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Functional Cure Study of Anti-PD-L1 Antibody ASC22 in Combination With Chidamide in HIV-infected Patients With Antiviral Suppression

Primary Purpose

HIV Infections

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
ASC22 group
Sponsored by
Shanghai Public Health Clinical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Functional cure of HIV, ASC22,PD-1

Eligibility Criteria

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

Inclusion Criteria:

  1. People diagnosed with HIV infection.
  2. Age ≥18 years.
  3. In good general health with a body mass index ≥18.0 to <35.0 kg/m2.
  4. Able to comply with the time requirements for study visits and assessments.
  5. Currently on cART for at least 24 months with two consecutive plasma HIV-1 RNA < 50 copies/ml at least 12 months apart.
  6. CD4+ T-cell count ≥ 250 cells/µl (including borderline values) and CD4/CD8 < 0.9 during the screening period.
  7. Agree to adhere to contraception during participation in the project and for 6 months after completion of the trial.
  8. Willing to sign the informed consent form.

Exclusion Criteria:

  1. Subjects who have had any serious acute illness within 8 weeks.
  2. Subjects with a history of active autoimmune disease or autoimmune disease requiring systemic therapy.
  3. Pre-treatment/exposure to any other immune checkpoint inhibitors [e.g., anti-programmed cell death protein 1 (PD-1), anti-PD-L1, anti-PD-L2, anti-CTLA4, etc.].
  4. The patient has been treated with

    1. Received previous treatment with other anti-submarine drugs within 30 days prior to enrollment.
    2. Received radiotherapy or chemotherapy 30 days prior to screening.
    3. Received immunosuppressive therapy 60 days prior to screening.
    4. Treatment with immunomodulators (e.g., interleukins, interferons), hydroxyurea, or phosphonates 60 days prior to screening.
    5. HIV vaccine or systemic cytotoxic chemotherapy 60 days prior to screening.
    6. Prior immunoglobulin (IgG) therapy.
    7. Previous blood transfusion or cell growth factor therapy 90 days prior to screening.
    8. Use of rifampicin, rifabutin, etc. at the time of screening or during the planned treatment phase.
  5. Laboratory tests meet the following criteria.

    1. absolute neutrophil count (ANC) <1.50×109/L; hemoglobin (Hb) <105 g/L (male) or <95 g/L (female); platelets <75×10^9/μ L; international normalized ratio (INR) >1× upper limit of normal (ULN).
    2. Serum alanine aminotransferase (SGPT/ALT) >1.5× upper limit of normal (ULN), serum aspartate aminotransferase (SGOT/AST) >1.5× upper limit of normal (ULN), total bilirubin, direct bilirubin >1.5× upper limit of normal (ULN), serum creatinine >1.5× upper limit of normal (ULN) × upper limit of normal value (ULN).
    3. Five abnormal thyroid functions with clinical significance: tests include triiodothyronine (T3), tetraiodothyronine (T4), free triiodothyronine (FT3), free tetraiodothyronine (FT3), free tetraiodothyronine (FT4), and thyroid stimulating hormone (TSH).
    4. Abnormal and clinically significant adrenaline tests, which must include at least ACTH and cortisol. Abnormal and clinically significant blood glucose and glycated hemoglobin.
  6. Abnormal and clinically significant twelve-lead ECG at the time of enrollment.
  7. Subjects with interstitial changes on chest CT at the time of enrollment.
  8. Subjects with severe cardiac disease, symptomatic or asymptomatic arrhythmias.
  9. Patients with co-infection with HBV, HCV, syphilis, etc., patients with diabetes mellitus, and patients with other liver diseases.
  10. Subjects with a history of active or suspected malignancy or malignant disease (except basal cell skin cancer or in situ cervical cancer) within five years.
  11. Subjects with a history of tuberculosis or active tuberculosis.
  12. Subjects with psychiatric or substance abuse disorders known to interfere with study requirements.
  13. Subjects who have received immunomodulation or immunosuppression within 24 weeks prior to the first dose of study drug (including any dose of IV/oral [PO] steroids, but excluding steroids by inhalation, topical, or by local injection) within 24 weeks prior to the first dose of the study drug.
  14. Pregnant and lactating women, or men and women who intend to conceive a child during the study period.
  15. Psychiatric patients or those whose substance abuse interferes with the conduct of the trial.
  16. Histone deacetylase inhibitors, such as valproate, butyrate, and phenylbutyrate, but may be enrolled after a 28-day elution period.
  17. Patients with severe cardiac insufficiency [New York Heart Association (NYHA) Cardiac Insufficiency Classification Class IV].
  18. Any arterial thromboembolic event, including myocardial infarction, unstable angina, cerebrovascular accident or transient ischemic attack, within 6 months prior to enrollment; normatively treated uncontrolled hypertension (systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥100 mmHg); cardiomyopathy
  19. Patients with significant QT/QTC interval during the screening period (Fridericia formula.

