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Single-Dose HPV Vaccination for the Prevention of Cervical Cancer in Young Adult Women in Costa Rica, The PRISMA ESCUDDO Trial (PRISMA)

Primary Purpose

Cervical Carcinoma, Human Papillomavirus Infection

Status
Active
Phase
Phase 4
Locations
Costa Rica
Study Type
Interventional
Intervention
Diphtheria Toxoid/Tetanus Toxoid/Acellular Pertussis Vaccine Adsorbed
Questionnaire Administration
Recombinant Human Papillomavirus Bivalent Vaccine
Recombinant Human Papillomavirus Nonavalent Vaccine
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Cervical Carcinoma

Eligibility Criteria

18 Years - 30 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • INCLUSION CRITERIA AT ENROLLMENT: Female.
  • INCLUSION CRITERIA AT ENROLLMENT: Aged between 18 and 30 years inclusive.
  • INCLUSION CRITERIA AT ENROLLMENT: Living in the study area.
  • INCLUSION CRITERIA AT ENROLLMENT: Able to communicate with study personnel.
  • INCLUSION CRITERIA AT ENROLLMENT: Willing to participate in the study and sign the informed consent.
  • INCLUSION CRITERIA AT ENROLLMENT: In good health as determined by a medical history (physical exam will be conducted if necessary per the doctor's criterion.
  • DEFERRAL CRITERIA AT ENROLLMENT VISIT: The enrollment visit will be deferred (i.e., rescheduled for another date) for participants if: the self-collected cervical sample is not able to be collected.
  • DEFERRAL CRITERIA AT THE VACCINATION VISIT: The vaccination visit will be deferred (i.e., rescheduled for another date) for participants if:

    • They have an acute disease that precludes vaccination (though vaccines can be administered to potential participants with a minor illness such as diarrhea and mild upper respiratory infection)
    • They are receiving immunosuppressive treatment, e.g. corticosteroids
    • They have received any registered vaccine in the last 15 days.

Exclusion Criteria:

  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have been vaccinated against human papillomavirus (HPV).
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They are allergic to yeast or another vaccine components.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have a diagnosis of an autoimmune, degenerative, or neurological disease without treatment or adequate control; a progressive or severe neurological disease; a genetic immunodeficiency; or any other serious chronic disease without treatment and / or adequate control that, according to the principal investigator or designee, for which vaccination is contraindicated.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have plans to move outside the country in the next six months.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They refuse or are unable to self-collect the cervical sample.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They are pregnant.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They do not have an identification document.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: The clinician determining eligibility in agreement with the principal investigator considers that there is a reason that precludes participation.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: Between the enrollment and vaccine visit, they have been vaccinated against HPV.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: Between the enrollment and vaccine visit, they are being evaluated for or have received a diagnosis of: an autoimmune, degenerative, or neurological disease without treatment or adequate control; a progressive or severe neurological disease; a genetic immunodeficiency; or any other serious chronic disease without treatment and/or adequate control, for which vaccination is contraindicated according to the principal investigator or designee.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They have plans to move outside the country in the next six months.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They refuse the urine pregnancy test.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They have a positive urine pregnancy test result.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They are pregnant.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They refuse or are unable to perform the self-collected cervical sample.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: The clinician determining eligibility in agreement with the principal investigator considers that there is a reason that precludes participation.

Sites / Locations

  • Agencia Costarricense de Investigaciones Biomédicas (ACIB)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Arm I (Gardasil 9)

Arm II (Cervarix)

Arm III (Adacel)

Arm Description

Patients receive one dose of Gardasil 9 IM.

Patients receive one dose of Cervarix IM.

Patients receive one dose of Adacel IM.

Outcomes

Primary Outcome Measures

Incidence of persistent HPV infection
Will estimate the rate of incident persistent infections (i.e. the primary endpoint defined above) in each of the three arms of an ATP cohort and then estimate the two Vaccine Efficacies (VE), comparing each HPV vaccine arm against the control arm. Will require a one-sided p-value of < 0.0125 for statistical significance. The 97.5% confidence intervals for the VE will be calculated by inverting appropriate hypotheses tests.

