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Safety and Efficacy of Tag-7 Gene-modified Vaccine in Locally Advanced or Metastatic Malignant Melanoma or Kidney Cancer

Primary Purpose

Melanoma, Kidney Cancer

Status
Completed
Phase
Phase 1
Locations
Russian Federation
Study Type
Interventional
Intervention
Tag-7 gene modified inactivated tumor cells
Sponsored by
N.N. Petrov National Medical Research Center of Oncology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring gene modified vaccine, tag-7, immunotherapy, tumor cells-based vaccine

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed inform consent form.
  2. Patients age ≥ 18 years of age at the time of informed consent.
  3. Ability to provide and understand written informed consent prior to any study procedures.
  4. Histologically confirmed locally advanced or metastatic MM or RCC.
  5. Tumor cell culture should be obtained and successfully transfected before inclusion.
  6. No evaluable therapy with a proved survival advantage in the current patient setting.
  7. The life expectancy of > 3 months as estimated by the investigator
  8. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 -2 at Screening.

Exclusion Criteria:

  1. Patient with any out-of-range laboratory values defined as:

    • Serum creatinine > 1.5 × upper limit of normal (ULN) and/or creatinine clearance (calculated using Cockcroft-Gault formula, or measured) < 50 mL/minute
    • Total bilirubin > 2.5 × ULN, except for patients with Gilbert's syndrome who are excluded if total bilirubin > 3.0 × ULN or direct bilirubin > 1.5 × ULN
    • Alanine aminotransferase > 2.5 × ULN
    • Aspartate aminotransferase > 2.5 × ULN
    • Absolute neutrophil count < 1.5 × 109/L
    • Platelet count < 100 × 109/L
    • Hemoglobin < 80 g/L (blood transfusions permitted)
  2. History of severe hypersensitivity reactions (eg, anaphylaxis) to other biologic drugs or monoclonal antibodies
  3. Any clinically significant unstable disease
  4. Presence of symptomatic or untreated central nervous system (CNS) metastases
  5. Active infection requiring systemic antibiotic therapy. Patients requiring systemic antibiotics for infection must have completed therapy at least 1 week prior to the first dose of study drug
  6. Known history of human immunodeficiency virus infection (HIV). Testing for HIV status is not necessary unless clinically indicated
  7. Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection per institutional protocol. Testing for HBV or HCV status is not necessary unless clinically indicated or the patient has a history of HBV or HCV infection
  8. Malignant disease, other than that being treated in this study
  9. Patients receiving systemic steroid therapy or any other systemic immunosuppressive medication at any dose level, as these may interfere with the mechanism of action of study treatment. Local steroid therapies (eg, otic, ophthalmic, intra-articular or inhaled medications) are acceptable
  10. Pregnant, likely to become pregnant, or lactating women (where pregnancy is defined as the state of a female after conception and until the termination of gestation)

Sites / Locations

  • N.N. Petrov Research Institute of Oncology Chemotherapy and Innovative Technologies Department

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Melanoma Adjuvant

Melanoma Therapeutic

Renal Cell Adjuvant

Renal Cell Therapeutic

Arm Description

Patients with completely resected stage III or IV melanoma receiving GMV in the adjuvant setting

Patients with incompletely resected stage III or IV melanoma receiving GMV in the therapeutic setting

Patients with completely resected stage III or IV kidney cancer receiving GMV in the adjuvant setting

Patients with incompletely resected stage III or IV kidney cancer receiving GMV in the therapeutic setting

