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Safety and Efficacy Study of TVGV-1 Vaccine to Treat HPV Induced Cervical HSIL

Primary Purpose

Human Papillomavirus, High-Grade Squamous Intraepithelial Lesions

Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
TVGV-1
GPI-0100
Placebo
Sponsored by
THEVAX Genetics Vaccine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Human Papillomavirus focused on measuring human papillomavirus, Cervical Intraepithelial Neoplasia, Cold Knife Conization, hysterectomy, Loop Electrosurgical Excision Procedure, LEEP, HSIL, High-Grade Squamous Intraepithelial Lesion

Eligibility Criteria

18 Years - 55 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Female age 18 to 55 years
  2. Written informed consent in accordance with institutional guidelines
  3. Negative pregnancy test (urine and blood tests)
  4. Women of child bearing potential must agree to use contraception through one menstrual cycle post end of study or if early withdrawal, through what would have been visit 11. Methods include intrauterine device or double barrier method, hormonal contraceptive in combination with a double barrier method.
  5. Patients who have ONLY HPV 16 OR HPV 16 AND 18 and no other High-Risk HPV by Cobas test will be included.
  6. Histologically confirmed, positive HSIL of CIN2+ or higher (only CIN2+/3 subjects will be selected) cervical biopsy, confirmed by external (independent) pathologist panel within the 12 weeks prior to enrollment. If the standard care biopsy is not available for evaluation by the independent pathologist, a fresh biopsy and endocervical curettage will be required. The extent of colposcopic HSIL disease should not involve more than two quadrants of the cervix. Biopsies should be taken from each affected quadrant
  7. Adequate visualization of entire cervix, cervical lesion(s) and squamous-columnar junction
  8. Normal electrocardiogram (ECG), laboratory values (chemistry, complete blood count) and urinalysis, as judged Grade 0-1 by per National Cancer Institute Common Toxicity Criteria (NCI-CTC)
  9. Agrees to Loop Electrosurgical Excision Procedure (LEEP), Cold Knife Conization (CKC) or Hysterectomy being performed at the end of study according to the standard-of-care

Exclusion Criteria:

  1. History of cancer (excluding basal cell carcinoma of the skin) including cervical cancer
  2. Eastern Cooperative Oncology Group (ECOG) performance status >2 (See Appendix G)
  3. Administration of any blood product within 3 months of enrollment
  4. Active infection requiring antimicrobial treatment that would interfere with interpretation of adverse events, cutaneous reactions or efficacy. Treatment of minor concurrent infections should be limited to less than 10 days.
  5. Administration of any vaccine within 8 weeks of enrollment and within 4 weeks for flu vaccine.
  6. Participation in any study with an investigational compound or device within 30 days prior to signing informed consent
  7. Any hematologic disorder involving platelets or clotting abnormalities or any condition requiring treatment with transfusions, anticoagulants except platelet inhibitors (NSAIDs as needed for pain are permitted)
  8. Active drug or alcohol use or dependence that, in the opinion of the Site Investigator, would interfere with adherence to study protocol
  9. Skin conditions that require consistent use of topical corticosteroids or other local or systemic therapy that may interfere with interpretation or description of skin-related adverse events linked to vaccination
  10. The standard criteria for prospective clinical trials of medications developed by Drug-Induced Liver Injury Network (established by The National Institute of Diabetes and Digestive and Kidney Diseases) will be used to assess the laboratory test abnormalities. Normal range for these labs will typically be 5 - 40 IU/L for AST; 7 - 56 IU/L for ALT; 0.2 - 1.2 mg/dL for bilirubin. Subjects will be excluded if values are x 2-x 2.5 the upper limit
  11. Evidence of hematopoietic, cardiovascular, hepatic, renal, neurologic, psychiatric, dermatologic, immune disorder, or other disease that may interfere with assessment of safety or efficacy of vaccine activity as indicated in study objectives
  12. Any known allergic reaction to vaccine components
  13. Any other medical condition(s) that, in the judgment of the Site Investigator, might interfere with the study or require treatment that might interfere with the study
  14. Family member of the investigation study staff
  15. Pregnant or breast-feeding
  16. Inability to provide informed consent
  17. A subject with a history or expectation of noncompliance with medications or treatment protocol
  18. Receipt of (e.g. Gardasil® or Cervarix®) HPV preventative vaccines within 8 years of study enrollment
  19. Excessive use of acetaminophen or other potentially hepatotoxic drugs

