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The Safety and Tolerability of PGV001-based Personalized Multi-peptide Vaccines in the Adjuvant Setting. (PGV-Prostate)

Primary Purpose

Prostate Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PGV-001
Poly-ICLC
CDX-301
Sponsored by
Ashutosh Kumar Tewari
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Prostate Cancer

Eligibility Criteria

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

Inclusion Criteria:

To be enrolled a subject must meet the following criteria:

  • The subject must have a histologically proven diagnosis of adenocarcinoma of prostate
  • The subject should have any one of:

    1. PSA persistence post surgery (defined as a PSA value that fails to become undetectable) by six weeks post treatment,
    2. Biochemical recurrence (defined as a PSA value ≥ 0.2ng/ml),
    3. An elevated PSA with a doubling time of > 3 months,
    4. Or an estimated risk of biochemical recurrence within 5 years of 30% or more as assessed by decipher™ report (decipher score of ≥0.3).
  • At the time of treatment, the subjects must have completed radical prostatectomy (rp), all additional s.o.c therapies and be clinically tumor free as defined by s.o.c imaging studies
  • Written informed consent obtained prior to any study procedure.
  • The subject must be able to provide the necessary tissue sample for sequencing, either by surgical resection or open-surgical or core biopsy sampling of the primary tumor
  • This requirement may be satisfied by providing an archival tissue sample that has been stored in rna later, flash-frozen, or under other rna/dna preserving conditions from an earlier resection.
  • This requirement may also be satisfied by providing rna/dna sequencing from a CLIA certified genomic sequencing laboratory.
  • Before administration of the investigational product, the following time must have elapsed:

    1. At least (4) weeks post general anesthesia
    2. At least seventy-two (72) hours post local/epidural anesthesia
    3. The subject must complete all prior systemic chemotherapy therapy, and all adverse events have either returned to baseline or have stabilized at least four (4) weeks prior to administration of the investigational product.
    4. The subject must complete all prior systemic radiation therapy at least four (4) weeks prior to administration of the investigational product. The subject must not have received a radiopharmaceutical within eight (8) weeks prior to the administration of the investigational product.
    5. The subject may continue hormonal therapy (e.g. Anti-androgens) during the study.
    6. Subjects may have a detectable or rising PSA provided there is no radiographic evidence of metastatic disease. For patients with a rising PSA, the doubling time should be >3 months.

      9. The subject must have a life expectancy greater than twelve (12) months at the time of screening as assessed by the treating physician.

  • The subject must have a performance status of 0-1 as determined by criteria set forward by the eastern cooperative oncology group243.
  • The subject must have at the time of screening acceptable hematologic, hepatic, and renal function, defined by the following:

    1. Absolute neutrophil count > 1000/mm3
    2. Platelet count > 50,000/mm3,
    3. Creatinine < 2.5 mg/dl,
    4. Total bilirubin ≤ 1.5 mg/dl, (except in patients with gilbert syndrome who can have total bilirubin < 3.0 mg/dl)
    5. Transaminases < 2 times above the upper limits of the institutional normal.
    6. INR<2 if off of anticoagulation. Patients on anticoagulation therapy with an INR>2 may be enrolled at the discretion of the investigator if they have not had any episodes of severe hemorrhage.
  • Adequate venous access (for leukapheresis and blood draws)
  • The subject must be male 18 years of age or older.
  • The subject must be deemed competent to give informed consent.
  • The subject must agree to use a condom and another effective method of birth control if he is having sex with a woman of childbearing potential or agrees to use a condom if he is having sex with a woman who is pregnant.

Exclusion Criteria:

Potential subjects who meet any of the following criteria will not be included in the study:

  • The subject has metastatic disease at the time of treatment.
  • Patients with history of AML or tumors with known Flt3 mutations/amplifications.
  • The subject has a history of unrelated neoplastic disease, which has been deemed active within thirty-six (36) months of the screening evaluation, with the exception of the following:

    1. Non-invasive non-melanoma skin cancer such as superficial basal cell carcinoma or squamous cell carcinoma.
    2. Subjects with tumors of the prostate with a combined Gleason Score ≤ 7
    3. Patients with other completely resected malignancies in the prior three years and no evidence of disease will be evaluated on a case-by-case basis with eligibility determined based on discussion with the Principal Investigator.
  • The subject has a prior history of unrelated neoplastic disease and has received systemic therapy for the secondary malignancy within the twelve (12) month period preceding the screening evaluation.
  • The subject has a history of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), chronic active hepatitis B or hepatitis C with positive PCR.
  • The subject has a history of, or is reasonably suspected to meet criteria for the diagnosis of a known congenital or acquired disorder causing systemic immunosuppression; or the subject is currently receiving any drug or supplement which is known to be associated with systemic immune suppression including those drugs which are prescribed for solid organ or stem cell transplant, autoimmune/inflammatory disorders, or other related medical conditions.
  • The subject has a history of, or is reasonably suspected to meet criteria for the diagnosis of a systemic auto-immune/inflammatory disease or other autoimmune disorder with the exception of:

