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B-pVAC-SARS-CoV-2: Study to Prevent COVID-19 Infection in Adults With Bcell/ Antibody Deficiency (B-pVAC)

Primary Purpose

Immune Deficiency Disease

Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
CoVAC-1
Sponsored by
University Hospital Tuebingen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Immune Deficiency Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Adult (≥18 years) male or non-pregnant, non-lactating female
  2. Primary antibody deficiency syndrome or Secondary antibody deficiency syndrome, defined by one of the following:

    • IgG < 4 g/l
    • Ongoing substitution of immunoglobline for hypogammaglobinemia
    • Anti-CD20 antibody (monospecific) therapy for malignant disease:
    • after combined Anti-CD20 antibody therapy with chemotherapy (e.g. fludarabin, cyclophosphamid, bendamustin, anthracycline, vincristin) or BTK-inhibitors or BCL2-inhibitors (within 1-6 months post therapy)
    • ongoing single agent Anti-CD20 antibody therapy
    • Anti-CD20 antibody maintenance therapy
  3. Ability to understand and voluntarily sign an informed consent form
  4. Ability to adhere to the study visit schedule and other protocol requirements
  5. Female patients of child bearing potential (FCBP) and male patients with partners of child bearing potential, who are sexually active, must agree to the use of two effective forms (at least one highly effective method) of contraception. This should be started from the signing of the informed consent and continue until three months after vaccination. Furthermore, contraception must be carried on by patients receiving B-cell depleting therapies for the whole duration of the treatment.
  6. Postmenopausal or evidence of non-child-bearing status. For women of childbearing potential: negative urine or serum pregnancy test within 7 days prior to study treatment. Postmenopausal or evidence of nonchildbearing status is defined as:

    • Amenorrhoea for 1 year or more following cessation of exogenous hormonal treatments
    • Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the postmenopausal range for women under 50

Exclusion Criteria:

  1. Pregnant or lactating females
  2. Participation in any clinical trial with intake of any nonregistered vaccine product
  3. Any concomitant disease affecting the effect of the therapeutic vaccine or interfering with the study primary endpoint:

    • Active infection
    • Psychiatric disorders
    • Known systemic anaphylaxis
  4. Prior or current infection with SARS-CoV-2 as assessed by medical history and/or by throat/nose swab (PCR) or serologically documented immunization against SARSCoV- 2 (after infection or vaccination)
  5. Persisting symptoms developed after SARS-CoV-2 vaccination with an approved vaccine product at study inclusion
  6. History of Guillain-Barré syndrome
  7. HIV infection, chronic or active hepatitis B or C
  8. History of relevant CNS pathology or current relevant CNS pathology (e.g. seizure, paresis, aphasia, cerebrovascular ischemia/haemorrhage, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, psychosis, coordination or movement disorder, excluding febrile seizures as child)
  9. Baseline laboratory CD4+ T cell count < 100 μl
  10. The following pre-existing medical conditions:

    • Chronic liver failure defined as Child-Pugh Score ≥B
    • Chronic renal failure defined as GFR <40 ml/min/1,73m2
    • Serious pre-existing cardiovascular disease such as NYHA ≥ III
    • Sickle cell anemia
  11. Patients presenting with any clinical, laboratory or radiological signs of tumor-progression
  12. Patient receiving active treatment with small molecules, including Tyrosine Kinases-Inhibitors (e.g. Ibrutinib), Proteosome-Inhibitors (e.g. Bortezomib), Bcl-2- Inhibitors (e.g. Venetoclax), Phosphoinositid-3-Kinase- Inhibors (e.g. Idelalisib)
  13. Known hypersensitivity to any of the components included in the CoVac-1 vaccine
  14. Pre-existing auto-immune disease except for Hashimoto thyroiditis and mild (not requiring immunosuppressive treatment) psoriasis
  15. Intention of receiving one dose of an already approved vaccine against SARS-CoV-2 before day 56

