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Comparing Safety and Protective Efficacy of Vaccine Candidate PfSPZ-CVac and MVA ME-TRAP/ ChAd63 ME-TRAP in Adults

Primary Purpose

Malaria

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Pyronaridine Tetraphosphate, Artesunate Drug Combination
PfSPZ Challenge (NF54)
MVA ME-TRAP
ChAd63 ME-TRAP
Sodium chloride (NaCl) 0.9%
Sponsored by
University Hospital Tuebingen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Malaria

Eligibility Criteria

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

Inclusion Criteria:

  • Able and willing (in the Investigator's opinion) to comply with all study requirements.
  • Willing to allow the investigators to discuss the volunteer's medical history with their general practitioner if required.
  • Residence in Tübingen or surroundings for the period of the trial.
  • Women only: Must agree to practice continuous highly effective contraception for the duration of the study and until the end of relevant systemic exposure (a method which results in a low failure rate; i.e. less than 1% per year). Additionally, women will only be exposed to the PfSPZ-CVac/ME-TRAP products following a negative highly sensitive pregnancy test the day before immunization/CHMI.
  • Agreement to refrain from blood donation during the course of the study and after the end of their involvement in the study according to the local and national blood banking eligibility criteria (which is a permanent refrain from blood donations after a malaria parasite infection).
  • Provision of written informed consent to receive PfSPZ Challenge products or ME-TRAP products for immunization and subsequently for CHMI.
  • Accept to be contacted (24/7) by mobile phone during the immunization and CHMI period.
  • Willingness to take Pyramax during immunization (PfSPZ-CVac group) and a curative antimalarial regimen following CHMI.
  • Agreement to stay overnight for observation during the period of intensive follow-up post-challenge if required.
  • Answer all questions on the informed consent quiz correctly.
  • A body mass index <35

Exclusion Criteria:

  • History of P. falciparum malaria within the last 5 years.
  • Prior receipt of malaria vaccine.
  • Planned travel to malaria endemic areas during the study period.
  • Use of drugs with known antimalarial activity within 30 days of study enrollment (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones, or azithromycin).
  • Participation in other clinical trials or the intake of an investigational medicinal product within the last 90 days or planned receipt during the duration of this study
  • Human Immunodeficiency Virus (HIV) infection.
  • Any confirmed or suspected immunosuppressive or immunodeficient state (e.g. repeated and/or unusual infections), history of infection caused by opportunistic organisms any infection or combination of infections that suggest underlying immunodeficiency, history of meningitis, encephalitis, septic shock, life-threatening soft tissue infection, more than one pneumonia, asplenia and/or chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed)).
  • Use of immunoglobulins or blood products within 3 months prior to enrollment.
  • Known (or signs consistent with) sickle cell anaemia, sickle cell trait, thalassemia or thalassemia trait, glucose-6-phosphate dehydrogenase deficiency.
  • Pregnancy, lactation or intention to become pregnant during the study.
  • Contraindications to the use of the following antimalarial medications: Atovaquone-proguanil, artemether-lumefantrine, artesunate, pyronaridine-artesunate, i.e.:

    • Known hypersensitivity to any of these drugs
    • intake of the following drugs: rifampicine, rifabutin, metoclopramide, warfarin, cumarine-derivatives, etoposide, antiretroviral drugs, imipramine, amytriptilin, clomipramin, carbamazepine, phenytoin, St. Johns wort, metoprolol, flecainide, propafenone, digoxin, dabigatran; drugs inducing QTc prolongation, drugs metabolized by CYP2D6, drugs inducing CAP3A4.
  • History of allergic disease or reactions likely to be exacerbated by any component of the vaccine (e.g. egg products, Kathon).
  • History of clinically significant contact dermatitis.
  • History of cancer within the last 5 years (except basal cell carcinoma of the skin and cervical carcinoma in situ).
  • History of serious psychiatric condition that may affect participation in the study.
  • Alcohol consumption should not exceed 24 g (men) or 12 g (women)/per day
  • Haemoglobin <14 g/dl (men) or <12 g/dl (women)
  • Suspected or known injected drug abuse in the 5 years preceding enrollment.
  • Positive for hepatitis B surface antigen (HBs-antigen).
  • Seropositivity for hepatitis C virus (antibodies to HCV)
  • Clinical signs or symptoms of hepatic injury (such as nausea and/or abdominal pain associated with jaundice) or known liver disease (i.e. decompensated cirrhosis, Child-Pugh stage B or C).
  • Renal abnormalities
  • GFR <30ml/min (glomerular filtration rate)
  • Presence or past history of cardiac arrhythmia or an abnormal electrocardiogram or suspected coronary heart disease or family history for sudden cardiac death.
  • Known or suspected porphyria.
  • Volunteers unable to be closely followed for social, geographic or psychological reasons.
  • History of seizure (except uncomplicated febrile convulsion at childhood)
  • Immunization with more than 3 other vaccines within four weeks.
  • Electrolyte disturbance.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    PfSPZ-CVac/Pyramax

