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Plasmodium Immunotherapy for Advanced Malignant Solid Tumors

Primary Purpose

Advanced Malignant Solid Tumor

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Plasmodium immunotherapy
Sponsored by
CAS Lamvac Biotech Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Malignant Solid Tumor focused on measuring advanced malignant solid tumor, Plasmodium immunotherapy, Plasmodiun vivax

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged 18-70 years male or female.
  2. Patients with advanced maligant solid tumors in lung, liver, prostate, ovary, brain, thyroid and colorectum, etc.
  3. Patients with primary central nervous system (CNS) tumor or brain metastases from solid tumors, comply with the following standards can participate in this study: Up to the clinical trial screening period, the imageological examination provides progression-free evidence for at least 3 months, blood brain barrier has not been damaged or is already recovered from the former treatment (surgery or radiotherapy) injury, without intracranial hemorrhage or myelorrhagia history, without metastases to the brain stem, midbrain, pons, medulla oblongata or eye subsidiary organs within 10 mm area (the optic nerve and optic chiasma).
  4. The patients have measurable tumors based on the criterion of RECIST1.1.
  5. Tumor classification should be determined by histopathology and pathological report should be provided. If tumor tissue is available, before participating in the trail, the research center need to obtain the paraffin blocks or at least 6 unstained sections of the tumor tissue and the relevant pathological reports. If the above tumor tissue samples are not available, samples of any kind (such as fine needle aspiration biopsy samples, cell mass samples (such as pleural, peritoneal effusion samples and lavage samples) are acceptable. If tumor tissue is not available, patients are still eligible for the study.
  6. For the patients who previously received one or more of the following therapies, the interval time of the termination of chemotherapy (including interventional chemotherapy) or radiotherapy is at least 28 days for patients who had received chemotherapy or radiotherapy; at least 5 half-life time for patients who had received targeted drug therapy (the half-life of targeted drug is according to the drug instructions).
  7. ECGO score is 0 to 2, and euphagia.
  8. Expected survival ≥ 3 months.
  9. WBC≥3× 10^9/L, PLT ≥ 100× 10^9/L, HGB ≥ 100 g/L, and albumin ≥ 30 g/L, no significant morphological abnormalities of red blood cells, or anemia (iron deficiency anemia, autoimmune hemolytic anemia, thalassemia, etc.).
  10. Patients with gastrointestinal bleeding, hemoptysis or other chronic bleeding symptoms were cured before enrollment.
  11. Patients with no severe dysfunction of cardiopulmonary, liver and kidney function (child-push grading of liver function A or B, Cr≤ 1.5 x ULN).
  12. Patient will be able to understand and sign informed consent.
  13. According to the researcher's judgment, the patient's compliance could meet the needs of follow-up.

Exclusion Criteria:

  1. Nasopharyngeal cancer, head and neck tumors.
  2. HPV positive patients with advanced malignant solid tumors in cervical, anal, vulvar, vaginal and penile.
  3. Pancreatic cancer patients.
  4. Small cell lung cancer patients.
  5. Patients with severe hemoglobin disease or severe G6PD deficiency.
  6. Patients with splenectomy or splenomegaly.
  7. Patients with drug addiction or alcohol dependence.
  8. Have not yet been washed out from the previous therapeutic effects, except the following: the bisphosphonates used for bone metastasis or osteoporosis.
  9. Uncontrolled pleural effusion, pericardial effusion or ascites.
  10. Tumor-related pain that are uncontrollable.
  11. Active malignant tumor metastasis of CNS (progression or controlling the symptoms with anticonvulsants or corticosteroids ).
  12. Patients with significant immunodeficiency detection ( CD4+T cell absolute count <200 /ul)
  13. With the following diseases or conditions: serious or uncontrolled systemic disease or any unstable systemic diseases (including but not limited to active infection, grade three hypertension, unstable angina, congestive heart failure, class III or IV heart disease, severe arrhythmia, liver and kidney dysfunction or metabolic disease), a clear history of neurological or psychiatric disorders, etc.
  14. According to the principal investigator's judgment, any other diseases, metabolic disorders, abnormal results of clinical laboratory tests or physical examination, the diseases that leading to usage of the prohibited drugs, influencing the results reliability, putting patients in high risk.
  15. Have undergone major surgery within 4 weeks of the screening period, or plan to undergo major surgery during the study period, PICC catheter and central venous catheter implantation are excluded.
  16. Received any antineoplastic drugs, immune cells, antibodies, or vaccines within five drug half-life (not sure the half-life, will be subject to two weeks) during the screening period.
  17. Patients who have previously received allogeneic bone marrow transplantation or solid organ transplantation.
  18. Receiving any other anti-tumor treatment at the same time.
  19. Lung function is seriously damaged, the MNW <39% or can't get out of bed, still feel short of breath when resting.
  20. Rough cough, dyspnea, without normal diet or difficult to cooperate.
  21. Poor body condition, the researchers assess that the patients can't tolerate the Plasmodium immunotherapy.
  22. Pregnant or lactating women.
  23. Patients that are unable to comply with the research and follow-up procedure.
  24. Any case that the researchers believe that the patient does not suit for this clinical study.