Sites / Locations

  • University Hospital Tuebingen
  • Krankenhaus Nordwest gGmbH Institut für Klinisch-Onkologische Forschung (IKF)
  • Charité - Universitätsmedizin Berlin Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie Charité Campus Benjamin Franklin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CoVAC-1 Vaccine

Arm Description

Peptide vaccination should be started as soon as possible after the screening visit. Or in case of two vaccinations: Peptide vaccination should be started as soon as possible after the screening visit (V1) and on day 42 (V5)

Outcomes

Primary Outcome Measures

Safety-Vital Signs 1 (Body Temperature)
Body temperature will be measured [temperature in centigrade]
Safety-Vital Signs 2 (Blood Pressure and Pulse)
blood pressure [mmHg] pulse [bpm]
Safety-Eastern Cooperative Oncology Group (ECOG) Status
Scale 0-5, the lower the scale value, the better
Safety-Hematology 1 (Hemoglobin)
hemoglobin (Hb). Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. Hemoglobin [g/dl ]
Safety-Hematology 2 (White Blood Cells)
white blood cells (WBC). Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. White Blood Cells [1/µl]
Safety-Hematology 3 (Platelet Count)
platelet count (PLT) . Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. Platelet Count [1000/µl]
Safety-Hematology 4 (Red Blood Cells)
red blood cells (RBC). Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. Red Blood Cells [Mio/µl]
T cell response
Blood will be taken before peptide vaccination on V1, and during vaccination phase and follow-up at each visit. IFN-gamma ELISPOT Counts

Secondary Outcome Measures

Full Information

First Posted
July 5, 2021
Last Updated
August 3, 2023
Sponsor
University Hospital Tuebingen
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1. Study Identification

Unique Protocol Identification Number
NCT04954469
Brief Title
B-pVAC-SARS-CoV-2: Study to Prevent COVID-19 Infection in Adults With Bcell/ Antibody Deficiency
Acronym
B-pVAC
Official Title
B-pVAC-SARS-CoV-2: Phase I/II Multicenter Safety and Immunogenicity Trial of Multi-peptide Vaccination to Prevent COVID-19 Infection in Adults With Bcell/ Antibody Deficiency
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Completed
Study Start Date
June 30, 2021 (Actual)
Primary Completion Date
August 18, 2022 (Actual)
Study Completion Date
April 30, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital Tuebingen