    MVA ME-TRAP/ChAd63 ME-TRAP

    Saline/placebo pill

    Arm Description

    200.000 PfSPZ of PfSPZ Challenge NF54 will be administered by DVI along with one weight-adjusted oral dose of Pyramax each on day 1, day 6, and day 29

    MVA ME-TRAP 1.5 x 10^8 pfu will be administered intramuscularly on day 1 for priming. ChAd63 ME-TRAP 5 x 10^10 vp will subsequently administered by DVI on day 29.

    As placebo comparator to PfSPZ-CVac/Pyramax, saline will be administered intravenously along with an oral placebo pill on day 1, day 6, and day 29. As placebo comparator to MVA ME-TRAP/ChAd63 ME-TRAP, saline will be administered intramuscularly on day 1 and intravenously on day 29. No placebo pill will be used to compare to the arm MVA ME-TRAP/ChAd63 ME-TRAP.

    Outcomes

    Primary Outcome Measures

    Assessment of safety and tolerability of PfSPZ-CVac/Pyramax and MVA ME-TRAP/ChAd63 ME-TRAP
    Assessment of all adverse events and serious adverse events that might be related to the administration of PfSPZ-CVac/Pyramax and MVA ME-TRAP/ChAd63 ME-TRAP

    Secondary Outcome Measures

    Assessment of protective efficacy of PfSPZ-CVac/Pyramax and of MVA ME-TRAP /ChAd63 ME-TRAP in healthy, malaria-naïve adults against homologous CHMI with PfSPZ Challenge (NF54) by DVI
    Assessment of the development of parasitemias following the controlled human malaria infection (CHMI)

    Full Information

    First Posted
    June 21, 2022
    Last Updated
    June 1, 2023
    Sponsor
    University Hospital Tuebingen
    Collaborators
    Sanaria Inc., University of Oxford
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05441410
    Brief Title
    Comparing Safety and Protective Efficacy of Vaccine Candidate PfSPZ-CVac and MVA ME-TRAP/ ChAd63 ME-TRAP in Adults
    Official Title
    Comparing Safety and Protective Efficacy of the Whole Plasmodium Falciparum Sporozoite Chemoprophylaxis Vaccine Candidate PfSPZ-CVac and Prime- Target Vaccination With Viral Vectored Vaccine Candidate Regime MVA ME-TRAP/ ChAd63 ME-TRAP in Malaria-naïve, Healthy Adult Volunteers in Germany
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 1, 2023 (Anticipated)
    Primary Completion Date
    April 30, 2024 (Anticipated)
    Study Completion Date
    April 30, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    University Hospital Tuebingen
    Collaborators
    Sanaria Inc., University of Oxford

