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EO2040 in Combination With Nivolumab, for Treatment of Patients With Minimal Residual Disease of Colorectal Cancer (CLAUDE)

Primary Purpose

Colorectal Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
EO2040
Sponsored by
Enterome
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

To be eligible to receive study treatment, a patient must meet all the criteria below:

  1. Provided written informed consent prior to any study-related procedures .
  2. Histological confirmation of colorectal cancer.
  3. Post R0-resection of stages II, III, or IV CRC and completion of all planned standard of care adjuvant therapies.
  4. Presence of minimal residual disease as defined by a positive ctDNA assay after completion of all planned standard of care therapies.
  5. Age ≥ 18 years old.
  6. Human leukocyte antigen (HLA)-A2 positive.
  7. No evidence of radiographic disease
  8. Predefined performance status
  9. Female patients of childbearing potential must have a negative serum pregnancy test within 72 hours prior to randomization.
  10. Considering the embryofetal toxicity of the immune checkpoint inhibitor (ICI) shown in animals' models, recommendations for contraception must be followed.
  11. Patients willing and able to comply with the scheduled visits, treatment plan, laboratory tests, and other study procedures indicated in the protocol.

Exclusion Criteria:

Patients who meet any of the following criteria will not be eligible to participate in the study:

  1. Patients treated with dexamethasone > 2 mg/day or equivalent .
  2. Patients treated with radiotherapy within 12 weeks, and cytotoxic chemotherapy therapy within 28 days (or 5 half lives of the compound(s) administered if longer) before study treatment start.
  3. Patients with persistent Grade ≥ 2 toxicities (according to NCI-CTCAE v5.0). Toxicities must be resolved for at least 2 weeks to Grade 1 or less. However, alopecia, neuropathy, and other persisting toxicities not constituting a safety risk based on Investigator's judgment are acceptable.
  4. Patients who have received any prior treatment with compounds targeting PD1, PD-L1, Cytotoxic T-lymphocyte-associated Antigen 4 (CTLA-4), or similar compounds where general resistance against therapeutic vaccination approaches might have developed.
  5. Patients with defined abnormal laboratory values:
  6. Patients with presence of other concomitant active, invasive malignancies .
  7. Patients with clinically significant active infection, cardiac disease, significant medical or psychiatric disease/condition that, in the opinion of the Investigator, would interfere with the interpretation of patient safety or study results or that would prohibit the understanding or rendering of informed consent
  8. Patients with suspected autoimmune or active autoimmune disorder or known history of an autoimmune neurologic condition (e.g., Guillain-Barré syndrome)..
  9. Patients with a history of solid organ transplantation or allogeneic hematopoietic stem cell transplantation.
  10. Patients with a history or known presence of tuberculosis.
  11. Pregnant and breastfeeding patients.
  12. Patients with a history or presence of human immunodeficiency virus (HIV) and/or active hepatitis B virus (HBV)/hepatitis C virus (HCV).
  13. Patients who have received live or attenuated vaccine therapy used for prevention of infectious diseases including seasonal (influenza) vaccinations within 4 weeks of the first dose of study drug.
  14. Patients with a history of hypersensitivity to any excipient, or active substance, present in the pharmaceutical forms of applicable study treatments.
  15. Patients under treatment with immunostimulatory or immunosuppressive medications, including herbal remedies, or herbal remedies known to potentially interfere with major organ function.
  16. Patients who have received treatment with any other investigational agent, or participation in another clinical trial

    -

Sites / Locations

  • MD AndersonRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Patients With Minimal Residual Disease of Colorectal Cancer

Arm Description

Patients With Circulating Tumor DNA-defined Minimal Residual Disease of Colorectal Cancer Stage II, III, or IV After Completion of Curative Therapy

Outcomes

Primary Outcome Measures

Response to treatment at 6 months
Percentage of patients with ctDNA clearance and no radiographic evidence of recurrence

