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A Personalized NeoAntigen Cancer Vaccine Combined With Anti-PD-1 in Melanoma

Primary Purpose

Melanoma (Skin)

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Peptide
Anti-PD-1
rhGM-CSF
Imiquimod 5% Topical Cream
Sponsored by
Xiangya Hospital of Central South University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma (Skin) focused on measuring Melanoma, Metastasis

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must meet the following criteria on screening examination to be eligible to participate in the study:
  2. Patient is willing and able to give written informed consent.
  3. Age ≥ 18 years, ≤75 years
  4. Pathologically confirmed, clinically evident (by physical examination or radiographic imaging) stage IIIDN3c、IVM1a、M1b、M1c cutaneous melanoma.
  5. Lesions that can be measured,and at least one lesion that can be used to evaluate the efficacy of immunotherapy;Multiple biopsies are available for lesions.
  6. Patient is agreeable to allow tumor、normal tissue samples and blood samples to be submitted for genomic/complete exome/transcriptional sequencing;
  7. ECOG score is 0 or 1
  8. Life expectancy >6 months
  9. Normal organ and bone marrow function as defined below:

    Leukocytes ≥ 3,500/mcL Absolute lymphocyte count > 800/mcL Absolute neutrophil count > 1,500/mcL Platelets > 100,000/mcL Hemoglobin > 10.0 g/dL Total serum bilirubin < 1.0 x institutional upper limit of normal AST (SGOT)/ALT (SGPT) < 2.0 x institutional upper limit of normal Serum creatinine< 1.5 x institutional upper limit of normal

  10. Women of childbearing potential (WOCBP) must have a negative pregnancy test before entering the trial and within 7 days prior to start of study medication.
  11. Female patients enrolled in the study, short-term have no fertility plan and must agree to use an adequate method of contraception starting with the first dose of study therapy through 90 days after the last dose of study therapy.
  12. Male patients must agree to use an adequate method of contraception starting with the first dose of study therapy through 90 days after the last dose of study therapy.
  13. Good compliance, able to follow research protocols and follow-up procedures.

Exclusion Criteria:

  1. Patients who meet any of the following criteria will not be eligible for this study.
  2. Uveal or mucosal melanoma;
  3. Patients who received immunotherapy or other targeted cancer therapy within 4 weeks (including, but not limited to: IL-2, CTLA-4 blockade, PD-1/PD-L1 blockade, but exception of INF-α given as adjuvant treatment)
  4. Previous bone marrow or stem cell transplant
  5. History of severe allergic reactions attributed to any vaccine therapy
  6. Active, known, or suspected autoimmune disease with the exception of vitiligo, type 1 diabetes, or psoriasis not requiring systemic treatment.
  7. Use of a non-oncology vaccine therapy for prevention of infectious diseases (up-to) 4 weeks prior to enrollment to the study. Patients may not receive any non-oncology vaccine therapy during the period of NeoVax administration and until at least 8 weeks after the last dose of study therapy
  8. In an immunosuppressive stage or immunosuppressive drugs were used systematically within 2 weeks.
  9. Patients with long-term use of glucocorticoids or with experimental anti-tumor drugs
  10. Active bacterial or fungal infections identified clinically (>= level 2 of NCI-CTC edition 3);
  11. Known chronic infections with HIV, hepatitis B or C
  12. Known active or latent tuberculosis infection
  13. A history of idiopathic pulmonary fibrosis and organized pneumonia, or active pneumonia on chest computed tomography.
  14. Complicated with other tumors, except for cervical cancer in situ and basal cell carcinoma five years ago.
  15. Severe coronary or cerebrovascular disease, or other diseases that the investigators considered should to be exclusion;
  16. Drug abuse, Clinical, psychological or social factor result in affecting informed consent or research implementation.

Sites / Locations

  • Xiangya Hospital, Central South UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention/Treatment

Arm Description

Personalized NeoAntigen Cancer Vaccine- Neo-Vac-Mn (peptides + rhGM-CSF+anti-PD1+Imiquimod 5% Topical Cream) NeoAntigen peptides:4 x 2 mg the total peptides given on days 84,87,91,98,105,133,and 161 Anti-PD-1 Toripalimab: 3mg/kg, ivgtt, Q2w rhGM-CSF: 3μg/kg given on Days 81,82,83,95,96,97,102,103,104,130,131,132,158,159,and 160 Imiquimod 5% Topical Cream:topical application on the injection site 6 hours before each NeoAntigen peptides injection

Outcomes

Primary Outcome Measures

Number of participants experiencing adverse events
Number of participants experiencing clinical and laboratory adverse events (AE)
Number of Patients with Complete Remission Rate
Number of Patients with Complete Remission Rate(CRR)
Number of Patients with Progressive Disease
Number of Patients with Progressive Disease(PD)
Number of Patients with Partial Response
Number of Patients with Partial Response(PR)

Secondary Outcome Measures

Monitoring of cellular immune response
the immune response of serum and tumor tissue

Full Information

First Posted
July 26, 2019
Last Updated
April 24, 2020
Sponsor
Xiangya Hospital of Central South University
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1. Study Identification

