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Activity and Safety of Peptide-based Immunotherapy in Patients With Squamous Cell Carcinoma of the Head and Neck. (HN1901)

Primary Purpose

Oropharynx Squamous Cell Carcinoma, Larynx Squamous Cell Carcinoma, Hypopharynx Squamous Cell Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
IO102
IO103
Sponsored by
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Oropharynx Squamous Cell Carcinoma focused on measuring vaccine, immunotherapy, squamous cell carcinoma, head and neck

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women ≥ 18 years of age on day of signing informed consent.
  2. Histologically proven squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx or larynx.
  3. Patients selected for a surgical treatment.
  4. No distant metastases.
  5. Measurable disease as per RECIST 1.1.
  6. No active second malignancy during the last 3 years except non melanomatous skin cancer or carcinoma in situ of the cervix.
  7. The participant provides written signed informed consent for the trial in accordance with ICH-GCP and local legislation prior to admission to the trial.
  8. Eastern Cooperative Oncology Group (ECOG) performance status scale 0-1 and Karnofsky score > or = 70.
  9. Neutrophil count > 1,500/mm3, platelet count > 75,000/mm3, WBC> or = 3.0/109 L, bilirubin or creatinine < 2 times ULN, ALT or AST < 5 times ULN, Hemoglobin ≥ 9 g/dL.
  10. A male participant able to father a child must agree to use contraception starting with the screening visit and throughout the duration of the trial.
  11. A female participant is eligible to participate if she is not pregnant not breastfeeding, and at least one of the following conditions applies:

    1. Not a woman of childbearing potential (WOCBP).
    2. A WOCBP who agrees to follow contraceptive guidance starting with the screening and throughout the duration of the trial. WOCBP are allowed in the trial if they are using proper contraception (follow guidelines from the European Union Heads of Medicines Agency (CTFG, 2014).

Exclusion Criteria:

  1. Nasopharynx cancer, unknown primary and nasal cavity and paranasal sinuses carcinomas.
  2. Previous exposure to immunotherapy.
  3. Known diagnosis of immune deficiency or a positive serology of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
  4. Active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected) or pre-existing liver cirrhosis.
  5. Other uncontrolled active illnesses or nonmalignant systemic disease (examples include, but are not limited to, active infections requiring antibiotics, bleeding disorders, uncontrolled diabetes, uncontrolled ventricular arrhythmia, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome).
  6. Has received a live vaccine within 30 days prior to the first dose of trial treatment
  7. Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed.
  8. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of trial treatment.
  9. Any psychiatric, psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
  10. Any malignancy (other than squamous cell carcinoma of the head and neck, non-melanoma skin cancer or localized cervical cancer or localized and presumed cured prostatic cancer or basal cell carcinoma of the skin and carcinoma in situ of the cervix or bladder) within the last 3 years prior to registration.
  11. Women of Child Bearing Potential (WOCBP) who has a positive urine pregnancy test (e.g., within 72 hours) prior to treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
  12. Pregnant woman and women who are expecting to conceive.
  13. Breastfeeding women.
  14. Patients expected to father children within the projected duration of the trial.

Sites / Locations

  • Cliniques Universitaires Saint-LucRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

No Intervention

Experimental

Arm Label

Arm A: IO102 vaccine

Arm B: Control group

Arm C: IO103

Arm Description

Randomization between arm A and B. Patients in arm A will receive IO102 3 to 4 times prior to curative treatment

Randomization between arm A and B

No randomization. Patients in arm C will receive IO103 3 to 4 times prior to curative treatment

Outcomes

Primary Outcome Measures

Number of participants with a T-cell peptide-specific response to the vaccine as assessed by an interferon(INF)-γ ELISpot assay.
ELISpot responses will be considered positive when the numbers of IFN-γ secreting cells will be at least twofold greater than the mean value of the baseline and with a minimum of 50 spots (per 5 × 10^5 peripheral blood mononuclear cell (PBMC) ) detected.