Sites / Locations

  • Yunnan Kungang HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Blood-stage infection of P.vivax

Arm Description

This is a single arm study that is planed to enroll 60 patients with advanced malignant solid tumor and each patient will be vaccinated with P.vivax-infected red blood cells containing approximately 0.1-1.0 × 10^7 Plasmodium parasites. And successful infection will be indicated by microscopic observation of parasitemia in peripheral blood samples. The treatment will last 5-10 weeks from the day of successful infection and will be terminated by antimalarial drugs.

Outcomes

Primary Outcome Measures

Progression free survival (PFS)
Starting from treatment until the disease progression is first found or the time of any cause of death (disease progression refers to tumor growth, or metastasis of primary tumor, or discovery of new lesions).

Secondary Outcome Measures

Tumor marker level
The patient's sensitive tumor markers will be reviewed periodically from the time they are enrolled into the study.
Disease Control Rate
The proportion of patients who had a best response rating of complete response, partial response, or stable disease.
Immunological index
Detection of absolute number of immune cells(such as CD3+CD4+、CD3+CD8+ and so on)in peripheral blood by flow cytometry.
Quality of life score
Patients are regularly filled with QLQ-C30 (cancer patient quality of life scale) to assess the quality of life of the patients.
Overall survival
The time starting from the treatment to death of whatever causes (when subjects have lost for follow-up before death, the last follow-up time will be calculated as the time of death).
1 year of survival rate
The number of cancer cases remaining after 1 year of treatment / the total number of cancer cases treated * 100%.
2 year of survival rate
The number of cancer cases remaining after 2 years of treatment / the total number of cancer cases treated * 100%.
time of tumor progression
TTP is the time between the beginning of treatment and the onset of tumor progression.
Duration of disease control
Duration of disease control is the time from the first evaluation of the tumor as CR, PR or SD to the first evaluation as PD (progressive disease) or any cause of death.
pain score
Patients are regularly evluated with pain assessment scale

Full Information

First Posted
November 14, 2019
Last Updated
November 14, 2019
Sponsor
CAS Lamvac Biotech Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04165590
Brief Title
Plasmodium Immunotherapy for Advanced Malignant Solid Tumors
Official Title
Clinical Study of Plasmodium Immunotherapy for Advanced Malignant Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Unknown status
Study Start Date
October 24, 2019 (Actual)
Primary Completion Date
June 30, 2021 (Anticipated)
Study Completion Date
October 31, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CAS Lamvac Biotech Co., Ltd.

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
The purpose of this study is: 1) to evaluate the effectiveness and extended safety of the Plasmodium immunotherapy for the advanced malignant solid tumors. 2) To explore the safe and effective course of the Plasmodium immunotherapy for the advanced malignant solid tumors. 3) To explore the possible indications of Plasmodium immunotherapy for advanced malignant solid tumors. The treatment will last 5-10 weeks from the day of successful infection and will be terminated by antimalarial drugs.
Detailed Description
This study is planed to enroll 60 patients. Each patient will be vaccinated with 2 ml of P. vivax-infected red blood cells, containing approximately 0.1-1.0 × 10^7 Plasmodium parasites. The treatment will last for 5-10 weeks from the day of successful infection. During the period of Plasmodium immunotherapy, doctor will use artesunate to control the P. vivax erythrocyte infection rate at a low level, so as to prevent the severe adverse event. After 5-10 weeks, parasitemia will be terminated by antimalarial drugs for ending the treatment of Plasmodium immunotherapy (the immunological treatment effect may persist after the termination of Plasmodium infection). After the treatment, patients will be followed up for 2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Malignant Solid Tumor
Keywords
advanced malignant solid tumor, Plasmodium immunotherapy, Plasmodiun vivax

