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Safety and Tolerability Study of AlloVax(TM) in Patients With Metastatic or Recurrent Cancer of the Head and Neck (HNC)

Primary Purpose

Cancer of Head and Neck, Squamous Cell Carcinoma of the Head and Neck

Status
Completed
Phase
Phase 2
Locations
Thailand
Study Type
Interventional
Intervention
AlloVax
CRCL
AlloStim
Sponsored by
Immunovative Therapies, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer of Head and Neck focused on measuring Head and neck cancers, tumor vaccine, immunotherapy, personalized anti-cancer vaccine

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Adult males and female patients aged 18 to 70 years old, inclusive, at screening visit.
  2. Patients with histopatholologically or cytologically confirmed diagnosis of recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) that is incurable with surgery, chemotherapy or radiation. No nasopharyngeal primaries.
  3. Patients must have a tumor safely accessable for biopsy resulting in a minimum of 0.1 g of tumor sample for CRCL processing.
  4. Patients must have visible external tumors measurable with at least one lesion deemed to be safely accessible for serial biopsy.
  5. ECOG ≤2.
  6. The result of screening test were in the criteria:

    6.1 Adequate organ function including:

    A. Marrow:

    • WBC >3000/mm3
    • Platelets >100,000/mm3.
    • Absolute neutrophil count ≥ 1,500/mm³
    • Hemoglobin ≥ 10.0 g/dL (transfusion allowed)

    B. Hepatic:

    • Serum Total bilirubin < 2 x ULN mg/dL,
    • ALT (SGPT) / AST (SGOT) ≤3 x upper limit of normal (ULN).

    C. Renal:

    • Serum creatinine (SCR) <2.0 x ULN, or
    • Creatinine clearance (CCR) >30 mL/min.

    6.2 All patients have a pre-study echocardiogram without significant abnormalities or Ejection fraction >50%.

    6.3 All patients must be screened to be negative for HIV1, HIV2, HTLVI, HTLVII, HBV, HCV and RPR (syphilis).

    6.4 Women of child-bearing potential must have a negative urine or serum pregnancy test result within 72 hours prior to the start of study drug administration.

  7. All patients of child producing potential must agree to use contraception or avoidance of pregnancy measures while enrolled on study and receiving the experimental product.
  8. Patients must have the ability to understand the study, its inherent risks, side effects and potential benefits and be able to give written informed consent to participate.

Exclusion Criteria:

  1. Clinical evidence or radiological evidence of nasopharyngeal primaries.
  2. Clinical evidence or radiological evidence of brain metastasis.
  3. History of severe hypersensitivity to monoclonal antibody drugs or any contraindication to any of the study drugs.
  4. Concomitant active autoimmune disease (e.g., rheumatoid arthritis, multiple sclerosis, autoimmune thyroid disease, uveitis).
  5. Prior experimental therapy or cancer vaccine treatment (e.g., dendritic cell therapy, heat shock vaccine).
  6. Clinical requirement for systemic steroids or current immunosuppressive therapy, including: cyclosporine, antithymocyte globulin, or tacrolimus within 1 month of study entry.
  7. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, requiring parenteral antibiotics, symptomatic congestive heart failure, severe myocardial insufficiency, cardiac arrhythmia
  8. All infections must be resolved and the patient must remain a febrile for seven days prior to being placed in the study.
  9. History of blood transfusion reactions.
  10. Psychiatric or addictive disorders or other condition that, in the opinion of the investigator, would preclude study participation.
  11. Pregnant or breast feeding.

The patient will discontinuation from the participation in the study:

  1. Less than 12 doses of CRCL able to be produced
  2. Tumor sample for CRCL processing contains less than 80% tumor.

Sites / Locations

  • National Cancer Institute of Thailand

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AlloStim+CRCL

Arm Description

AlloStim priming followed by AlloStim+CRCL priming and AlloStim IV. 3 cycles

Outcomes

Primary Outcome Measures

Tumor Response
Tumor response evaluation by clinical exam including photographs of visible tumor lesions on head, neck and/or tongue (endoscopic) and by CT scan assessment for change in target lesion tumor volume (TV). TV is defined as the volume occupied by macroscopic visible target lesion in two longest cross-sectional diameters.

Secondary Outcome Measures

Anti-tumor immune response
change in tumor pathology and immune cell inflitration
Anti-Tumor Response
expression of CTLA4.