Unique Protocol Identification Number
NCT04072900
Brief Title
A Personalized NeoAntigen Cancer Vaccine Combined With Anti-PD-1 in Melanoma
Official Title
A Phase I Study With a Personalized NeoAntigen Cancer Vaccine Combined With Anti-PD-1 in Metastatic Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Unknown status
Study Start Date
April 21, 2020 (Anticipated)
Primary Completion Date
September 1, 2021 (Anticipated)
Study Completion Date
September 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Xiangya Hospital of Central South University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This study assessed the safety and efficacy of individualized new antigen cancer vaccine combined with Programmed Cell Death Protein 1(PD1) inhibitor Toripalimab in the treatment of metastatic cutaneous melanoma. Melanoma is the most malignant skin neoplasm. Immunotherapy is the main treatment at present. PD1 is an immunological checkpoint and the inhibitors can reduce the immune escape of tumors, enhance T cell function and kill tumors. At present, PD1 antibody is the representative drug of immunotherapy, but the overall efficiency of its single drug treatment of acral melanoma is still low, and the combined treatment can significantly improve the efficiency. Melanoma has a high mutation load, which makes each patient have mutations specific to individual patients and tumors (changes in genetic material). These mutations lead to tumour cells producing proteins that are distinct from those of the body's own cells. These proteins used in vaccines may cause a strong immune response, which may help participants' bodies fight against any cancer cells that may lead to future recurrence of melanoma. Inhibition of PD1 can enhance the activity of T cells and form T cells with sustained killing activity. Tumor vaccines activate human Antigen Presenting Cells (APC) by injecting tumor antigens and adjuvants, and then activate T cells by APC to produce specific killing T cells. Therefore, the combination of "tumor vaccine + PD1 inhibitor" can produce effective specific killing and sustained activation of T cells, and prevent the establishment of inhibitory tumor microenvironment by tumor cells. The study will examine the safety and efficiency of the combined therapy at different time points and assess whether there is an immune response in the patient's peripheral blood and tumor tissue.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma (Skin)
Keywords
Melanoma, Metastasis

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 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intervention/Treatment
Arm Type
Experimental
Arm Description
Personalized NeoAntigen Cancer Vaccine- Neo-Vac-Mn (peptides + rhGM-CSF+anti-PD1+Imiquimod 5% Topical Cream) NeoAntigen peptides:4 x 2 mg the total peptides given on days 84,87,91,98,105,133,and 161 Anti-PD-1 Toripalimab: 3mg/kg, ivgtt, Q2w rhGM-CSF: 3μg/kg given on Days 81,82,83,95,96,97,102,103,104,130,131,132,158,159,and 160 Imiquimod 5% Topical Cream:topical application on the injection site 6 hours before each NeoAntigen peptides injection
Intervention Type
Drug
Intervention Name(s)
Peptide
Other Intervention Name(s)
NeoAntigen peptides
Intervention Description
4 x 3 mg all the peptides given on days 84,87,91,98,105,133,and 161
Intervention Type
Drug
Intervention Name(s)
Anti-PD-1
Other Intervention Name(s)
Toripalimab
Intervention Description
3mg/kg, ivgtt, Q2w
Intervention Type
Drug
Intervention Name(s)
rhGM-CSF
Intervention Description
3μg/kg given on Days 81,82,83,95,96,97,102,103,104,130,131,132,158,159,and 160
Intervention Type
Drug
Intervention Name(s)
Imiquimod 5% Topical Cream
Intervention Description
topical application on the injection site 6 hours before each NeoAntigen peptides injection
Primary Outcome Measure Information:
Title
Number of participants experiencing adverse events
Description
Number of participants experiencing clinical and laboratory adverse events (AE)
Time Frame
up to a maximum of 252 days
Title
Number of Patients with Complete Remission Rate
Description
Number of Patients with Complete Remission Rate(CRR)
Time Frame
up to a maximum of 252 days
Title
Number of Patients with Progressive Disease
Description
Number of Patients with Progressive Disease(PD)
Time Frame
up to a maximum of 252 days
Title
Number of Patients with Partial Response
Description
Number of Patients with Partial Response(PR)
Time Frame
up to a maximum of 252 days
Secondary Outcome Measure Information:
Title
Monitoring of cellular immune response
Description
the immune response of serum and tumor tissue
Time Frame
up to a maximum of 252 days

