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PolyPEPI1018 Vaccine and CDx for the Treatment of Metastatic Colorectal Cancer (OBERTO) (OBERTO)

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
PolyPEPI1018 CRC Vaccine
Sponsored by
Treos Bio Zrt
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female subjects, 18-75 years of age at time of Screening who provide written informed consent prior to initiation of any study procedure
  2. Histologically confirmed metastatic adenocarcinoma originating from the colon or the rectum
  3. Presence of at least 1 measurable reference lesion according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria
  4. Experienced PR or stable disease during first-line treatment with a systemic chemotherapy regimen and 1 biological therapy regimen
  5. Maintenance therapy with a fluoropyrimidine (5-fluorouracil or capecitabine) plus the same biologic agent (bevacizumab, cetuximab or panitumumab) used during induction, scheduled to initiate prior to the first day of treatment with the study drug
  6. No more than 1 line of chemotherapy regimen for mCRC (adjuvant therapy for non-metastasized disease is allowed if terminated more than 6 months before Screening and without recurrence within 6 months after the end of adjuvant treatment)
  7. Last CT scan at 3 weeks or less before the first day of treatment
  8. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  9. Women of childbearing potential must agree to appropriately use an effective form of contraception (failure rate of <1% per year) for 3 months from the day of the treatment. An effective form of contraception is defined as using hormonal contraceptives or an intrauterine device combined with at least 1 of the following forms of contraception: a diaphragm, cervical cap or condom
  10. Men must agree to use an effective form of contraception (as defined above), and not donate sperm for 3 months from the day of the treatment
  11. White blood cell count ≥3.0 × 109/L with neutrophils ≥1.5 × 109/L
  12. Platelets ≥100 × 109/L, hemoglobin ≥5.6 mmol/L (corresponding to 9 g/dL)
  13. Serum bilirubin ≤1.5 × upper limit of normal (ULN) set by the site
  14. Alanine amino transferase (ALAT) and aspartate amino transferase (ASAT) ≤2.5 × ULN in the absence of liver metastases. ALAT and ASAT ≤5 × ULN set by the site in the presence of liver metastases
  15. Serum creatinine ≤1.5 × ULN set by the site and creatinine clearance >30 mL/min using Cockroft formula
  16. Relevant toxicities of prior therapies must have resolved, except for oxaliplatin-related neuropathy or alopecia
  17. Anticipated life expectancy ≥6 months Subject is willing and able to comply with the requirements of the protocol

Exclusion Criteria:

  1. Received chronic systemic immune therapy or immunosuppressant medication other than steroids within the last 6 weeks prior to start of study treatment
  2. Received continuous systemic steroid treatment within the last 2 weeks prior to start of study treatment
  3. Colorectal cancer with documented high microsatellite instability (MSI-H)
  4. Colorectal cancer with documented BRAF mutations
  5. Pre-existing systemic autoimmune or antibody-mediated diseases or immune deficiency diseases
  6. Central nervous system (CNS) metastases
  7. Active or uncontrolled severe infections or undiagnosed febrile condition >38ºC
  8. Acute or subacute intestinal obstruction or history of chronic intestinal inflammatory diseases
  9. Symptomatic peritoneal carcinomatosis
  10. Peritonitis
  11. Serious, non-healing wounds, ulcers or bone fractures
  12. Nephrotic syndrome
  13. Arterial thromboembolisms or severe hemorrhages within 6 months before study enrolment (except bleeding tumor before tumor resection surgery)
  14. Hemorrhagic diathesis or thrombotic tendency
  15. Major surgery or radiotherapy within 12 weeks prior to the study treatment or anticipation of needing such procedure during the study period
  16. Uncontrolled pleural effusion, pericardial effusion or ascites requiring repeated drainage more than once every 28 days
  17. Participants with active malignancy (other than colorectal cancer) or a prior malignancy within the past 12 months
  18. Participant with myocardial infarction within 6 months prior to enrollment or New York Heart Association Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to the first dose of study treatment, any electrocardiogram (ECG) abnormality at Screening must be documented by the investigator as not medically relevant
  19. Administration of a live, attenuated vaccine within 4 weeks before randomization or anticipation of a live attenuated vaccine will be required during the study
  20. Participant has participated in another clinical study involving an investigational product (IP) or investigational device within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an IP or investigational device during the course of this study
  21. Known hypersensitivity to any component of the investigational drug
  22. If female, participant is pregnant (exclusion confirmed with beta-human chorionic gonadotropin [hCG] test) or lactating at the time of enrollment, or has plans to become pregnant or start breastfeeding during the study
  23. Pre-existing alcohol or drug abuse
  24. Medical or mental impairments which make it impossible to obtain the patient's consent or to conduct the study
  25. A significant concomitant medical condition which the clinical investigator believes precludes the patient from enrolling in the study Absent or limited legal competence