Sites / Locations

  • Visions Clinical Research - Tucson
  • Red Rocks OBGYN
  • Progressive Medical Research
  • Comprehensive Clinical Trials, LLC
  • Grady Memorial Hospital
  • ProHEALTH Care Associates LLP
  • Unified Women's Clinical Research
  • Unified Women's Clinical Research
  • Complete Healthcare for Women
  • Penn Fertility Care/Reproductive Research Unit Univ of Pennsylvania
  • Insearch-Tidewater Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm Type

Experimental

Active Comparator

Placebo Comparator

Experimental

Active Comparator

Placebo Comparator

Experimental

Active Comparator

Placebo Comparator

Arm Label

TVGV-1 (cohort 1)

GPI-0100 (cohort 1)

Placebo (cohort 1)

TVGV-1 (cohort 2)

GPI-0100 (cohort 2)

Placebo (cohort 2)

TVGV-1 (cohort 3)

GPI-0100 (cohort 3)

Placebo (cohort 3)

Arm Description

Antigen + Adjuvant - 0.6 mg lyophilized PEK fusion protein + 0.6 ml* GPI- 0100 (1:1 ratio)

Adjuvant Alone - 0 mg lyophilized PEK fusion protein. 0.6 mg lyophilized placebo cake + 0.6 ml* GPI- 0100 (1:1 ratio)

Placebo- 0 mg lyophilized PEK fusion protein. 0.6 mg lyophilized placebo cake + 0.6 ml placebo-diluent (1:1 ratio)

Antigen + Adjuvant - 0.9 mg lyophilized PEK fusion protein + 0.9 ml* GPI- 0100 (1:1 ratio)

Adjuvant Alone - 0 mg lyophilized PEK fusion protein. 0.9 mg lyophilized placebo cake + 0.9 ml* GPI- 0100 (1:1 ratio)

Placebo - 0 mg lyophilized PEK fusion protein. 0.9 mg lyophilized placebo cake + 0.9 ml placebo diluent (1:1 ratio)

Antigen + Adjuvant - 1.2 mg lyophilized PEK fusion protein + 1.2 ml* GPI- 0100 (1:1 ratio)

Adjuvant Alone - 0 mg lyophilized PEK fusion protein + 1.2 mg lyophilized placebo cake 1.2 ml* GPI- 0100 (1:1 ratio)

Placebo - 0 mg lyophilized PEK fusion protein. 1.2 mg lyophilized placebo cake + 1.2 ml placebo-diluent (1:1 ratio)

Outcomes

Primary Outcome Measures

Absence of histologic HSIL (CIN2/3) as assessed by biopsy at last study Visit 11, Day 270.
The primary analysis for efficacy will be a comparison between subjects treated with and without the PEK fusion protein with respect to the percentage who present regression of HSIL at Day 270. Separate comparisons within each cohort will be performed using Fisher's exact test (or an appropriate analogue). No adjustment for multiple comparisons will be employed in these analyses. Additionally, a corresponding comparison across all study subjects combined will be performed, based on Cochran-Matel-Haenszel test stratified for cohort.
Assessment of cutaneous toxicities (i.e., size, induration and time to resolution of skin reactions to vaccine).
Summaries of the data pertaining to the primary safety outcome of skin toxicity will be provided. Summaries will be provided for the within-cohort subsets of subjects treated with the active, and with the adjuvant alone; and the combined subsets across all three cohorts of subject treated with the active, with the adjuvant alone, and with the placebo. Serious adverse events will be described in narrative with the participant's demographics, treatment date, event, onset date, relationship to the study treatment and the descriptions of the actions and outcomes during this event. Any deaths occurring in the study will be summarized in narrative with the demographics, treatment duration, cause of death, date of death and additional information surrounding that serious adverse event.

