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Safety Study of Recombinant Listeria Monocytogenes(Lm)Based Vaccine Virus Vaccine to Treat Oropharyngeal Cancer (REALISTIC:)

Primary Purpose

HPV-16 +ve Oropharyngeal Carcinoma

Status
Terminated
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
ADXS11-001
Sponsored by
University of Liverpool
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HPV-16 +ve Oropharyngeal Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed HPV-16 +ve, p16 +ve OPSCC.
  • Patients in remission from disease, i.e. complete response (CR) or unconfirmed complete response (CRu) in the case of non-surgical treatment or complete macroscopic resection of tumour and associated cervical lymph nodes in patients undergoing surgery.
  • Completion of standard therapy for malignancy at least 6 weeks before trial entry.
  • A positive result following anergy testing.
  • Written informed consent and the ability of the patient to co-operate with treatment and follow up must be ensured and documented.
  • Age greater than 18 years.
  • World Health Organisation (WHO) performance status of 0 or 1.
  • Life expectancy of at least 12 months.
  • Haematological and biochemical indices (these measurements must be performed within 8 days prior to the patient going on study):
  • Haematological:

Haemoglobin (Hb) > 10.0 g/dl Neutrophils ≥ 1.5 x 10e9/L Platelets (Plts) ≥ 100 x 10e9/L

  • Baseline liver function tests:

Serum bilirubin ≤ 1.5 x upper normal limit Serum alkaline phosphatase, alanine amino-transferase (ALT) and/or aspartate amino-transferase (AST) < 1.5 x ULN.

  • Baseline renal function test:

Calculated creatinine clearance > 50ml/min (uncorrected value) or isotope clearance measurement > 50ml/min.

  • Female patients of child-bearing potential are eligible, provided they have a negative serum pregnancy test prior to enrolment and agree to use appropriate medically approved contraception during the study up to six months after the last vaccination Male patients must agree to use appropriate medically approved contraception during the study up to six months after the last vaccination.

Exclusion Criteria:

  • Receiving, or having received, chemotherapy or radiotherapy within 6 weeks of trial entry.
  • Having undergone surgery +/- PORT within 6 weeks of trial therapy
  • A negative result following anergy testing.
  • Known chronic active infection with Hepatitis B, Hepatitis C or Human Immunodeficiency Virus (HIV).
  • Current active autoimmune disease.
  • Current active skin diseases requiring therapy (psoriasis, eczema etc).
  • Ongoing active infection.
  • History of anaphylaxis or severe allergy to vaccination.
  • Previous myeloablative therapy followed by an autologous or allogeneic haematopoietic stem cell transplant.
  • Patients who have had a splenectomy or splenic irradiation, or with known splenic dysfunction.
  • Receiving current immunosuppressive medication, including corticosteroids within 4 weeks of the first dose.
  • Pregnant and lactating women.
  • Ongoing toxic manifestations of previous treatment.
  • Major thoracic and/or abdominal surgery in the preceding four weeks from which the patient has not yet recovered.
  • Patients with any other condition which in the Investigator"s opinion would not make the patient a good candidate for the clinical trial.
  • Concurrent congestive heart failure or prior history of class III/ IV cardiac disease

Sites / Locations

  • Velindre NHS Trust
  • The Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust
  • Aintree University NHS Foundation Trust
  • The Royal Marsden NHS Foundation Trust

Outcomes

Primary Outcome Measures

Safety
Occurrence of drug-related grade 3 or 4 systemic or local adverse events (defined using the NCI Common Criteria Adverse Events (CTCAE) Version 4.03

Secondary Outcome Measures

Translational
Demonstration by ELISPOT assay of the frequency of IFN-γ secreting lymphocytes recognising MHC class I and II-restricted epitopes within HPV-16 E& protein in peripheral blood at sequential time-points before, during and up to ten months after vaccination course. This protocol has been used by our group to demonstrate vaccine induced T cell responses in a previous HPV vaccine trial.

Full Information

First Posted
May 11, 2012
Last Updated
May 17, 2016
Sponsor
University of Liverpool
Collaborators
Liverpool University Hospitals NHS Foundation Trust, Cancer Research UK, Advaxis, Inc., Recipharm AB
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1. Study Identification

Unique Protocol Identification Number
NCT01598792
Brief Title
Safety Study of Recombinant Listeria Monocytogenes(Lm)Based Vaccine Virus Vaccine to Treat Oropharyngeal Cancer
Acronym
REALISTIC:
Official Title
REALISTIC: A Phase I, Dose Escalation Trial Of Recombinant Listeria Monocytogenes (Lm)-Based Vaccine Encoding Human Papilloma Virus Genotype 16 Target Antigens (ADXS11-001) In Patients With HPV-16 +ve Oropharyngeal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2016
Overall Recruitment Status
Terminated
Why Stopped
Patient 2 suffered DLT post-vaccination. The vaccine manufacturers withdrew support for the study on commercial grounds.
Study Start Date
February 2012 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Liverpool
Collaborators
Liverpool University Hospitals NHS Foundation Trust, Cancer Research UK, Advaxis, Inc., Recipharm AB

