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Immunization With IMM-101 vs Observation for Prevention of Respiratory and Severe COVID-19 Related Infections in Cancer Patients at Increased Risk of Exposure (COV-IMMUNO)

Primary Purpose

Cancer, Covid-19

Status
Active
Phase
Phase 3
Locations
Canada
Study Type
Interventional
Intervention
IMM-101
Observation
Sponsored by
Canadian Cancer Trials Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patient must be undergoing (or be planned to undergo) active treatment for one or more solid malignancy, lymphoma or myeloma. active treatment includes adjuvant, neoadjuvant and palliative intent treatment with surgery, radiation, chemotherapy, targeted therapy or immunotherapy.
  • Patients must have one or more of the following risk factors [CDC 2019] for a severe COVID-19 infection:

    • Age > 65 years old
    • Hypertension (on medications);
    • Type 1 or 2 Diabetes (on medication)
    • A relevant chronic condition as per the investigator based on the medical record, including:

      • heart (e.g. heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension)
      • lung (e.g. chronic obstructive pulmonary disease (COPD including emphysema and chronic bronchitis), moderate to severe asthma, idiopathic pulmonary fibrosis and cystic fibrosis)
      • liver cirrhosis
      • serious kidney disease requiring dialysis
    • Receiving systemic therapy (such as cytotoxic chemotherapy, immunotherapy or targeted agents excluding single-agent hormonal therapy)
    • Body Mass Index > 40
    • Living in a nursing home or long term care facility
  • Patient must have a life expectancy of >6 months as assessed by the investigator
  • Patient must have an ECOG Performance Status ≤ 2
  • Patient has adequate organ function appropriate for the therapy the patient is planned to receive in the opinion of the investigator and based on local assessment and practices.
  • Patient is aged ≥ 18 years
  • Patient has agreed to receive pneumococcal vaccination and a seasonal influenza vaccination in accordance with Canadian Guidelines.
  • Patient is able (i.e. sufficiently fluent) and willing to complete the health utility questionnaires in either English or French.
  • Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate.
  • Patient must be willing to provide identifying information including provincial health insurance number to facilitate data linkage and follow up.
  • Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients enrolled on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
  • Women/men of childbearing potential must have agreed to use a highly effective contraceptive method throughout the treatment period and for at least 3 months after discontinuation of treatment.

Exclusion Criteria:

  • Patient previously received treatment with IMM-101.
  • Patient cannot have either at present or in the past, a positive test for COVID-19 infection. If a patient has been tested for COVID-19, result must be confirmed as negative prior to enrollment.
  • Patient cannot have experienced "flu-like symptoms" within 14 days prior to enrollment, including fever, extreme fatigue, new or worsening cough, myalgias, new or worsening dyspnea, and/or sputum production.
  • Patient is receiving concomitant treatment with another investigational product or has received such treatment within the 3 weeks prior to enrollment.
  • Patient has any co-existing active infection that, in the opinion of the Investigator, may increase the risk associated with study participation or study drug administration, impair the ability of the subject to receive protocol therapy, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate.
  • Patient has previously experienced an allergic reaction to any mycobacterial product, including the BCG vaccine.
  • Patients with superficial bladder cancer or any other condition currently receiving or planned to be treated with BCG.
  • Patient has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies) or a known history of or is known to have a positive test for Hepatitis B (HBsAg reactive) or Hepatitis C (HCV RNA [qualitative]).
  • Patients with prior or concurrent leukemia.
  • Patient has had a prior bone marrow transplant.
  • Patient is pregnant or breast-feeding
  • Patient has documented history of clinically severe autoimmune disease or a syndrome that requires systemic steroids or immunosuppressive agents. This includes patient requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent, or depot corticosteroids in the 6 weeks before enrollment) or immunosuppressant drugs (such as azathioprine, tacrolimus, cyclosporine, etc.) within the 14 days prior to enrollment. Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease. Steroids used for premedication prior to chemotherapy or as part of a chemotherapy regimen are allowed.

Sites / Locations

  • Juravinski Cancer Centre at Hamilton Health Sciences
  • London Regional Cancer Program
  • Ottawa Hospital Research Institute
  • Odette Cancer Centre
  • University Health Network
  • CHUM-Centre Hospitalier de l'Universite de Montreal
  • The Research Institute of the McGill University
  • CIUSSS de l'Estrie - Centre hospitalier

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

IMM-101

Observation

Arm Description

The treatment regimen with IMM-101 will be one 1.0 mg (= 0.1 mL) dose given on Day 0, followed by a second dose of 0.5 mg (= 0.05 mL) on Day 14 (-2/+5 days), and a third Dose of 0.5 mg (= 0.05 mL) on Day 45 (+/-14 days)

Outcomes

Primary Outcome Measures

The rate of "flu-like illness" which includes:
WHO definition of "influenza-like illness" (ILI) [Fitzner 2018] or confirmed viral/bacterial respiratory infection AND Results in a change or delay in cancer treatment or requirement for and unscheduled medical assesment, hospitalization or death.