Outcomes

Primary Outcome Measures

Adverse events rate
CTC AE v.3 was used for safety assesment

Secondary Outcome Measures

Response rate
To assess the objective response rate (OR) RECIST v1.1 and irRC were used at the final assesment
Concentration of MICA in patient's cultures supernatants
Factor production by culture of patient's tumor cells, used for vaccine preparation
Concentration of TGF-β1 in patient's cultures supernatants
Factor production by culture of patient's tumor cells, used for vaccine preparation
Concentration of IL-10 in patient's cultures supernatants
Factor production by culture of patient's tumor cells, used for vaccine preparation
Concentration of VEGF in patient's cultures supernatants
Factor production by culture of patient's tumor cells, used for vaccine preparation
Number of T-cells in peripheral blood of patients
Absolute (10^9/L) of CD3+ cells in peripheral blood
Number of T-helper lympocytes in peripheral blood of patients
Absolute (10^9/L) concentration of CD4+ cells in peripheral blood
Number of Cytotoxic lymphocytes in peripheral blood of patients
Absolute (10^9/L) concentration of CD8+ cells in peripheral blood
Number of NK-lymphocytes in peripheral blood of patients
Absolute (10^9/L) concentration of CD16+CD56+ cells in peripheral blood
Number of CD38+ cells in peripheral blood of patients
Absolute (10^9/L) concentration of CD38+ cells in peripheral blood
Number of HLA-DR+ cells in peripheral blood of patients
Absolute (10^9/L) concentration of HLA-DR+ cells in peripheral blood
Number of CD71+ cells in peripheral blood of patients
Absolute (10^9/L) concentration of CD71+ cells in peripheral blood
Number of B-lymphocytes cells in peripheral blood of patients
Absolute (10^9/L) concentration of CD71+ cells in peripheral blood
Number of CD25+ cells in peripheral blood of patients
Absolute (10^9/L) concentration of CD25+ cells in peripheral blood
IgA level
IgA (g/L) level in serum
IgG level
IgG (g/L) level in serum
IgM level
IgM (g/L) level in serum
Spontaneous lymphocytes migration
Lymphocytes migration (U) without stimulation
Kon-A stimulated migration
Lymphocyte migration after in vitro stimulation with Kon A (% inhibition of migration)
PGA stimulated migration
Lymphocyte migration after in vitro stimulation with PGA (% inhibition of migration)
Ingestion rate of monocytes
Ingestion rate (%)
Ingestion rate of neutrophils
Ingestion rate (%)
Circulating immune complex level
Immune complexes (U) in peripheral blood

Full Information

First Posted
November 22, 2019
Last Updated
December 3, 2019
Sponsor
N.N. Petrov National Medical Research Center of Oncology
Collaborators
Institute of Gene Biology Russian Academy of Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT04180774
Brief Title
Safety and Efficacy of Tag-7 Gene-modified Vaccine in Locally Advanced or Metastatic Malignant Melanoma or Kidney Cancer
Official Title
An Open-label Study of the Safety and Efficacy of Tag-7 Gene-modified Tumor Cell-based Vaccine in Patients With Locally Advanced or Metastatic Malignant Melanoma or Renal Cell Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
January 31, 2001 (Actual)
Primary Completion Date
December 31, 2018 (Actual)
Study Completion Date
December 31, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
N.N. Petrov National Medical Research Center of Oncology
Collaborators
Institute of Gene Biology Russian Academy of Sciences

