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A Study of IO103 in Montanide Adjuvant for Basal Cell Carcinoma

Primary Purpose

Basal Cell Carcinoma

Status
Completed
Phase
Phase 2
Locations
Denmark
Study Type
Interventional
Intervention
PD-L1
Sponsored by
Herlev and Gentofte Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Basal Cell Carcinoma

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age ≥ 18
  2. At least 1 histological verified superficial or nodular basal cell carcinoma on the body or limbs of bigger than 14 mm in the longest diameter
  3. Willing to provide three 4 mm biopsies from the lesion/lesions
  4. Not previously treated with a hedgehog pathway inhibitor
  5. For women of childbearing potential: Agreement to use contraceptive methods with a failure rate of < 1 % per year during the treatment period and for at least 150 days after the treatment. Safe contraceptive methods for women are birth control pills, intrauterine device, contraceptive injection, contraceptive implant, contraceptive patch or contraceptive vaginal ring.
  6. For men: Agreement to use contraceptive measures and agreement to refrain from donating sperm
  7. The participant (or legally acceptable representative if applicable) provides written informed consent for the trial in accordance with ICH-GCP and local legislation prior to admission to the trial
  8. Sufficient bone marrow function, i.e.

    1. Leucocytes ≥ 1,5 x 109
    2. Granulocytes ≥ 1,0 x 109
    3. Thrombocytes ≥ 20 x 109

2. Creatinine < 2.5 upper normal limit, i.e. < 300 μmol/l 3. Sufficient liver function, i.e.

  1. ALAT < 2.5 upper normal limit, i.e. ALAT <112 U/l
  2. Bilirubin < 30 U/l

Exclusion Criteria:

  1. The patient has a history of life-threatening or severe immune related adverse events on treatment with another immunotherapy and is considered to be at risk of not recovering
  2. The patient has a history of severe clinical autoimmune disease
  3. The patient has a history of pneumonitis, organ transplant, human immunodeficiency virus positive, active hepatitis B or hepatitis C
  4. The patient has any condition that will interfere with patient compliance or safety (including but not limited to psychiatric or substance abuse disorders)
  5. The patient is pregnant or breastfeeding
  6. The patient has an active infection requiring systemic therapy
  7. The patient has received a live virus vaccine within 30 days of planned start of therapy
  8. Known side effects to Montanide ISA-51
  9. Significant medical disorder according to investigator; e.g. severe asthma or chronic obstructive lung disease, dysregulated heart disease or dysregulated diabetes mellitus
  10. Concurrent treatment with other experimental drugs
  11. Any active autoimmune diseases e.g. autoimmune neutropenia, thrombocytopenia or hemolytic anemia, systemic lupus erythematosus, scleroderma, myasthenia gravis, autoimmune glomerulonephritis, autoimmune adrenal deficiency, autoimmune thyroiditis etc.
  12. Severe allergy or anaphylactic reactions earlier in life.

Sites / Locations

  • Herlev and Gentofte Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment arm

Arm Description

The vaccine consists of 500µl of 100µg PD-L1 peptide, dissolved in DMSO and PBS reconstituted with 500 µl Montanide ISA-51. Patients will be vaccinated Q2W for 10 weeks, and a further 12 weeks if a clinical response is measured.

Outcomes

Primary Outcome Measures

Clinical response
Evaluation and measurement of target BCC in cm2. Clinical response is evaluated as change in tumor size in mm.
Disease control rate
Defined as change of the largest diameter of target BCC
Immune responses
Immune responses in biopsies from basal cell carcinomas (BCC). Analyses which will include (but are not restricted to): Immunosign®CR/Pan Cancer Immune panel (gene expression level of multiple immune genes); Halioseek® CD8/PDL1(PDL1/CD8, CD8+ quantification by digital pathology, PDL1+ tumoral cells and Immune cells analysis by a pathologist); Immunoscore (CD3 and CD8 immune histochemistry (IHC) testing, scanning and image analysis); MHC Class I and II (IHC, scanning and image analysis)

Secondary Outcome Measures

Immune responses in skin
Immune responses in skin delayed type hypersensitivity (DTH). Skin-infiltrating lymphocytes (SKILs) are tested for specificity to the PD-L peptides as a sign of induction of a functional immune response
Incidence of treatment emergent adverse events (safety and tolerability)
Events will be recorded and graded using CTCAE version 4.03

Full Information

First Posted
September 27, 2018
Last Updated
October 2, 2020
Sponsor
Herlev and Gentofte Hospital
Collaborators
University of Copenhagen
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1. Study Identification

Unique Protocol Identification Number
NCT03714529
Brief Title
A Study of IO103 in Montanide Adjuvant for Basal Cell Carcinoma
Official Title
Phase IIa Trial With PD-L1 IO103 Vaccination With Montanide in Patients With Basal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
November 1, 2018 (Actual)
Primary Completion Date
February 5, 2020 (Actual)
Study Completion Date
February 5, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Herlev and Gentofte Hospital
Collaborators
University of Copenhagen