Secondary Outcome Measures

The incidence of documented COVID-19 infection (confirmed by any Health Canada approved COVID-19 test. Both symptomatic and asymptomatic infections will be documented
The rate of severe respiratory and COVID-19 infection defined as a confirmed COVID-19 infection leading to hospitalization, ICU admission or death
The number of events that meet the definition of the primary endpoint, as measured within the one-year follow-up (patients may meet the primary endpoint more than once and be counted multiple times).
The incidence of COVID-19 seroconverted patients between baseline, 3 months, 6 months and 12 months
The incremental cost-effectiveness ratio (in the unit of CAD$ per life-years gained) measured with EQ-5D-5L
Failure-free survival, as time from enrollment to recurrence or progression declared by the investigator on the basis of objective standard evaluation consistent with the disease site or death
Overall survival (OS), as time from enrollment to death from any cause
Incidence, frequency, and severity of AEs considered possibly, probably or definitely related to receipt of IMM-101
Incidence and frequency of local injection site reactions subsequent to IMM-101 administration
Incidence and duration of ICU admission related to documented COVID-19 infection

Full Information

First Posted
June 19, 2020
Last Updated
August 3, 2023
Sponsor
Canadian Cancer Trials Group
Collaborators
Immodulon Therapeutics Ltd, BioCan Rx, Canadian Cancer Society (CCS), ATGen Canada Inc, Canadian Centre for Applied Research in Cancer Control (ARCC), Ontario Institute for Cancer Research
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1. Study Identification

Unique Protocol Identification Number
NCT04442048
Brief Title
Immunization With IMM-101 vs Observation for Prevention of Respiratory and Severe COVID-19 Related Infections in Cancer Patients at Increased Risk of Exposure
Acronym
COV-IMMUNO
Official Title
COV-IMMUNO: A Randomized, Phase III Trial of Immunization With IMM-101 Versus Observation for the Prevention of Severe Respiratory and COVID-19 Related Infections in Cancer Patients at Increased Risk of Exposure
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 1, 2020 (Actual)
Primary Completion Date
October 31, 2023 (Anticipated)
Study Completion Date
April 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Canadian Cancer Trials Group
Collaborators
Immodulon Therapeutics Ltd, BioCan Rx, Canadian Cancer Society (CCS), ATGen Canada Inc, Canadian Centre for Applied Research in Cancer Control (ARCC), Ontario Institute for Cancer Research