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a single centre, randomized, placebo-controlled phase 1/2 study comparing two malaria vaccine candidates. The first vaccine candidate PfSPZ-CVac (Plasmodium falciparum sporozoites (PfSPZ) challenge administered with a chemoprophylactic antimalarial) will be chemoattenuated in vivo with the antimalarial Pyramax. The second vaccine candidate is prime- target vaccination with viral vectored vaccine candidate regime MVA ME-TRAP (Modified Vaccinia Ankara (MVA) multiple epitope thrombosponin-related adhesion protein (ME-TRAP)) and ChAd63 ME-TRAP (Chimpanzee adenovirus 63 (ChAd63). The safety and protective efficacy of both vaccine candidates will be to assessed by controlled human malaria infection with PfSPZ Challenge strain NF54 administered intravenously by syringe.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Factorial Assignment
    Model Description
    There will be two groups: Group 1 ("PfSPZ-CVac") and Group 2 ("ME-TRAP"). Within Group 1, Arm 1 (N=12) participants will receive PfSPZ Challenge (NF54) via direct venous inoculation (DVI) along with one weight-adjusted oral dose of Pyramax on day 1, day 6, and day 29. The placebo group of Arm 2 (N=3) will receive an oral placebo pill and saline DVI on day 1, day 6, and day 29. In Group 2, participants of Arm 1 (N=12) will receive MVA ME-TRAP intramuscularly on day 1 and ChAd63 ME-TRAP intravenously by DVI on day 29. The placebo group of Arm 2 (N=3) will receive saline intramuscularly on day 1 and intravenously on day 29.
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    30 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    PfSPZ-CVac/Pyramax
    Arm Type
    Experimental
    Arm Description
    200.000 PfSPZ of PfSPZ Challenge NF54 will be administered by DVI along with one weight-adjusted oral dose of Pyramax each on day 1, day 6, and day 29
    Arm Title
    MVA ME-TRAP/ChAd63 ME-TRAP
    Arm Type
    Experimental
    Arm Description
    MVA ME-TRAP 1.5 x 10^8 pfu will be administered intramuscularly on day 1 for priming. ChAd63 ME-TRAP 5 x 10^10 vp will subsequently administered by DVI on day 29.
    Arm Title
    Saline/placebo pill
    Arm Type
    Placebo Comparator
    Arm Description
    As placebo comparator to PfSPZ-CVac/Pyramax, saline will be administered intravenously along with an oral placebo pill on day 1, day 6, and day 29. As placebo comparator to MVA ME-TRAP/ChAd63 ME-TRAP, saline will be administered intramuscularly on day 1 and intravenously on day 29. No placebo pill will be used to compare to the arm MVA ME-TRAP/ChAd63 ME-TRAP.
    Intervention Type
    Drug
    Intervention Name(s)
    Pyronaridine Tetraphosphate, Artesunate Drug Combination
    Other Intervention Name(s)
    Pyramax
    Intervention Description
    Combination drug for treatment of uncomplicated malaria
    Intervention Type
    Biological
    Intervention Name(s)
    PfSPZ Challenge (NF54)
    Intervention Description
    cryopreserved Plasmodium falciparum sporozoites injected by intravenous inoculation
    Intervention Type
    Biological
    Intervention Name(s)
    MVA ME-TRAP
    Intervention Description
    virally vectored subunit vaccine candidates where ME-TRAP is expressed by the non-replicating viral vector Modified Vaccinia Ankara (MVA)
    Intervention Type
    Biological
    Intervention Name(s)
    ChAd63 ME-TRAP
    Intervention Description
    virally vectored subunit vaccine candidates where ME-TRAP is expressed by the non-replicating viral vector Chimpanzee Adenovirus 63 (ChAd63)
    Intervention Type
    Biological
    Intervention Name(s)
    Sodium chloride (NaCl) 0.9%
    Other Intervention Name(s)
    Placebo: Saline
    Intervention Description
    0.9% NaCl solution for injection
    Primary Outcome Measure Information:
    Title
    Assessment of safety and tolerability of PfSPZ-CVac/Pyramax and MVA ME-TRAP/ChAd63 ME-TRAP
    Description
    Assessment of all adverse events and serious adverse events that might be related to the administration of PfSPZ-CVac/Pyramax and MVA ME-TRAP/ChAd63 ME-TRAP
    Time Frame
    From the first administration until the last follow-up visit (Group 1: day 136, Group 2: day 82)
    Secondary Outcome Measure Information:
    Title
    Assessment of protective efficacy of PfSPZ-CVac/Pyramax and of MVA ME-TRAP /ChAd63 ME-TRAP in healthy, malaria-naïve adults against homologous CHMI with PfSPZ Challenge (NF54) by DVI
    Description
    Assessment of the development of parasitemias following the controlled human malaria infection (CHMI)
    Time Frame
    From administration of CHMI (Group 1:day 113, Group 2: 59) until the last follow-up visit (Group 1: day 136, Group 2: day 82)
    Other Pre-specified Outcome Measures:
    Title
    Assessment of Pyramax as a drug for in vivo chemoattenuation of PfSPZ Challenge (NF54) for the PfSPZ-CVac approach
    Description
    Assessment of the development of parasitemias and side effects following immunization with PfSPZ-CVac and Pyramax
    Time Frame
    From the first administration (day 1) until the last follow-up visit (Group 1: day 136)
    Title
    Assessment of the immunogenicity of each of the malaria vaccine candidates
    Description
    Assessment of several immungenic blood parameters and their development throughout the trial
    Time Frame
    From the first administration until the last follow-up visit (Group 1: day 136, Group 2: day 82)