Secondary Outcome Measures

Number of participants experiencing toxicity
Maximum grade of each toxicity and percentage of patients experiencing toxicity as assessed by CTC-NCIv5.0. Patients will have blood tests before the second and third administration of the vaccine and 4 weeks after surgery and clinical examinations before each administration of the vaccine and during the 3 months after surgery.
Increase in CD8+ T-cell density (cells/mm2) between tumour biopsies taken before and after treatment, as demonstrated by immunohistochemistry.
Overall survival (OS)
The length of time (in months) from the end of standard treatments during which patients are still alive.
Objective response rate (ORR) by RECIST Version 1.1
Disease-free survival (DFS)
The time (in months) from the end of the surgery to the time of first recurrence, death from any cause or last contact date, whichever occurred first
Disease-specific survival (DSS)
The time of survival (in months) of patients from the end of treatment to the date of death from a head and neck squamous cell carcinoma, or to the last follow-up date for patients still alive

Full Information

First Posted
June 3, 2020
Last Updated
May 6, 2022
Sponsor
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
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1. Study Identification

Unique Protocol Identification Number
NCT04445064
Brief Title
Activity and Safety of Peptide-based Immunotherapy in Patients With Squamous Cell Carcinoma of the Head and Neck.
Acronym
HN1901
Official Title
Activity and Safety of Peptide-based Immunotherapy in an Umbrella Window-of-opportunity Phase II Study in Patients With Squamous Cell Carcinoma of the Head and Neck.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 14, 2020 (Actual)
Primary Completion Date
June 8, 2024 (Anticipated)
Study Completion Date
June 8, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cliniques universitaires Saint-Luc- Université Catholique de Louvain

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
The purpose of this project is to realize a randomized open-label study (EudraCT number: 2020-000120-19) to evaluate the safety and the anti-tumor activity of peptide(s)-based immunotherapy in an umbrella window pre-operative opportunity phase II study in patients with squamous cell carcinoma of the head and neck.
Detailed Description
Patients with a head and neck squamous cell carcinoma eligible for curative treatment are eligible for this proof of concept study. The included patients in arm A will receive IO102 subcutaneous at 100μg every week during the three weeks following the first endoscopy. The included patients in am B (control group) won't receive any treatment. The included patients in arm C will receive IO103 subcutaneous at 100μg every week during the three weeks following the first endoscopy. The main objectives of this study are: To evaluate the T-cell peptide-specific response to the vaccine in a interferon(INF)-γ ELISpot assay. To assess the safety and tolerability of the vaccine. To investigate the decreased action of the IDO enzyme in evaluating the increased tumoral infiltration by CD8+ T-lymphocytes and by measuring the serum levels of kynurenin, tryptophan,... To evaluate the anti-tumor effect (objective response rate, overall survival, disease free- survival, disease specific survival). To evaluate the pre-operative activity of peptide vaccine using MRI (Magnetic Resonance Imaging), DWI-MRI (Diffusion Weighted Imaging-MRI) and MRS (Magnetic Resonance Spectroscopy) to visualize possible significant tumor modifications.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Oropharynx Squamous Cell Carcinoma, Larynx Squamous Cell Carcinoma, Hypopharynx Squamous Cell Carcinoma, Oral Cavity Squamous Cell Carcinoma
Keywords
vaccine, immunotherapy, squamous cell carcinoma, head and neck

