- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04049864
DNA Vaccination Against Neuroblastoma
Pilot Clinical Study of DNA Vaccination Against Neuroblastoma
This is pilot open-label study to evaluate the safety and immunogenicity of a DNA vaccine strategy in relapsed neuroblastoma patients following chemotherapy and HSC transplantation. The combined form of the vaccine includes an intramuscular injection of the DNA-polyethylenimine conjugate and oral administration using the attenuated Salmonella enterica as DNA vaccine carriers.
Objectives of the study:
- To assess safety and document local and systemic toxicity to combined DNA vaccine
- To determine immunogenicity of the vaccine
- To evaluate clinical response to vaccination. Control of minimal residual disease in bone marrow and duration of remission.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
DNA vaccine construction includes chimeric fusion of neuroblastoma-associated antigen and potato virus X coat protein (PVXCP) as an immune enhancer. In each course vaccine for one antigen is applies. The selection of antigens is carried out after analyzing of their expression in the tumor biopsy material by PCR and IHC. The list of antigens used in the study: tyrosine hydroxylase (TH), Phox2B, Survivin, MAGEA1, MAGEA3, PRAME. The antigens with the highest level of expression in the tumor sample of each patient are selected for vaccination.
Vaccination schedule for each patient includes three courses of vaccination. One course includes three administrations of vaccines against a single antigen. Vaccination is repeated at intervals of 1 week (plus minus 3 working days). Break between courses - 3-4 weeks. Each vaccination includes an injection and taking a capsule with a dose of bacteria.
For intramuscular injection, we use conjugate (polyplex) DNA with linear polyethylenimine 20 kDa (PEI). One dose includes 400 µg of DNA and 500 µg of PEI. When administered orally, the patient receives a suspension 10^10 CFU of an attenuated Salmonella enterica serovar typhimurium strain (SS2017) containing the plasmid of the corresponding DNA vaccine.
Before and during vaccination, an accompanying chemotherapy is carried out, including cyclophosphamide, propranolol, celecoxib and lenalidomide. Cyclophosphamide is prescribed three days before the start of each vaccination course in a single dose of 300 mg / m2. Lenalidomide is prescribed in a dose of 25 mg / day in a course of three weeks starting 7 days before the first vaccination course and ending on the day of the last vaccination course
Study Type
Enrollment (Anticipated)
Phase
- Early Phase 1
Contacts and Locations
Study Contact
- Name: Alexander N Meleshko, PhD
- Phone Number: +375296940023
- Email: alexander.meleshko@gmail.com
Study Locations
-
-
Minsk Region
-
Minsk, Minsk Region, Belarus, 223053
- Recruiting
- Belarussian Research Center for Pediatric Oncology, Hematology and Immunology
-
Contact:
- Phone Number: +375 17 265 42 22
- Email: mail@oncology.by
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- The diagnosis of neuroblastoma recurrence with morphological / cytological confirmation;
- The presence of tumor tissue for biopsy;
- The absence of progression or a large tumor mass (bulky disease);
- The physical status on the scale of ECOG 0 - 2.
- Life expectancy of at least 12 months
- Indicators of cellular immunity of the blood: lymphocytes - at least 1 * 10^9;
- Availability of written informed consent of the patient and his parents (legal representatives) to participate in this protocol.
- Compliance of parents (legal representatives) and the patient himself with participation in the study protocol.
Exclusion Criteria:
A. Based on the anamnesis:
- The presence of any primary immunodeficiency;
- The presence of a primary multiple malignant tumor;
- The presence of autoimmune diseases in history (except thyroiditis);
- Polyalgia;
- Severe diseases, including those with severe symptoms, untreated inflammatory and infectious processes, due to which the patient cannot receive treatment in accordance with the study protocol.
- Socioeconomic or geographical circumstances that cannot guarantee proper compliance with the requirements of the protocol for treatment and further observation.
B. based on survey data:
- The absence of expression in the tumor tissue of two or more antigens used in the protocol;
- The level of peripheral blood leukocytes <1.5 × 10^9 /L, platelet <50.0 × 10^9 /L, Hemoglobin less than 80 g / L;
- Positive tests for human immunodeficiency virus (HIV), hepatitis B or C.
- Severe impaired liver function - the levels of AST / SGOT or ALT / SGPT exceed the upper limit of normal 5 times or more.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: All subjects
All subjects will receive the vaccine and be followed per the schedule of procedures.
|
conjugate of plasmid DNA with linear polyethylenimine 20 kDa (PEI) One dose includes 400 µg of DNA and 500 µg of PEI.
Other Names:
suspension 10^10 CFU of an attenuated Salmonella enterica serovar typhimurium strain (SS2017) containing the plasmid of the corresponding DNA vaccine.