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Blood-stage infection of P.vivax
Arm Type
Experimental
Arm Description
This is a single arm study that is planed to enroll 60 patients with advanced malignant solid tumor and each patient will be vaccinated with P.vivax-infected red blood cells containing approximately 0.1-1.0 × 10^7 Plasmodium parasites. And successful infection will be indicated by microscopic observation of parasitemia in peripheral blood samples. The treatment will last 5-10 weeks from the day of successful infection and will be terminated by antimalarial drugs.
Intervention Type
Other
Intervention Name(s)
Plasmodium immunotherapy
Intervention Description
The patient will be vaccinated with P. vivax-infected red blood cells containing approximately 0.1-1.0 × 10^7 Plasmodium parasites.
Primary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
Starting from treatment until the disease progression is first found or the time of any cause of death (disease progression refers to tumor growth, or metastasis of primary tumor, or discovery of new lesions).
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Tumor marker level
Description
The patient's sensitive tumor markers will be reviewed periodically from the time they are enrolled into the study.
Time Frame
2 years
Title
Disease Control Rate
Description
The proportion of patients who had a best response rating of complete response, partial response, or stable disease.
Time Frame
2 years
Title
Immunological index
Description
Detection of absolute number of immune cells(such as CD3+CD4+、CD3+CD8+ and so on)in peripheral blood by flow cytometry.
Time Frame
2 years
Title
Quality of life score
Description
Patients are regularly filled with QLQ-C30 (cancer patient quality of life scale) to assess the quality of life of the patients.
Time Frame
2 years
Title
Overall survival
Description
The time starting from the treatment to death of whatever causes (when subjects have lost for follow-up before death, the last follow-up time will be calculated as the time of death).
Time Frame
2 years
Title
1 year of survival rate
Description
The number of cancer cases remaining after 1 year of treatment / the total number of cancer cases treated * 100%.
Time Frame
2 years
Title
2 year of survival rate
Description
The number of cancer cases remaining after 2 years of treatment / the total number of cancer cases treated * 100%.
Time Frame
2 years
Title
time of tumor progression
Description
TTP is the time between the beginning of treatment and the onset of tumor progression.
Time Frame
2 years
Title
Duration of disease control
Description
Duration of disease control is the time from the first evaluation of the tumor as CR, PR or SD to the first evaluation as PD (progressive disease) or any cause of death.
Time Frame
2 years
Title
pain score
Description
Patients are regularly evluated with pain assessment scale
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 18-70 years male or female. Patients with advanced maligant solid tumors in lung, liver, prostate, ovary, brain, thyroid and colorectum, etc. Patients with primary central nervous system (CNS) tumor or brain metastases from solid tumors, comply with the following standards can participate in this study: Up to the clinical trial screening period, the imageological examination provides progression-free evidence for at least 3 months, blood brain barrier has not been damaged or is already recovered from the former treatment (surgery or radiotherapy) injury, without intracranial hemorrhage or myelorrhagia history, without metastases to the brain stem, midbrain, pons, medulla oblongata or eye subsidiary organs within 10 mm area (the optic nerve and optic chiasma). The patients have measurable tumors based on the criterion of RECIST1.1. Tumor classification should be determined by histopathology and pathological report should be provided. If tumor tissue is available, before participating in the trail, the research center need to obtain the paraffin blocks or at least 6 unstained sections of the tumor tissue and the relevant pathological reports. If the above tumor tissue samples are not available, samples of any kind (such as fine needle aspiration biopsy samples, cell mass samples (such as pleural, peritoneal effusion samples and lavage samples) are acceptable. If tumor tissue is not available, patients are still eligible for the study. For the patients who previously received one or more of the following therapies, the interval time of the termination of chemotherapy (including interventional chemotherapy) or radiotherapy is at least 28 days for patients who had received chemotherapy or radiotherapy; at least 5 half-life time for patients who had received targeted drug therapy (the half-life of targeted drug is according to the drug instructions). ECGO score is 0 to 2, and euphagia. Expected survival ≥ 3 months. WBC≥3× 10^9/L, PLT ≥ 100× 10^9/L, HGB ≥ 100 g/L, and albumin ≥ 30 g/L, no significant morphological abnormalities of red blood cells, or anemia (iron deficiency anemia, autoimmune hemolytic anemia, thalassemia, etc.). Patients with gastrointestinal bleeding, hemoptysis or other chronic bleeding symptoms were cured before enrollment. Patients with no severe dysfunction of cardiopulmonary, liver and kidney function (child-push grading of liver function A or B, Cr≤ 1.5 x ULN). Patient will be able to understand and sign informed consent. According to the researcher's judgment, the patient's compliance could meet the needs of follow-up. Exclusion Criteria: Nasopharyngeal cancer, head and neck tumors. HPV positive patients with advanced malignant solid tumors in cervical, anal, vulvar, vaginal and penile. Pancreatic cancer patients. Small cell lung cancer patients. Patients with severe hemoglobin disease or severe G6PD deficiency. Patients with splenectomy or splenomegaly. Patients with drug addiction or alcohol dependence. Have not yet been washed out from the previous therapeutic effects, except the following: the bisphosphonates used for bone metastasis or osteoporosis. Uncontrolled pleural effusion, pericardial effusion or ascites. Tumor-related pain that are uncontrollable. Active malignant tumor metastasis of CNS (progression or controlling the symptoms with anticonvulsants or corticosteroids ). Patients with significant immunodeficiency detection ( CD4+T cell absolute count <200 /ul) With the following diseases or conditions: serious or uncontrolled systemic disease or any unstable systemic diseases (including but not limited to active infection, grade three hypertension, unstable angina, congestive heart failure, class III or IV heart disease, severe arrhythmia, liver and kidney dysfunction or metabolic disease), a clear history of neurological or psychiatric disorders, etc. According to the principal investigator's judgment, any other diseases, metabolic disorders, abnormal results of clinical laboratory tests or physical examination, the diseases that leading to usage of the prohibited drugs, influencing the results reliability, putting patients in high risk. Have undergone major surgery within 4 weeks of the screening period, or plan to undergo major surgery during the study period, PICC catheter and central venous catheter implantation are excluded. Received any antineoplastic drugs, immune cells, antibodies, or vaccines within five drug half-life (not sure the half-life, will be subject to two weeks) during the screening period. Patients who have previously received allogeneic bone marrow transplantation or solid organ transplantation. Receiving any other anti-tumor treatment at the same time. Lung function is seriously damaged, the MNW <39% or can't get out of bed, still feel short of breath when resting. Rough cough, dyspnea, without normal diet or difficult to cooperate. Poor body condition, the researchers assess that the patients can't tolerate the Plasmodium immunotherapy. Pregnant or lactating women. Patients that are unable to comply with the research and follow-up procedure. Any case that the researchers believe that the patient does not suit for this clinical study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Qin Li, Ph.D
Phone
0086-18802043960
Email
qin_li@cas-lamvac.com
First Name & Middle Initial & Last Name or Official Title & Degree
Huang Qiumei, M.D
Phone
0086-20-82258809
Email
huang_qiumei@cas-lamvac.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hou Jianghou, Ph.D
Organizational Affiliation
Yunnan Kungang Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Yunnan Kungang Hospital
City
Kunming
State/Province
Yunnan
ZIP/Postal Code
650000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hou Jianghou, Ph.D
Phone
86+15116919815
Email
coolhou@vip.sina.com
First Name & Middle Initial & Last Name & Degree
Xu Jinsong, M.D
Phone
86+13888866278
Email
780173080@qq.com

