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VAC 072-An Efficacy Study of R21/MM in Different Dose Schedules

Primary Purpose

Malaria

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
R21 Matrix-M vaccination
R21 Matrix-M vaccination and CHMI
R21 Matrix-M vaccination booster
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Malaria focused on measuring Malaria challenge, Malaria vaccine

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy adults aged 18 to 45 years.
  • Able and willing (in the Investigator's opinion) to comply with all study requirements.
  • Willing to allow the investigators to discuss the volunteer's medical history with their General Practitioner.
  • Women only: Must practice continuous effective contraception for the duration of the study.
  • Agreement to refrain from blood donation during the course of the study.
  • Agree to refrain from blood donation for at least 3 years after the end of their involvement in the study.*
  • Written informed consent to participate in the trial.
  • Reachable (24/7) by mobile phone during the period between CHMI and completion of antimalarial treatment.*
  • Willingness to take a curative anti-malaria regimen following CHMI.*
  • For volunteers not living close to the malaria challenge follow-up site (CCVTM, Oxford) agreement to stay in a hotel room close to the trial centre during a part of the study (from at least day 6.5 post mosquito bite until anti-malarial treatment is completed).*
  • Answer all questions on the informed consent quiz correctly.*

Exclusion Criteria:

  • History of clinical malaria (any species).
  • Travel to a clearly malaria endemic locality during the study period or within the preceding six months
  • Use of systemic antibiotics with known antimalarial activity within 30 days of CHMI (e.g. trimethoprim- sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin)*
  • Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period.
  • Prior receipt of an investigational vaccine likely to impact on interpretation of the trial data as assessed by the investigator.
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
  • Use of immunoglobulins or blood products within 3 months prior to enrolment.
  • History of allergic disease or reactions likely to be exacerbated by any component of the vaccine (e.g. egg products) or malaria infection.
  • Any history of anaphylaxis post vaccination.
  • History of clinically significant contact dermatitis.
  • History of sickle cell anaemia, sickle cell trait, thalassaemia or thalassaemia trait or any haematological condition that could affect susceptibility to malaria infection.
  • Pregnancy, lactation or intention to become pregnant during the study.
  • Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone*
  • Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone*
  • Any clinical condition known to prolong the QT interval and existing contraindication to the use of Malarone.*
  • History of cardiac arrhythmia, including clinically relevant bradycardia and existing contraindication to the use of Malarone.*
  • Clinically significant disturbances of electrolyte balance, eg, hypokalaemia or hypomagnesaemia
  • Family history of congenital QT prolongation or sudden death and existing contraindication to the use of Malarone.*
  • Contraindications to the use of both Riamet and Malarone*
  • History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ).
  • History of serious psychiatric condition that may affect participation in the study.
  • Any other serious chronic illness requiring hospital specialist supervision.
  • Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 25 standard UK units every week.
  • Suspected or known injecting drug abuse in the 5 years preceding enrolment.
  • Seropositive for hepatitis C virus (antibodies to HCV) at screening (unless has taken part in a prior hepatitis C vaccine study with confirmed negative HCV antibodies prior to participation in that study, and negative HCV RNA PCR at screening for this study).
  • Positive family history in both 1st and 2nd degree relatives < 50 years old for cardiac disease.*
  • Volunteers unable to be closely followed for social, geographic or psychological reasons.
  • Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. In the event of abnormal test results, confirmatory repeat tests will be requested. Procedures for identifying laboratory values meeting exclusion criteria are shown in Appendix A.
  • Any other significant disease, disorder, or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data.

    • Not applicable for volunteers who do not undergo CHMI (Groups 1, 4 and 5)

Sites / Locations

  • Guy's and St Thomas' NHS Foundation Trust
  • Imperial College Healthcare NHS Trust
  • CCVTM, University of Oxford, Churchill Hospital
  • University Hospital Southampton NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

No Intervention

No Intervention

Experimental

Experimental

Experimental

Experimental

Arm Label

Group 1a

Group 2a

Group 3a

Group 4a

Group 5

Group 6

Group 7

Group 1b

Group 2b

Group 3b

Group 4b

Arm Description

Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M 4 weeks apart and an optional booster vaccination 12 months after the third dose

Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M at 0, 4 and 24 weeks, followed by CHMI by sporozoite challenge (mosquito bite) 4 weeks later. If protected from malaria, volunteers will receive an optional booster vaccination 28 days prior to malaria rechallenge

Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M 4 weeks apart, followed by CHMI by sporozoite challenge (mosquito bite) 4 weeks later. If protected from malaria, volunteers will receive an optional booster vaccination 28 days prior to malaria rechallenge

Volunteers will receive 2 doses of 50μg R21/50μg Matrix-M 4 weeks apart and a 3rd fractional dose of 10μg R21/50μg Matrix-M at 24 weeks. This is followed by optional CHMI by sporozoite challenge (mosquito bite) 4 weeks later

Volunteers will receive 2 doses of 10μg R21/50μg Matrix-M 4 weeks apart and a 3rd fractional dose of 2μg R21/50μg Matrix-M at 24 weeks. This is followed by optional CHMI by sporozoite challenge (mosquito bite) 4 weeks later

They are infectivity control volunteers for the sporozoite challenge procedures: these volunteers are not vaccinated.

