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A Phase 1 Trial of PfSPZ Vaccine in Healthy Adults to Determine Safety, Tolerability and Efficacy Against Heterologous CHMI

Primary Purpose

Malaria, Malaria,Falciparum

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PfSPZ Vaccine
PfSPZ Challenge (7G8)
Normal Saline
Sponsored by
Sanaria Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Malaria focused on measuring Malaria, Plasmodium falciparum, Sporozoites, PfSPZ Vaccine

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Healthy adults (male or non-pregnant female) 18 to 50 years of age. Able and willing to participate for the duration of the study. Able and willing to provide written informed consent and satisfactorily complete a test of understanding with a passing score >80%. Physical examination and laboratory results without clinically significant findings. Women of childbearing potential must agree to use effective means of birth control (e.g. oral or implanted contraceptives, IUD, female condom, diaphragm with spermicide, cervical cap, abstinence, use of a condom by the sexual partner or sterile sexual partner) during the entire study. Women with a history of surgical or chemical sterilization (e.g. tubal ligation, hysterectomy, other). Willing to refrain from blood donation for 3 years following CHMI. Agree not to travel to a malaria endemic region during the trial. Exclusion Criteria: Unable to provide informed consent including inability to pass the test of understanding, which is written in English for the US-based study sites. Receipt of a malaria vaccine in a prior clinical trial. History of a splenectomy or sickle cell disease. History of a neurologic disorder (including non-febrile seizures or complex febrile seizures) or formal history of migraine headache. Current use of systemic immunosuppressant pharmacotherapy. Receipt of a live vaccine within 4 weeks of first immunization or of 3 or more non-live vaccines within 2 weeks of first immunization. Women who are breast-feeding, pregnant or planning to become pregnant during the study period. Known allergy to atovaquone-proguanil (Malarone®), artemether-lumefantrine (Coartem®), or any component of the investigational products. A history of malaria in the 2 years prior to screening. Participation in any study involving investigational vaccine or drug within 4 weeks prior to enrollment that in the estimation of the site PI might adversely affect the individual's safety or the quality of data to be collected. Evidence of increased cardiovascular disease risk; defined as >10% five-year risk by nonlaboratory method. Plan to participate in another investigational vaccine/drug research during the study. Plan for major surgery between enrollment until 28 days post-CHMI. Use or planned use of any drug with anti-malarial activity that would precede or coincide with malaria challenge or vaccination. Anticipated use of medications known to cause drug reactions with atovaquone-proguanil or artemether-lumefantrine such as cimetidine, metoclopramide, antacids, and kaolin. Positive HBsAg or positive HIV or HCV testing consistent with active infection. An abnormal electrocardiogram, defined as one showing pathologic Q waves and significant STT wave changes; left ventricular hypertrophy; any non-sinus rhythm including isolated premature ventricular contractions, but excluding isolated premature atrial contractions; right or left bundle branch block; or advanced (secondary or tertiary) A-V heart block; or other clinically significant abnormalities on the electrocardiogram as determined by the consulting cardiologist. Any clinically significant deviation from the normal range in biochemistry or hematology tests measured at screening and not resolving. Any medical, psychiatric, social, behavioral or occupational condition or situation (including active alcohol or drug abuse) that, in the judgment of the site PI, impairs the volunteer's ability to give informed consent, increases the risk to the participant of participation in the study, affects the ability of the participant to participate fully in the study, or might negatively impact the quality, consistency, integrity or interpretation of data derived from their participation in the study.

Sites / Locations

  • University of Maryland, Baltimore, Center for Vaccine Development and Global Health

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Placebo Comparator

Placebo Comparator

Arm Label

Group 1a: PfSPZ Vaccine

Group 1b: PfSPZ Vaccine

Group 2a: Normal Saline Controls

Group 2b: Normal Saline Controls

Arm Description

45 participants will receive 3 doses of 9.0x10^5 PfSPZ Vaccine on Days 1, 8, and 29 with a total dose of 2.7x10^6 PfSPZ Vaccine. Group 1a: Approximately half (22/23) of the volunteers will undergo CHMI 3 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).

45 participants will receive 3 doses of 9.0x10^5 PfSPZ Vaccine on Days 1, 8, and 29 with a total dose of 2.7x10^6 PfSPZ Vaccine. Group 1b: Approximately half (22/23) of the volunteers will undergo CHMI 12 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).

15 participants will receive 3 doses of normal saline on Days 1, 8, and 29. Group 2a: Approximately half (7/8) of the volunteers will undergo CHMI 3 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).

