A Feasibility Study Utilizing Immune Recall to Increase Response to Checkpoint Therapy (TdVax)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Carol Ann Wiggs, BSN
- Phone Number: 919-684-0281
- Email: carolann.wiggs@duke.edu
Study Locations
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-
North Carolina
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Durham, North Carolina, United States, 27710
- Recruiting
- Duke University Medical Center
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Contact:
- Carol Ann Wiggs, BSN
- Phone Number: 919-684-0281
- Email: carolann.wiggs@duke.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically confirmed advanced metastatic melanoma
- Male or female participants who are at least 18 years of age on the day of signing informed consent
- Participants must be planned or scheduled by their treating physician to receive PD-1 therapy or PD-1 plus anti CTLA-4 therapy as standard of care
- Participant (or legally acceptable representative if applicable) provides written informed consent for the trial
- Participant must have at least 1 lesion that is at least 8 mm in size and is cutaneous, subcutaneous, palpable, or amenable to ultrasound guided core biopsy. The lesion chosen for biopsy can also be a target lesion but does not have to be a target lesion
Adequate organ function as defined below. Standard of care labs drawn within 45 days prior to consent may be used for the purposes of determining eligibility
- ANC >/= 1500/uL
- platelets >/=100,000/uL
- Hemoglobin >/= 9.0 g/dL
Exclusion Criteria:
- Uveal or mucosal melanoma
- Any women known to be pregnant or breastfeeding
- Any prior systemic therapy for metastatic melanoma (prior surgery is allowed)
- Known diagnosis of immunodeficiency or receiving chronic systemic steroid therapy (in doses exceeding 10 mg daily of prednisone or equivalent), or any other form of immunosuppressive therapy within 7 days prior to first research biopsy
Patients with symptomatic CNS metastases and/or carcinomatous meningitis
a) Patients with asymptomatic, stable CNS metastases are allowed provided that they are not on >10mg prednisone daily
- History of or active (non-infectious) pneumonitis that required steroids
- Active infection requiring systemic therapy
- Known history of Human Immunodeficiency Virus (HIV) infection
- Known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection. NOTE: no testing for Hepatitis B or Hepatitis C is required
- Known history of active TB (Bacillus Tuberculosis)
- History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with subject's participation for the full duration of the study, or make it not in the best interest of the subject to participate, in the opinion of the treating physician
- Known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial
- History of allogenic tissue or solid organ transplant
- History of allergic reaction to IPOL or Td vaccine
- Receipt of Td vaccine within 30 days prior to starting IO therapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Td Vaccine
The first 15 subjects enrolled will receive the Td (tetanus diphtheria) vaccine at cycle 4 of IO therapy.
The Td vaccine is administered as 0.5 mL intramuscular injection in the extremity (thigh or upper arm) in closest proximity to the largest tumor.
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tetanus and diphtheria toxoids
Other Names:
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Experimental: IPOL Vaccine
Subjects 16 through 25 will receive the IPOL (polio booster) vaccine at cycle 4 of IO therapy.
The IPOL vaccine is administered as 0.5 mL intramuscular or subcutaneous injection in the extremity (thigh or upper arm) in closest proximity to the largest tumor
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trivalent inactivated polio vaccine
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of subjects out of the proposed 25 that successfully receive the vaccine after 4 cycles of IO therapy
Time Frame: informed consent through date of vaccine (est apx 4-5 months)
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Evaluable patients are defined as those who receive four cycles of IO therapy and then receive a Td or IPOL vaccine
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informed consent through date of vaccine (est apx 4-5 months)
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Safety, as measured by the change in the number and severity of adverse events deemed related to the vaccine or study procedures (blood draw and biopsies)
Time Frame: Baseline, cycle 4 of IO therapy (apx 12-16 weeks), 12-17 days post vaccine, SOC scan following vaccine (apx 8-12 weeks post vaccine)
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Adverse events will only include those that are determined to be related to the study vaccine or study procedures (blood draw and biopsies)
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Baseline, cycle 4 of IO therapy (apx 12-16 weeks), 12-17 days post vaccine, SOC scan following vaccine (apx 8-12 weeks post vaccine)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Preliminary efficacy, as measured by objective response rate
Time Frame: up to 36 months
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Number of patients that experience tumor response vs. stable disease vs. progression as determined by PI assessment of standard of care scans
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up to 36 months
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Georgia Beasley, MD, Duke University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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 (Actual)
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
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Skin Diseases
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroendocrine Tumors
- Nevi and Melanomas
- Skin Neoplasms
- Skin and Connective Tissue Diseases
- Melanoma
- Biological Products
- Complex Mixtures
- Bacterial Vaccines
- Vaccines
- Diphtheria Toxoid
- Toxoids
- Tetanus Toxoid
- Vaccines, Combined
- Diphtheria-Tetanus Vaccine
Other Study ID Numbers
Other Study ID Numbers
- Pro00108367
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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