Vaccine Responsiveness After CAR-T Cell Therapy
Rabies Vaccination to Assess Vaccine Responsiveness After B Cell Targeted CAR-T Cell Therapies
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
STUDY DESIGN:
This study will be a prospective, open-label clinical trial of primary and secondary vaccination with the inactivated rabies vaccine in patients treated with CARTx for B cell malignancies and healthy individuals. The target enrollment for this trial is 43 CARTx recipients and 10 healthy controls. The study is open to anyone regardless of gender or ethnicity.
OUTLINE:
BOLUS COHORT: Patients receive the inactivated rabies vaccine intramuscularly (IM) on day 1 and 6-10 weeks later. Patients also undergo a blood collection prior to each vaccine, and at approximately 1, 2, and 4 weeks after each vaccination. A final blood collection occurs 6 months after the first immunization. This will include up to 31 participants.
FRACTIONAL DOSE COHORT: Patients receive the inactivated rabies vaccine fractionated primary dose IM on days 1, 3, 7, 10, 14, and 17 and the second dose 6-10 weeks later. Patients also undergo a blood collection prior to each vaccine, and at approximately 1, 2, and 4 weeks after each vaccination. A final blood collection occurs 6 months after the first immunization. This will include up to 12 participants.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Joshua A. Hill
- Phone Number: 206-667-6504
- Email: jahill3@fredhutch.org
Study Locations
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Washington
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Seattle, Washington, United States, 98109
- Fred Hutch/University of Washington Cancer Consortium
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- CARTx RECIPIENTS: Patients must be capable of understanding and providing a written informed consent
- CARTx RECIPIENTS: Patients must be 18 years of age or older, of any gender, race or ethnicity
- CARTx RECIPIENTS: Patients must have had relapse-free survival for >= 6 months after receiving CARTx for B-cell malignancies
- CARTx RECIPIENTS: Platelet count > 30,000 / mm^3
- HEALTHY CONTROLS: Patients must be capable of understanding and providing a written informed consent
- HEALTHY CONTROLS: Patients must be 18 years of age or older, of any gender, race or ethnicity
Exclusion Criteria:
- CARTx RECIPIENTS: Patients who have received a hematopoietic cell transplant after CARTx
- CARTx RECIPIENTS: Previously received 1 or more rabies vaccines prior to the first vaccine visit
- CARTx RECIPIENTS: Patients who have received lymphodepleting therapies after CARTx and within the past 6 months
- CARTx RECIPIENTS: Patients with signs or symptoms of active infection
- CARTx RECIPIENTS: Patients who are pregnant or breastfeeding
- CARTx RECIPIENTS: Patients with previous known allergies to any component of the vaccine
- CARTx RECIPIENTS: Patients who have previously experienced a reaction to any vaccine that required medical attention
- CARTx RECIPIENTS: Study participants who report a severe adverse event following the first rabies vaccine will not be eligible for a second dose
- CARTx RECIPIENTS: Receiving corticosteroids > 0.5 mg/kg/day prednisone equivalence in the 7 days prior to first or second vaccination
- HEALTHY CONTROLS: Previously received 1 or more rabies vaccines
- HEALTHY CONTROLS: Chronic illness
- HEALTHY CONTROLS: Signs or symptoms of active infection
- HEALTHY CONTROLS: Pregnant or breastfeeding
- HEALTHY CONTROLS: Patients with previous known allergies to any component of the vaccine
- HEALTHY CONTROLS: Previous reaction to a vaccine that required medical attention
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Control (anti-rabies vaccine, collection of blood)
Patients receive anti-rabies vaccine IM on day 1 and 6-10 weeks later.
Patients also undergo collection of blood samples at baseline, and at approximately 1, 2, and 4 weeks after each vaccination.
There will be an additional blood draw 6 months (+/- 14 days) after the first immunization.
|
Undergo collection of blood samples
Other Names:
Given IM
Other Names:
|
|
Experimental: Experimental (anti-rabies vaccine, collection of blood)
BOLUS COHORT: Patients receive the inactivated rabies vaccine IM on day 1 and 6-10 weeks later. Patients also undergo a blood collection prior to each vaccine, and at approximately 1, 2, and 4 weeks after each vaccination. A final blood collection occurs 6 months after the first immunization. FRACTIONAL DOSE COHORT: Patients receive the inactivated rabies vaccine fractionated primary dose IM on days 1, 3, 7, 10, 14, and 17 and the second dose 6-10 weeks later. Patients also undergo a blood collection prior to each vaccine, and at approximately 1, 2, and 4 weeks after each vaccination. A final blood collection occurs 6 months after the first immunization. |
Undergo collection of blood samples
Other Names:
Given IM
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Proportion of participants with positive vaccine response
Time Frame: 4 weeks after the secondary vaccination
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This will be defined as a rabies virus neutralizing antibody (RVNA) titer ≥0.5 IU/ml at week 4 post-secondary immunization.
This RVNA titer is considered to be evidence of an adequate immune response by the World Health Organization.
Will estimate with 95% confidence intervals.
|
4 weeks after the secondary vaccination
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of participants with sustained vaccine response
Time Frame: 6 months after the primary vaccination
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This will be defined as a rabies virus neutralizing antibody (RVNA) titer ≥0.5 IU/ml at 6 months following the primary vaccination in participants who also receive secondary vaccination per-protocol
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6 months after the primary vaccination
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Longitudinal rabies virus neutralizing antibody (RVNA) titers
Time Frame: From baseline (prior to primary vaccination) through 6 months after primary vaccination based on measurements at weeks 0, 1, 2, 4, 6, 7, 8, 10, and 24.
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Will compare quantitative levels of RVNA (log10 IU/mL) between CAR-T cell therapy and healthy participants at weekly intervals after each vaccination and at 6 months after primary vaccination.
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From baseline (prior to primary vaccination) through 6 months after primary vaccination based on measurements at weeks 0, 1, 2, 4, 6, 7, 8, 10, and 24.
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Longitudinal rabies virus binding IgM antibody titers
Time Frame: From baseline (prior to primary vaccination) through 6 months after primary vaccination based on measurements at weeks 0, 1, 2, 4, 6, 7, 8, 10, and 24.
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Will compare quantitative levels of anti-rabies virus IgM between CAR-T cell therapy and healthy participants at weekly intervals after each vaccination and at 6 months after primary vaccination.
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From baseline (prior to primary vaccination) through 6 months after primary vaccination based on measurements at weeks 0, 1, 2, 4, 6, 7, 8, 10, and 24.
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Longitudinal rabies virus binding IgG antibody titers
Time Frame: From baseline (prior to primary vaccination) through 6 months after primary vaccination based on measurements at weeks 0, 1, 2, 4, 6, 7, 8, 10, and 24.
|
Will compare quantitative levels of anti-rabies virus IgG between CAR-T cell therapy and healthy participants at weekly intervals after each vaccination and at 6 months after primary vaccination.
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From baseline (prior to primary vaccination) through 6 months after primary vaccination based on measurements at weeks 0, 1, 2, 4, 6, 7, 8, 10, and 24.
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Joshua A. Hill, Fred Hutch/University of Washington Cancer Consortium
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- RG1007238
- 10411 (Other Identifier: CTEP)
- NCI-2020-03444 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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