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: Patients must meet the following criteria on screening examination to be eligible to participate in the study: Patient is willing and able to give written informed consent. Age ≥ 18 years, ≤75 years Pathologically confirmed, clinically evident (by physical examination or radiographic imaging) stage IIIDN3c、IVM1a、M1b、M1c cutaneous melanoma. Lesions that can be measured,and at least one lesion that can be used to evaluate the efficacy of immunotherapy;Multiple biopsies are available for lesions. Patient is agreeable to allow tumor、normal tissue samples and blood samples to be submitted for genomic/complete exome/transcriptional sequencing; ECOG score is 0 or 1 Life expectancy >6 months Normal organ and bone marrow function as defined below: Leukocytes ≥ 3,500/mcL Absolute lymphocyte count > 800/mcL Absolute neutrophil count > 1,500/mcL Platelets > 100,000/mcL Hemoglobin > 10.0 g/dL Total serum bilirubin < 1.0 x institutional upper limit of normal AST (SGOT)/ALT (SGPT) < 2.0 x institutional upper limit of normal Serum creatinine< 1.5 x institutional upper limit of normal Women of childbearing potential (WOCBP) must have a negative pregnancy test before entering the trial and within 7 days prior to start of study medication. Female patients enrolled in the study, short-term have no fertility plan and must agree to use an adequate method of contraception starting with the first dose of study therapy through 90 days after the last dose of study therapy. Male patients must agree to use an adequate method of contraception starting with the first dose of study therapy through 90 days after the last dose of study therapy. Good compliance, able to follow research protocols and follow-up procedures. Exclusion Criteria: Patients who meet any of the following criteria will not be eligible for this study. Uveal or mucosal melanoma; Patients who received immunotherapy or other targeted cancer therapy within 4 weeks (including, but not limited to: IL-2, CTLA-4 blockade, PD-1/PD-L1 blockade, but exception of INF-α given as adjuvant treatment) Previous bone marrow or stem cell transplant History of severe allergic reactions attributed to any vaccine therapy Active, known, or suspected autoimmune disease with the exception of vitiligo, type 1 diabetes, or psoriasis not requiring systemic treatment. Use of a non-oncology vaccine therapy for prevention of infectious diseases (up-to) 4 weeks prior to enrollment to the study. Patients may not receive any non-oncology vaccine therapy during the period of NeoVax administration and until at least 8 weeks after the last dose of study therapy In an immunosuppressive stage or immunosuppressive drugs were used systematically within 2 weeks. Patients with long-term use of glucocorticoids or with experimental anti-tumor drugs Active bacterial or fungal infections identified clinically (>= level 2 of NCI-CTC edition 3); Known chronic infections with HIV, hepatitis B or C Known active or latent tuberculosis infection A history of idiopathic pulmonary fibrosis and organized pneumonia, or active pneumonia on chest computed tomography. Complicated with other tumors, except for cervical cancer in situ and basal cell carcinoma five years ago. Severe coronary or cerebrovascular disease, or other diseases that the investigators considered should to be exclusion; Drug abuse, Clinical, psychological or social factor result in affecting informed consent or research implementation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xiang Chen, Doctor's
Phone
+86-8975-3406
Email
chenxiangck@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Juan Su, Doctor's
Phone
_86-8432-8478
Email
sujuanderm@csu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xiang Chen, Doctor's
Organizational Affiliation
Xiangya Hospital of Central South University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Xiangya Hospital, Central South University
City
Changsha
State/Province
Hunan
ZIP/Postal Code
410008
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juan Su
Phone
+86-8432-7128
Email
sujuanderm@csu.edu.cn
First Name & Middle Initial & Last Name & Degree
Xiang Chen
Phone
+86-8975-3406
Email
chenxiangck@126.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
28678778
Citation
Ott PA, Hu Z, Keskin DB, Shukla SA, Sun J, Bozym DJ, Zhang W, Luoma A, Giobbie-Hurder A, Peter L, Chen C, Olive O, Carter TA, Li S, Lieb DJ, Eisenhaure T, Gjini E, Stevens J, Lane WJ, Javeri I, Nellaiappan K, Salazar AM, Daley H, Seaman M, Buchbinder EI, Yoon CH, Harden M, Lennon N, Gabriel S, Rodig SJ, Barouch DH, Aster JC, Getz G, Wucherpfennig K, Neuberg D, Ritz J, Lander ES, Fritsch EF, Hacohen N, Wu CJ. An immunogenic personal neoantigen vaccine for patients with melanoma. Nature. 2017 Jul 13;547(7662):217-221. doi: 10.1038/nature22991. Epub 2017 Jul 5. Erratum In: Nature. 2018 Mar 14;555(7696):402.
Results Reference
result
PubMed Identifier
28678784
Citation
Sahin U, Derhovanessian E, Miller M, Kloke BP, Simon P, Lower M, Bukur V, Tadmor AD, Luxemburger U, Schrors B, Omokoko T, Vormehr M, Albrecht C, Paruzynski A, Kuhn AN, Buck J, Heesch S, Schreeb KH, Muller F, Ortseifer I, Vogler I, Godehardt E, Attig S, Rae R, Breitkreuz A, Tolliver C, Suchan M, Martic G, Hohberger A, Sorn P, Diekmann J, Ciesla J, Waksmann O, Bruck AK, Witt M, Zillgen M, Rothermel A, Kasemann B, Langer D, Bolte S, Diken M, Kreiter S, Nemecek R, Gebhardt C, Grabbe S, Holler C, Utikal J, Huber C, Loquai C, Tureci O. Personalized RNA mutanome vaccines mobilize poly-specific therapeutic immunity against cancer. Nature. 2017 Jul 13;547(7662):222-226. doi: 10.1038/nature23003. Epub 2017 Jul 5.
Results Reference
result

Learn more about this trial

A Personalized NeoAntigen Cancer Vaccine Combined With Anti-PD-1 in Melanoma

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