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Personalized Immunotherapy in Adults With Upper Gastrointestinal Tract Cancers

Primary Purpose

Cancer of Gastrointestinal Tract

Status
Not yet recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
personalized vaccine
Nivolumab
Sponsored by
Ezra Cohen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer of Gastrointestinal Tract focused on measuring cancer, gastrointestinal, immunotherapy, personalized cancer vaccine, nivolumab, neoantigen, vaccine

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically documented gastroespohageal or gastric ademocarcinoma.
  • Measurable disease as defined by RECIST 1.1
  • Adequate organ function
  • Women of child-bearing potential and men with partners of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence)

Exclusion Criteria:

  • Currently receiving or has received another anti-cancer therapy within 4 weeks prior to first dose of vaccine study treatment.
  • Currently receiving or has received CTLA4 or PD1/PDL1 inhibitor immunotherapy within 4 weeks prior to first dose of study treatment.
  • Received an investigational agent within 28 days prior to the first dose of study drug.
  • Untreated brain metastases; individuals with treated and stable metastases are eligible. Eligible subjects should have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for brain metastases for at least 4 weeks and are neurologically stable for 8 weeks (confirmed by MRI) prior to administration of experimental therapy
  • Has known history of Human Immunodeficiency Virus (HIV).
  • Received a diagnosis of hepatitis B or hepatitis C for which there is no clear evidence of natural immunity, immunity subsequent to vaccination, or successful eradication of the virus following antiviral therapy (individuals who are hepatitis C antibody positive may be enrolled if negative viral load confirmed).
  • History of autoimmune disease including: inflammatory bowel disease (including ulcerative colitis and Crohn's Disease), rheumatoid arthritis, systemic progressive sclerosis (scleroderma), systemic lupus erythematosus, autoimmune vasculitis (e.g. Wegener's granulomatosis); central nervous system or motor neuropathy considered of autoimmune origin (e.g. Guillain-Barré syndrome, myasthenia gravis, multiple sclerosis). Individuals with vitiligo, Sjogren's Syndrome, interstitial cystitis, Graves' or Hashimoto's Disease, celiac disease, DM1, or hypothyroidism stable on hormone replacement will be allowed with Study Medical Monitor's approval.
  • Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.
  • History of receiving a solid organ transplant or allogeneic bone marrow transplant.
  • Major surgical procedure within 28 days prior to the first dose of study drug.
  • If female, pregnant or breastfeeding.

Sites / Locations

  • University of California, San Diego

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

anti-PD1 and personalized vaccine

Arm Description

Outcomes

Primary Outcome Measures

Quantitative frequency of TCR
Treatment-related Adverse Events

Secondary Outcome Measures

Progression-free survival (PFS)
Overall Survival
Overall Response
Duration of response

Full Information

First Posted
November 29, 2021
Last Updated
May 16, 2023
Sponsor
Ezra Cohen
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1. Study Identification

Unique Protocol Identification Number
NCT05153304
Brief Title
Personalized Immunotherapy in Adults With Upper Gastrointestinal Tract Cancers
Official Title
A Phase I/II Study of Personalized Immunotherapy in Adults With Upper Gastrointestinal Tract Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 2023 (Anticipated)
Primary Completion Date
June 2026 (Anticipated)
Study Completion Date
June 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Ezra Cohen