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 study was designed to assess the safety and efficacy of inactivated tumor cells genetically modified with the TAG-7 gene as immunotherapy for cancer. Patients with melanoma or kidney cancer were included since they have immune-dependent tumors. Treatment was done in the adjuvant setting after complete cytoreduction of locally advanced or metastatic disease or in the therapeutic setting in patients where complete cytoreduction was impossible.
Detailed Description
During the last decade, novel approaches for cancer treatment have been developed. Antitumor vaccines are one of the most promising approaches in tumor immunotherapy. Tumor cells possess low immunogenicity properties due to a number of the not completely understood mechanisms of resistance. One of the ways to overcome it is immune genes transfection. Genes encoding granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-2 and IL-12 have been used most commonly, both in preclinical studies and clinical trials. These cytokines are well known to participate in the systemic immune response. Several studies have shown that the professional antigen-presenting cells (APCs) of the host, rather than the vaccinating tumor cells themselves, are responsible for priming CD4+ and CD8+ T cells, both of which are required to generate systemic antitumor immunity. Recent findings indicate that the adaptive arm of immunity is governed by the innate immune mechanisms that control the co-stimulatory signaling of APCs. Recently, investigators identified a novel gene, tag7, also know as PGRP-S. The insect ortholog of the tag7/PGRP-S was shown to be involved in the innate immune response in Drosophila. In preclinical studies, tag7-modified mouse tumor cells induced a long-lasting T-cell dependent immune response in mice. The effectiveness of antitumor vaccination was demonstrated on different models of mouse tumors, particularly for melanoma cells (M3, B16, F10). Clinically important results of vaccine therapy were achieved in patients with melanoma and renal carcinoma in a number of studies. The results with this treatment are comparable to chemotherapy and immunotherapy. Investigators assume that one has to activate the innate component of immunity first, followed by the activation of the adaptive one, to make anticancer vaccines more effective. Thus, a phase I/II clinical trial has been performed to evaluate the feasibility and toxicity of treatment with autologous tumor cells modified with the tag7 gene, which has been shown to be involved in innate immunity mechanisms,