They are infectivity control volunteers for the sporozoite challenge procedures: these volunteers are not vaccinated.

Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M, 4 weeks apart followed by an optional vaccination booster 12 months after the third dose.

Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M at 0, 4 and 24 weeks.

Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M 4 weeks apart.

Volunteers will receive 2 doses of 50μg R21/50μg Matrix-M 4 weeks apart and a 3rd fractional dose of 10μg R21/50μg Matrix-M at 24 weeks.

Outcomes

Primary Outcome Measures

The safety and tolerability of adjuvanted R21 using different immunisation schedules in healthy malaria naïve volunteers
Occurrence of solicited and unsolicited local and systemic adverse events
The efficacy (prevention of occurrence of P. falciparum parasitemia) of adjuvanted R21 against malaria sporozoite challenge, in healthy malaria-naïve volunteers using two immunisation regimes
Assessed by PCR of adjuvanted R21 in two different vaccination regimes

Secondary Outcome Measures

To assess humoral immunogenicity generated in malaria-naïve individuals by adjuvanted R21 using different immunisation schedules in healthy malaria-naïve volunteers.
To document immunogenicity measures, capturing humoral and cellular immune responses to R21 as follows: Anti-CS antibody titers
To assess the safety and tolerability of adjuvanted R21 using different immunisation schedules in healthy malaria-naïve volunteers following booster vaccination
Occurrence of solicited and unsolicited local and systemic adverse events
To assess the efficacy of adjuvanted R21 against malaria sporozoite challenge in healthy malaria-naïve volunteers following a booster vaccination.
To assess the efficacy (prevention of occurrence of P. falciparum parasitemia, assessed by PCR) of adjuvanted R21 against malaria sporozoite challenge, in healthy malaria-naïve volunteers following a booster vaccination.
To further assess the efficacy using different thresholds of adjuvanted R21 in two different vaccination regimes and compared to R21c against malaria sporozoite challenge, in healthy malaria-naïve volunteers.
To further assess the efficacy using different thresholds, measured as time to P. falciparum parasitemia, assessed by PCR of adjuvanted R21 in two different vaccination regimes and compared to R21c against malaria sporozoite challenge, in healthy malaria-naïve volunteers.

Full Information

First Posted
May 29, 2019
Last Updated
October 12, 2021
Sponsor
University of Oxford
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1. Study Identification

Unique Protocol Identification Number
NCT03970993
Brief Title
VAC 072-An Efficacy Study of R21/MM in Different Dose Schedules
Official Title
A Phase I/IIa Sporozoite Challenge Study to Assess the Safety, Immunogenicity and Protective Efficacy of Adjuvanted R21, Administered in Different Dose Schedules in Healthy UK Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
June 17, 2019 (Actual)
Primary Completion Date
August 24, 2021 (Actual)
Study Completion Date
August 24, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford

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
An open label, partially blinded clinical trial in which healthy volunteers will be administered experimental malaria vaccines. There will be seven experimental groups of volunteers, of which five receive vaccination with the novel malaria vaccine candidate, R21, in combination with the vaccine adjuvant, Matrix M. The study will assess the safety & immune responses to vaccination, and the efficacy of the vaccine.
Detailed Description
Arms 1a & 1b receive vaccines at 3 vaccinations at 4 week intervals and a booster vaccination approximately 12 months after the first vaccination. Arms 2a & 2b receive 3 vaccinations at 0, 4 and 24 weeks. The protected volunteers in 2a from the first malaria challenge, VAC072A, will receive a booster vaccination 28 days before the rechallenge, VAC072B. Arms 3a and 3b receive 3 vaccinations at 0, 4 and 8 weeks. The protected volunteers in 3a from the first malaria challenge, VAC072A, will receive a booster vaccination 28 days before the rechallenge, VAC072B. Arms 4a and 4b will receive 3 vaccinations at 0, 4 and 24 weeks. The third dose is fractional. Volunteers then have the option to be challenged 28 days after final vaccination. Group 5 will receive 3 vaccinations at 0, 4 and 24 weeks. The third dose is fractional. Volunteers then have the option to be challenged 28 days after final vaccination. Groups 6 & 7 are control groups and will receive controlled human malaria infection (CHMI) Healthy volunteers will be recruited in England across four research sites in Oxford, London, and Southampton.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria
Keywords
Malaria challenge, Malaria vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
78 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1a
Arm Type
Experimental
Arm Description
Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M 4 weeks apart and an optional booster vaccination 12 months after the third dose
Arm Title
Group 2a
Arm Type
Experimental
Arm Description
Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M at 0, 4 and 24 weeks, followed by CHMI by sporozoite challenge (mosquito bite) 4 weeks later. If protected from malaria, volunteers will receive an optional booster vaccination 28 days prior to malaria rechallenge
Arm Title
Group 3a
Arm Type
Experimental
Arm Description
Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M 4 weeks apart, followed by CHMI by sporozoite challenge (mosquito bite) 4 weeks later. If protected from malaria, volunteers will receive an optional booster vaccination 28 days prior to malaria rechallenge
Arm Title
Group 4a
Arm Type
Experimental
Arm Description
Volunteers will receive 2 doses of 50μg R21/50μg Matrix-M 4 weeks apart and a 3rd fractional dose of 10μg R21/50μg Matrix-M at 24 weeks. This is followed by optional CHMI by sporozoite challenge (mosquito bite) 4 weeks later
Arm Title
Group 5
Arm Type
Experimental
Arm Description
Volunteers will receive 2 doses of 10μg R21/50μg Matrix-M 4 weeks apart and a 3rd fractional dose of 2μg R21/50μg Matrix-M at 24 weeks. This is followed by optional CHMI by sporozoite challenge (mosquito bite) 4 weeks later
Arm Title
Group 6
Arm Type
No Intervention
Arm Description
They are infectivity control volunteers for the sporozoite challenge procedures: these volunteers are not vaccinated.
Arm Title
Group 7
Arm Type
No Intervention
Arm Description
They are infectivity control volunteers for the sporozoite challenge procedures: these volunteers are not vaccinated.
Arm Title
Group 1b
Arm Type
Experimental
Arm Description
Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M, 4 weeks apart followed by an optional vaccination booster 12 months after the third dose.
Arm Title
Group 2b
Arm Type
Experimental
Arm Description
Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M at 0, 4 and 24 weeks.
Arm Title
Group 3b
Arm Type
Experimental
Arm Description
Volunteers will receive 3 doses of 10μg R21/50μg Matrix-M 4 weeks apart.
Arm Title
Group 4b
Arm Type
Experimental
Arm Description
Volunteers will receive 2 doses of 50μg R21/50μg Matrix-M 4 weeks apart and a 3rd fractional dose of 10μg R21/50μg Matrix-M at 24 weeks.
Intervention Type
Biological
Intervention Name(s)
R21 Matrix-M vaccination
Intervention Description
Three dose vaccination of 2μg, 10μg or 50μg of R21 and 50ug Matrix-M delivered intramuscularly
Intervention Type
Biological
Intervention Name(s)
R21 Matrix-M vaccination and CHMI
Intervention Description
Three dose vaccination of 2μg, 10μg or 50μg of R21 and 50ug Matrix-M delivered intramuscularly. Volunteers then have the option to be challenged with malaria by mosquito bite
Intervention Type
Biological
Intervention Name(s)
R21 Matrix-M vaccination booster
Intervention Description
Optional R21 Matrix-M vaccination booster following a three dose vaccination schedule
Primary Outcome Measure Information:
Title
The safety and tolerability of adjuvanted R21 using different immunisation schedules in healthy malaria naïve volunteers
Description
Occurrence of solicited and unsolicited local and systemic adverse events
Time Frame
Solicited AEs will be collected for 7 days and Unsolicited AEs will be collected for 28 days. SAEs will be collected from enrolment until the end of the follow-up period
Title
The efficacy (prevention of occurrence of P. falciparum parasitemia) of adjuvanted R21 against malaria sporozoite challenge, in healthy malaria-naïve volunteers using two immunisation regimes
Description
Assessed by PCR of adjuvanted R21 in two different vaccination regimes
Time Frame
Weeks 2 & 3 following malaria infection
Secondary Outcome Measure Information:
Title
To assess humoral immunogenicity generated in malaria-naïve individuals by adjuvanted R21 using different immunisation schedules in healthy malaria-naïve volunteers.
Description
To document immunogenicity measures, capturing humoral and cellular immune responses to R21 as follows: Anti-CS antibody titers
Time Frame
Blood samples will be taken to assess immune responses at specified time points over the duration of the study
Title
To assess the safety and tolerability of adjuvanted R21 using different immunisation schedules in healthy malaria-naïve volunteers following booster vaccination
Description
Occurrence of solicited and unsolicited local and systemic adverse events
