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Adenovirus Vaccine for Malaria

Primary Purpose

Plasmodium Falciparum Infection

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Placebo
Ad35.CS.01 Circumsporozoite Malaria Vaccine
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Plasmodium Falciparum Infection focused on measuring circumsporozoite, malaria, vaccine

Eligibility Criteria

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

Inclusion Criteria: Provision of informed consent before any protocol procedures are performed. Males and non-pregnant females between the ages of 18 and 45 years, inclusive. Females and males must agree to practice adequate contraception until at least 28 days following their last immunization dose (including abstinence; hormonal contraception; condoms with spermicidal agents; post-menopausal; or surgical sterilization/vasectomy). Participants must agree to avoid high risk sexual behavior for exposure to human immunodeficiency virus (HIV). In good health as determined by screening medical history, physical examination (PE), and laboratory assessments. Willingness to comply with protocol requirements. Willingness to be contacted annually for five years for assessment of serious adverse events. Must have access to a cell phone. Exclusion Criteria: Current or recent (within the last four weeks) treatment with parenteral, inhaled, or oral corticosteroids (intranasal steroids are acceptable), or other immunosuppressive agents, or chemotherapy. History of splenectomy. Abnormal screening laboratory values. Any abnormal screening value for any screening test will exclude the subject from the study. Abnormal screening labs will not be repeated with the exception of high glucose levels will be repeated at a fasting state. Detectible neutralizing antibody titer against adenovirus serotype 35. History of intravenous (IV) drug abuse. History of, or current medical, occupational, social or family problems as a result of alcohol or illicit drug use. History of moderate to severe mental illness, as defined by symptoms interfering with social or occupational function or suicidal thoughts/attempts. History of receiving blood or blood products (such as blood transfusion, platelet transfusion, immunoglobulins, hyperimmune serum) in the previous 6 months. Vaccination with a live vaccine within the past 30 days or with a nonreplicating, inactivated, or subunit vaccine within the last 14 days. Known hypersensitivity to components of the vaccine. History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, or nervous system, or other metabolic or autoimmune/inflammatory conditions. History of coagulation defect or bleeding from (bruising at) multiple sites that cannot be linked to trauma or surgery. History of anaphylaxis or severe hypersensitivity reaction. Severe asthma, as defined by an emergency room visit or hospitalization within the last 12 months. Pregnant or breastfeeding women. Acute illness, including temperature greater than 100 degrees Fahrenheit within one week prior to vaccination. Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg). Concurrent participation in other investigational protocols or receipt of an investigational product within the previous 30 days or planned receipt of an investigational product within 28 days following the last immunization dose. Identification of any condition that, in the opinion of the investigator, would affect the ability of the subject to understand or comply with the study protocol or would jeopardize the safety or rights of a subject participating in the study. History of malignancy, including hematologic and skin cancers (except for a localized basal cell carcinoma), or known immunodeficiency syndrome. History of malaria infection or previous receipt of a malaria vaccine. History of travel to malaria-endemic area or receipt of antimalarial prophylaxis in the past 12 months. Planned travel to a malaria-endemic area prior to Visit 16 (Day 208). Pre-medication with analgesic or antipyretic agents in the 6 hours prior to vaccination, or planned medication with analgesic or antipyretic in the 24 hours following vaccination. This criterion should not preclude subjects receiving such medication if the need arises. Receipt of a recombinant adenovirus vector vaccine in a prior study.

Sites / Locations

  • Stanford University School of Medicine
  • Vanderbilt University - Pediatric - Vanderbilt Vaccine Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Group C: Ad35.CS.01-10^10 vp/ml

Group D: Ad35.CS.01-10^11 vp/ml

Group A: Ad35.CS.01-10^8 vp/ml

Group B: Ad35.CS.01-10^9 vp/ml

Arm Description

15 subjects will receive dosage 10^10 vp/mL; 3 subjects will receive placebo.

15 subjects will receive dosage 10^11 vp/mL; 3 subjects will receive placebo.

15 subjects will receive dosage 10^8 vp/mL; 3 subjects will receive placebo.

15 subjects will receive dosage 10^9 vp/mL; 3 subjects will receive placebo.

Outcomes

Primary Outcome Measures

Frequency and severity of local, systemic, and safety laboratory adverse events.

Secondary Outcome Measures

T cell responses against the malaria circumsporozoite antigen by enzyme-linked immunosorbent spot (ELISPOT) and flow cytometry.
Antibody titers against the malaria circumsporozoite antigen via enzyme-linked immunosorbent assay (ELISA).
Neutralizing antibody titers against Adenovirus type 35 by Adenovirus Neutralization Assay.