15 participants will receive 3 doses of normal saline on Days 1, 8, and 29. Group 2b: Approximately half (7/8) of the volunteers will undergo CHMI 12 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).

Outcomes

Primary Outcome Measures

Vaccine efficacy (VE)
VE computed as one minus the estimated risk ratio for Pf malaria (parasitemia) detected by PCR beginning 7 days after CHMI up to 28 days in the modified intention to treat population (proportional efficacy analysis) combining data across the two CHMI timepoints.
Adverse events
The differences in proportions of vaccinees compared to controls experiencing related moderate, severe, or serious solicited and unsolicited adverse events and laboratory abnormalities after vaccination.

Secondary Outcome Measures

VE for CHMI at 3 weeks
VE computed as one minus the estimated risk ratio for Pf malaria (parasitemia) detected by PCR beginning 7 days after CHMI up to 28 days in the modified intention to treat population (proportional efficacy analysis) for CHMI at 3 weeks.
VE for CHMI at 12 weeks
VE computed as one minus the estimated risk ratio for Pf malaria (parasitemia) detected by PCR beginning 7 days after CHMI up to 28 days in the modified intention to treat population (proportional efficacy analysis) for CHMI at 12 weeks.
Antibody levels to PfCSP measured by ELISA
Antibody levels to PfCSP measured by ELISA comparing vaccinees to controls, and protected (no parasitemia occurring post CHMI) to non-protected (parasitemia occurring post CHMI) vaccinees.

Full Information

First Posted
October 28, 2022
Last Updated
October 5, 2023
Sponsor
Sanaria Inc.
Collaborators
University of Maryland, Baltimore
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1. Study Identification

Unique Protocol Identification Number
NCT05604521
Brief Title
A Phase 1 Trial of PfSPZ Vaccine in Healthy Adults to Determine Safety, Tolerability and Efficacy Against Heterologous CHMI
Official Title
A Randomized, Double-blind, Placebo-controlled, Clinical Trial of a 3-dose, 28-day Regimen of PfSPZ Vaccine in Healthy, Adult Participants to Determine Safety, Tolerability and Efficacy Against Heterologous Plasmodium Falciparum Controlled Human Malaria Infection Conducted 3 or 12 Weeks After Immunization
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Terminated
Why Stopped
The main reason for trial discontinuation was the inability to address the primary objectives of the study following an extended gap between the second and third doses due to the clinical hold on IND 14826 since 15 December 2022.
Study Start Date
December 6, 2022 (Actual)
Primary Completion Date
September 5, 2023 (Actual)
Study Completion Date
September 5, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanaria Inc.
Collaborators
University of Maryland, Baltimore