Secondary Outcome Measures

Absence of HPV16 in cervical cytological specimen. Absence of cervical dysplasia 6 months and 8 months after last dose of TVGV-1.
The primary analysis for efficacy will be a comparison between subjects treated with and without the PEK fusion protein with respect to the percentage who present regression of HSIL at Day 270. Separate comparisons within each cohort will be performed using Fisher's exact test (or an appropriate analogue). No adjustment for multiple comparisons will be employed in these analyses. Additionally, a corresponding comparison across all study subjects combined will be performed, based on Cochran-Matel-Haenszel test stratified for cohort.
Assessment of clinical or laboratory findings and other safety variables.
Appropriate laboratory data will be transformed prior to analysis as defined in the Statistical Analysis Plan (SAP). Summaries will be presented for each evaluation time point, as well as for changes from baseline. Changes from baseline will also be presented using shift tables for selected laboratory parameters.

Full Information

First Posted
October 9, 2015
Last Updated
October 24, 2017
Sponsor
THEVAX Genetics Vaccine
Collaborators
Clinical Research Management, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02576561
Brief Title
Safety and Efficacy Study of TVGV-1 Vaccine to Treat HPV Induced Cervical HSIL
Official Title
Phase 2a Double-Blind, Randomized, Parallel Group, Dose-Ranging Study to Assess the Safety and Efficacy of Three Doses of TVGV-1 Vaccine Compared to Its Adjuvant, GPI-0100, in Subjects With Histologically Confirmed HPV Induced Cervical HSIL
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Unknown status
Study Start Date
November 2015 (undefined)
Primary Completion Date
May 2018 (Anticipated)
Study Completion Date
September 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
THEVAX Genetics Vaccine
Collaborators
Clinical Research Management, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research study is to test the safety and effectiveness of the investigational study vaccine, called TVGV-1. The study will test the vaccine in women with high grade HPV cervical infection.
Detailed Description
The purpose of the Phase 2a Study VAX 02-01 is to assess the safety and activity of TVGV-1 vaccine construct in achieving the absence of histologic HSIL (CIN2/3) (regression to LSIL or less) as assessed by biopsy at last study Visit 11, Day 270. The objective of the TVGV-1 program is to develop a non-surgical alternative that is reliable, safe, and would avoid potential surgical risks such as preterm birth, perinatal mortality, risk of infertility, incontinence and disfigurement, as well as reduced cost and inconvenience for an otherwise economically productive young subject population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Human Papillomavirus, High-Grade Squamous Intraepithelial Lesions
Keywords
human papillomavirus, Cervical Intraepithelial Neoplasia, Cold Knife Conization, hysterectomy, Loop Electrosurgical Excision Procedure, LEEP, HSIL, High-Grade Squamous Intraepithelial Lesion