    1. Vitiligo
    2. Hypothyroidism
  • The subject has a history of anaphylaxis or other serious adverse reactions relating to administration of any components of the investigational product.
  • The subject has a history of serious allergic reaction to any substance, resulting in hospitalization or requiring other emergent medical attention.
  • The subject has a history of advanced cardiac, hepatic or renal disease or other chronic illness.
  • The subject has been diagnosed and treated at an external facility, and the resulting tissue specimen is of insufficient quality such that it precludes clinical sequencing or any other necessary study procedure, and the subject is unwilling to undergo an additional biopsy procedure.
  • Previous treatment with therapeutic cancer vaccine of any type
  • The subject is less than eighteen (18) years of age, or otherwise unable to give informed consent due to minor status.
  • The subject is a prisoner, as defined by [45 CFR 46.303(c)].
  • The subject is cognitively impaired, and unable to give informed consent.

Sites / Locations

  • Icahn School of Medicine at Mount Sinai (ISMMS)Recruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Cohort 1 - Primary treatment cohort

Cohort 2 - Secondary treatment cohort

Cohort 3 - Expansion treatment cohort

Arm Description

Patients receive the personalized genomic vaccine (PGV) and Poly-ICLC.

Patients receive the personalized genomic vaccine (PGV) and Poly-ICLC, and CDX-301

An expansion cohort if the treatment of all 3 together has not triggered a safety stopping event.

Outcomes

Primary Outcome Measures

Number of adverse events
Adverse events will be measured by severity of Adverse events with toxicity grading defined by Cancer Therapy Evaluation Program's (CTEP) v5.0 of National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) scale .
Number of adverse events
Adverse events will be measured by severity of Adverse events with toxicity grading defined by Cancer Therapy Evaluation Program's (CTEP) v5.0 of National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) scale .

Secondary Outcome Measures

Change in immune cell subsets
Changes in immune cell subsets to compare immune responses at baseline to prostate antigens and viruses with immune responses obtained after treatment with the vaccine combination
Change in immune cell subsets
Changes in immune cell subsets to compare immune responses at baseline to prostate antigens and viruses with immune responses obtained after treatment with the vaccine combination
Change in immune cell subsets
Changes in immune cell subsets to compare immune responses at baseline to prostate antigens and viruses with immune responses obtained after treatment with the vaccine combination
Change in the frequency of vaccine epitope-specific T lymphocyte populations
Change in the frequency of vaccine epitope-specific T lymphocyte populations in post-treatment peripheral blood compared to peripheral blood obtained prior to the start of vaccination.
Change in the frequency of vaccine epitope-specific T lymphocyte populations
Change in the frequency of vaccine epitope-specific T lymphocyte populations in post-treatment peripheral blood compared to peripheral blood obtained prior to the start of vaccination.
Change in the frequency of vaccine epitope-specific T lymphocyte populations
Change in the frequency of vaccine epitope-specific T lymphocyte populations in post-treatment peripheral blood compared to peripheral blood obtained prior to the start of vaccination.
Radiographic free survival
Radiographic free survival (RFS) by Kaplan-Meier (KM) method.

Full Information

First Posted
June 18, 2021
Last Updated
October 18, 2023
Sponsor
Ashutosh Kumar Tewari
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1. Study Identification

Unique Protocol Identification Number
NCT05010200
Brief Title
The Safety and Tolerability of PGV001-based Personalized Multi-peptide Vaccines in the Adjuvant Setting.
Acronym
PGV-Prostate
Official Title
Phase I, Open-label, Single-center Proof of Concept Study Designed to Test the Safety and Tolerability of PGV001-based Personalized Multi-peptide Vaccines in Combination With CDX-301 in Subjects With a History of Prostate Cancer, in the Adjuvant Setting
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 5, 2022 (Actual)
Primary Completion Date
January 2027 (Anticipated)
Study Completion Date
January 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Ashutosh Kumar Tewari