Sites / Locations

  • Mayo Clinic
  • Universiti di Pisa

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PolyPEPI1018 CRC Vaccine

Arm Description

The vaccine contains 6 synthetic peptides mixed with the adjuvant Montanide™. The peptides were selected to induce T cell responses against 12 dominant epitopes from 7 cancer testis antigens (CTAs), which are the most frequently expressed CTAs in colorectal cancer. The 6 peptides were optimized to induce long lasting CRC specific T cell responses.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment Related Adverse Events
Occurrence of at least 1 ≥Grade 4 local adverse event (AE) or 1 ≥Grade 3 systemic AE and/or signs/symptoms, lab toxicities, and/or clinical events that is probably or definitely related to study treatment

Secondary Outcome Measures

Number of Participants Having T Cell Immune Response
Measured CD4+ and CD8+ T cell responses from each subject for each antigen of the vaccine
Number of Predicted Antigen Specific T Cell Responses Per Patient
Epitopes restricted to multiple HLA class I alleles (Personal Epitope, PEPI) of a subject were predicted. PEPIs determined for each vaccine antigen can predict the antigen-specific T cell responses for each patient.

Full Information

First Posted
December 19, 2017
Last Updated
May 2, 2022
Sponsor
Treos Bio Zrt
Collaborators
Mayo Clinic, University of Pisa, Laboratory Corporation of America, PPD, ImmunXperts SA
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1. Study Identification

Unique Protocol Identification Number
NCT03391232
Brief Title
PolyPEPI1018 Vaccine and CDx for the Treatment of Metastatic Colorectal Cancer (OBERTO)
Acronym
OBERTO
Official Title
Safety, Tolerability, Immunogenicity and Efficacy of Multiple PolyPEPI1018 Vaccinations as an Add-on Immunotherapy to the Standard-of-Care Maintenance Therapy in Subjects With Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
May 3, 2018 (Actual)
Primary Completion Date
July 17, 2019 (Actual)
Study Completion Date
July 17, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Treos Bio Zrt
Collaborators
Mayo Clinic, University of Pisa, Laboratory Corporation of America, PPD, ImmunXperts SA

4. Oversight

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

5. Study Description

Brief Summary
Phase I/II clinical trial investigates the safety, tolerability, immunogenicity and preliminary efficacy of multiple doses of PolyPEPI1018 CRC vaccine as an add-on treatment to the standard-of-care maintenance therapy in patients with metastatic colorectal cancer. Clinical responses will be evaluated by indiction of T cell responses, T lymphocyte infiltration in accessible biopsy sites, and by objective tumor responses. This study will also explore the accuracy of the predicted T cell responses in each patient using the candidate companion diagnostic test and the correlations between clinical responses and predicted T cell responses.
Detailed Description
This is a Phase I/II, open-label, single-arm, multicenter study to evaluate the safety, tolerability, immunogenicity and efficacy of a multiple subcutaneous injection of PolyPEPI1018 as an add-on immunotherapy to the standard-of-care maintenance therapy in approximately 15 subjects with metastatic colorectal cancer. The first part of the study investigates the administration of a single vaccine dose during 12-week follow-up period on an outpatient basis. Screening is performed in parallel with the subject's completion of the standard-of-care first-line treatment and initiation of the standard-of-care maintenance treatment. A single dose of PolyPEPI1018 is administered after the subject initiates the maintenance regimen, and within 3 weeks after the eligibility CT scan was performed. Subjects are monitored every 3 weeks for 12 weeks. The second part of the study investigates the administration of 3 vaccine doses (Weeks 0, 13, 26) then 12 weeks follow-up on an outpatient basis.