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 purpose of this study is to find out if immunization with IMM-101 will reduce the incidence of severe respiratory and COVID-19 infections in cancer patients.
Detailed Description
IMM-101 is a new type of immune stimulating therapy being developed for the treatment of cancer that may also help in preventing severe respiratory and COVID-19 infections. Laboratory tests show that IMM-101 works by activating parts of the immune system that are also involved with protecting against viral and bacterial infections, so that if you are exposed to these types of infections your body may be able fight off the infection better. That could help prevent severe symptoms from respiratory and COVID-19 related infections. It has been studied in over 300 cancer patients who have also been receiving other cancer treatments, including chemotherapy and radiation, and seems promising, but it is not clear if it can offer better results than not having the immunization at all.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer, Covid-19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
195 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IMM-101
Arm Type
Experimental
Arm Description
The treatment regimen with IMM-101 will be one 1.0 mg (= 0.1 mL) dose given on Day 0, followed by a second dose of 0.5 mg (= 0.05 mL) on Day 14 (-2/+5 days), and a third Dose of 0.5 mg (= 0.05 mL) on Day 45 (+/-14 days)
Arm Title
Observation
Arm Type
Active Comparator
Intervention Type
Biological
Intervention Name(s)
IMM-101
Intervention Description
Three doses of IMM-101 on days 0, 14, and 45.
Intervention Type
Other
Intervention Name(s)
Observation
Intervention Description
No active treatment. Observation only
Primary Outcome Measure Information:
Title
The rate of "flu-like illness" which includes:
Description
WHO definition of "influenza-like illness" (ILI) [Fitzner 2018] or confirmed viral/bacterial respiratory infection AND Results in a change or delay in cancer treatment or requirement for and unscheduled medical assesment, hospitalization or death.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
The incidence of documented COVID-19 infection (confirmed by any Health Canada approved COVID-19 test. Both symptomatic and asymptomatic infections will be documented
Time Frame
1 year
Title
The rate of severe respiratory and COVID-19 infection defined as a confirmed COVID-19 infection leading to hospitalization, ICU admission or death
Time Frame
1 year
Title
The number of events that meet the definition of the primary endpoint, as measured within the one-year follow-up (patients may meet the primary endpoint more than once and be counted multiple times).
Time Frame
1 year
Title
The incidence of COVID-19 seroconverted patients between baseline, 3 months, 6 months and 12 months
Time Frame
3, 6, and 12 months
Title
The incremental cost-effectiveness ratio (in the unit of CAD$ per life-years gained) measured with EQ-5D-5L
Time Frame
1 year
Title
Failure-free survival, as time from enrollment to recurrence or progression declared by the investigator on the basis of objective standard evaluation consistent with the disease site or death
Time Frame
1 year
Title
Overall survival (OS), as time from enrollment to death from any cause
Time Frame
1 year
Title
Incidence, frequency, and severity of AEs considered possibly, probably or definitely related to receipt of IMM-101
Time Frame
1 year
Title
Incidence and frequency of local injection site reactions subsequent to IMM-101 administration
Time Frame
1 year
Title
Incidence and duration of ICU admission related to documented COVID-19 infection
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient must be undergoing (or be planned to undergo) active treatment for one or more solid malignancy, lymphoma or myeloma. active treatment includes adjuvant, neoadjuvant and palliative intent treatment with surgery, radiation, chemotherapy, targeted therapy or immunotherapy. Patients must have one or more of the following risk factors [CDC 2019] for a severe COVID-19 infection: Age > 65 years old Hypertension (on medications); Type 1 or 2 Diabetes (on medication) A relevant chronic condition as per the investigator based on the medical record, including: heart (e.g. heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension) lung (e.g. chronic obstructive pulmonary disease (COPD including emphysema and chronic bronchitis), moderate to severe asthma, idiopathic pulmonary fibrosis and cystic fibrosis) liver cirrhosis serious kidney disease requiring dialysis Receiving systemic therapy (such as cytotoxic chemotherapy, immunotherapy or targeted agents excluding single-agent hormonal therapy) Body Mass Index > 40 Living in a nursing home or long term care facility Patient must have a life expectancy of >6 months as assessed by the investigator Patient must have an ECOG Performance Status ≤ 2 Patient has adequate organ function appropriate for the therapy the patient is planned to receive in the opinion of the investigator and based on local assessment and practices. Patient is aged ≥ 18 years Patient has agreed to receive pneumococcal vaccination and a seasonal influenza vaccination in accordance with Canadian Guidelines. Patient is able (i.e. sufficiently fluent) and willing to complete the health utility questionnaires in either English or French. Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate. Patient must be willing to provide identifying information including provincial health insurance number to facilitate data linkage and follow up. Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients enrolled on this trial will be available for complete documentation of the treatment, adverse events, and follow-up. Women/men of childbearing potential must have agreed to use a highly effective contraceptive method throughout the treatment period and for at least 3 months after discontinuation of treatment. Exclusion Criteria: Patient previously received treatment with IMM-101. Patient cannot have either at present or in the past, a positive test for COVID-19 infection. If a patient has been tested for COVID-19, result must be confirmed as negative prior to enrollment. Patient cannot have experienced "flu-like symptoms" within 14 days prior to enrollment, including fever, extreme fatigue, new or worsening cough, myalgias, new or worsening dyspnea, and/or sputum production. Patient is receiving concomitant treatment with another investigational product or has received such treatment within the 3 weeks prior to enrollment. Patient has any co-existing active infection that, in the opinion of the Investigator, may increase the risk associated with study participation or study drug administration, impair the ability of the subject to receive protocol therapy, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate. Patient has previously experienced an allergic reaction to any mycobacterial product, including the BCG vaccine. Patients with superficial bladder cancer or any other condition currently receiving or planned to be treated with BCG. Patient has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies) or a known history of or is known to have a positive test for Hepatitis B (HBsAg reactive) or Hepatitis C (HCV RNA [qualitative]). Patients with prior or concurrent leukemia. Patient has had a prior bone marrow transplant. Patient is pregnant or breast-feeding Patient has documented history of clinically severe autoimmune disease or a syndrome that requires systemic steroids or immunosuppressive agents. This includes patient requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent, or depot corticosteroids in the 6 weeks before enrollment) or immunosuppressant drugs (such as azathioprine, tacrolimus, cyclosporine, etc.) within the 14 days prior to enrollment. Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease. Steroids used for premedication prior to chemotherapy or as part of a chemotherapy regimen are allowed.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rebecca A Auer
Organizational Affiliation
Ottawa Hospital Research Institute
Official's Role
Study Chair
Facility Information:
Facility Name
Juravinski Cancer Centre at Hamilton Health Sciences
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8V 5C2
Country
Canada
Facility Name
London Regional Cancer Program
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 5W9
Country
Canada
Facility Name
Ottawa Hospital Research Institute
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Facility Name
Odette Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4N 3M5
Country
Canada
Facility Name
University Health Network
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
CHUM-Centre Hospitalier de l'Universite de Montreal
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2X 3E4
Country
Canada
Facility Name
The Research Institute of the McGill University
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H4A 3J1
Country
Canada
Facility Name
CIUSSS de l'Estrie - Centre hospitalier
City
Sherbrooke
State/Province
Quebec
ZIP/Postal Code
J1H 5N4
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Immunization With IMM-101 vs Observation for Prevention of Respiratory and Severe COVID-19 Related Infections in Cancer Patients at Increased Risk of Exposure

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