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
21931708
Citation
Chen L, He Z, Qin L, Li Q, Shi X, Zhao S, Chen L, Zhong N, Chen X. Antitumor effect of malaria parasite infection in a murine Lewis lung cancer model through induction of innate and adaptive immunity. PLoS One. 2011;6(9):e24407. doi: 10.1371/journal.pone.0024407. Epub 2011 Sep 9.
Results Reference
result
PubMed Identifier
28228842
Citation
Qin L, Chen C, Chen L, Xue R, Ou-Yang M, Zhou C, Zhao S, He Z, Xia Y, He J, Liu P, Zhong N, Chen X. Worldwide malaria incidence and cancer mortality are inversely associated. Infect Agent Cancer. 2017 Feb 14;12:14. doi: 10.1186/s13027-017-0117-x. eCollection 2017.
Results Reference
result
PubMed Identifier
28650446
Citation
Yang Y, Liu Q, Lu J, Adah D, Yu S, Zhao S, Yao Y, Qin L, Qin L, Chen X. Exosomes from Plasmodium-infected hosts inhibit tumor angiogenesis in a murine Lewis lung cancer model. Oncogenesis. 2017 Jun 26;6(6):e351. doi: 10.1038/oncsis.2017.52.
Results Reference
result
PubMed Identifier
28445973
Citation
Liu Q, Yang Y, Tan X, Tao Z, Adah D, Yu S, Lu J, Zhao S, Qin L, Qin L, Chen X. Plasmodium parasite as an effective hepatocellular carcinoma antigen glypican-3 delivery vector. Oncotarget. 2017 Apr 11;8(15):24785-24796. doi: 10.18632/oncotarget.15806.
Results Reference
result
PubMed Identifier
30979375
Citation
Adah D, Yang Y, Liu Q, Gadidasu K, Tao Z, Yu S, Dai L, Li X, Zhao S, Qin L, Qin L, Chen X. Plasmodium infection inhibits the expansion and activation of MDSCs and Tregs in the tumor microenvironment in a murine Lewis lung cancer model. Cell Commun Signal. 2019 Apr 12;17(1):32. doi: 10.1186/s12964-019-0342-6.
Results Reference
result
Links:
URL
http://www.ncbi.nlm.nih.gov/pubmed/21931708
Description
Free full text.
URL
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307699/
Description
Free full text.This article has been cited by other articles in PMC.
URL
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519199/
Description
Free full text.This article has been cited by other articles in PMC.
URL
http://ncbi.nlm.nih.gov/pubmed/28445973
Description
Free full text.
URL
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461823/
Description
Free full text.

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Plasmodium Immunotherapy for Advanced Malignant Solid Tumors

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