Secondary Outcome Measures

Benefit of one dose of HPV vaccination compared to no vaccination
Will require a one-sided p-value of < 0.0125 for statistical significance. The 97.5% confidence intervals for the VE will be calculated by inverting appropriate hypotheses tests.
Health impact of older-age single-dose HPV vaccination
Will require a one-sided p-value of < 0.0125 for statistical significance. The 97.5% confidence intervals for the VE will be calculated by inverting appropriate hypotheses tests.
Immunogenicity (absolute levels and stability of serum antibodies) of single dose HPV vaccination
Will report the Geometric Mean Titer (GMT) of the antibodies for each HPV type at the five follow-up visits.
New HPV16/18 anal infection
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
New HPV16/18 oral infection
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
Carcinogenic HPV cervical, anal or oral infection detected at a single timepoint
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
Cervical HPV6/11 infection
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.

Full Information

First Posted
February 8, 2022
Last Updated
September 1, 2023
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT05237947
Brief Title
Single-Dose HPV Vaccination for the Prevention of Cervical Cancer in Young Adult Women in Costa Rica, The PRISMA ESCUDDO Trial
Acronym
PRISMA
Official Title
Single-Dose HPV Vaccination Among Young Adult Women in Costa Rica: the PRISMA-ESCUDDO Trial (PRevencIón Del Cáncer Cervical Con Una Sola Dosis de Vacuna Contra VPH en Mujeres Adultas Jóvenes)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 1, 2022 (Actual)
Primary Completion Date
May 31, 2026 (Anticipated)
Study Completion Date
May 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

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

5. Study Description

Brief Summary
This phase IV trial tests whether a single dose of the human papillomavirus (HPV) vaccine works in preventing cervical cancer in young women in Costa Rica. Human papilloma viruses, called HPV, are a group of viruses that very frequently cause infection in both men and women, mainly in the genital organs. There are many types of HPV, and some can cause cancer. The World Health Organization recommends a two-dose schedule for adolescents 9-14 and three doses for individuals 15 years old or older. This study examines whether a single dose of HPV vaccine can reduce the frequency with which women between ages 18-30 become infected with HPV.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate one dose of nonavalent human papillomavirus (HPV) vaccination compared to no vaccination in the protection against incident HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years who are cervical HPV16/18 deoxyribonucleic acid (DNA) negative prior to and at the time of vaccination. II. To evaluate one dose of bivalent HPV vaccination compared to no vaccination in the protection against incident HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years who are cervical HPV16/18 DNA negative prior to and at the time of vaccination. SECONDARY OBJECTIVES: I. To quantitate the benefit of one dose of HPV vaccination compared to no vaccination in the protection against incident HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years regardless of cervical HPV DNA status at the time of vaccination. II. To estimate the health impact of older-age single-dose HPV vaccination by modeling the number of cervical cancer cases prevented as well as the cost-effectiveness of cervical cancer prevention strategies incorporating vaccination and screening in Costa Rica. III. To evaluate the immunogenicity (absolute levels and stability of serum antibodies) of single dose HPV vaccination in women. IV. For each vaccine separately, to evaluate one dose of HPV vaccination compared to no vaccination in the protection against: IVa. Any new HPV16/18 anal infection that persists 6+ months. IVb. Any new HPV16/18 oral infection that persists 6+ months. IVc. Any new carcinogenic HPV cervical, anal or oral infection detected at a single timepoint and that persists 6+ months. IVd. Any new cervical HPV6/11 infection that persists 6+ months. OUTLINE: Patients are randomized to 1 of 3 arms. ARM I: Patients receive one dose of recombinant human papillomavirus nonavalent vaccine (Gardasil 9) intramuscularly (IM). ARM II: Patients receive one dose of recombinant human papillomavirus bivalent vaccine (Cervarix) IM. ARM III: Patients receive one dose of diphtheria toxoid/tetanus toxoid/acellular pertussis vaccine adsorbed vaccine (Adacel) IM. After completion of study, patients are followed up at 6 and 12 months, and then every 6 months thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Carcinoma, Human Papillomavirus Infection