    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: Able and willing (in the Investigator's opinion) to comply with all study requirements. Willing to allow the investigators to discuss the volunteer's medical history with their general practitioner if required. Residence in Tübingen or surroundings for the period of the trial. Women only: Must agree to practice continuous highly effective contraception for the duration of the study and until the end of relevant systemic exposure (a method which results in a low failure rate; i.e. less than 1% per year). Additionally, women will only be exposed to the PfSPZ-CVac/ME-TRAP products following a negative highly sensitive pregnancy test the day before immunization/CHMI. Agreement to refrain from blood donation during the course of the study and after the end of their involvement in the study according to the local and national blood banking eligibility criteria (which is a permanent refrain from blood donations after a malaria parasite infection). Provision of written informed consent to receive PfSPZ Challenge products or ME-TRAP products for immunization and subsequently for CHMI. Accept to be contacted (24/7) by mobile phone during the immunization and CHMI period. Willingness to take Pyramax during immunization (PfSPZ-CVac group) and a curative antimalarial regimen following CHMI. Agreement to stay overnight for observation during the period of intensive follow-up post-challenge if required. Answer all questions on the informed consent quiz correctly. A body mass index <35 Exclusion Criteria: History of P. falciparum malaria within the last 5 years. Prior receipt of malaria vaccine. Planned travel to malaria endemic areas during the study period. Use of drugs with known antimalarial activity within 30 days of study enrollment (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones, or azithromycin). Participation in other clinical trials or the intake of an investigational medicinal product within the last 90 days or planned receipt during the duration of this study Human Immunodeficiency Virus (HIV) infection. Any confirmed or suspected immunosuppressive or immunodeficient state (e.g. repeated and/or unusual infections), history of infection caused by opportunistic organisms any infection or combination of infections that suggest underlying immunodeficiency, history of meningitis, encephalitis, septic shock, life-threatening soft tissue infection, more than one pneumonia, asplenia and/or chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed)). Use of immunoglobulins or blood products within 3 months prior to enrollment. Known (or signs consistent with) sickle cell anaemia, sickle cell trait, thalassemia or thalassemia trait, glucose-6-phosphate dehydrogenase deficiency. Pregnancy, lactation or intention to become pregnant during the study. Contraindications to the use of the following antimalarial medications: Atovaquone-proguanil, artemether-lumefantrine, artesunate, pyronaridine-artesunate, i.e.: Known hypersensitivity to any of these drugs intake of the following drugs: rifampicine, rifabutin, metoclopramide, warfarin, cumarine-derivatives, etoposide, antiretroviral drugs, imipramine, amytriptilin, clomipramin, carbamazepine, phenytoin, St. Johns wort, metoprolol, flecainide, propafenone, digoxin, dabigatran; drugs inducing QTc prolongation, drugs metabolized by CYP2D6, drugs inducing CAP3A4. History of allergic disease or reactions likely to be exacerbated by any component of the vaccine (e.g. egg products, Kathon). History of clinically significant contact dermatitis. History of cancer within the last 5 years (except basal cell carcinoma of the skin and cervical carcinoma in situ). History of serious psychiatric condition that may affect participation in the study. Alcohol consumption should not exceed 24 g (men) or 12 g (women)/per day Haemoglobin <14 g/dl (men) or <12 g/dl (women) Suspected or known injected drug abuse in the 5 years preceding enrollment. Positive for hepatitis B surface antigen (HBs-antigen). Seropositivity for hepatitis C virus (antibodies to HCV) Clinical signs or symptoms of hepatic injury (such as nausea and/or abdominal pain associated with jaundice) or known liver disease (i.e. decompensated cirrhosis, Child-Pugh stage B or C). Renal abnormalities GFR <30ml/min (glomerular filtration rate) Presence or past history of cardiac arrhythmia or an abnormal electrocardiogram or suspected coronary heart disease or family history for sudden cardiac death. Known or suspected porphyria. Volunteers unable to be closely followed for social, geographic or psychological reasons. History of seizure (except uncomplicated febrile convulsion at childhood) Immunization with more than 3 other vaccines within four weeks. Electrolyte disturbance.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Jaana Heinze, Dr.
    Phone
    +49070712982191
    Email
    jaana.heinze@med.uni-tuebingen.de
    First Name & Middle Initial & Last Name or Official Title & Degree
    Diane Egger-Adam, Dr.
    Phone
    +49070712982191
    Email
    diane.egger-adam@uni-tuebingen.de
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Sabine Bélard, Dr.
    Organizational Affiliation
    University Hospital Tuebingen
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    Citations:
    PubMed Identifier
    33947856
    Citation
    Sulyok Z, Fendel R, Eder B, Lorenz FR, Kc N, Karnahl M, Lalremruata A, Nguyen TT, Held J, Adjadi FAC, Klockenbring T, Flugge J, Woldearegai TG, Lamsfus Calle C, Ibanez J, Rodi M, Egger-Adam D, Kreidenweiss A, Kohler C, Esen M, Sulyok M, Manoj A, Richie TL, Sim BKL, Hoffman SL, Mordmuller B, Kremsner PG. Heterologous protection against malaria by a simple chemoattenuated PfSPZ vaccine regimen in a randomized trial. Nat Commun. 2021 May 4;12(1):2518. doi: 10.1038/s41467-021-22740-w.
    Results Reference
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    Comparing Safety and Protective Efficacy of Vaccine Candidate PfSPZ-CVac and MVA ME-TRAP/ ChAd63 ME-TRAP in Adults

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