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 indication of this study is To evaluate the safety and immunogenicity of a SARSCoV- 2-derived multi-peptide vaccine in combination with the TLR1/2 ligand XS15 in adults with congenital or acquired B-cell/antibody deficiency
Detailed Description
Multicenter Phase I-II clinical trial Phase I: Part I: 14-patients will receive an open-label 500 μl subcutaneous injection via needle and syringe of the study IMP (CoVac-1). 28 days following vaccination of the 1th patient, there will be an interim analysis of safety and immunogenicity and a review by the data safety monitoring board (DSMB) before proceeding to Phase II Definition of sufficient immunogenicity after one dose of vaccination: T cell response to at least one CoVAC-1 vaccine peptide on day28 in ≥80% of study patients, with proven general ability to mount antigen-specific T cell responses (detection of T cell responses to EBV/CMV control peptides) assessed by Interferon gamma (IFN-γ) ELISpot. The time point (day28) for the assessment of CoVac-1 induced T cell responses was selected based on the results of the ongoing P-pVAC-SARS-CoV-2 study, where CoVac-1-induced SARS-CoV-2 T cell responses were observed in 100% of study subjects at day28. The threshold of 80% was introduced after considering recent findings about cancer patients with hematological malignancies (comprising patients with B cell or antibody deficiencies) vaccinated with BNT162b2. Here it was observed that only 50% of patients had a BNT162b2-induced T cell response, while this was achieved in 80% of the healthy donors. Thus, the threshold of 80% was chosen, with the aim of providing our study population an immunization comparable to the one achieved in the healthy population vaccinated with the approved vaccines. CoVac-1 induced T cell responses are defined as positive T cell response in Interferon gamm (IFN-γ) ELISPOT assay with spot count at least 2-fold higher than the baseline assay (Visit 1). T cell responses are considered to be positive when the mean spot count per well is at least 3-fold higher than the mean number of spots in the negative control wells (stimulated with a control peptide). Only patients with detectable T cell response to the viral peptide panel ex vivo or after in vitro T cell expansion, and thus general ability to mount an antigen-specific immune response will be considered for the evaluation of sufficient immune responses after one CoVac-1 vaccination. Part II (optional): If there is an insufficient immune response measured by Interferon gamma (IFN-γ) ELISpot in Part I of Phase I on day 28, an additional Part (Part II) of Phase I will start enrollment of 14 subjects receiving two open-label 500 μl subcutaneous injection via needle and syringe of the study IMP (CoVac-1) on day1 and day42. Phase II (after an amendment to the protocol): 40 subjects will receive an open-label 500 μl subcutaneous injection via needle and syringe of the study IMP (CoVac-1) on d1 and, depending on the data collected in Phase I, a second vaccination on day42 if necessary.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immune Deficiency Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Phase I: Part I: 14 patients not infected with SARS-CoV-2 will receive an open-label 500 μl subcutaneous injection via needle and syringe of the study IMP (CoVAC-1). Part II (optional): If there is an insufficient immune response measured by IFN-γ ELISpot in Part I of Phase I on day 28, an additional Part (Part II) of Phase I will start enrollment of 14 subjects receiving two open-label 500 μl subcutaneous injection via needle and syringe of the study IMP (CoVac-1) on d1 and d42. Phase II (after an amendment to the protocol): 40 subjects will receive an open-label 500 μl subcutaneous injection via needle and syringe of the study IMP (CoVac-1) on d1 and, depending on the data collected in Phase I, a econd vaccination on d42 if necessary.
Masking
None (Open Label)
Allocation
N/A
Enrollment
54 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CoVAC-1 Vaccine
Arm Type
Experimental
Arm Description
Peptide vaccination should be started as soon as possible after the screening visit. Or in case of two vaccinations: Peptide vaccination should be started as soon as possible after the screening visit (V1) and on day 42 (V5)
Intervention Type
Biological
Intervention Name(s)
CoVAC-1
Intervention Description
Peptide vaccination should be started as soon as possible after the screening visit.
Primary Outcome Measure Information:
Title
Safety-Vital Signs 1 (Body Temperature)
Description
Body temperature will be measured [temperature in centigrade]
Time Frame
Day 28
Title
Safety-Vital Signs 2 (Blood Pressure and Pulse)
Description
blood pressure [mmHg] pulse [bpm]
Time Frame
Day 28
Title
Safety-Eastern Cooperative Oncology Group (ECOG) Status
Description
Scale 0-5, the lower the scale value, the better
Time Frame
Day 28
Title
Safety-Hematology 1 (Hemoglobin)
Description
hemoglobin (Hb). Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. Hemoglobin [g/dl ]
Time Frame
day 28
Title
Safety-Hematology 2 (White Blood Cells)
Description
white blood cells (WBC). Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. White Blood Cells [1/µl]
Time Frame
day 28
Title