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma, Kidney Cancer
Keywords
gene modified vaccine, tag-7, immunotherapy, tumor cells-based vaccine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Studied therapy - tag-7 gene-modified vaccine (GMV) is administered intradermally at three spots (3 cm from each other) in the paravertebral area 4-6 weeks after surgery in an adjuvant or metastatic setting in patients with melanoma or kidney cancer (4 cohorts in parallel). Treatment with GMV will be administered as described until the patient experiences either unacceptable toxicity or unequivocal disease progression (PD). Biomarkers were assessed at the end of the study.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
80 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Melanoma Adjuvant
Arm Type
Experimental
Arm Description
Patients with completely resected stage III or IV melanoma receiving GMV in the adjuvant setting
Arm Title
Melanoma Therapeutic
Arm Type
Experimental
Arm Description
Patients with incompletely resected stage III or IV melanoma receiving GMV in the therapeutic setting
Arm Title
Renal Cell Adjuvant
Arm Type
Experimental
Arm Description
Patients with completely resected stage III or IV kidney cancer receiving GMV in the adjuvant setting
Arm Title
Renal Cell Therapeutic
Arm Type
Experimental
Arm Description
Patients with incompletely resected stage III or IV kidney cancer receiving GMV in the therapeutic setting
Intervention Type
Biological
Intervention Name(s)
Tag-7 gene modified inactivated tumor cells
Intervention Description
Patients received GMV once in three weeks subcutaneously in three points in the paravertebral region. One dose consisted of 10 million transfected and inactivated tumor cells. No dose reduction was allowed.
Primary Outcome Measure Information:
Title
Adverse events rate
Description
CTC AE v.3 was used for safety assesment
Time Frame
From the fist injection to 3 month after the last injection
Secondary Outcome Measure Information:
Title
Response rate
Description
To assess the objective response rate (OR) RECIST v1.1 and irRC were used at the final assesment
Time Frame
every 8 weeks until disease progression or therapy completion, then every 3 month for 2 years, every 6 month for the next 2 years and annually thereafter
Title
Concentration of MICA in patient's cultures supernatants
Description
Factor production by culture of patient's tumor cells, used for vaccine preparation
Time Frame
Samples obtained before therapy start
Title
Concentration of TGF-β1 in patient's cultures supernatants
Description
Factor production by culture of patient's tumor cells, used for vaccine preparation
Time Frame
Samples obtained before therapy start
Title
Concentration of IL-10 in patient's cultures supernatants
Description
Factor production by culture of patient's tumor cells, used for vaccine preparation
Time Frame
Samples obtained before therapy start
Title
Concentration of VEGF in patient's cultures supernatants
Description
Factor production by culture of patient's tumor cells, used for vaccine preparation
Time Frame
Samples obtained before therapy start
Title
Number of T-cells in peripheral blood of patients
Description
Absolute (10^9/L) of CD3+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of T-helper lympocytes in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD4+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of Cytotoxic lymphocytes in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD8+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of NK-lymphocytes in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD16+CD56+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of CD38+ cells in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD38+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of HLA-DR+ cells in peripheral blood of patients
Description
Absolute (10^9/L) concentration of HLA-DR+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of CD71+ cells in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD71+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of B-lymphocytes cells in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD71+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Number of CD25+ cells in peripheral blood of patients
Description
Absolute (10^9/L) concentration of CD25+ cells in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
IgA level
Description
IgA (g/L) level in serum
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
IgG level
Description
IgG (g/L) level in serum
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
IgM level
Description
IgM (g/L) level in serum
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Spontaneous lymphocytes migration
Description
Lymphocytes migration (U) without stimulation
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Kon-A stimulated migration
Description
Lymphocyte migration after in vitro stimulation with Kon A (% inhibition of migration)
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
PGA stimulated migration
Description
Lymphocyte migration after in vitro stimulation with PGA (% inhibition of migration)
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Ingestion rate of monocytes
Description
Ingestion rate (%)
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Ingestion rate of neutrophils
Description
Ingestion rate (%)
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)
Title
Circulating immune complex level
Description
Immune complexes (U) in peripheral blood
Time Frame
1-5 days before each therapy cycle during course of therapy (cycle 21 days) through therapy completion, an average of 6 cycles (18 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed inform consent form. Patients age ≥ 18 years of age at the time of informed consent. Ability to provide and understand written informed consent prior to any study procedures. Histologically confirmed locally advanced or metastatic MM or RCC. Tumor cell culture should be obtained and successfully transfected before inclusion. No evaluable therapy with a proved survival advantage in the current patient setting. The life expectancy of > 3 months as estimated by the investigator Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 -2 at Screening. Exclusion Criteria: Patient with any out-of-range laboratory values defined as: Serum creatinine > 1.5 × upper limit of normal (ULN) and/or creatinine clearance (calculated using Cockcroft-Gault formula, or measured) < 50 mL/minute Total bilirubin > 2.5 × ULN, except for patients with Gilbert's syndrome who are excluded if total bilirubin > 3.0 × ULN or direct bilirubin > 1.5 × ULN Alanine aminotransferase > 2.5 × ULN Aspartate aminotransferase > 2.5 × ULN Absolute neutrophil count < 1.5 × 109/L Platelet count < 100 × 109/L Hemoglobin < 80 g/L (blood transfusions permitted) History of severe hypersensitivity reactions (eg, anaphylaxis) to other biologic drugs or monoclonal antibodies Any clinically significant unstable disease Presence of symptomatic or untreated central nervous system (CNS) metastases Active infection requiring systemic antibiotic therapy. Patients requiring systemic antibiotics for infection must have completed therapy at least 1 week prior to the first dose of study drug Known history of human immunodeficiency virus infection (HIV). Testing for HIV status is not necessary unless clinically indicated Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection per institutional protocol. Testing for HBV or HCV status is not necessary unless clinically indicated or the patient has a history of HBV or HCV infection Malignant disease, other than that being treated in this study Patients receiving systemic steroid therapy or any other systemic immunosuppressive medication at any dose level, as these may interfere with the mechanism of action of study treatment. Local steroid therapies (eg, otic, ophthalmic, intra-articular or inhaled medications) are acceptable Pregnant, likely to become pregnant, or lactating women (where pregnancy is defined as the state of a female after conception and until the termination of gestation)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Georgy P Georgiev
Organizational Affiliation
Institute of Gene Biology of the Russian Academy of Sciences
Official's Role
Study Director
Facility Information:
Facility Name
N.N. Petrov Research Institute of Oncology Chemotherapy and Innovative Technologies Department
City
St. Petersburg
ZIP/Postal Code
197758
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Efficacy of Tag-7 Gene-modified Vaccine in Locally Advanced or Metastatic Malignant Melanoma or Kidney Cancer

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