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A Study to Determine if New Types of Malaria Vaccines Are Safe, Effective and Lead to Immunity in Kenyan Adults

Primary Purpose

Malaria,Falciparum

Status
Recruiting
Phase
Phase 2
Locations
Kenya
Study Type
Interventional
Intervention
R21/Matrix-M
ChAd63/MVA ME-TRAP
intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malaria,Falciparum

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy adults aged 18 to 45 years
  • Able and willing (in the Investigator's opinion) to comply with all study requirements
  • Non-pregnant, non-lactating adult female or adult male
  • Agreement to refrain from blood donation during the study
  • Use of effective method of contraception for the duration of study for female participants. For those with no contraception, they will be referred for contraception at the relevant health facility. For female participants, we will ask them to attend with their family planning records for verification. Effective contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly, in accordance with the product label. Examples of these include: combined oral contraceptives; injectable progestogen; implants of etenogestrel or levonorgestrel; intrauterine device or intrauterine system; male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository); and male condom combined with a female diaphragm, either with or without a vaginal spermicide (foam, gel, film, cream, or suppository)
  • Provide written informed consent
  • Plan to remain resident in the study area for 1 year following first dose of vaccination

Exclusion Criteria:

  • Clinically significant congenital abnormalities as judged by the study clinicians
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
  • Sickle cell disease
  • Any history of anaphylaxis in relation to vaccination
  • Clinically significant laboratory abnormality as judged by the study clinician
  • Blood transfusion within one month of enrolment
  • Haemoglobin less than 11.3 g/dl for men and less than 10g/dl for in women, where judged to be clinically significant in the opinion of the investigator.
  • Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate
  • Participation in another research study involving receipt of an investigational product in the 30 days preceding enrolment, or planned use during the study period
  • Seropositive for hepatitis B surface antigen (HBsAg) or hepatitis C (HCV IgG)
  • Use of systemic antibiotics with known antimalarial activity within 30 days of administration of PfSPZ Challenge (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin)
  • Women only; pregnancy, or an intention to become pregnant a day before challenge i.e. at C-1
  • Any significant disease, disorder or situation which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial
  • Confirmed parasite positive by PCR a day before challenge i.e. at C-1.

Sites / Locations

  • KEMRI/Wellcome Trust Programme, Centre for Geographic Medicine Research - CoastRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Group 1

Group 2

Group 3

Group 4

Arm Description

Group 1 adults (n=20) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.

Group 2 adults (n=20) will be receiving 5x10^10 vp ChAd63 ME-TRAP and 2x10^8 pfu MVA ME-TRAP vaccines, 8 weeks apart, and then a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge, 4 weeks later.

Group 3 adults (n=10) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intravenously (DVI) by inoculation of 3,200 PfSPZ Challenge.

Group 4 adults (n=14) will be the control group receiving no vaccine, only a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.

Outcomes

Primary Outcome Measures

Occurrence of solicited local and systemic reactogenicity signs and symptoms, and unsolicited adverse events
Assessing the safety and reactogenicity of adjuvanted R21/MM and heterologous prime- boost regime of ChAd63-MVA ME-TRAP in healthy adult volunteers
Occurrence of P. falciparum parasitemia assessed by PCR, and parasite density dynamics assessed by PCR, against malaria sporozoite challenge
To assess the safety of intradermal sporozoite infection dose in semi-immune healthy adult volunteers
Occurrence of P. falciparum parasitemia, assessed by qPCR
To assess the efficacy of adjuvanted R21 and heterologous prime- boost regime of ChAd63-MVA ME-TRAP against malaria sporozoite challenge, in healthy adult volunteers

Secondary Outcome Measures

To measure cellular immunogenicity assessed by ELISPOT
Assessing cellular immunogenicity by ELISPOT to enumerate IFN-ƴ producing T cells
To measure humoral immunogenicity assessed by ELISA
Assessing humoral immunogenicity by ELISA to quantify antibodies to the vaccine components CS, NANP, TRAP and HBsAb.
Parasite density dynamics assessed by qPCR
To assess any differences in efficacy estimates with ID versus DVI challenge in individuals receiving R21/MM

Full Information

First Posted
May 7, 2019
Last Updated
September 14, 2022
Sponsor
University of Oxford
Collaborators
Kenya Medical Research Institute, European and Developing Countries Clinical Trials Partnership (EDCTP)
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1. Study Identification

Unique Protocol Identification Number
NCT03947190
Brief Title
A Study to Determine if New Types of Malaria Vaccines Are Safe, Effective and Lead to Immunity in Kenyan Adults
Official Title
Safety, Immunogenicity, and Efficacy of R21/Matrix-M and ChAd63/MVA-ME-TRAP in the Context of Controlled Human Malaria Infection: A Phase IIb Trial in Kenyan Adults
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 31, 2022 (Actual)
Primary Completion Date
April 2023 (Anticipated)
Study Completion Date
April 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford
Collaborators
Kenya Medical Research Institute, European and Developing Countries Clinical Trials Partnership (EDCTP)

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
This is a phase IIb clinical trial in malaria-exposed individuals to assess the immunogenicity, safety and efficacy of the two vaccines in the context of controlled human malaria infection, P. falciparum sporozoite challenge (PfSPZ Challenge).
Detailed Description
A total of 64 participants will be enrolled for challenge and divided into four groups as follows: 20 participants to receive R21/Matrix M (R21/MM) with intradermal PfSPZ Challenge; 20 participants to receive viral-vectored ME-TRAP with intradermal PfSPZ Challenge; 10 participants to receive R21/MM with direct venous inoculation PfSPZ Challenge; and 14 participants comprising of the control group with intradermal PfSPZ Challenge. Blood tests and clinical assessments will be conducted to screen out participants with health conditions that may impact participation in the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria,Falciparum