Time Frame
Solicited AEs will be collected for 7 days and Unsolicited AEs will be collected for 28 days. SAEs will be collected from enrolment until the end of the follow-up period
Title
To assess the efficacy of adjuvanted R21 against malaria sporozoite challenge in healthy malaria-naïve volunteers following a booster vaccination.
Description
To assess the efficacy (prevention of occurrence of P. falciparum parasitemia, assessed by PCR) of adjuvanted R21 against malaria sporozoite challenge, in healthy malaria-naïve volunteers following a booster vaccination.
Time Frame
Week 2 following malaria infection
Title
To further assess the efficacy using different thresholds of adjuvanted R21 in two different vaccination regimes and compared to R21c against malaria sporozoite challenge, in healthy malaria-naïve volunteers.
Description
To further assess the efficacy using different thresholds, measured as time to P. falciparum parasitemia, assessed by PCR of adjuvanted R21 in two different vaccination regimes and compared to R21c against malaria sporozoite challenge, in healthy malaria-naïve volunteers.
Time Frame
Weeks 2 & 3 following malaria infection
Other Pre-specified Outcome Measures:
Title
To evaluate further exploratory immunological end points in the vaccinees.
Time Frame
Duration of the study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy adults aged 18 to 45 years. Able and willing (in the Investigator's opinion) to comply with all study requirements. Willing to allow the investigators to discuss the volunteer's medical history with their General Practitioner. Women only: Must practice continuous effective contraception for the duration of the study. Agreement to refrain from blood donation during the course of the study. Agree to refrain from blood donation for at least 3 years after the end of their involvement in the study.* Written informed consent to participate in the trial. Reachable (24/7) by mobile phone during the period between CHMI and completion of antimalarial treatment.* Willingness to take a curative anti-malaria regimen following CHMI.* For volunteers not living close to the malaria challenge follow-up site (CCVTM, Oxford) agreement to stay in a hotel room close to the trial centre during a part of the study (from at least day 6.5 post mosquito bite until anti-malarial treatment is completed).* Answer all questions on the informed consent quiz correctly.* Exclusion Criteria: History of clinical malaria (any species). Travel to a clearly malaria endemic locality during the study period or within the preceding six months Use of systemic antibiotics with known antimalarial activity within 30 days of CHMI (e.g. trimethoprim- sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin)* Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period. Prior receipt of an investigational vaccine likely to impact on interpretation of the trial data as assessed by the investigator. Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed). Use of immunoglobulins or blood products within 3 months prior to enrolment. History of allergic disease or reactions likely to be exacerbated by any component of the vaccine (e.g. egg products) or malaria infection. Any history of anaphylaxis post vaccination. History of clinically significant contact dermatitis. History of sickle cell anaemia, sickle cell trait, thalassaemia or thalassaemia trait or any haematological condition that could affect susceptibility to malaria infection. Pregnancy, lactation or intention to become pregnant during the study. Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone* Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone* Any clinical condition known to prolong the QT interval and existing contraindication to the use of Malarone.* History of cardiac arrhythmia, including clinically relevant bradycardia and existing contraindication to the use of Malarone.* Clinically significant disturbances of electrolyte balance, eg, hypokalaemia or hypomagnesaemia Family history of congenital QT prolongation or sudden death and existing contraindication to the use of Malarone.* Contraindications to the use of both Riamet and Malarone* History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ). History of serious psychiatric condition that may affect participation in the study. Any other serious chronic illness requiring hospital specialist supervision. Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 25 standard UK units every week. Suspected or known injecting drug abuse in the 5 years preceding enrolment. Seropositive for hepatitis C virus (antibodies to HCV) at screening (unless has taken part in a prior hepatitis C vaccine study with confirmed negative HCV antibodies prior to participation in that study, and negative HCV RNA PCR at screening for this study). Positive family history in both 1st and 2nd degree relatives < 50 years old for cardiac disease.* Volunteers unable to be closely followed for social, geographic or psychological reasons. Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. In the event of abnormal test results, confirmatory repeat tests will be requested. Procedures for identifying laboratory values meeting exclusion criteria are shown in Appendix A. Any other significant disease, disorder, or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data. Not applicable for volunteers who do not undergo CHMI (Groups 1, 4 and 5)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adrian V Hill, DPhill FRCP
Organizational Affiliation
Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, United Kingdom
Official's Role
Principal Investigator
Facility Information:
Facility Name
Guy's and St Thomas' NHS Foundation Trust
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Facility Name
Imperial College Healthcare NHS Trust
City
London
ZIP/Postal Code
W2 1NY
Country
United Kingdom
Facility Name
CCVTM, University of Oxford, Churchill Hospital
City
Oxford
ZIP/Postal Code
OX3 7LE
Country
United Kingdom
Facility Name
University Hospital Southampton NHS Foundation Trust
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom

12. IPD Sharing Statement

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VAC 072-An Efficacy Study of R21/MM in Different Dose Schedules

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