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
The purpose of this study is to determine if it is possible to make and safely administer a 'personalized' cancer vaccine for people diagnosed with an upper gastrointestinal tract cancer.
Detailed Description
The purpose of this study is to determine if it is possible to make and safely administer a 'personalized' cancer vaccine for people diagnosed with an upper gastrointestinal tract cancer. It is known that cancer has mutations (changes in genetic material) that are specific to an individual person and their tumor. These mutations can cause the tumor cells to produce proteins that are different from the body's normal, healthy cells. The study will use a sample of your tumor to create a vaccine against it, with the idea being that the study vaccine will "teach" the body's immune system to recognize and attack the cancer cells. The study will examine the safety of the study vaccine when given at several time points and will examine your blood for signs that the study vaccine causes the immune system to respond. The personalized cancer vaccine will be given alone or in combination with nivolumab. Nivolumab is a drug that blocks certain proteins on cells that help to keep immune responses in check. In a healthy person, this keeps the immune system from attacking healthy cells and tissues, but cancer cells use these proteins to keep the immune system from killing cancer cells and tumors. When these proteins are blocked, the check on the immune system is removed and immune cells may be able to recognize and kill cancer cells. This personalized cancer vaccine is considered experimental because it is not approved by the US Food & Drug Administration (FDA) as a treatment for cancer. The combination of nivolumab and the personalized cancer vaccine is experimental and is not FDA approved.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer of Gastrointestinal Tract
Keywords
cancer, gastrointestinal, immunotherapy, personalized cancer vaccine, nivolumab, neoantigen, vaccine

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
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
anti-PD1 and personalized vaccine
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
personalized vaccine
Intervention Description
Vaccine will be constructed for each subject that express multiple candidate tumor-derived neoantigens.
Intervention Type
Drug
Intervention Name(s)
Nivolumab
Other Intervention Name(s)
Opdivo
Intervention Description
3mg/kg nivolumab will be administered intravenous (IV) infusion every 3 weeks for 4 doses. After 4 doses, 480 mg nivolumab will be administered intravenous (IV) infusion every 4 weeks.
Primary Outcome Measure Information:
Title
Quantitative frequency of TCR
Time Frame
1 year
Title
Treatment-related Adverse Events
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Time Frame
1 year
Title
Overall Survival
Time Frame
1 year
Title
Overall Response
Time Frame
1 year
Title
Duration of response
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically documented gastroespohageal or gastric adenocarcinoma. Measurable disease as defined by RECIST 1.1 Adequate organ function Women of child-bearing potential and men with partners of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) Exclusion Criteria: Currently receiving or has received another anti-cancer therapy within 4 weeks prior to first dose of vaccine study treatment. Currently receiving or has received PD1/PDL1 inhibitor immunotherapy within 4 weeks prior to first dose of study treatment. Received an investigational agent within 28 days prior to the first dose of study drug. Untreated brain metastases; individuals with treated and stable metastases are eligible. Eligible subjects should have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for brain metastases for at least 4 weeks and are neurologically stable for 8 weeks (confirmed by MRI) prior to administration of experimental therapy Has known history of Human Immunodeficiency Virus (HIV). Received a diagnosis of hepatitis B or hepatitis C for which there is no clear evidence of natural immunity, immunity subsequent to vaccination, or successful eradication of the virus following antiviral therapy (individuals who are hepatitis C antibody positive may be enrolled if negative viral load confirmed). History of autoimmune disease including: inflammatory bowel disease (including ulcerative colitis and Crohn's Disease), rheumatoid arthritis, systemic progressive sclerosis (scleroderma), systemic lupus erythematosus, autoimmune vasculitis (e.g. Wegener's granulomatosis); central nervous system or motor neuropathy considered of autoimmune origin (e.g. Guillain-Barré syndrome, myasthenia gravis, multiple sclerosis). Individuals with vitiligo, Sjogren's Syndrome, interstitial cystitis, Graves' or Hashimoto's Disease, celiac disease, DM1, or hypothyroidism stable on hormone replacement will be allowed with Study Medical Monitor's approval. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis. History of receiving a solid organ transplant or allogeneic bone marrow transplant. Major surgical procedure within 28 days prior to the first dose of study drug. If female, pregnant or breastfeeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shakeela Dad
Phone
(858) 822-6100
Email
sdad@health.ucsd.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Aaron Miller
Email
ammiller@health.ucsd.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ezra Cohen, MD
Organizational Affiliation
University of California, San Diego
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States

12. IPD Sharing Statement

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Personalized Immunotherapy in Adults With Upper Gastrointestinal Tract Cancers

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