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TVGV-1 (cohort 1)
Arm Type
Experimental
Arm Description
Antigen + Adjuvant - 0.6 mg lyophilized PEK fusion protein + 0.6 ml* GPI- 0100 (1:1 ratio)
Arm Title
GPI-0100 (cohort 1)
Arm Type
Active Comparator
Arm Description
Adjuvant Alone - 0 mg lyophilized PEK fusion protein. 0.6 mg lyophilized placebo cake + 0.6 ml* GPI- 0100 (1:1 ratio)
Arm Title
Placebo (cohort 1)
Arm Type
Placebo Comparator
Arm Description
Placebo- 0 mg lyophilized PEK fusion protein. 0.6 mg lyophilized placebo cake + 0.6 ml placebo-diluent (1:1 ratio)
Arm Title
TVGV-1 (cohort 2)
Arm Type
Experimental
Arm Description
Antigen + Adjuvant - 0.9 mg lyophilized PEK fusion protein + 0.9 ml* GPI- 0100 (1:1 ratio)
Arm Title
GPI-0100 (cohort 2)
Arm Type
Active Comparator
Arm Description
Adjuvant Alone - 0 mg lyophilized PEK fusion protein. 0.9 mg lyophilized placebo cake + 0.9 ml* GPI- 0100 (1:1 ratio)
Arm Title
Placebo (cohort 2)
Arm Type
Placebo Comparator
Arm Description
Placebo - 0 mg lyophilized PEK fusion protein. 0.9 mg lyophilized placebo cake + 0.9 ml placebo diluent (1:1 ratio)
Arm Title
TVGV-1 (cohort 3)
Arm Type
Experimental
Arm Description
Antigen + Adjuvant - 1.2 mg lyophilized PEK fusion protein + 1.2 ml* GPI- 0100 (1:1 ratio)
Arm Title
GPI-0100 (cohort 3)
Arm Type
Active Comparator
Arm Description
Adjuvant Alone - 0 mg lyophilized PEK fusion protein + 1.2 mg lyophilized placebo cake 1.2 ml* GPI- 0100 (1:1 ratio)
Arm Title
Placebo (cohort 3)
Arm Type
Placebo Comparator
Arm Description
Placebo - 0 mg lyophilized PEK fusion protein. 1.2 mg lyophilized placebo cake + 1.2 ml placebo-diluent (1:1 ratio)
Intervention Type
Biological
Intervention Name(s)
TVGV-1
Other Intervention Name(s)
lyophilized PEK fusion protein, GPI-0100, Antigen, Adjuvant
Intervention Description
Antigen + Adjuvant
Intervention Type
Biological
Intervention Name(s)
GPI-0100
Other Intervention Name(s)
Adjuvant
Intervention Description
Adjuvant Alone
Intervention Type
Biological
Intervention Name(s)
Placebo
Other Intervention Name(s)
lyophilized placebo cak, placebo diluent, sterile water
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Absence of histologic HSIL (CIN2/3) as assessed by biopsy at last study Visit 11, Day 270.
Description
The primary analysis for efficacy will be a comparison between subjects treated with and without the PEK fusion protein with respect to the percentage who present regression of HSIL at Day 270. Separate comparisons within each cohort will be performed using Fisher's exact test (or an appropriate analogue). No adjustment for multiple comparisons will be employed in these analyses. Additionally, a corresponding comparison across all study subjects combined will be performed, based on Cochran-Matel-Haenszel test stratified for cohort.
Time Frame
DAY 270
Title
Assessment of cutaneous toxicities (i.e., size, induration and time to resolution of skin reactions to vaccine).
Description
Summaries of the data pertaining to the primary safety outcome of skin toxicity will be provided. Summaries will be provided for the within-cohort subsets of subjects treated with the active, and with the adjuvant alone; and the combined subsets across all three cohorts of subject treated with the active, with the adjuvant alone, and with the placebo. Serious adverse events will be described in narrative with the participant's demographics, treatment date, event, onset date, relationship to the study treatment and the descriptions of the actions and outcomes during this event. Any deaths occurring in the study will be summarized in narrative with the demographics, treatment duration, cause of death, date of death and additional information surrounding that serious adverse event.
Time Frame
DAY 270
Secondary Outcome Measure Information:
Title
Absence of HPV16 in cervical cytological specimen. Absence of cervical dysplasia 6 months and 8 months after last dose of TVGV-1.
Description
The primary analysis for efficacy will be a comparison between subjects treated with and without the PEK fusion protein with respect to the percentage who present regression of HSIL at Day 270. Separate comparisons within each cohort will be performed using Fisher's exact test (or an appropriate analogue). No adjustment for multiple comparisons will be employed in these analyses. Additionally, a corresponding comparison across all study subjects combined will be performed, based on Cochran-Matel-Haenszel test stratified for cohort.
Time Frame
DAY 270
Title
Assessment of clinical or laboratory findings and other safety variables.
Description
Appropriate laboratory data will be transformed prior to analysis as defined in the Statistical Analysis Plan (SAP). Summaries will be presented for each evaluation time point, as well as for changes from baseline. Changes from baseline will also be presented using shift tables for selected laboratory parameters.
Time Frame
DAy 270