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Arm A: IO102 vaccine
Arm Type
Experimental
Arm Description
Randomization between arm A and B. Patients in arm A will receive IO102 3 to 4 times prior to curative treatment
Arm Title
Arm B: Control group
Arm Type
No Intervention
Arm Description
Randomization between arm A and B
Arm Title
Arm C: IO103
Arm Type
Experimental
Arm Description
No randomization. Patients in arm C will receive IO103 3 to 4 times prior to curative treatment
Intervention Type
Biological
Intervention Name(s)
IO102
Intervention Description
100µg each week during the 3 weeks prior to curative treatment (total of 3 to 4 doses maximum)
Intervention Type
Biological
Intervention Name(s)
IO103
Intervention Description
100µg each week during the 3 weeks prior to curative treatment (total of 3 to 4 doses maximum)
Primary Outcome Measure Information:
Title
Number of participants with a T-cell peptide-specific response to the vaccine as assessed by an interferon(INF)-γ ELISpot assay.
Description
ELISpot responses will be considered positive when the numbers of IFN-γ secreting cells will be at least twofold greater than the mean value of the baseline and with a minimum of 50 spots (per 5 × 10^5 peripheral blood mononuclear cell (PBMC) ) detected.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Number of participants experiencing toxicity
Description
Maximum grade of each toxicity and percentage of patients experiencing toxicity as assessed by CTC-NCIv5.0. Patients will have blood tests before the second and third administration of the vaccine and 4 weeks after surgery and clinical examinations before each administration of the vaccine and during the 3 months after surgery.
Time Frame
2 years
Title
Increase in CD8+ T-cell density (cells/mm2) between tumour biopsies taken before and after treatment, as demonstrated by immunohistochemistry.
Time Frame
2 years
Title
Overall survival (OS)
Description
The length of time (in months) from the end of standard treatments during which patients are still alive.
Time Frame
2 years
Title
Objective response rate (ORR) by RECIST Version 1.1
Time Frame
2 years
Title
Disease-free survival (DFS)
Description
The time (in months) from the end of the surgery to the time of first recurrence, death from any cause or last contact date, whichever occurred first
Time Frame
2 years
Title
Disease-specific survival (DSS)
Description
The time of survival (in months) of patients from the end of treatment to the date of death from a head and neck squamous cell carcinoma, or to the last follow-up date for patients still alive
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women ≥ 18 years of age on day of signing informed consent. Histologically proven squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx or larynx. Patients selected for a surgical treatment. No distant metastases. Measurable disease as per RECIST 1.1. No active second malignancy during the last 3 years except non melanomatous skin cancer or carcinoma in situ of the cervix. The participant provides written signed informed consent for the trial in accordance with ICH-GCP and local legislation prior to admission to the trial. Eastern Cooperative Oncology Group (ECOG) performance status scale 0-1 and Karnofsky score > or = 70. Neutrophil count > 1,500/mm3, platelet count > 75,000/mm3, WBC> or = 3.0/109 L, bilirubin or creatinine < 2 times ULN, ALT or AST < 5 times ULN, Hemoglobin ≥ 9 g/dL. A male participant able to father a child must agree to use contraception starting with the screening visit and throughout the duration of the trial. A female participant is eligible to participate if she is not pregnant not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP). A WOCBP who agrees to follow contraceptive guidance starting with the screening and throughout the duration of the trial. WOCBP are allowed in the trial if they are using proper contraception (follow guidelines from the European Union Heads of Medicines Agency (CTFG, 2014). Exclusion Criteria: Nasopharynx cancer, unknown primary and nasal cavity and paranasal sinuses carcinomas. Previous exposure to immunotherapy. Known diagnosis of immune deficiency or a positive serology of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies). Active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected) or pre-existing liver cirrhosis. Other uncontrolled active illnesses or nonmalignant systemic disease (examples include, but are not limited to, active infections requiring antibiotics, bleeding disorders, uncontrolled diabetes, uncontrolled ventricular arrhythmia, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome). Has received a live vaccine within 30 days prior to the first dose of trial treatment Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of trial treatment. Any psychiatric, psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule. Any malignancy (other than squamous cell carcinoma of the head and neck, non-melanoma skin cancer or localized cervical cancer or localized and presumed cured prostatic cancer or basal cell carcinoma of the skin and carcinoma in situ of the cervix or bladder) within the last 3 years prior to registration. Women of Child Bearing Potential (WOCBP) who has a positive urine pregnancy test (e.g., within 72 hours) prior to treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. Pregnant woman and women who are expecting to conceive. Breastfeeding women. Patients expected to father children within the projected duration of the trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jean-Pascal Machiels
Phone
+3227645457
Email
jean-pascal.machiels@uclouvain.be
First Name & Middle Initial & Last Name or Official Title & Degree
Sandra Schmitz
Phone
+3227641881
Email
sandra.schmitz@uclouvain.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Pascal Machiels
Organizational Affiliation
Insitut de Recherche Expérimentale et Clinique, pôle MIRO
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cliniques Universitaires Saint-Luc
City
Brussels
ZIP/Postal Code
1200
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jean-Pascal Machiels
Phone
+3227645457
Email
jean-pascal.machiels@uclouvain.be
First Name & Middle Initial & Last Name & Degree
Sandra Schmitz
Phone
+3227641881
Email
sandra.schmitz@uclouvain.be

12. IPD Sharing Statement

Learn more about this trial

Activity and Safety of Peptide-based Immunotherapy in Patients With Squamous Cell Carcinoma of the Head and Neck.

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