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 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PolyPEPI1018 CRC Vaccine
Arm Type
Experimental
Arm Description
The vaccine contains 6 synthetic peptides mixed with the adjuvant Montanide™. The peptides were selected to induce T cell responses against 12 dominant epitopes from 7 cancer testis antigens (CTAs), which are the most frequently expressed CTAs in colorectal cancer. The 6 peptides were optimized to induce long lasting CRC specific T cell responses.
Intervention Type
Biological
Intervention Name(s)
PolyPEPI1018 CRC Vaccine
Intervention Description
Colorectal Cancer Vaccine
Primary Outcome Measure Information:
Title
Number of Participants With Treatment Related Adverse Events
Description
Occurrence of at least 1 ≥Grade 4 local adverse event (AE) or 1 ≥Grade 3 systemic AE and/or signs/symptoms, lab toxicities, and/or clinical events that is probably or definitely related to study treatment
Time Frame
from 1st vaccination to 21 days after last vaccinations, up to 41 weeks
Secondary Outcome Measure Information:
Title
Number of Participants Having T Cell Immune Response
Description
Measured CD4+ and CD8+ T cell responses from each subject for each antigen of the vaccine
Time Frame
12 weeks
Title
Number of Predicted Antigen Specific T Cell Responses Per Patient
Description
Epitopes restricted to multiple HLA class I alleles (Personal Epitope, PEPI) of a subject were predicted. PEPIs determined for each vaccine antigen can predict the antigen-specific T cell responses for each patient.
Time Frame
21 days
Other Pre-specified Outcome Measures:
Title
Number of Participants With Objective Tumor Responses - Objective Response Rate (RECIST v1.1)
Description
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR. CT scans were performed at screening and weeks 6,12 after each vaccination. The objective response were based on for each subject's last CT scan evaluation.
Time Frame
12 weeks
Title
Number of Participants With Objective Tumor Responses - Disease Control Rate (Best Overall Response is Partial Response or Stable Disease)
Description
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD) <30% increase compare to smallest sum of the longest diameter of target lesions. CT scans were performed at screening and weeks 6,12 after each vaccination. The DCR were counted as the best response (PR or SD) for each subject's during the trial.
Time Frame
12 weeks
Title
Number of Participants Having Induced Recruitment of TILs
Description
Assessments of TILs was performed using IHC (Immunoscore CR) CD3/CD8 testing on liver biopsy tissue samples obtained from subjects during a time course from baseline until the Last Visit. The CD3+ and CD8+ cell densities were determined in the core tumor and invasive margin using Immunohistochemistry (IHC) staining followed by digital pathology.
Time Frame
Last visit, up to 38 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects, 18-75 years of age at time of Screening who provide written informed consent prior to initiation of any study procedure Histologically confirmed metastatic adenocarcinoma originating from the colon or the rectum Presence of at least 1 measurable reference lesion according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria Experienced PR or stable disease during first-line treatment with a systemic chemotherapy regimen and 1 biological therapy regimen Maintenance therapy with a fluoropyrimidine (5-fluorouracil or capecitabine) plus the same biologic agent (bevacizumab, cetuximab or panitumumab) used during induction, scheduled to initiate prior to the first day of treatment with the study drug No more than 1 line of chemotherapy regimen for mCRC (adjuvant therapy for non-metastasized disease is allowed if terminated more than 6 months before Screening and without recurrence within 6 months after the end of adjuvant treatment) Last CT scan at 3 weeks or less before the first day of treatment Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Women of childbearing potential must agree to appropriately use an effective form of contraception (failure rate of <1% per year) for 3 months from the day of the treatment. An effective form of contraception is defined as using hormonal contraceptives or an intrauterine device combined with at least 1 of the following forms of contraception: a diaphragm, cervical cap or condom Men must agree to use an effective form of contraception (as defined above), and not donate sperm for 3 