, or other experimental drug treatments, or surgery (excluding diagnostic biopsy) within 7 days prior to the first administration of mRNA tumor vaccine treatment; Adverse effects from previous antitumor therapy have not recovered referred to CTCAE (V5.0) rating ≤1 (except hair loss); The investigator evaluates that the subject is unable or unwilling to comply with the requirements of study protocol.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Li Yang
Phone
0371-66295320
Email
yanglizzuyl@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yi Zhang
Phone
0371-66295219
Email
yizhang001@163.com
Facility Information:
Facility Name
The First Affiliated Hospital of Zhengzhou University
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yi Zhang, Doctor
Phone
15138928971
Email
yizhang00@163.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Clinical Study of Personalized mRNA Vaccine Encoding Neoantigen in Patients With Advanced Esophageal Cancer and Non-small Cell Lung Cancer

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