Full Information

First Posted
August 31, 2006
Last Updated
September 18, 2014
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00371189
Brief Title
Adenovirus Vaccine for Malaria
Official Title
A Phase I Randomized, Controlled, Dosage-Escalation Trial to Evaluate the Immunogenicity, Safety, and Reactogenicity of an Adenovirus Type 35 Based Circumsporozoite Malaria Vaccine in Healthy Adults 18 to 45 Years of Age
Study Type
Interventional

2. Study Status

Record Verification Date
June 2014
Overall Recruitment Status
Completed
Study Start Date
January 2007 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
Malaria is caused by a parasite carried by a mosquito. Currently, there is no vaccine licensed to prevent malaria. The purpose of this study is to find the most effective and safest dose of an experimental vaccine for the treatment of malaria. Participants will include 72 healthy adults, ages18 to 45, enrolled at Vanderbilt University Medical Center and Stanford University. Volunteers will receive 3 doses of either the malaria vaccine or placebo (contains no vaccine) by injection into a muscle at 0, 1 and 6 months. Investigators will evaluate how the body responds to increasing dosage strengths of the vaccine. Study procedures include physical exam, multiple blood draws, and completion of a memory aid (diary). Each participant will be actively involved in the study for about 12 months. Then, an annual phone call will be made to check for any serious illness events for a period of 5 years.
Detailed Description
Malaria currently represents one of the most prevalent infections in tropical and subtropical areas throughout the world. Each year, malaria affects around 300 million people and kills 1 to 3 million people in developing countries. The widespread occurrence and the growing incidence of malaria are a consequence of the increasing numbers of drug-resistant parasites and insecticide-resistant parasite vectors. Other factors include environmental and climatic changes, civil disturbances and increased mobility of populations. It is hypothesized that the Ad35.CS.01 vaccine will prevent the Plasmodium (P.) falciparum parasite, which causes malaria, from entering and developing within the liver of those who become infected. Ad35.CS.01 would therefore be expected to reduce malaria-attributable morbidity and mortality. The purpose of this phase I, randomized, controlled, dosage-escalation trial is to evaluate the immunogenicity, safety, and reactogenicity of an Adenovirus Type 35 based circumsporozoite malaria vaccine in 72 healthy adults, 18 to 45 years of age, in the United States. Subjects will be randomized in a 5:1 ratio to receive 3 doses of the Adenovirus Type 35 circumsporozoite malaria vaccine (Ad35.CS.01) or normal saline placebo control by the intramuscular route at 0, 1 and 6 months. The safety, reactogenicity, and immunogenicity of ascending dosages of the vaccine will be assessed. Fifteen subjects will receive vaccine at each of the following dosage levels: 10^8 viral particles (vp)/milliliters (ml), 10^9 vp/ml, 10^10 vp/ml and 10^11 vp/ml with 3 subjects receiving control at each of these dosage levels. Dosage escalation will proceed only after review of the safety data by the Safety Monitoring Committee of the prior dosage level. The primary objective is to assess the safety and reactogenicity of ascending dosages of Adenovirus Type 35 based circumsporozoite malaria vaccine among healthy subjects given in 3 intramuscular doses at 0, 1 and 6 months. The secondary objective is to evaluate the immunogenicity of the Adenovirus Type 35 based circumsporozoite malaria vaccine through performance of Humoral Immune Assays [ELISA (enzyme-linked immunosorbent assay)] for antibodies to circumsporozoite antigen and Adenovirus Neutralization Assay for neutralizing antibodies to Adenovirus type 35) and Cellular Immune Assays [enzyme-linked immunosorbent spot (ELISPOT) and Flow Cytometry] for circumsporozoite (CS)-specific cluster of differentiation (CD)4+ and CD8+ T cell responses.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasmodium Falciparum Infection
Keywords
circumsporozoite, malaria, vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group C: Ad35.CS.01-10^10 vp/ml
Arm Type
Experimental
Arm Description
15 subjects will receive dosage 10^10 vp/mL; 3 subjects will receive placebo.
Arm Title
Group D: Ad35.CS.01-10^11 vp/ml
Arm Type
Experimental
Arm Description
15 subjects will receive dosage 10^11 vp/mL; 3 subjects will receive placebo.
Arm Title
Group A: Ad35.CS.01-10^8 vp/ml
Arm Type
Experimental
Arm Description
15 subjects will receive dosage 10^8 vp/mL; 3 subjects will receive placebo.
Arm Title
Group B: Ad35.CS.01-10^9 vp/ml
Arm Type
Experimental
Arm Description
15 subjects will receive dosage 10^9 vp/mL; 3 subjects will receive placebo.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Normal saline.
Intervention Type
Biological
Intervention Name(s)
Ad35.CS.01 Circumsporozoite Malaria Vaccine
Intervention Description
Adenovirus Type 35 Circumsporozoite Malaria Vaccine (Ad35.CS.01); administered at 0, 1, and 6 months; dosage levels: 10^8 viral particles (vp)/mL, 10^9 vp/mL, 10^10 vp/mL and 10^11 vp/mL.
Primary Outcome Measure Information:
Title
Frequency and severity of local, systemic, and safety laboratory adverse events.
Time Frame
Enrollment through to Day 208
Secondary Outcome Measure Information:
Title
T cell responses against the malaria circumsporozoite antigen by enzyme-linked immunosorbent spot (ELISPOT) and flow cytometry.
Time Frame
Days 28, 56, 120, 180, 208.
Title
Antibody titers against the malaria circumsporozoite antigen via enzyme-linked immunosorbent assay (ELISA).
Time Frame
Days 28, 56, 120, 180, 208.
Title
Neutralizing antibody titers against Adenovirus type 35 by Adenovirus Neutralization Assay.
Time Frame
Days 28, 56, 120, 180, 208.

