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WT1 Immunity Via DNA Fusion Gene Vaccination in Haematological Malignancies by Intramuscular Injection Followed by Intramuscular Electroporation (WIN)

Primary Purpose

Leukaemia (Acute), Leukaemia (Chronic), Leukaemia (Acute Myeloid)

Status
Completed
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
p.DOM-WT1-37 DNA Vaccine and p.DOM-WT1-126 DNA Vaccine
Sponsored by
University Hospital Southampton NHS Foundation Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukaemia (Acute)

Eligibility Criteria

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

Inclusion Criteria:

  • CML patients:

Philadelphia chromosome positive CML in chronic phase, in complete cytogenetic response (CCyR) but with detectable BCR-ABL transcripts and maintained the CCyR on imatinib monotherapy for a minimum of 24 months

AML patients:

WT1+ AML in CR or morphologic CR with incomplete blood count recovery (CRi);

All patients:

  • ≥ 18 years of age, written informed consent
  • Performance status of 0 or 1.
  • for vaccination groups: HLA-A0201 positive in at least one allele
  • for control groups: HLA A2 negative in both alleles
  • renal function and liver function (Creatinine <1.5 x upper limit of normal, liver function tests < 1.5 x upper limit of normal); Lymphocyte count > 1.0 x109/l; normal clotting
  • HB>100 g/l
  • Adequate venous access for repeated blood sampling according to protocol schedule.
  • If sexually active and possibly fertile, patients must agree to use appropriate contraceptive methods during the trial and for six months afterwards.

Exclusion Criteria:

  • CML patients:

    • CML in accelerated phase or blast crisis or having achieved CMR at any point during imatinib therapy.
    • Imatinib dose modification in the previous year, Imatinib interruption for more than 15 days in the previous 6 months to enrolment
    • Prior interferon-α therapy
    • hypocellular bone marrow (<20%)
    • Complete molecular response (CMR)

AML patients:

  • AML in haematological relapse or eligible for allogeneic SCT.
  • hypocellular bone marrow (<20%)
  • AML patients with the "good-risk" abnormalities comprised by the core binding factor leukaemias (i.e., AML with the translocation (8;21) and inversion of chromosome 16, and acute promyelocytic leukaemia with the translocation (15;17))

All patients:

  • Systemic steroids or other drugs with a likely effect on immune competence are forbidden during the trial. The predictable need of their use will preclude the patient from trial entry
  • Major surgery in the preceding three to four weeks from which the patient has not yet recovered.
  • Patients who are of high medical risk because of non-malignant systemic disease, as well as those with active uncontrolled infection.
  • Patients with any other condition which in the Investigator's opinion would not make the patient a good candidate for the clinical trial, such as concurrent congestive heart failure or prior history of New York Heart Association (NYHA) class III/ IV cardiac disease
  • Current malignancies at other sites, with the exception of adequately treated basal or squamous cell carcinoma of the skin. Cancer survivors, who have undergone potentially curative therapy for a prior malignancy, have no evidence of that disease for five years and are deemed at low risk for recurrence, are eligible for the study.
  • Patients who are serologically positive for or are known to suffer from Hepatitis B, C, Syphilis or HIV. Counselling will be offered to all patients prior to testing.

Sites / Locations

  • Royal Devon and Exeter NHS Foundation Trust
  • Imperial College NHS Trust
  • Southampton University Hospitals NHS Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

No Intervention

No Intervention

Experimental

Experimental

Arm Label

CML HLA A2-

AML HLA A2-

AML HLA A2+

CML HLA A2+

Arm Description

Outcomes

Primary Outcome Measures

Molecular response following p.DOM-epitope DNA vaccination in patients with CML (BCR-ABL, WT1) and AML (WT1)

Secondary Outcome Measures

CML-Time to disease progression, next treatment and survival
AML-2 year survival, overall survival

Full Information

First Posted
April 11, 2011
Last Updated
September 5, 2018
Sponsor
University Hospital Southampton NHS Foundation Trust
Collaborators
Imperial College Healthcare NHS Trust, Royal Devon and Exeter NHS Foundation Trust, Inovio Pharmaceuticals, Efficacy and Mechanism Evaluation (EME) Programme, Leukemia Research Fund
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1. Study Identification

Unique Protocol Identification Number
NCT01334060
Brief Title
WT1 Immunity Via DNA Fusion Gene Vaccination in Haematological Malignancies by Intramuscular Injection Followed by Intramuscular Electroporation
Acronym
WIN
Official Title
WT1 Immunity Via DNA Fusion Gene Vaccination in Haematological Malignancies by Intramuscular Injection Followed by Intramuscular Electroporation
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
February 1, 2011 (Actual)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
February 26, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital Southampton NHS Foundation Trust
Collaborators
Imperial College Healthcare NHS Trust, Royal Devon and Exeter NHS Foundation Trust, Inovio Pharmaceuticals, Efficacy and Mechanism Evaluation (EME) Programme, Leukemia Research Fund

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The study is not currently recruiting new subjects due to an interruption in funding from its sponsors. Efforts are under way to re-establish funding, however, the study is currently on-hold pending the outcome of these re-funding efforts. There have been no safety concerns identified during the study This is an open label, single dose level, phase II study in two patient groups (CML and AML) using genetic randomisation. Consented and eligible HLA A2+ve patients will be vaccinated with two DNA vaccines and HLA A2 -ve patients will be followed up with molecular monitoring only. The objectives are to evaluate: 1) Molecular response following p.DOM-epitope DNA vaccination in patients with CML (BCR-ABL, WT1) and AML (WT1) at weeks 4, 8, 12, 16, 20 and at months 6, 12, 18 and 24. 2) Time to disease progression, 2 year survival rate (patients with AML) 3) Correlation of molecular responses with immunological responses. Primary Objective: CML: Molecular response of BCR-ABL. AML: Time to disease progression. Secondary Objective: Molecular response of WT1 transcript levels, immune responses to WT1 and DOM, Toxicity, CML-Time to disease progression, next treatment and survival, AML-2 year survival, overall survival