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
64 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Description
Group 1 adults (n=20) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Group 2 adults (n=20) will be receiving 5x10^10 vp ChAd63 ME-TRAP and 2x10^8 pfu MVA ME-TRAP vaccines, 8 weeks apart, and then a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge, 4 weeks later.
Arm Title
Group 3
Arm Type
Experimental
Arm Description
Group 3 adults (n=10) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intravenously (DVI) by inoculation of 3,200 PfSPZ Challenge.
Arm Title
Group 4
Arm Type
Experimental
Arm Description
Group 4 adults (n=14) will be the control group receiving no vaccine, only a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.
Intervention Type
Biological
Intervention Name(s)
R21/Matrix-M
Intervention Description
R21: Protein particle malaria vaccine candidate in Matrix-M: Saponin based vaccine adjuvant.
Intervention Type
Biological
Intervention Name(s)
ChAd63/MVA ME-TRAP
Intervention Description
ChAd63, chimpanzee adenovirus serotype 63; ME-TRAP, multiple epitope string fused to the thrombospondin-related adhesion protein; MVA, modified vaccinia Ankara.
Intervention Type
Biological
Intervention Name(s)
intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
Intervention Description
PfSPZ Challenge: cryopreserved Plasmodium falciparum sporozoites.
Primary Outcome Measure Information:
Title
Occurrence of solicited local and systemic reactogenicity signs and symptoms, and unsolicited adverse events
Description
Assessing the safety and reactogenicity of adjuvanted R21/MM and heterologous prime- boost regime of ChAd63-MVA ME-TRAP in healthy adult volunteers
Time Frame
Solicited AEs are collected for 7 days post vaccination and unsolicited AEs for 28 days post vaccination
Title
Occurrence of P. falciparum parasitemia assessed by PCR, and parasite density dynamics assessed by PCR, against malaria sporozoite challenge
Description
To assess the safety of intradermal sporozoite infection dose in semi-immune healthy adult volunteers
Time Frame
up to 3 months after malaria sporozoite challenge
Title
Occurrence of P. falciparum parasitemia, assessed by qPCR
Description
To assess the efficacy of adjuvanted R21 and heterologous prime- boost regime of ChAd63-MVA ME-TRAP against malaria sporozoite challenge, in healthy adult volunteers
Time Frame
from vaccination day up to 90 days after malaria sporozoite challenge
Secondary Outcome Measure Information:
Title
To measure cellular immunogenicity assessed by ELISPOT
Description
Assessing cellular immunogenicity by ELISPOT to enumerate IFN-ƴ producing T cells
Time Frame
from vaccination day up to 90 days after malaria sporozoite challenge
Title
To measure humoral immunogenicity assessed by ELISA
Description
Assessing humoral immunogenicity by ELISA to quantify antibodies to the vaccine components CS, NANP, TRAP and HBsAb.
Time Frame
from vaccination day up to 90 days after malaria sporozoite challenge
Title
Parasite density dynamics assessed by qPCR
Description
To assess any differences in efficacy estimates with ID versus DVI challenge in individuals receiving R21/MM
Time Frame
up to 3 months after malaria sporozoite challenge

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy adults aged 18 to 45 years Able and willing (in the Investigator's opinion) to comply with all study requirements Non-pregnant, non-lactating adult female or adult male Agreement to refrain from blood donation during the study Use of effective method of contraception for the duration of study for female participants. For those with no contraception, they will be referred for contraception at the relevant health facility. For female participants, we will ask them to attend with their family planning records for verification. Effective contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly, in accordance with the product label. Examples of these include: combined oral contraceptives; injectable progestogen; implants of etenogestrel or levonorgestrel; intrauterine device or intrauterine system; male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository); and male condom combined with a female diaphragm, either with or without a vaginal spermicide (foam, gel, film, cream, or suppository) Provide written informed consent Plan to remain resident in the study area for 1 year following first dose of vaccination Exclusion Criteria: Clinically significant congenital abnormalities as judged by the study clinicians Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed). Sickle cell disease Any history of anaphylaxis in relation to vaccination Clinically significant laboratory abnormality as judged by the study clinician Blood transfusion within one month of enrolment Haemoglobin less than 11.3 g/dl for men and less than 10g/dl for in women, where judged to be clinically significant in the opinion of the investigator. Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate Participation in another research study involving receipt of an investigational product in the 30 days preceding enrolment, or planned use during the study period Seropositive for hepatitis B surface antigen (HBsAg) or hepatitis C (HCV IgG) Use of systemic antibiotics with known antimalarial activity within 30 days of administration of PfSPZ Challenge (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin) Women only; pregnancy, or an intention to become pregnant a day before challenge i.e. at C-1 Any significant disease, disorder or situation which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial Confirmed parasite positive by PCR a day before challenge i.e. at C-1.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Rachel Roberts
Phone
+44 (0)1865 611418
Email
vaccinetrials@ndm.ox.ac.uk
Facility Information:
Facility Name
KEMRI/Wellcome Trust Programme, Centre for Geographic Medicine Research - Coast
City
Kilifi
ZIP/Postal Code
PO Box 230, 80108
Country
Kenya
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mainga Hamaluba
Email
MHamaluba@kemri-wellcome.org
First Name & Middle Initial & Last Name & Degree
Mainga Hamaluba
First Name & Middle Initial & Last Name & Degree
Melissa Kapulu

12. IPD Sharing Statement

Learn more about this trial

A Study to Determine if New Types of Malaria Vaccines Are Safe, Effective and Lead to Immunity in Kenyan Adults

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