Safety-Hematology 3 (Platelet Count)
Description
platelet count (PLT) . Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. Platelet Count [1000/µl]
Time Frame
day 28
Title
Safety-Hematology 4 (Red Blood Cells)
Description
red blood cells (RBC). Differential cell counts should be performed at baseline, at each visit during vaccination phase and thereafter at investigators discretion. Clinical status and laboratory parameters are to be followed using individual institutional guidelines and the best clinical judgment of the responsible physician, which can involve more frequent testing. Red Blood Cells [Mio/µl]
Time Frame
day 28
Title
T cell response
Description
Blood will be taken before peptide vaccination on V1, and during vaccination phase and follow-up at each visit. IFN-gamma ELISPOT Counts
Time Frame
Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult (≥18 years) male or non-pregnant, non-lactating female Primary antibody deficiency syndrome or Secondary antibody deficiency syndrome, defined by one of the following: IgG < 4 g/l Ongoing substitution of immunoglobline for hypogammaglobinemia Anti-CD20 antibody (monospecific) therapy for malignant disease: after combined Anti-CD20 antibody therapy with chemotherapy (e.g. fludarabin, cyclophosphamid, bendamustin, anthracycline, vincristin) or BTK-inhibitors or BCL2-inhibitors (within 1-6 months post therapy) ongoing single agent Anti-CD20 antibody therapy Anti-CD20 antibody maintenance therapy Ability to understand and voluntarily sign an informed consent form Ability to adhere to the study visit schedule and other protocol requirements Female patients of child bearing potential (FCBP) and male patients with partners of child bearing potential, who are sexually active, must agree to the use of two effective forms (at least one highly effective method) of contraception. This should be started from the signing of the informed consent and continue until three months after vaccination. Furthermore, contraception must be carried on by patients receiving B-cell depleting therapies for the whole duration of the treatment. Postmenopausal or evidence of non-child-bearing status. For women of childbearing potential: negative urine or serum pregnancy test within 7 days prior to study treatment. Postmenopausal or evidence of nonchildbearing status is defined as: Amenorrhoea for 1 year or more following cessation of exogenous hormonal treatments Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the postmenopausal range for women under 50 Exclusion Criteria: Pregnant or lactating females Participation in any clinical trial with intake of any nonregistered vaccine product Any concomitant disease affecting the effect of the therapeutic vaccine or interfering with the study primary endpoint: Active infection Psychiatric disorders Known systemic anaphylaxis Prior or current infection with SARS-CoV-2 as assessed by medical history and/or by throat/nose swab (PCR) or serologically documented immunization against SARSCoV- 2 (after infection or vaccination) Persisting symptoms developed after SARS-CoV-2 vaccination with an approved vaccine product at study inclusion History of Guillain-Barré syndrome HIV infection, chronic or active hepatitis B or C History of relevant CNS pathology or current relevant CNS pathology (e.g. seizure, paresis, aphasia, cerebrovascular ischemia/haemorrhage, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, psychosis, coordination or movement disorder, excluding febrile seizures as child) Baseline laboratory CD4+ T cell count < 100 μl The following pre-existing medical conditions: Chronic liver failure defined as Child-Pugh Score ≥B Chronic renal failure defined as GFR <40 ml/min/1,73m2 Serious pre-existing cardiovascular disease such as NYHA ≥ III Sickle cell anemia Patients presenting with any clinical, laboratory or radiological signs of tumor-progression Patient receiving active treatment with small molecules, including Tyrosine Kinases-Inhibitors (e.g. Ibrutinib), Proteosome-Inhibitors (e.g. Bortezomib), Bcl-2- Inhibitors (e.g. Venetoclax), Phosphoinositid-3-Kinase- Inhibors (e.g. Idelalisib) Known hypersensitivity to any of the components included in the CoVac-1 vaccine Pre-existing auto-immune disease except for Hashimoto thyroiditis and mild (not requiring immunosuppressive treatment) psoriasis Intention of receiving one dose of an already approved vaccine against SARS-CoV-2 before day 56
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Helmut Salih, Prof. MD
Organizational Affiliation
University Hospital Tuebingen
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Tuebingen
City
Tuebingen
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
72076
Country
Germany
Facility Name
Krankenhaus Nordwest gGmbH Institut für Klinisch-Onkologische Forschung (IKF)
City
Frankfurt am main
State/Province
Frankfurt
ZIP/Postal Code
60488
Country
Germany
Facility Name
Charité - Universitätsmedizin Berlin Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie Charité Campus Benjamin Franklin
City
Berlin
ZIP/Postal Code
12203
Country
Germany

12. IPD Sharing Statement

Learn more about this trial

B-pVAC-SARS-CoV-2: Study to Prevent COVID-19 Infection in Adults With Bcell/ Antibody Deficiency

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