Full Information

First Posted
November 21, 2013
Last Updated
January 21, 2020
Sponsor
Immunovative Therapies, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01998542
Brief Title
Safety and Tolerability Study of AlloVax(TM) in Patients With Metastatic or Recurrent Cancer of the Head and Neck
Acronym
HNC
Official Title
Phase II Study Designed To Evaluate Safety and Tumor Debulking Mechanism of an Individualized Cancer Vaccine (AllovaxTM) in Patients With Metastatic or Recurrent Cancer of the Head and Neck.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
January 2016 (Actual)
Primary Completion Date
June 1, 2017 (Actual)
Study Completion Date
November 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Immunovative Therapies, Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and tumor debulking efficacy of personalized anti-cancer vaccine AlloVax(TM) in Subjects with confirmed recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) who cannot be treated with surgery, chemotherapy or radiation. AlloVax(TM) is a personalized anti-cancer vaccine combining Chaperone Rich Cell Lysate (CRCL) as a source of tumor antigen prepared from patient's tumor and AlloStim(TM) as an adjuvant. The combination of CRCL and AlloStim(TM) is designed to provide cross-reactivity of alloantigen specific recognition with tumor-specific recognition. All the key components necessary to develop tumor-specific immunity by creating the inflammatory environment necessary to overcome the HNC immunosuppressive environment, breaking tumor immune tolerance, and provision of specific HNC antigens for generation of a specific adaptive anti-tumor response.
Detailed Description
This is a Phase II study following up on a previous Phase I/II study in chemotherapy refractory metastatic disease with <90 day survival expectancy. In the Phase I/II study all patients progressed using RECIST criteria. However, 11/42 (26%) were alive at 1yr and 9/42 (21%) alive at 2 yr. Therefore, CT scans did not correlate with clinical presentation and "pseudo-progression" was suspected. This study was designed to select subjects with visible tumor burden on the head, neck or tongue that could be measured and photographed so as not to rely solely on CT scans to determine anti-tumor debulking efficacy. Subjects are initially primed with intradermal AlloStim(TM) injections creating systemic anti-allo-specific cellular immunity. Tumor biopsy samples taken prior to dosing were processed into personalized Chaperone Rich Cell Lysate (CRCL) vaccine containing enriched heat shock proteins which are believed to chaperone tumor-specific neoantigens . AlloStim(TM) was then injected with CRCL into primed subjects to create tumor-specific cellular immunity. Subsequently, subjects are infused with intravenous AlloStim(TM) to cause extravasation of memory cells to the tumor lesions. The protocol including intradermal AlloStim(TM) day 0, 3, 7, 10. Intradermal AlloStim(TM)+CRCL on days 14, 17, 21, 24. Intravenous AlloStim(TM) day 28. This experimental treatment schedule will continue for 3 cycles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer of Head and Neck, Squamous Cell Carcinoma of the Head and Neck
Keywords
Head and neck cancers, tumor vaccine, immunotherapy, personalized anti-cancer vaccine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
12 subjects with externally measurable disease
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AlloStim+CRCL
Arm Type
Experimental
Arm Description
AlloStim priming followed by AlloStim+CRCL priming and AlloStim IV. 3 cycles
Intervention Type
Biological
Intervention Name(s)
AlloVax
Other Intervention Name(s)
CRCL and AlloStim
Intervention Description
Personalized anti-cancer vaccine with AlloStim(TM) and CRCL
Intervention Type
Biological
Intervention Name(s)
CRCL
Other Intervention Name(s)
Chaperone Rich Cell Lysate, CRCL injection
Intervention Description
autologous tumor-derived chaperone protein mixture
Intervention Type
Biological
Intervention Name(s)
AlloStim
Other Intervention Name(s)
AlloStim ID, AlloStim IV
Intervention Description
AlloStim (ID) injection AlloStim (IV) infusion
Primary Outcome Measure Information:
Title
Tumor Response
Description
Tumor response evaluation by clinical exam including photographs of visible tumor lesions on head, neck and/or tongue (endoscopic) and by CT scan assessment for change in target lesion tumor volume (TV). TV is defined as the volume occupied by macroscopic visible target lesion in two longest cross-sectional diameters.
Time Frame
baseline, every 28 days for 5 months (CT scan confirmation at baseline and day 90 and day 150)
Secondary Outcome Measure Information:
Title
Anti-tumor immune response
Description
change in tumor pathology and immune cell inflitration
Time Frame
baseline, 30 days after the last dose
Title
Anti-Tumor Response
Description
expression of CTLA4.
Time Frame
baseline and 30 days after the last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult males and female patients aged 18 to 70 years old, inclusive, at screening visit. Patients with histopatholologically or cytologically confirmed diagnosis of recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) that is incurable with surgery, chemotherapy or radiation. No nasopharyngeal primaries. Patients must have a tumor safely accessable for biopsy resulting in a minimum of 0.1 g of tumor sample for CRCL processing. Patients must have visible external tumors measurable with at least one lesion deemed to be safely accessible for serial biopsy. ECOG ≤2. The result of screening test were in the criteria: 6.1 Adequate organ function including: A. Marrow: WBC >3000/mm3 Platelets >100,000/mm3. Absolute neutrophil count ≥ 1,500/mm³ Hemoglobin ≥ 10.0 g/dL (transfusion allowed) B. Hepatic: Serum Total bilirubin < 2 x ULN mg/dL, ALT (SGPT) / AST (SGOT) ≤3 x upper limit of normal (ULN). C. Renal: Serum creatinine (SCR) <2.0 x ULN, or Creatinine clearance (CCR) >30 mL/min. 6.2 All patients have a pre-study echocardiogram without significant abnormalities or Ejection fraction >50%. 6.3 All patients must be screened to be negative for HIV1, HIV2, HTLVI, HTLVII, HBV, HCV and RPR (syphilis). 6.4 Women of child-bearing potential must have a negative urine or serum pregnancy test result within 72 hours prior to the start of study drug administration. All patients of child producing potential must agree to use contraception or avoidance of pregnancy measures while enrolled on study and receiving the experimental product. Patients must have the ability to understand the study, its inherent risks, side effects and potential benefits and be able to give written informed consent to participate. Exclusion Criteria: Clinical evidence or radiological evidence of nasopharyngeal primaries. Clinical evidence or radiological evidence of brain metastasis. History of severe hypersensitivity to monoclonal antibody drugs or any contraindication to any of the study drugs. Concomitant active autoimmune disease (e.g., rheumatoid arthritis, multiple sclerosis, autoimmune thyroid disease, uveitis). Prior experimental therapy or cancer vaccine treatment (e.g., dendritic cell therapy, heat shock vaccine). Clinical requirement for systemic steroids or current immunosuppressive therapy, including: cyclosporine, antithymocyte globulin, or tacrolimus within 1 month of study entry. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, requiring parenteral antibiotics, symptomatic congestive heart failure, severe myocardial insufficiency, cardiac arrhythmia All infections must be resolved and the patient must remain a febrile for seven days prior to being placed in the study. History of blood transfusion reactions. Psychiatric or addictive disorders or other condition that, in the opinion of the investigator, would preclude study participation. Pregnant or breast feeding. The patient will discontinuation from the participation in the study: Less than 12 doses of CRCL able to be produced Tumor sample for CRCL processing contains less than 80% tumor.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Har-Noy, Dr.
Organizational Affiliation
Immunovative Therapies, Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
National Cancer Institute of Thailand
City
Bangkok
Country
Thailand