Secondary Outcome Measures

Treatment-Emergent Adverse Events
Number and percentage of patients with Treatment-Emergent Adverse Events (TEAEs)
Serious Adverse Events
Number and percentage of patients with Serious Adverse Events (SAEs )
NCI-CTCAE grading
Number and percentage of patients with at least one NCI-CTCAE v5.0 grade increase or decrease
Response to therapy at 3 months
Percentage of patients with ctDNA clearance and no radiographic evidence of recurrence
DIsease-free survival
Disease-free survival (DFS) defined as the time from start of study treatment to the date of first documented colorectal cancer (CRC) recurrence or death due to any cause,
Overall survival
Overall survival (OS), measured as the time from start of study treatment until death from any cause.
Immunogenicity and cross-reactivity
Percentage of patients with a positive tetramer staining in peripheral blood mononuclear cells for the two microbial-derived peptides which are part of the therapeutic vaccine EO2040.

Full Information

First Posted
April 6, 2022
Last Updated
July 20, 2023
Sponsor
Enterome
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1. Study Identification

Unique Protocol Identification Number
NCT05350501
Brief Title
EO2040 in Combination With Nivolumab, for Treatment of Patients With Minimal Residual Disease of Colorectal Cancer
Acronym
CLAUDE
Official Title
A Phase 2 Trial of EO2040, a miCrobiaL-derived Peptide therApeUtic Vaccine, in Combination With Nivolumab, for Treatment of Patients With Circulating Tumor DNA-dEfined Minimal Residual Disease of Colorectal Cancer Stage II, III, or IV After Completion of Curative Therapy (the "CLAUDE" Study)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 1, 2023 (Actual)
Primary Completion Date
June 2025 (Anticipated)
Study Completion Date
January 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Enterome