4. Oversight

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

5. Study Description

Brief Summary
A single center, open-label, phase IIa, single arm, window of opportunity trial with IO103 and Montanide adjuvant in patients with surgically resectable BCC.
Detailed Description
10 patients with BCC will be vaccinated with a peptide derived from the immune checkpoint molecule PD-L1. Patients will be vaccinated once every 2 weeks (Q2W) for 10 weeks and then evaluated for a clinical response. Patients with clinical response to vaccination will continue with one vaccination once every 4 weeks (Q4W) for 12 weeks and thus receive 9 vaccinations in total over the course of 22 weeks. Patients with no effect of treatment after 6 vaccinations will be treated with standard of care (SOC).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Basal Cell Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment arm
Arm Type
Experimental
Arm Description
The vaccine consists of 500µl of 100µg PD-L1 peptide, dissolved in DMSO and PBS reconstituted with 500 µl Montanide ISA-51. Patients will be vaccinated Q2W for 10 weeks, and a further 12 weeks if a clinical response is measured.
Intervention Type
Biological
Intervention Name(s)
PD-L1
Other Intervention Name(s)
IO103
Intervention Description
IO103 is a anti-cancer therapy consisting of a synthetic PD-L1-derived peptide.
Primary Outcome Measure Information:
Title
Clinical response
Description
Evaluation and measurement of target BCC in cm2. Clinical response is evaluated as change in tumor size in mm.
Time Frame
All patients were evaluated 3 Month after last vaccination
Title
Disease control rate
Description
Defined as change of the largest diameter of target BCC
Time Frame
After 6 vaccinations with IO103 (10 weeks)
Title
Immune responses
Description
Immune responses in biopsies from basal cell carcinomas (BCC). Analyses which will include (but are not restricted to): Immunosign®CR/Pan Cancer Immune panel (gene expression level of multiple immune genes); Halioseek® CD8/PDL1(PDL1/CD8, CD8+ quantification by digital pathology, PDL1+ tumoral cells and Immune cells analysis by a pathologist); Immunoscore (CD3 and CD8 immune histochemistry (IHC) testing, scanning and image analysis); MHC Class I and II (IHC, scanning and image analysis)
Time Frame
After 6 vaccinations with IO103 (10 weeks)
Secondary Outcome Measure Information:
Title
Immune responses in skin
Description
Immune responses in skin delayed type hypersensitivity (DTH). Skin-infiltrating lymphocytes (SKILs) are tested for specificity to the PD-L peptides as a sign of induction of a functional immune response
Time Frame
After 6 vaccinations with IO103 (10 weeks)
Title
Incidence of treatment emergent adverse events (safety and tolerability)
Description
Events will be recorded and graded using CTCAE version 4.03
Time Frame
From the time that the subject provides written informed consent and throughout the trial duration, until 30 days post last dose of trial treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 At least 1 histological verified superficial or nodular basal cell carcinoma on the body or limbs of bigger than 14 mm in the longest diameter Willing to provide three 4 mm biopsies from the lesion/lesions Not previously treated with a hedgehog pathway inhibitor For women of childbearing potential: Agreement to use contraceptive methods with a failure rate of < 1 % per year during the treatment period and for at least 150 days after the treatment. Safe contraceptive methods for women are birth control pills, intrauterine device, contraceptive injection, contraceptive implant, contraceptive patch or contraceptive vaginal ring. For men: Agreement to use contraceptive measures and agreement to refrain from donating sperm The participant (or legally acceptable representative if applicable) provides written informed consent for the trial in accordance with ICH-GCP and local legislation prior to admission to the trial Sufficient bone marrow function, i.e. Leucocytes ≥ 1,5 x 109 Granulocytes ≥ 1,0 x 109 Thrombocytes ≥ 20 x 109 2. Creatinine < 2.5 upper normal limit, i.e. < 300 μmol/l 3. Sufficient liver function, i.e. ALAT < 2.5 upper normal limit, i.e. ALAT <112 U/l Bilirubin < 30 U/l Exclusion Criteria: The patient has a history of life-threatening or severe immune related adverse events on treatment with another immunotherapy and is considered to be at risk of not recovering The patient has a history of severe clinical autoimmune disease The patient has a history of pneumonitis, organ transplant, human immunodeficiency virus positive, active hepatitis B or hepatitis C The patient has any condition that will interfere with patient compliance or safety (including but not limited to psychiatric or substance abuse disorders) The patient is pregnant or breastfeeding The patient has an active infection requiring systemic therapy The patient has received a live virus vaccine within 30 days of planned start of therapy Known side effects to Montanide ISA-51 Significant medical disorder according to investigator; e.g. severe asthma or chronic obstructive lung disease, dysregulated heart disease or dysregulated diabetes mellitus Concurrent treatment with other experimental drugs Any active autoimmune diseases e.g. autoimmune neutropenia, thrombocytopenia or hemolytic anemia, systemic lupus erythematosus, scleroderma, myasthenia gravis, autoimmune glomerulonephritis, autoimmune adrenal deficiency, autoimmune thyroiditis etc. Severe allergy or anaphylactic reactions earlier in life.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Inge Marie Svane, Prof
Organizational Affiliation
Herlev and Gentofte Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Herlev and Gentofte Hospital
City
Hellerup
State/Province
Hovedstaden
ZIP/Postal Code
2900
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
27622072
Citation
Munir Ahmad S, Martinenaite E, Hansen M, Junker N, Borch TH, Met O, Donia M, Svane IM, Andersen MH. PD-L1 peptide co-stimulation increases immunogenicity of a dendritic cell-based cancer vaccine. Oncoimmunology. 2016 Jul 1;5(8):e1202391. doi: 10.1080/2162402X.2016.1202391. eCollection 2016 Aug.
Results Reference
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A Study of IO103 in Montanide Adjuvant for Basal Cell Carcinoma

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