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female age 18 to 55 years Written informed consent in accordance with institutional guidelines Negative pregnancy test (urine and blood tests) Women of child bearing potential must agree to use contraception through one menstrual cycle post end of study or if early withdrawal, through what would have been visit 11. Methods include intrauterine device or double barrier method, hormonal contraceptive in combination with a double barrier method. Patients who have ONLY HPV 16 OR HPV 16 AND 18 and no other High-Risk HPV by Cobas test will be included. Histologically confirmed, positive HSIL of CIN2+ or higher (only CIN2+/3 subjects will be selected) cervical biopsy, confirmed by external (independent) pathologist panel within the 12 weeks prior to enrollment. If the standard care biopsy is not available for evaluation by the independent pathologist, a fresh biopsy and endocervical curettage will be required. The extent of colposcopic HSIL disease should not involve more than two quadrants of the cervix. Biopsies should be taken from each affected quadrant Adequate visualization of entire cervix, cervical lesion(s) and squamous-columnar junction Normal electrocardiogram (ECG), laboratory values (chemistry, complete blood count) and urinalysis, as judged Grade 0-1 by per National Cancer Institute Common Toxicity Criteria (NCI-CTC) Agrees to Loop Electrosurgical Excision Procedure (LEEP), Cold Knife Conization (CKC) or Hysterectomy being performed at the end of study according to the standard-of-care Exclusion Criteria: History of cancer (excluding basal cell carcinoma of the skin) including cervical cancer Eastern Cooperative Oncology Group (ECOG) performance status >2 (See Appendix G) Administration of any blood product within 3 months of enrollment Active infection requiring antimicrobial treatment that would interfere with interpretation of adverse events, cutaneous reactions or efficacy. Treatment of minor concurrent infections should be limited to less than 10 days. Administration of any vaccine within 8 weeks of enrollment and within 4 weeks for flu vaccine. Participation in any study with an investigational compound or device within 30 days prior to signing informed consent Any hematologic disorder involving platelets or clotting abnormalities or any condition requiring treatment with transfusions, anticoagulants except platelet inhibitors (NSAIDs as needed for pain are permitted) Active drug or alcohol use or dependence that, in the opinion of the Site Investigator, would interfere with adherence to study protocol Skin conditions that require consistent use of topical corticosteroids or other local or systemic therapy that may interfere with interpretation or description of skin-related adverse events linked to vaccination The standard criteria for prospective clinical trials of medications developed by Drug-Induced Liver Injury Network (established by The National Institute of Diabetes and Digestive and Kidney Diseases) will be used to assess the laboratory test abnormalities. Normal range for these labs will typically be 5 - 40 IU/L for AST; 7 - 56 IU/L for ALT; 0.2 - 1.2 mg/dL for bilirubin. Subjects will be excluded if values are x 2-x 2.5 the upper limit Evidence of hematopoietic, cardiovascular, hepatic, renal, neurologic, psychiatric, dermatologic, immune disorder, or other disease that may interfere with assessment of safety or efficacy of vaccine activity as indicated in study objectives Any known allergic reaction to vaccine components Any other medical condition(s) that, in the judgment of the Site Investigator, might interfere with the study or require treatment that might interfere with the study Family member of the investigation study staff Pregnant or breast-feeding Inability to provide informed consent A subject with a history or expectation of noncompliance with medications or treatment protocol Receipt of (e.g. Gardasil® or Cervarix®) HPV preventative vaccines within 8 years of study enrollment Excessive use of acetaminophen or other potentially hepatotoxic drugs
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frank L Douglas, PhD, MD
Organizational Affiliation
THEVAX Genetics Vaccine
Official's Role
Study Director
Facility Information:
Facility Name
Visions Clinical Research - Tucson
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
Red Rocks OBGYN
City
Lakewood
State/Province
Colorado
ZIP/Postal Code
80228
Country
United States
Facility Name
Progressive Medical Research
City
Port Orange
State/Province
Florida
ZIP/Postal Code
32127
Country
United States
Facility Name
Comprehensive Clinical Trials, LLC
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33409
Country
United States
Facility Name
Grady Memorial Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30303
Country
United States
Facility Name
ProHEALTH Care Associates LLP
City
Port Jefferson
State/Province
New York
ZIP/Postal Code
11777
Country
United States
Facility Name
Unified Women's Clinical Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Unified Women's Clinical Research
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Complete Healthcare for Women
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43231
Country
United States
Facility Name
Penn Fertility Care/Reproductive Research Unit Univ of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Insearch-Tidewater Clinical Research
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23502
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy Study of TVGV-1 Vaccine to Treat HPV Induced Cervical HSIL

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