months from the day of the treatment White blood cell count ≥3.0 × 109/L with neutrophils ≥1.5 × 109/L Platelets ≥100 × 109/L, hemoglobin ≥5.6 mmol/L (corresponding to 9 g/dL) Serum bilirubin ≤1.5 × upper limit of normal (ULN) set by the site Alanine amino transferase (ALAT) and aspartate amino transferase (ASAT) ≤2.5 × ULN in the absence of liver metastases. ALAT and ASAT ≤5 × ULN set by the site in the presence of liver metastases Serum creatinine ≤1.5 × ULN set by the site and creatinine clearance >30 mL/min using Cockroft formula Relevant toxicities of prior therapies must have resolved, except for oxaliplatin-related neuropathy or alopecia Anticipated life expectancy ≥6 months Subject is willing and able to comply with the requirements of the protocol Exclusion Criteria: Received chronic systemic immune therapy or immunosuppressant medication other than steroids within the last 6 weeks prior to start of study treatment Received continuous systemic steroid treatment within the last 2 weeks prior to start of study treatment Colorectal cancer with documented high microsatellite instability (MSI-H) Colorectal cancer with documented BRAF mutations Pre-existing systemic autoimmune or antibody-mediated diseases or immune deficiency diseases Central nervous system (CNS) metastases Active or uncontrolled severe infections or undiagnosed febrile condition >38ºC Acute or subacute intestinal obstruction or history of chronic intestinal inflammatory diseases Symptomatic peritoneal carcinomatosis Peritonitis Serious, non-healing wounds, ulcers or bone fractures Nephrotic syndrome Arterial thromboembolisms or severe hemorrhages within 6 months before study enrolment (except bleeding tumor before tumor resection surgery) Hemorrhagic diathesis or thrombotic tendency Major surgery or radiotherapy within 12 weeks prior to the study treatment or anticipation of needing such procedure during the study period Uncontrolled pleural effusion, pericardial effusion or ascites requiring repeated drainage more than once every 28 days Participants with active malignancy (other than colorectal cancer) or a prior malignancy within the past 12 months Participant with myocardial infarction within 6 months prior to enrollment or New York Heart Association Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to the first dose of study treatment, any electrocardiogram (ECG) abnormality at Screening must be documented by the investigator as not medically relevant Administration of a live, attenuated vaccine within 4 weeks before randomization or anticipation of a live attenuated vaccine will be required during the study Participant has participated in another clinical study involving an investigational product (IP) or investigational device within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an IP or investigational device during the course of this study Known hypersensitivity to any component of the investigational drug If female, participant is pregnant (exclusion confirmed with beta-human chorionic gonadotropin [hCG] test) or lactating at the time of enrollment, or has plans to become pregnant or start breastfeeding during the study Pre-existing alcohol or drug abuse Medical or mental impairments which make it impossible to obtain the patient's consent or to conduct the study A significant concomitant medical condition which the clinical investigator believes precludes the patient from enrolling in the study Absent or limited legal competence
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eva Vegh, MD, MDA
Organizational Affiliation
Treos Bio Zrt
Official's Role
Study Chair
Facility Information:
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Universiti di Pisa
City
Pisa
State/Province
PI
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35472243
Citation
Hubbard JM, Toke ER, Moretto R, Graham RP, Youssoufian H, Lorincz O, Molnar L, Csiszovszki Z, Mitchell JL, Wessling J, Toth J, Cremolini C. Safety and Activity of PolyPEPI1018 Combined with Maintenance Therapy in Metastatic Colorectal Cancer: an Open-Label, Multicenter, Phase Ib Study. Clin Cancer Res. 2022 Jul 1;28(13):2818-2829. doi: 10.1158/1078-0432.CCR-22-0112.
Results Reference
derived
Links:
URL
http://www.treosbio.com
Description
Treos Bio uses novel biomarkers to develop personalized and off-the-shelf cancer vaccines

Learn more about this trial

PolyPEPI1018 Vaccine and CDx for the Treatment of Metastatic Colorectal Cancer (OBERTO)

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