(19) Patients with a significant prolongation of the QT/QTC interval (Fridericia formula: QTcF=QT/RR0.33) during the screening period (e.g., repeated measurements showing a QTc interval >450 ms, or another risk of torsional ventricular tachycardia [TdP] [e.g., heart failure, hypokalemia, familial long QT syndrome]) or combination of drugs that may cause prolongation of the QT/QTc interval.

(20) Known allergy or anti-drug antibodies to drugs or excipients used in this trial.

(21) Those who are judged by the investigator to be unsuitable for participation in this trial.

Sites / Locations

  • Shanghai Public Health Clinical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ASC22 group

Arm Description

ASC22 1mg/kg hypodermic injection Q4W+Chidamide 10mg PO BIW

Outcomes

Primary Outcome Measures

HIV-1 DNA levels
Change in HIV-1 DNA levels from baseline at each cycle of treatment

Secondary Outcome Measures

CD4+ T-cell count, CD4+ T-cell percentage, CD8+ T-cell count, CD4+/CD8+ ratio
Changes in CD4+ T-cell count, CD4+ T-cell percentage, CD8+ T-cell count, CD4+/CD8+ ratio, and change from baseline at each cycle of treatment
HIV gag-specific CD8+ T ratio
Change from baseline in HIV gag-specific CD8+ T ratio at each cycle of treatment
HIV-1 RNA
Change in HIV-1 RNA from baseline at each cycle of treatment

Full Information

First Posted
November 15, 2021
Last Updated
September 15, 2022
Sponsor
Shanghai Public Health Clinical Center
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1. Study Identification

Unique Protocol Identification Number
NCT05129189
Brief Title
Functional Cure Study of Anti-PD-L1 Antibody ASC22 in Combination With Chidamide in HIV-infected Patients With Antiviral Suppression
Official Title
Functional Cure Study of Anti-PD-L1 Antibody ASC22 in Combination With Chidamide
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 29, 2022 (Actual)
Primary Completion Date
July 30, 2023 (Anticipated)
Study Completion Date
July 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai Public Health Clinical Center

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
In HIV-infected patients, enhanced PD-1 expression of T cells correlates with T cell depletion, as evidenced by reduced virus-specific proliferative capacity and decreased cytokine expression.Targeting PD-L1 drugs to block PD-1/PD-L1 signaling may promote the secretion of antiviral cytokines and achieve HIV clearance.The mechanism of action of ASC22 is to competitively block the binding of PD-1 molecules to PD-L1 through its antigen-binding region with a high affinity for hPD-L1, thereby stimulating an innate or adaptive immune response with sustained T-cell activation.This study was conducted to evaluate whether ASC22 combined with chidamide in HIV-infected patients with antiviral suppression could shrink the viral reservoir.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Functional cure of HIV, ASC22,PD-1