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
It is the investigators intention to investigate whether a specially designed vaccine, based on a genetically modified strain of the bacterium Listeria monocytogenes and called ADXS11-001 is safe to use and is able to boost the immune system of patients presenting with Human Papilloma Virus (HPV) associated oropharyngeal cancer (OPSCC). It is hoped that the vaccine will boost the immune system so that immune cells with cell killing properties are able to attack any cancer cells remaining after the patients have been treated. However, the vaccine is so novel the investigators are not sure whether it is able to do this and before they can answer that question in a larger group of patients they need to make sure that the vaccine is safe to use and has some effect on the immune system in the patients for whom they intend its ultimate use. In a previous study, patients with incurable cervix cancer which is caused by the same virus, were vaccinated with ADXS11-001. Although all patients vaccinated experienced flu-like symptoms, patients tolerated the vaccine well with no patient suffering long term adverse effects of vaccination. However, because the patients and cancer type was so different in this earlier study, the investigators need to test whether ADXS11-001 is also safe in patients with HPV associated OPSCC. That said, the earlier study guided the dosing schedule for the current study and patients entering the REALISTIC trial will receive lower doses than those administered to patients in the earlier cervix cancer study. It is hoped that by doing this, patients will experience fewer side effects of vaccination without reducing the chances of stimulating the immune system.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HPV-16 +ve Oropharyngeal Carcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
ADXS11-001
Intervention Description
Escalating doses will be administered: 3.3 x 10e8,1 x 10e9 and 3.3 x 10e9 cfu to patient in 3 different groups. Dose-escalation will only occur if fewer than two patients in each group of six experience Dose Limiting Toxicity (DLT).
Primary Outcome Measure Information:
Title
Safety
Description
Occurrence of drug-related grade 3 or 4 systemic or local adverse events (defined using the NCI Common Criteria Adverse Events (CTCAE) Version 4.03
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Translational
Description
Demonstration by ELISPOT assay of the frequency of IFN-γ secreting lymphocytes recognising MHC class I and II-restricted epitopes within HPV-16 E& protein in peripheral blood at sequential time-points before, during and up to ten months after vaccination course. This protocol has been used by our group to demonstrate vaccine induced T cell responses in a previous HPV vaccine trial.
Time Frame
24 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed HPV-16 +ve, p16 +ve OPSCC. Patients in remission from disease, i.e. complete response (CR) or unconfirmed complete response (CRu) in the case of non-surgical treatment or complete macroscopic resection of tumour and associated cervical lymph nodes in patients undergoing surgery. Completion of standard therapy for malignancy at least 6 weeks before trial entry. A positive result following anergy testing. Written informed consent and the ability of the patient to co-operate with treatment and follow up must be ensured and documented. Age greater than 18 years. World Health Organisation (WHO) performance status of 0 or 1. Life expectancy of at least 12 months. Haematological and biochemical indices (these measurements must be performed within 8 days prior to the patient going on study): Haematological: Haemoglobin (Hb) > 10.0 g/dl Neutrophils ≥ 1.5 x 10e9/L Platelets (Plts) ≥ 100 x 10e9/L Baseline liver function tests: Serum bilirubin ≤ 1.5 x upper normal limit Serum alkaline phosphatase, alanine amino-transferase (ALT) and/or aspartate amino-transferase (AST) < 1.5 x ULN. Baseline renal function test: Calculated creatinine clearance > 50ml/min (uncorrected value) or isotope clearance measurement > 50ml/min. Female patients of child-bearing potential are eligible, provided they have a negative serum pregnancy test prior to enrolment and agree to use appropriate medically approved contraception during the study up to six months after the last vaccination Male patients must agree to use appropriate medically approved contraception during the study up to six months after the last vaccination. Exclusion Criteria: Receiving, or having received, chemotherapy or radiotherapy within 6 weeks of trial entry. Having undergone surgery +/- PORT within 6 weeks of trial therapy A negative result following anergy testing. Known chronic active infection with Hepatitis B, Hepatitis C or Human Immunodeficiency Virus (HIV). Current active autoimmune disease. Current active skin diseases requiring therapy (psoriasis, eczema etc). Ongoing active infection. History of anaphylaxis or severe allergy to vaccination. Previous myeloablative therapy followed by an autologous or allogeneic haematopoietic stem cell transplant. Patients who have had a splenectomy or splenic irradiation, or with known splenic dysfunction. Receiving current immunosuppressive medication, including corticosteroids within 4 weeks of the first dose. Pregnant and lactating women. Ongoing toxic manifestations of previous treatment. Major thoracic and/or abdominal surgery in the preceding four weeks from which the patient has not yet recovered. Patients with any other condition which in the Investigator"s opinion would not make the patient a good candidate for the clinical trial. Concurrent congestive heart failure or prior history of class III/ IV cardiac disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Terence Jones, BSc,FRCS,MD
Organizational Affiliation
University of Liverpool
Official's Role
Principal Investigator
Facility Information:
Facility Name
Velindre NHS Trust
City
Cardiff
ZIP/Postal Code
CF14 2TL
Country
United Kingdom
Facility Name
The Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust
City
Liverpool
ZIP/Postal Code
L7 8XP
Country
United Kingdom
Facility Name
Aintree University NHS Foundation Trust
City
Liverpool
ZIP/Postal Code
L9 7AL
Country
United Kingdom
Facility Name
The Royal Marsden NHS Foundation Trust
City
London
ZIP/Postal Code
SW3 6JJ
Country
United Kingdom

12. IPD Sharing Statement

Links:
URL
http://www.cancerresearchuk.org/
Description
Cancer Research UK
URL
http://www.lctu.org.uk
Description
Liverpool Cancer Trials Unit
URL
http://www.nihr.ac.uk/Pages/default.aspx
Description
National Institute for Health Research

Learn more about this trial

Safety Study of Recombinant Listeria Monocytogenes(Lm)Based Vaccine Virus Vaccine to Treat Oropharyngeal Cancer

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