Lenalidomide is prescribed in a dose of 25 mg / day in a course of three weeks starting 7 days before the first vaccination course and ending on the day of the last vaccination course.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adverse events experienced by subjects
Time Frame: for 3 months from the first vaccination
|
To assess the safety of the DNA-PEI and Salmonella vaccines
|
for 3 months from the first vaccination
|
Immune response to the vaccine
Time Frame: In check point after 2nd course (9 week after first vaccine)
|
Immunogenicity will be evaluated by assessing T-cell IFN-γ production in ELISPOT and PVXCP antibody production by ELISA
|
In check point after 2nd course (9 week after first vaccine)
|
Immune response to the vaccine
Time Frame: In check point after 3rd course (14 week after the first vaccine)
|
Immunogenicity will be evaluated by assessing T-cell IFN-γ production in ELISPOT and PVXCP antibody production by ELISA
|
In check point after 3rd course (14 week after the first vaccine)
|
Minimal residual disease - MRD
Time Frame: up to 4 weeks after the last vaccination
|
MRD in bone marrow measured by RQ-PCR and flow cytometry
|
up to 4 weeks after the last vaccination
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression free survival - PFS
Time Frame: Up to 12 months
|
Time from treatment to date of first documented progression or date of death
|
Up to 12 months
|
Collaborators and Investigators
Investigators
- Study Director: Inna V Proleskovskaya, PhD, MD, Belarussian Research Center for Pediatric Oncology, Hematology and Immunology
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms, Glandular and Epithelial
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroectodermal Tumors, Primitive
- Neuroectodermal Tumors, Primitive, Peripheral
- Neuroblastoma
- Physiological Effects of Drugs
- Antineoplastic Agents
- Immunologic Factors
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Vaccines
- Lenalidomide
Other Study ID Numbers
- BelarusianPediatric
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Relapsed Neuroblastoma
-
Stephan Grupp MD PhDChildren's Hospital of Philadelphia; University of Pennsylvania; Tmunity TherapeuticsRecruitingRefractory Neuroblastoma | High-risk Neuroblastoma | Relapsed NeuroblastomaUnited States
-
Emory UniversityRecruitingNeuroblastoma | Refractory Neuroblastoma | Relapsed NeuroblastomaUnited States
-
Clarity Pharmaceuticals LtdRecruitingNeuroblastoma | Refractory Neuroblastoma | Relapsed NeuroblastomaUnited States
-
Nationwide Children's HospitalRecruitingRefractory Neuroblastoma | Relapsed NeuroblastomaUnited States
-
Giselle ShollerVan Andel Research InstituteCompletedRefractory Neuroblastoma | Relapsed NeuroblastomaUnited States
-
Baylor College of MedicineCancer Prevention Research Institute of Texas; The Methodist Hospital Research... and other collaboratorsActive, not recruitingRefractory Neuroblastoma | Uveal Melanoma | Relapsed Ewing Sarcoma | Relapsed Osteosarcoma | Relapsed Neuroblastoma | Relapsed Rhabdomyosarcoma | Phyllodes Breast TumorUnited States
-
Sinobioway Cell Therapy Co., Ltd.Children's Hospital of Fudan University; Nanjing Children's HospitalUnknownRelapsed or Refractory NeuroblastomaChina
-
Masonic Cancer Center, University of MinnesotaSuspendedRelapsed Neuroblastoma | Metastatic PheochromocytomaUnited States
-
Dana-Farber Cancer InstitutePatient-Centered Outcomes Research InstituteActive, not recruitingRelapsed NeuroblastomaUnited States
-
PersonGen BioTherapeutics (Suzhou) Co., Ltd.Tianjin Medical University Cancer Institute and Hospital; Shandong Cancer Hospital...RecruitingB7-H3-positive Relapsed/ Refractory NeuroblastomaChina
Clinical Trials on DNA vaccine
-
National Institute of Allergy and Infectious Diseases...The Emmes Company, LLCCompleted
-
National Institute of Allergy and Infectious Diseases...The Emmes Company, LLCCompleted
-
Eli Lilly and CompanyMemorial Sloan Kettering Cancer CenterCompleted
-
Washington University School of MedicineSusan G. Komen Breast Cancer FoundationCompletedTriple Negative Breast Cancer | Triple Negative Breast Neoplasms | Triple-Negative Breast CancerUnited States
-
French National Agency for Research on AIDS and...CompletedChronic Hepatitis BFrance
-
Memorial Sloan Kettering Cancer CenterNational Cancer Institute (NCI)CompletedMelanoma (Skin)United States
-
National Institute of Allergy and Infectious Diseases...HIV Vaccine Trials NetworkCompletedHIV InfectionsUnited States
-
University Hospital Southampton NHS Foundation...Imperial College Healthcare NHS Trust; Royal Devon and Exeter NHS Foundation... and other collaboratorsCompletedLeukaemia (Acute) | Leukaemia (Chronic) | Leukaemia (Acute Myeloid) | Leukaemia (Acute Lymphoblastic) | Leukaemia (Acute Promyelocytic)United Kingdom
-
Institut National de la Santé Et de la Recherche...Completed
-
Washington University School of MedicineCompleted