4. Oversight

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

5. Study Description

Brief Summary
USSPZV7 is a randomized, phase 1, double-blind, placebo-controlled trial of Sanaria® PfSPZ Vaccine administered on Days 1, 8 and 29 by direct venous inoculation (DVI) to assess safety, tolerability, immunogenicity, and vaccine efficacy (VE) against heterologous controlled human malaria infection (CHMI) with the 7G8 clone of Plasmodium falciparum (Pf) conducted at 3 or 12 weeks after the third immunization. The trial is designed to determine if individuals living in a non-malaria endemic area such as the United States (US) are protected against heterologous CHMI conducted at these time points.
Detailed Description
Randomized, phase 1, double-blind, placebo-controlled clinical trial enrolling healthy adult participants 18-50-years-old living in the US. The trial is designed to measure safety, tolerability, immunogenicity and VE against heterologous controlled human malaria vaccine conducted at 3 or 12 weeks after vaccination. Participants will be randomized to two study groups, vaccine and placebo, in a 3:1 ratio. Treatment assignment will be double blind; however, whether a given participant will be receiving CHMI at 3 or 12 weeks will not be blind. Bias will be minimized by the randomized, double-blind design and by the inability to distinguish vaccine or placebo based on appearance, tolerability or other characteristics discernable by clinical staff or study participants. The study will take approximately 6 to 8 months to complete, not including 2-3 months of recruitment. The period of follow-up for each immunized participant and placebo controls is through 8 weeks post-CHMI. Study participation by individuals will last 4 to 6 months (not including screening) depending upon group assignment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria, Malaria,Falciparum
Keywords
Malaria, Plasmodium falciparum, Sporozoites, PfSPZ Vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1a: PfSPZ Vaccine
Arm Type
Active Comparator
Arm Description
45 participants will receive 3 doses of 9.0x10^5 PfSPZ Vaccine on Days 1, 8, and 29 with a total dose of 2.7x10^6 PfSPZ Vaccine. Group 1a: Approximately half (22/23) of the volunteers will undergo CHMI 3 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).
Arm Title
Group 1b: PfSPZ Vaccine
Arm Type
Active Comparator
Arm Description
45 participants will receive 3 doses of 9.0x10^5 PfSPZ Vaccine on Days 1, 8, and 29 with a total dose of 2.7x10^6 PfSPZ Vaccine. Group 1b: Approximately half (22/23) of the volunteers will undergo CHMI 12 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).
Arm Title
Group 2a: Normal Saline Controls
Arm Type
Placebo Comparator
Arm Description
15 participants will receive 3 doses of normal saline on Days 1, 8, and 29. Group 2a: Approximately half (7/8) of the volunteers will undergo CHMI 3 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).
Arm Title
Group 2b: Normal Saline Controls
Arm Type
Placebo Comparator
Arm Description
15 participants will receive 3 doses of normal saline on Days 1, 8, and 29. Group 2b: Approximately half (7/8) of the volunteers will undergo CHMI 12 weeks after last immunization by exposure to 3.2x10^3 PfSPZ Challenge (7G8).
Intervention Type
Biological
Intervention Name(s)
PfSPZ Vaccine
Intervention Description
PfSPZ vaccine consists of radiation-attenuated, aseptic, purified Plasmodium falciparum (NF54) sporozoites (SPZ) cryopreserved in liquid nitrogen vapor phase (LNVP) at -150C to - 196C. PfSPZ Vaccine is composed of PfSPZ derived from the NF54 strain of Pf, which is thought to be from West Africa. PfSPZ Vaccine is diluted in phosphate buffered saline (PBS) with human serum albumin (HSA) to achieve the correct dosage and is administered by DVI.
Intervention Type
Biological
Intervention Name(s)
PfSPZ Challenge (7G8)
Intervention Description
PfSPZ Challenge (7G8) is similar to PfSPZ Vaccine but has not been attenuated by radiation and is therefore infectious.PfSPZ Challenge (7G8) is composed of PfSPZ derived from the 7G8 clone of Pf, which is from Brazil.
Intervention Type
Other
Intervention Name(s)
Normal Saline
Other Intervention Name(s)
Placebo
Intervention Description
0.9% sodium chloride
Primary Outcome Measure Information:
Title
Vaccine efficacy (VE)
Description
VE computed as one minus the estimated risk ratio for Pf malaria (parasitemia) detected by PCR beginning 7 days after CHMI up to 28 days in the modified intention to treat population (proportional efficacy analysis) combining data across the two CHMI timepoints.
Time Frame
7 days after CHMI up to 28 days
Title
Adverse events
Description
The differences in proportions of vaccinees compared to controls experiencing related moderate, severe, or serious solicited and unsolicited adverse events and laboratory abnormalities after vaccination.
Time Frame
Day of immunization to 28 days post immunization
Secondary Outcome Measure Information:
Title
VE for CHMI at 3 weeks
Description
VE computed as one minus the estimated risk ratio for Pf malaria (parasitemia) detected by PCR beginning 7 days after CHMI up to 28 days in the modified intention to treat population (proportional efficacy analysis) for CHMI at 3 weeks.
Time Frame
7 Days after first CHMI up to 28 days
Title
VE for CHMI at 12 weeks
Description
VE computed as one minus the estimated risk ratio for Pf malaria (parasitemia) detected by PCR beginning 7 days after CHMI up to 28 days in the modified intention to treat population (proportional efficacy analysis) for CHMI at 12 weeks.
Time Frame
7 Days after second CHMI up to 28 days
Title
Antibody levels to PfCSP measured by ELISA
Description
Antibody levels to PfCSP measured by ELISA comparing vaccinees to controls, and protected (no parasitemia occurring post CHMI) to non-protected (parasitemia occurring post CHMI) vaccinees.
Time Frame
Pre vaccination 1 to Day 141