4. Oversight

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

5. Study Description

Brief Summary
The current study will evaluate the microbiome-derived therapeutic vaccine EO2040 in combination with nivolumab in patients with circulating tumor DNA-defined Minimal Residual Disease (MRD) of colorectal cancer stage II, III, or IV after completion of standard curative therapy.
Detailed Description
The microbiome-derived therapeutic vaccine concept utilized in conjunction with anti-Programmed cell Death protein 1 (PD1) blockade is an innovative option for testing of a rational immunotherapy in colorectal cancer. The concept as such, including the combination with nivolumab, has already been tested in the clinical setting (i.e. in recurrent glioblastoma and adrenal tumors) and shown to be well tolerated.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
34 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Patients With Minimal Residual Disease of Colorectal Cancer
Arm Type
Experimental
Arm Description
Patients With Circulating Tumor DNA-defined Minimal Residual Disease of Colorectal Cancer Stage II, III, or IV After Completion of Curative Therapy
Intervention Type
Drug
Intervention Name(s)
EO2040
Other Intervention Name(s)
Nivolumab
Intervention Description
EO2040, is a therapeutic peptide vaccine composed of two microbial-derived peptides mimicking cytotoxic T cell (CD8+ T cell) epitopes from the Tumor Associated Antigens (TAAs) combined with the helper peptide (CD4+ T cell epitope) Universal Cancer Peptide 2 (UCP2). The peptide mix EO2040, i.e. drug product (DP), will be emulsified with the adjuvant Montanide. EO2040 will be given in combination with nivolumab, which is an anti-PD1. Nivolumab is approved for use for the treatment of multiple cancer types, including subtypes of CRC (mismatch repair deficient or microsatellite instability-high metastatic disease after prior treatment). However, it is not currently approved for ctDNA defined MRD of CRC.
Primary Outcome Measure Information:
Title
Response to treatment at 6 months
Description
Percentage of patients with ctDNA clearance and no radiographic evidence of recurrence
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Treatment-Emergent Adverse Events
Description
Number and percentage of patients with Treatment-Emergent Adverse Events (TEAEs)
Time Frame
36 months
Title
Serious Adverse Events
Description
Number and percentage of patients with Serious Adverse Events (SAEs )
Time Frame
36 months
Title
NCI-CTCAE grading
Description
Number and percentage of patients with at least one NCI-CTCAE v5.0 grade increase or decrease
Time Frame
36 months
Title
Response to therapy at 3 months
Description
Percentage of patients with ctDNA clearance and no radiographic evidence of recurrence
Time Frame
3 months
Title
DIsease-free survival
Description
Disease-free survival (DFS) defined as the time from start of study treatment to the date of first documented colorectal cancer (CRC) recurrence or death due to any cause,
Time Frame
36 months
Title
Overall survival
Description
Overall survival (OS), measured as the time from start of study treatment until death from any cause.
Time Frame
36 months
Title
Immunogenicity and cross-reactivity
Description
Percentage of patients with a positive tetramer staining in peripheral blood mononuclear cells for the two microbial-derived peptides which are part of the therapeutic vaccine EO2040.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be eligible to receive study treatment, a patient must meet all the criteria below: Provided written informed consent prior to any study-related procedures . Histological confirmation of colorectal cancer. Post R0-resection of stages II, III, or IV CRC and completion of all planned standard of care adjuvant therapies. Presence of minimal residual disease as defined by a positive ctDNA assay after completion of all planned standard of care therapies. Age ≥ 18 years old. Human leukocyte antigen (HLA)-A2 positive. No evidence of radiographic disease Predefined performance status Female patients of childbearing potential must have a negative serum pregnancy test within 72 hours prior to randomization. Considering the embryofetal toxicity of the immune checkpoint inhibitor (ICI) shown in animals' models, recommendations for contraception must be followed. Patients willing and able to comply with the scheduled visits, treatment plan, laboratory tests, and other study procedures indicated in the protocol. Exclusion Criteria: Patients who meet any of the following criteria will not be eligible to participate in the study: Patients treated with dexamethasone > 2 mg/day or equivalent . Patients treated with radiotherapy within 12 weeks, and cytotoxic chemotherapy therapy within 28 days (or 5 half lives of the compound(s) administered if longer) before study treatment start. Patients with persistent Grade ≥ 2 toxicities (according to NCI-CTCAE v5.0). Toxicities must be resolved for at least 2 weeks to Grade 1 or less. However, alopecia, neuropathy, and other persisting toxicities not constituting a safety risk based on Investigator's judgment are acceptable. Patients who have received any prior treatment with compounds targeting PD1, PD-L1, Cytotoxic T-lymphocyte-associated Antigen 4 (CTLA-4), or similar compounds where general resistance against therapeutic vaccination approaches might have developed. Patients with defined abnormal laboratory values: Patients with presence of other concomitant active, invasive malignancies . Patients with clinically significant active infection, cardiac disease, significant medical or psychiatric disease/condition that, in the opinion of the Investigator, would interfere with the interpretation of patient safety or study results or that would prohibit the understanding or rendering of informed consent Patients with suspected autoimmune or active autoimmune disorder or known history of an autoimmune neurologic condition (e.g., Guillain-Barré syndrome).. Patients with a history of solid organ transplantation or allogeneic hematopoietic stem cell transplantation. Patients with a history or known presence of tuberculosis. Pregnant and breastfeeding patients. Patients with a history or presence of human immunodeficiency virus (HIV) and/or active hepatitis B virus (HBV)/hepatitis C virus (HCV). Patients who have received live or attenuated vaccine therapy used for prevention of infectious diseases including seasonal (influenza) vaccinations within 4 weeks of the first dose of study drug. Patients with a history of hypersensitivity to any excipient, or active substance, present in the pharmaceutical forms of applicable study treatments. Patients under treatment with immunostimulatory or immunosuppressive medications, including herbal remedies, or herbal remedies known to potentially interfere with major organ function. Patients who have received treatment with any other investigational agent, or participation in another clinical trial -
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jan Fagerberg
Phone
+32 3 205 55 55
Email
medicalmonitoring-crc@enterome.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jan Fagerberg, MD
Organizational Affiliation
Enterome
Official's Role
Study Director
Facility Information:
Facility Name
MD Anderson
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Arvind Dasari, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

EO2040 in Combination With Nivolumab, for Treatment of Patients With Minimal Residual Disease of Colorectal Cancer

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