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ASC22 group
Arm Type
Experimental
Arm Description
ASC22 1mg/kg hypodermic injection Q4W+Chidamide 10mg PO BIW
Intervention Type
Drug
Intervention Name(s)
ASC22 group
Intervention Description
The trial group received ASC22 1mg/kg hypodermic injection Q4W and Chidamide 10mg PO BIW.
Primary Outcome Measure Information:
Title
HIV-1 DNA levels
Description
Change in HIV-1 DNA levels from baseline at each cycle of treatment
Time Frame
52 weeks
Secondary Outcome Measure Information:
Title
CD4+ T-cell count, CD4+ T-cell percentage, CD8+ T-cell count, CD4+/CD8+ ratio
Description
Changes in CD4+ T-cell count, CD4+ T-cell percentage, CD8+ T-cell count, CD4+/CD8+ ratio, and change from baseline at each cycle of treatment
Time Frame
52 weeks
Title
HIV gag-specific CD8+ T ratio
Description
Change from baseline in HIV gag-specific CD8+ T ratio at each cycle of treatment
Time Frame
52 weeks
Title
HIV-1 RNA
Description
Change in HIV-1 RNA from baseline at each cycle of treatment
Time Frame
52 weeks
Other Pre-specified Outcome Measures:
Title
Treatment-Emergent Adverse Events
Description
All adverse events occurred after drug administration
Time Frame
52 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: People diagnosed with HIV infection. Age ≥18 years. In good general health with a body mass index ≥18.0 to <35.0 kg/m2. Able to comply with the time requirements for study visits and assessments. Currently on cART for at least 24 months with two consecutive plasma HIV-1 RNA < 50 copies/ml at least 12 months apart. CD4+ T-cell count ≥ 250 cells/µl (including borderline values) and CD4/CD8 < 0.9 during the screening period. Agree to adhere to contraception during participation in the project and for 6 months after completion of the trial. Willing to sign the informed consent form. Exclusion Criteria: Subjects who have had any serious acute illness within 8 weeks. Subjects with a history of active autoimmune disease or autoimmune disease requiring systemic therapy. Pre-treatment/exposure to any other immune checkpoint inhibitors [e.g., anti-programmed cell death protein 1 (PD-1), anti-PD-L1, anti-PD-L2, anti-CTLA4, etc.]. The patient has been treated with Received previous treatment with other anti-submarine drugs within 30 days prior to enrollment. Received radiotherapy or chemotherapy 30 days prior to screening. Received immunosuppressive therapy 60 days prior to screening. Treatment with immunomodulators (e.g., interleukins, interferons), hydroxyurea, or phosphonates 60 days prior to screening. HIV vaccine or systemic cytotoxic chemotherapy 60 days prior to screening. Prior immunoglobulin (IgG) therapy. Previous blood transfusion or cell growth factor therapy 90 days prior to screening. Use of rifampicin, rifabutin, etc. at the time of screening or during the planned treatment phase. Laboratory tests meet the following criteria. absolute neutrophil count (ANC) <1.50×109/L; hemoglobin (Hb) <105 g/L (male) or <95 g/L (female); platelets <75×10^9/μ L; international normalized ratio (INR) >1× upper limit of normal (ULN). Serum alanine aminotransferase (SGPT/ALT) >1.5× upper limit of normal (ULN), serum aspartate aminotransferase (SGOT/AST) >1.5× upper limit of normal (ULN), total bilirubin, direct bilirubin >1.5× upper limit of normal (ULN), serum creatinine >1.5× upper limit of normal (ULN) × upper limit of normal value (ULN). Five abnormal thyroid functions with clinical significance: tests include triiodothyronine (T3), tetraiodothyronine (T4), free triiodothyronine (FT3), free tetraiodothyronine (FT3), free tetraiodothyronine (FT4), and thyroid stimulating hormone (TSH). Abnormal and clinically significant adrenaline tests, which must include at least ACTH and cortisol. Abnormal and clinically significant blood glucose and glycated hemoglobin. Abnormal and clinically significant twelve-lead ECG at the time of enrollment. Subjects with interstitial changes on chest CT at the time of enrollment. Subjects with severe cardiac disease, symptomatic or asymptomatic arrhythmias. Patients with co-infection with HBV, HCV, syphilis, etc., patients with diabetes mellitus, and patients with other liver diseases. Subjects with a history of active or suspected malignancy or malignant disease (except basal cell skin cancer or in situ cervical cancer) within five years. Subjects with a history of tuberculosis or active tuberculosis. Subjects with psychiatric or substance abuse disorders known to interfere with study requirements. Subjects who have received immunomodulation or immunosuppression within 24 weeks prior to the first dose of study drug (including any dose of IV/oral [PO] steroids, but excluding steroids by inhalation, topical, or by local injection) within 24 weeks prior to the first dose of the study drug. Pregnant and lactating women, or men and women who intend to conceive a child during the study period. Psychiatric patients or those whose substance abuse interferes with the conduct of the trial. Histone deacetylase inhibitors, such as valproate, butyrate, and phenylbutyrate, but may be enrolled after a 28-day elution period. Patients with severe cardiac insufficiency [New York Heart Association (NYHA) Cardiac Insufficiency Classification Class IV]. Any arterial thromboembolic event, including myocardial infarction, unstable angina, cerebrovascular accident or transient ischemic attack, within 6 months prior to enrollment; normatively treated uncontrolled hypertension (systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥100 mmHg); cardiomyopathy Patients with significant QT/QTC interval during the screening period (Fridericia formula. (19) Patients with a significant prolongation of the QT/QTC interval (Fridericia formula: QTcF=QT/RR0.33) during the screening period (e.g., repeated measurements showing a QTc interval >450 ms, or another risk of torsional ventricular tachycardia [TdP] [e.g., heart failure, hypokalemia, familial long QT syndrome]) or combination of drugs that may cause prolongation of the QT/QTc interval. (20) Known allergy or anti-drug antibodies to drugs or excipients used in this trial. (21) Those who are judged by the investigator to be unsuitable for participation in this trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jun Chen, M.D
Phone
+86-21-37990333
Ext
3222
Email
qtchenjun@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Shanghai Public Health Clinical Center Chen, M.D
Phone
+86-21-37990333
Ext
3222
Email
qtchenjun@163.com
Facility Information:
Facility Name
Shanghai Public Health Clinical Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
201508
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jun Chen, M.D
Phone
+86-021-37990333
Ext
3222
Email
qtchenjun@163.com

12. IPD Sharing Statement

Learn more about this trial

Functional Cure Study of Anti-PD-L1 Antibody ASC22 in Combination With Chidamide in HIV-infected Patients With Antiviral Suppression

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