12. IPD Sharing Statement

Citations:
PubMed Identifier
23786302
Citation
Epple LM, Bemis LT, Cavanaugh RP, Skope A, Mayer-Sonnenfeld T, Frank C, Olver CS, Lencioni AM, Dusto NL, Tal A, Har-Noy M, Lillehei KO, Katsanis E, Graner MW. Prolonged remission of advanced bronchoalveolar adenocarcinoma in a dog treated with autologous, tumour-derived chaperone-rich cell lysate (CRCL) vaccine. Int J Hyperthermia. 2013 Aug;29(5):390-8. doi: 10.3109/02656736.2013.800997. Epub 2013 Jun 20.
Results Reference
result
PubMed Identifier
23734882
Citation
Mayer-Sonnenfeld T, Har-Noy M, Lillehei KO, Graner MW. Proteomic analyses of different human tumour-derived chaperone-rich cell lysate (CRCL) anti-cancer vaccines reveal antigen content and strong similarities amongst the vaccines along with a basis for CRCL's unique structure: CRCL vaccine proteome leads to unique structure. Int J Hyperthermia. 2013 Sep;29(6):520-7. doi: 10.3109/02656736.2013.796529. Epub 2013 Jun 4.
Results Reference
result
PubMed Identifier
22075702
Citation
LaCasse CJ, Janikashvili N, Larmonier CB, Alizadeh D, Hanke N, Kartchner J, Situ E, Centuori S, Har-Noy M, Bonnotte B, Katsanis E, Larmonier N. Th-1 lymphocytes induce dendritic cell tumor killing activity by an IFN-gamma-dependent mechanism. J Immunol. 2011 Dec 15;187(12):6310-7. doi: 10.4049/jimmunol.1101812. Epub 2011 Nov 9.
Results Reference
result
PubMed Identifier
21123824
Citation
Janikashvili N, LaCasse CJ, Larmonier C, Trad M, Herrell A, Bustamante S, Bonnotte B, Har-Noy M, Larmonier N, Katsanis E. Allogeneic effector/memory Th-1 cells impair FoxP3+ regulatory T lymphocytes and synergize with chaperone-rich cell lysate vaccine to treat leukemia. Blood. 2011 Feb 3;117(5):1555-64. doi: 10.1182/blood-2010-06-288621. Epub 2010 Dec 1.
Results Reference
result
PubMed Identifier
18834631
Citation
Har-Noy M, Zeira M, Weiss L, Fingerut E, Or R, Slavin S. Allogeneic CD3/CD28 cross-linked Th1 memory cells provide potent adjuvant effects for active immunotherapy of leukemia/lymphoma. Leuk Res. 2009 Apr;33(4):525-38. doi: 10.1016/j.leukres.2008.08.017. Epub 2008 Oct 1.
Results Reference
result
PubMed Identifier
18054441
Citation
Har-Noy M, Slavin S. The anti-tumor effect of allogeneic bone marrow/stem cell transplant without graft vs. host disease toxicity and without a matched donor requirement? Med Hypotheses. 2008;70(6):1186-92. doi: 10.1016/j.mehy.2007.10.008. Epub 2007 Dec 3.
Results Reference
result
Links:
URL
http://www.nlm.nih.gov/medlineplus/cancer.html
Description
Cancer
URL
http://www.nlm.nih.gov/medlineplus/headandneckcancer.html
Description
Head and Neck Cancer

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Safety and Tolerability Study of AlloVax(TM) in Patients With Metastatic or Recurrent Cancer of the Head and Neck

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