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
5000 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm I (Gardasil 9)
Arm Type
Experimental
Arm Description
Patients receive one dose of Gardasil 9 IM.
Arm Title
Arm II (Cervarix)
Arm Type
Experimental
Arm Description
Patients receive one dose of Cervarix IM.
Arm Title
Arm III (Adacel)
Arm Type
Active Comparator
Arm Description
Patients receive one dose of Adacel IM.
Intervention Type
Biological
Intervention Name(s)
Diphtheria Toxoid/Tetanus Toxoid/Acellular Pertussis Vaccine Adsorbed
Other Intervention Name(s)
Adacel, Daptacel, Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed, Diphtheria Toxoid Tetanus Toxoid Acellular Pertussis Vaccine Adsorbed, Diphtheria Toxoid/Tetanus Toxoid/Acellular Pertussis Vaccine, DTaP, Infanrix, Tripedia
Intervention Description
Given IM
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Intervention Type
Biological
Intervention Name(s)
Recombinant Human Papillomavirus Bivalent Vaccine
Other Intervention Name(s)
Cervarix, GSK-580299, HPV 16/18 L1 VLP/AS04 VAC, HPV-16/18 VLP/AS04 Vaccine, Human Papillomavirus 16/18 L1 Virus-Like Particle/AS04 Vaccine, Human Papillomavirus Bivalent Types 16 and 18 Vaccine, Recombinant, Human Papillomavirus Vaccine L1 16,18, Human Papillomavirus Vaccine, L1 Type 16, 18, Recombinant HPV Bivalent Vaccine
Intervention Description
Given IM
Intervention Type
Biological
Intervention Name(s)
Recombinant Human Papillomavirus Nonavalent Vaccine
Other Intervention Name(s)
Gardasil 9, Nonavalent HPV VLP Vaccine, Recombinant HPV Nonavalent Vaccine, Recombinant Human Papillomavirus 9-valent Vaccine
Intervention Description
Given IM
Primary Outcome Measure Information:
Title
Incidence of persistent HPV infection
Description
Will estimate the rate of incident persistent infections (i.e. the primary endpoint defined above) in each of the three arms of an ATP cohort and then estimate the two Vaccine Efficacies (VE), comparing each HPV vaccine arm against the control arm. Will require a one-sided p-value of < 0.0125 for statistical significance. The 97.5% confidence intervals for the VE will be calculated by inverting appropriate hypotheses tests.
Time Frame
6-month persistence observed during follow-up
Secondary Outcome Measure Information:
Title
Benefit of one dose of HPV vaccination compared to no vaccination
Description
Will require a one-sided p-value of < 0.0125 for statistical significance. The 97.5% confidence intervals for the VE will be calculated by inverting appropriate hypotheses tests.
Time Frame
6-month persistence observed during follow-up
Title
Health impact of older-age single-dose HPV vaccination
Description
Will require a one-sided p-value of < 0.0125 for statistical significance. The 97.5% confidence intervals for the VE will be calculated by inverting appropriate hypotheses tests.
Time Frame
6-month persistence observed during follow-up
Title
Immunogenicity (absolute levels and stability of serum antibodies) of single dose HPV vaccination
Description
Will report the Geometric Mean Titer (GMT) of the antibodies for each HPV type at the five follow-up visits.
Time Frame
6-month persistence observed during follow-up
Title
New HPV16/18 anal infection
Description
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
Time Frame
6-month persistence observed during follow-up
Title
New HPV16/18 oral infection
Description
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
Time Frame
6-month persistence observed during follow-up
Title
Carcinogenic HPV cervical, anal or oral infection detected at a single timepoint
Description
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
Time Frame
6-month persistence observed during follow-up
Title
Cervical HPV6/11 infection
Description
Will report the VE against any new carcinogenic HPV type and against HPV 6/11 in the according to protocol (ATP) cohort using an analysis plan similar to that described for the primary objectives.
Time Frame
6-month persistence observed during follow-up