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: Provision of informed consent before any protocol procedures are performed. Males and non-pregnant females between the ages of 18 and 45 years, inclusive. Females and males must agree to practice adequate contraception until at least 28 days following their last immunization dose (including abstinence; hormonal contraception; condoms with spermicidal agents; post-menopausal; or surgical sterilization/vasectomy). Participants must agree to avoid high risk sexual behavior for exposure to human immunodeficiency virus (HIV). In good health as determined by screening medical history, physical examination (PE), and laboratory assessments. Willingness to comply with protocol requirements. Willingness to be contacted annually for five years for assessment of serious adverse events. Must have access to a cell phone. Exclusion Criteria: Current or recent (within the last four weeks) treatment with parenteral, inhaled, or oral corticosteroids (intranasal steroids are acceptable), or other immunosuppressive agents, or chemotherapy. History of splenectomy. Abnormal screening laboratory values. Any abnormal screening value for any screening test will exclude the subject from the study. Abnormal screening labs will not be repeated with the exception of high glucose levels will be repeated at a fasting state. Detectible neutralizing antibody titer against adenovirus serotype 35. History of intravenous (IV) drug abuse. History of, or current medical, occupational, social or family problems as a result of alcohol or illicit drug use. History of moderate to severe mental illness, as defined by symptoms interfering with social or occupational function or suicidal thoughts/attempts. History of receiving blood or blood products (such as blood transfusion, platelet transfusion, immunoglobulins, hyperimmune serum) in the previous 6 months. Vaccination with a live vaccine within the past 30 days or with a nonreplicating, inactivated, or subunit vaccine within the last 14 days. Known hypersensitivity to components of the vaccine. History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, or nervous system, or other metabolic or autoimmune/inflammatory conditions. History of coagulation defect or bleeding from (bruising at) multiple sites that cannot be linked to trauma or surgery. History of anaphylaxis or severe hypersensitivity reaction. Severe asthma, as defined by an emergency room visit or hospitalization within the last 12 months. Pregnant or breastfeeding women. Acute illness, including temperature greater than 100 degrees Fahrenheit within one week prior to vaccination. Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg). Concurrent participation in other investigational protocols or receipt of an investigational product within the previous 30 days or planned receipt of an investigational product within 28 days following the last immunization dose. Identification of any condition that, in the opinion of the investigator, would affect the ability of the subject to understand or comply with the study protocol or would jeopardize the safety or rights of a subject participating in the study. History of malignancy, including hematologic and skin cancers (except for a localized basal cell carcinoma), or known immunodeficiency syndrome. History of malaria infection or previous receipt of a malaria vaccine. History of travel to malaria-endemic area or receipt of antimalarial prophylaxis in the past 12 months. Planned travel to a malaria-endemic area prior to Visit 16 (Day 208). Pre-medication with analgesic or antipyretic agents in the 6 hours prior to vaccination, or planned medication with analgesic or antipyretic in the 24 hours following vaccination. This criterion should not preclude subjects receiving such medication if the need arises. Receipt of a recombinant adenovirus vector vaccine in a prior study.
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305-2200
Country
United States
Facility Name
Vanderbilt University - Pediatric - Vanderbilt Vaccine Research Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232-2573
Country
United States

12. IPD Sharing Statement

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Adenovirus Vaccine for Malaria

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