4. Oversight

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

5. Study Description

Brief Summary
This proof of concept study is designed to test the safety and tolerability of PGV001-based personalized multi-peptide vaccines in combination with CDX-301 in subjects with a history of aggressive prostate cancer, in the tumor free adjuvant setting.
Detailed Description
This proof of concept study is designed to test the safety and tolerability of PGV001-based personalized multi-peptide vaccines in combination with CDX-301 in subjects with a history of aggressive prostate cancer, in the tumor free adjuvant setting. This study will also assess the capacity of PGV001-based a multi-peptide therapeutic vaccines to produce a robust tumor antigen-specific T lymphocytic response in the peripheral circulation when combined with CDX-301, and it will expand the collective body of knowledge regarding the identification, selection and use of mutation-derived tumor antigens for personalized immunotherapy in prostate cancer patients. The purpose of the proposed trial will be to assess the following hypothesis: Mutation-derived tumor antigens (MTA) may arise as a result of somatic non-synonymous variations-including nucleotide substitutions, as well as small insertions and deletions-which occur during tumorigenesis. Somatic mutations may be characterized through the use of high-throughput sequencing technologies, and the resulting sequence data used to identify TSA. Sequence data can inform the design of patient-specific immune-based therapies, which may be capable of inducing quantitative changes in the concentration of circulating antigen-specific T lymphocytes directed against TSA, which may in-turn lead to immune-mediated elimination of residual malignant cells.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
27 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 - Primary treatment cohort
Arm Type
Experimental
Arm Description
Patients receive the personalized genomic vaccine (PGV) and Poly-ICLC.
Arm Title
Cohort 2 - Secondary treatment cohort
Arm Type
Experimental
Arm Description
Patients receive the personalized genomic vaccine (PGV) and Poly-ICLC, and CDX-301
Arm Title
Cohort 3 - Expansion treatment cohort
Arm Type
Experimental
Arm Description
An expansion cohort if the treatment of all 3 together has not triggered a safety stopping event.
Intervention Type
Biological
Intervention Name(s)
PGV-001
Intervention Description
personalized genomic peptide vaccine
Intervention Type
Biological
Intervention Name(s)
Poly-ICLC
Intervention Description
immune modulator
Intervention Type
Biological
Intervention Name(s)
CDX-301
Intervention Description
soluble recombinant human protein to work on stem cell
Primary Outcome Measure Information:
Title
Number of adverse events
Description
Adverse events will be measured by severity of Adverse events with toxicity grading defined by Cancer Therapy Evaluation Program's (CTEP) v5.0 of National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) scale .
Time Frame
37 days
Title
Number of adverse events
Description
Adverse events will be measured by severity of Adverse events with toxicity grading defined by Cancer Therapy Evaluation Program's (CTEP) v5.0 of National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) scale .
Time Frame
191 days
Secondary Outcome Measure Information:
Title
Change in immune cell subsets
Description
Changes in immune cell subsets to compare immune responses at baseline to prostate antigens and viruses with immune responses obtained after treatment with the vaccine combination
Time Frame
37 days
Title
Change in immune cell subsets
Description
Changes in immune cell subsets to compare immune responses at baseline to prostate antigens and viruses with immune responses obtained after treatment with the vaccine combination
Time Frame
191 days
Title
Change in immune cell subsets
Description
Changes in immune cell subsets to compare immune responses at baseline to prostate antigens and viruses with immune responses obtained after treatment with the vaccine combination
Time Frame
365 days
Title
Change in the frequency of vaccine epitope-specific T lymphocyte populations
Description
Change in the frequency of vaccine epitope-specific T lymphocyte populations in post-treatment peripheral blood compared to peripheral blood obtained prior to the start of vaccination.
Time Frame
37 days
Title
Change in the frequency of vaccine epitope-specific T lymphocyte populations
Description
Change in the frequency of vaccine epitope-specific T lymphocyte populations in post-treatment peripheral blood compared to peripheral blood obtained prior to the start of vaccination.
Time Frame
191 days
Title
Change in the frequency of vaccine epitope-specific T lymphocyte populations
Description
Change in the frequency of vaccine epitope-specific T lymphocyte populations in post-treatment peripheral blood compared to peripheral blood obtained prior to the start of vaccination.
Time Frame
365 days
Title
Radiographic free survival
Description
Radiographic free survival (RFS) by Kaplan-Meier (KM) method.
Time Frame
10 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be enrolled a subject must meet the following criteria: The subject must have a histologically proven diagnosis of adenocarcinoma of prostate The subject should have any one of: PSA persistence post surgery (defined as a PSA value that fails to become undetectable) by six weeks post treatment, Biochemical recurrence (defined as a PSA value ≥ 0.2ng/ml), An elevated PSA with a doubling time of > 3 months, Or an estimated risk of biochemical recurrence within 5 years of 30% or more as assessed by decipher™ report (decipher score of ≥0.3). At the time of treatment, the subjects must have completed radical prostatectomy (rp), all additional s.o.c therapies and be clinically tumor free as defined by s.o.c imaging studies Written informed consent obtained prior to any study procedure. The subject must be able to provide the necessary tissue sample for sequencing, either by surgical resection or open-surgical or core biopsy sampling of the primary tumor This requirement may be satisfied by providing an archival tissue sample that has been stored in rna later, flash-frozen, or under other rna/dna