10. Eligibility

Sex
All
Gender Based
Yes
Gender Eligibility Description
Healthy adults (male or non-pregnant female).
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy adults (male or non-pregnant female) 18 to 50 years of age. Able and willing to participate for the duration of the study. Able and willing to provide written informed consent and satisfactorily complete a test of understanding with a passing score >80%. Physical examination and laboratory results without clinically significant findings. Women of childbearing potential must agree to use effective means of birth control (e.g. oral or implanted contraceptives, IUD, female condom, diaphragm with spermicide, cervical cap, abstinence, use of a condom by the sexual partner or sterile sexual partner) during the entire study. Women with a history of surgical or chemical sterilization (e.g. tubal ligation, hysterectomy, other). Willing to refrain from blood donation for 3 years following CHMI. Agree not to travel to a malaria endemic region during the trial. Exclusion Criteria: Unable to provide informed consent including inability to pass the test of understanding, which is written in English for the US-based study sites. Receipt of a malaria vaccine in a prior clinical trial. History of a splenectomy or sickle cell disease. History of a neurologic disorder (including non-febrile seizures or complex febrile seizures) or formal history of migraine headache. Current use of systemic immunosuppressant pharmacotherapy. Receipt of a live vaccine within 4 weeks of first immunization or of 3 or more non-live vaccines within 2 weeks of first immunization. Women who are breast-feeding, pregnant or planning to become pregnant during the study period. Known allergy to atovaquone-proguanil (Malarone®), artemether-lumefantrine (Coartem®), or any component of the investigational products. A history of malaria in the 2 years prior to screening. Participation in any study involving investigational vaccine or drug within 4 weeks prior to enrollment that in the estimation of the site PI might adversely affect the individual's safety or the quality of data to be collected. Evidence of increased cardiovascular disease risk; defined as >10% five-year risk by nonlaboratory method. Plan to participate in another investigational vaccine/drug research during the study. Plan for major surgery between enrollment until 28 days post-CHMI. Use or planned use of any drug with anti-malarial activity that would precede or coincide with malaria challenge or vaccination. Anticipated use of medications known to cause drug reactions with atovaquone-proguanil or artemether-lumefantrine such as cimetidine, metoclopramide, antacids, and kaolin. Positive HBsAg or positive HIV or HCV testing consistent with active infection. An abnormal electrocardiogram, defined as one showing pathologic Q waves and significant STT wave changes; left ventricular hypertrophy; any non-sinus rhythm including isolated premature ventricular contractions, but excluding isolated premature atrial contractions; right or left bundle branch block; or advanced (secondary or tertiary) A-V heart block; or other clinically significant abnormalities on the electrocardiogram as determined by the consulting cardiologist. Any clinically significant deviation from the normal range in biochemistry or hematology tests measured at screening and not resolving. Any medical, psychiatric, social, behavioral or occupational condition or situation (including active alcohol or drug abuse) that, in the judgment of the site PI, impairs the volunteer's ability to give informed consent, increases the risk to the participant of participation in the study, affects the ability of the participant to participate fully in the study, or might negatively impact the quality, consistency, integrity or interpretation of data derived from their participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kirsten E Lyke, MD
Organizational Affiliation
University of Maryland, Baltimore
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Maryland, Baltimore, Center for Vaccine Development and Global Health
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
35999221
Citation
Mordmuller B, Sulyok Z, Sulyok M, Molnar Z, Lalremruata A, Calle CL, Bayon PG, Esen M, Gmeiner M, Held J, Heimann HL, Woldearegai TG, Ibanez J, Flugge J, Fendel R, Kreidenweiss A, Kc N, Murshedkar T, Chakravarty S, Riyahi P, Billingsley PF, Church LWP, Richie TL, Sim BKL, Hoffman SL, Kremsner PG. A PfSPZ vaccine immunization regimen equally protective against homologous and heterologous controlled human malaria infection. NPJ Vaccines. 2022 Aug 23;7(1):100. doi: 10.1038/s41541-022-00510-z.
Results Reference
background
PubMed Identifier
32920641
Citation
Lyke KE, Singer A, Berry AA, Reyes S, Chakravarty S, James ER, Billingsley PF, Gunasekera A, Manoj A, Murshedkar T, Laurens MB, Church WP, Garver Baldwin LS, Sedegah M, Banania G, Ganeshan H, Guzman I, Reyes A, Wong M, Belmonte A, Ozemoya A, Belmonte M, Huang J, Villasante E, Sim BKL, Hoffman SL, Richie TL, Epstein JE; Warfighter II Study Team. Multidose Priming and Delayed Boosting Improve Plasmodium falciparum Sporozoite Vaccine Efficacy Against Heterologous P. falciparum Controlled Human Malaria Infection. Clin Infect Dis. 2021 Oct 5;73(7):e2424-e2435. doi: 10.1093/cid/ciaa1294.
Results Reference
background

Learn more about this trial

A Phase 1 Trial of PfSPZ Vaccine in Healthy Adults to Determine Safety, Tolerability and Efficacy Against Heterologous CHMI

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