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: INCLUSION CRITERIA AT ENROLLMENT: Female. INCLUSION CRITERIA AT ENROLLMENT: Aged between 18 and 30 years inclusive. INCLUSION CRITERIA AT ENROLLMENT: Living in the study area. INCLUSION CRITERIA AT ENROLLMENT: Able to communicate with study personnel. INCLUSION CRITERIA AT ENROLLMENT: Willing to participate in the study and sign the informed consent. INCLUSION CRITERIA AT ENROLLMENT: In good health as determined by a medical history (physical exam will be conducted if necessary per the doctor's criterion. DEFERRAL CRITERIA AT ENROLLMENT VISIT: The enrollment visit will be deferred (i.e., rescheduled for another date) for participants if: the self-collected cervical sample is not able to be collected. DEFERRAL CRITERIA AT THE VACCINATION VISIT: The vaccination visit will be deferred (i.e., rescheduled for another date) for participants if: They have an acute disease that precludes vaccination (though vaccines can be administered to potential participants with a minor illness such as diarrhea and mild upper respiratory infection) They are receiving immunosuppressive treatment, e.g. corticosteroids They have received any registered vaccine in the last 15 days. Exclusion Criteria: EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have been vaccinated against human papillomavirus (HPV). EXCLUSION CRITERIA AT ENROLLMENT VISIT: They are allergic to yeast or another vaccine components. EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have a diagnosis of an autoimmune, degenerative, or neurological disease without treatment or adequate control; a progressive or severe neurological disease; a genetic immunodeficiency; or any other serious chronic disease without treatment and / or adequate control that, according to the principal investigator or designee, for which vaccination is contraindicated. EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have plans to move outside the country in the next six months. EXCLUSION CRITERIA AT ENROLLMENT VISIT: They refuse or are unable to self-collect the cervical sample. EXCLUSION CRITERIA AT ENROLLMENT VISIT: They are pregnant. EXCLUSION CRITERIA AT ENROLLMENT VISIT: They do not have an identification document. EXCLUSION CRITERIA AT ENROLLMENT VISIT: The clinician determining eligibility in agreement with the principal investigator considers that there is a reason that precludes participation. EXCLUSION CRITERIA AT VACCINATION VISIT: Between the enrollment and vaccine visit, they have been vaccinated against HPV. EXCLUSION CRITERIA AT VACCINATION VISIT: Between the enrollment and vaccine visit, they are being evaluated for or have received a diagnosis of: an autoimmune, degenerative, or neurological disease without treatment or adequate control; a progressive or severe neurological disease; a genetic immunodeficiency; or any other serious chronic disease without treatment and/or adequate control, for which vaccination is contraindicated according to the principal investigator or designee. EXCLUSION CRITERIA AT VACCINATION VISIT: They have plans to move outside the country in the next six months. EXCLUSION CRITERIA AT VACCINATION VISIT: They refuse the urine pregnancy test. EXCLUSION CRITERIA AT VACCINATION VISIT: They have a positive urine pregnancy test result. EXCLUSION CRITERIA AT VACCINATION VISIT: They are pregnant. EXCLUSION CRITERIA AT VACCINATION VISIT: They refuse or are unable to perform the self-collected cervical sample. EXCLUSION CRITERIA AT VACCINATION VISIT: The clinician determining eligibility in agreement with the principal investigator considers that there is a reason that precludes participation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aimee R Kreimer
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Agencia Costarricense de Investigaciones Biomédicas (ACIB)
City
Liberia
State/Province
Guanacaste
ZIP/Postal Code
50101
Country
Costa Rica

12. IPD Sharing Statement

Learn more about this trial

Single-Dose HPV Vaccination for the Prevention of Cervical Cancer in Young Adult Women in Costa Rica, The PRISMA ESCUDDO Trial

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