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukaemia (Acute), Leukaemia (Chronic), Leukaemia (Acute Myeloid), Leukaemia (Acute Lymphoblastic), Leukaemia (Acute Promyelocytic)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CML HLA A2-
Arm Type
No Intervention
Arm Title
AML HLA A2-
Arm Type
No Intervention
Arm Title
AML HLA A2+
Arm Type
Experimental
Arm Title
CML HLA A2+
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
p.DOM-WT1-37 DNA Vaccine and p.DOM-WT1-126 DNA Vaccine
Intervention Description
p.DOM-WT1-37: 1mg/dose/vaccine p.DOM-WT1-126: 1mg/dose/vaccine The DNA vaccine will be administered 6 times at 4 weekly intervals. Responders (Immunological but without molecular progression) may continue vaccination 3 monthly to maximum of 24 months. The vaccines will be injected intramuscularly (im) followed by electroporation (EP) into separate locations.
Primary Outcome Measure Information:
Title
Molecular response following p.DOM-epitope DNA vaccination in patients with CML (BCR-ABL, WT1) and AML (WT1)
Time Frame
2 years
Secondary Outcome Measure Information:
Title
CML-Time to disease progression, next treatment and survival
Time Frame
2 years
Title
AML-2 year survival, overall survival
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: CML patients: Philadelphia chromosome positive CML in chronic phase, in complete cytogenetic response (CCyR) but with detectable BCR-ABL transcripts and maintained the CCyR on imatinib monotherapy for a minimum of 24 months AML patients: WT1+ AML in CR or morphologic CR with incomplete blood count recovery (CRi); All patients: ≥ 18 years of age, written informed consent Performance status of 0 or 1. for vaccination groups: HLA-A0201 positive in at least one allele for control groups: HLA A2 negative in both alleles renal function and liver function (Creatinine <1.5 x upper limit of normal, liver function tests < 1.5 x upper limit of normal); Lymphocyte count > 1.0 x109/l; normal clotting HB>100 g/l Adequate venous access for repeated blood sampling according to protocol schedule. If sexually active and possibly fertile, patients must agree to use appropriate contraceptive methods during the trial and for six months afterwards. Exclusion Criteria: CML patients: CML in accelerated phase or blast crisis or having achieved CMR at any point during imatinib therapy. Imatinib dose modification in the previous year, Imatinib interruption for more than 15 days in the previous 6 months to enrolment Prior interferon-α therapy hypocellular bone marrow (<20%) Complete molecular response (CMR) AML patients: AML in haematological relapse or eligible for allogeneic SCT. hypocellular bone marrow (<20%) AML patients with the "good-risk" abnormalities comprised by the core binding factor leukaemias (i.e., AML with the translocation (8;21) and inversion of chromosome 16, and acute promyelocytic leukaemia with the translocation (15;17)) All patients: Systemic steroids or other drugs with a likely effect on immune competence are forbidden during the trial. The predictable need of their use will preclude the patient from trial entry Major surgery in the preceding three to four weeks from which the patient has not yet recovered. Patients who are of high medical risk because of non-malignant systemic disease, as well as those with active uncontrolled infection. Patients with any other condition which in the Investigator's opinion would not make the patient a good candidate for the clinical trial, such as concurrent congestive heart failure or prior history of New York Heart Association (NYHA) class III/ IV cardiac disease Current malignancies at other sites, with the exception of adequately treated basal or squamous cell carcinoma of the skin. Cancer survivors, who have undergone potentially curative therapy for a prior malignancy, have no evidence of that disease for five years and are deemed at low risk for recurrence, are eligible for the study. Patients who are serologically positive for or are known to suffer from Hepatitis B, C, Syphilis or HIV. Counselling will be offered to all patients prior to testing.
Facility Information:
Facility Name
Royal Devon and Exeter NHS Foundation Trust
City
Exeter
ZIP/Postal Code
EX2 5DW
Country
United Kingdom
Facility Name
Imperial College NHS Trust
City
London
ZIP/Postal Code
W12 0HS
Country
United Kingdom
Facility Name
Southampton University Hospitals NHS Trust
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
18502835
Citation
Chaise C, Buchan SL, Rice J, Marquet J, Rouard H, Kuentz M, Vittes GE, Molinier-Frenkel V, Farcet JP, Stauss HJ, Delfau-Larue MH, Stevenson FK. DNA vaccination induces WT1-specific T-cell responses with potential clinical relevance. Blood. 2008 Oct 1;112(7):2956-64. doi: 10.1182/blood-2008-02-137695. Epub 2008 May 23.
Results Reference
result
PubMed Identifier
18219306
Citation
Rice J, Ottensmeier CH, Stevenson FK. DNA vaccines: precision tools for activating effective immunity against cancer. Nat Rev Cancer. 2008 Feb;8(2):108-20. doi: 10.1038/nrc2326.
Results Reference
result

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WT1 Immunity Via DNA Fusion Gene Vaccination in Haematological Malignancies by Intramuscular Injection Followed by Intramuscular Electroporation

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