preserving conditions from an earlier resection. This requirement may also be satisfied by providing rna/dna sequencing from a CLIA certified genomic sequencing laboratory. Before administration of the investigational product, the following time must have elapsed: At least (4) weeks post general anesthesia At least seventy-two (72) hours post local/epidural anesthesia The subject must complete all prior systemic chemotherapy therapy, and all adverse events have either returned to baseline or have stabilized at least four (4) weeks prior to administration of the investigational product. The subject must complete all prior systemic radiation therapy at least four (4) weeks prior to administration of the investigational product. The subject must not have received a radiopharmaceutical within eight (8) weeks prior to the administration of the investigational product. The subject may continue hormonal therapy (e.g. Anti-androgens) during the study. Subjects may have a detectable or rising PSA provided there is no radiographic evidence of metastatic disease. For patients with a rising PSA, the doubling time should be >3 months. 9. The subject must have a life expectancy greater than twelve (12) months at the time of screening as assessed by the treating physician. The subject must have a performance status of 0-1 as determined by criteria set forward by the eastern cooperative oncology group243. The subject must have at the time of screening acceptable hematologic, hepatic, and renal function, defined by the following: Absolute neutrophil count > 1000/mm3 Platelet count > 50,000/mm3, Creatinine < 2.5 mg/dl, Total bilirubin ≤ 1.5 mg/dl, (except in patients with gilbert syndrome who can have total bilirubin < 3.0 mg/dl) Transaminases < 2 times above the upper limits of the institutional normal. INR<2 if off of anticoagulation. Patients on anticoagulation therapy with an INR>2 may be enrolled at the discretion of the investigator if they have not had any episodes of severe hemorrhage. Adequate venous access (for leukapheresis and blood draws) The subject must be male 18 years of age or older. The subject must be deemed competent to give informed consent. The subject must agree to use a condom and another effective method of birth control if he is having sex with a woman of childbearing potential or agrees to use a condom if he is having sex with a woman who is pregnant. Exclusion Criteria: Potential subjects who meet any of the following criteria will not be included in the study: The subject has metastatic disease at the time of treatment. Patients with history of AML or tumors with known Flt3 mutations/amplifications. The subject has a history of unrelated neoplastic disease, which has been deemed active within thirty-six (36) months of the screening evaluation, with the exception of the following: Non-invasive non-melanoma skin cancer such as superficial basal cell carcinoma or squamous cell carcinoma. Subjects with tumors of the prostate with a combined Gleason Score ≤ 7 Patients with other completely resected malignancies in the prior three years and no evidence of disease will be evaluated on a case-by-case basis with eligibility determined based on discussion with the Principal Investigator. The subject has a prior history of unrelated neoplastic disease and has received systemic therapy for the secondary malignancy within the twelve (12) month period preceding the screening evaluation. The subject has a history of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), chronic active hepatitis B or hepatitis C with positive PCR. The subject has a history of, or is reasonably suspected to meet criteria for the diagnosis of a known congenital or acquired disorder causing systemic immunosuppression; or the subject is currently receiving any drug or supplement which is known to be associated with systemic immune suppression including those drugs which are prescribed for solid organ or stem cell transplant, autoimmune/inflammatory disorders, or other related medical conditions. The subject has a history of, or is reasonably suspected to meet criteria for the diagnosis of a systemic auto-immune/inflammatory disease or other autoimmune disorder with the exception of: Vitiligo Hypothyroidism The subject has a history of anaphylaxis or other serious adverse reactions relating to administration of any components of the investigational product. The subject has a history of serious allergic reaction to any substance, resulting in hospitalization or requiring other emergent medical attention. The subject has a history of advanced cardiac, hepatic or renal disease or other chronic illness. The subject has been diagnosed and treated at an external facility, and the resulting tissue specimen is of insufficient quality such that it precludes clinical sequencing or any other necessary study procedure, and the subject is unwilling to undergo an additional biopsy procedure. Previous treatment with therapeutic cancer vaccine of any type The subject is less than eighteen (18) years of age, or otherwise unable to give informed consent due to minor status. The subject is a prisoner, as defined by [45 CFR 46.303(c)]. The subject is cognitively impaired, and unable to give informed consent.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sujit S Nair, Ph.D.
Phone
212-241-7005
Email
Sujit.Nair@mountsinai.org
First Name & Middle Initial & Last Name or Official Title & Degree
Monali Fatterpekar
Phone
212-241-0751
Email
monali.fatterpekar@mountsinai.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ashutosh Tewari, MD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sujit S Nair, Ph.D.
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Dara Lundon, MD MSc MBA PhD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Study Director
Facility Information:
Facility Name
Icahn School of Medicine at Mount Sinai (ISMMS)
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Monali Fatterpekar, PhD
Email
monali.fatterpekar@mountsinai.org
First Name & Middle Initial & Last Name & Degree
Ashutosh Tewari, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Safety and Tolerability of PGV001-based Personalized Multi-peptide Vaccines in the Adjuvant Setting.

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