Prime-boost Vaccine Study in Women With Low-grade Cervical HPV Lesions

January 18, 2024 updated by: Barinthus Biotherapeutics

A Phase 1b/2, Randomised, Placebo-controlled, Dose-ranging Study to Evaluate Safety, Tolerability and Immunogenicity of a Chimpanzee Adenovirus (ChAdOx1)-Vectored Multigenotype High Risk Human Papillomavirus (hrHPV) Vaccine and Modified Vaccinia Ankara (MVA)-Vectored Multigenotype hrHPV Vaccine in Women With Low-grade HPV-related Cervical Lesions

A Phase 1b/2 multi-centre study evaluating the safety, efficacy and immunogenicity of prime-boost vaccines ChAdOx1-HPV and MVA-HPV in women with HPV related low grade cervical lesions.

Study Overview

Detailed Description

The study consists of an open label, non-randomised, dose escalation Lead in phase. 9 participants with high-risk HPV, in cohorts of 3 in 3 dose ascending groups, will be vaccinated after SMC safety data reviews.

This is followed by a blinded, randomised Main phase with 96 participants with high-risk HPV, in parallel running dose cohorts (three different doses of ChAdOx1-HPV plus two different doses of MVA-HPV versus placebo plus placebo boost). At least 60 of these participants will take part in the immunogenicity sub-study.

A blinded, randomised expansion phase investigating the effects of up to two different main phase doses against placebo will be further defined prior to commencing this phase of the study.

Study Type

Interventional

Enrollment (Actual)

99

Phase

  • Phase 2
  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Antwerp, Belgium, 2650
        • UZA
      • Brussels, Belgium, 1090
        • UZ Brussel
      • Brussels, Belgium, 1070
        • Erasme hospital
      • Gent, Belgium, 9000
        • UZ Gent
      • Leuven, Belgium, 3000
        • UZ Leuven
      • Parnu, Estonia, 80010
        • Parnu Hospital Womens and Childrens Clinic
      • Tallinn, Estonia, 10119
        • East-Tallinn Central Hospital
      • Tallinn, Estonia, 13419
        • North Estonia Medical Centre Foundation Surgery Clinic
      • Tartu, Estonia, 51014
        • Tartu University Hospital Womens Clinic
      • Aberdeen, United Kingdom, AB25 2ZN
        • Aberdeen Royal Infirmary
      • Bristol, United Kingdom, BS2 8EG
        • University Hospital Bristol NHS Trust
      • Liverpool, United Kingdom, L8 7SS
        • Liverpool Women's NHS Foundation Trust
      • Newcastle Upon Tyne, United Kingdom, NE1 4LP
        • Royal Victoria Infirmary
      • Nottingham, United Kingdom, NG5 1PB
        • Nottingham University Hospital NHS Trust
      • Oxford, United Kingdom, OX3 9DU
        • The University of Oxford, Nuffield Department of Women's & Reproductive Health
      • Preston, United Kingdom, PR2 9HT
        • Royal Preston Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

25 years to 55 years (Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Females aged ≥25 and ≤55 years of age at screening.
  2. Persistent hrHPV infection defined as a documented cervical infection with hrHPV type(s) in the 6 to 18 months prior to screening and confirmed at screening (participants in the main and expansion phases only). Participants in the lead-in phase are only required to have the screening result.
  3. Low- grade cervical lesion (CIN1 or HPV-related change only) confirmed by histology and/or cytology report within the 1 year prior to screening.
  4. Not pregnant or breast feeding and one of the following:

    • Of non-childbearing potential (i.e. women who have had a hysterectomy or tubal ligation or are postmenopausal, as defined by no menses for at least 12 months and without an alternative medical cause)
    • Of childbearing potential but agrees to practice highly effective contraception for 4 weeks prior to administration of the first dose of study vaccine and throughout the study until 8 weeks after administration of the second dose. Highly effective methods of contraception include one or more of the following:

      • Male partner who is sterile (medically effective vasectomy) prior to the female participant's entry into the study and is the sole sexual partner for the female participant
      • Hormonal (oral, intravaginal, transdermal, implantable or injectable). Progestogen-only hormonal contraceptives without inhibition of ovulation are not considered to be highly effective.
      • An intrauterine hormone releasing system
      • An intrauterine device
      • Bilateral tubal occlusion
      • Sexual abstinence, only if the participant refrains from heterosexual intercourse during the entire study period and it is the usual lifestyle of the participant
  5. Willing to abstain from sexual activity for 48 hours prior to all swabbing procedures

Exclusion Criteria:

  1. Presence of any significant acute or chronic, uncontrolled medical (or psychiatric) illness, including blood dyscrasias.
  2. Immunosuppression as a result of underlying illness or treatment including:

    • Use of high dose corticosteroids ( >10 mg/day prednisone or equivalent) for ≥7 days (inhaled, otic and ophthalmic corticosteroids are permitted)
    • Primary immune deficiency disease
    • Use of synthetic or biologic disease-modifying antirheumatic drugs
    • History of bone marrow or solid organ transplant
    • History of any other clinically significant autoimmune or immunosuppressive disease
  3. Positive diagnostic tests (for human immunodeficiency virus, hepatitis B or hepatitis C) indicating chronic infection.
  4. Evidence of high grade cervical lesions by colposcopy or by Papanicolaou (Pap) smear test in the 1 year prior to screening.
  5. Any history of anaphylaxis in reaction to vaccination or history of allergic reactions likely to be exacerbated by any component of the vaccine, e.g. severe allergy to eggs.
  6. Receipt of any investigational drug or investigational vaccine within 3 months prior to administration of ChAdOx1-HPV on Day 0, or prior participation in a clinical study of any HPV vaccine.
  7. Receipt of any adenoviral based vaccine within 3 months prior to administration of ChAdOx1 HPV on Day 0, or plan to receive an adenoviral-based vaccine within 3 months after Day 0.
  8. Receipt of any live vaccines within the 30 days or inactivated vaccine within the 14 days prior to administration of ChAdOx1-HPV on Day 0 or planned to occur in the 2 months after the Day 0 vaccination.
  9. Current or history of illicit drug use within the 6 months prior to screening.
  10. Current or history of severe alcohol abuse within the 6 months prior to screening.
  11. Any laboratory test which is abnormal and deemed by the Investigator to be clinically significant which will potentially affect the participation in the study.
  12. Current known infection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2)
  13. Any other finding that, in the opinion of the Investigator, deems the participant unsuitable for the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Sequential Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Lead-in Group A ChAdOx1-HPV low dose and MVA-HPV low dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^8 vp) and MVA-HPV (1 x 10^7 pfu)
Trial vaccine
Trial vaccine
Experimental: Lead-in Group B ChAdOx1-HPV mid dose and MVA-HPV low dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^9 vp) and MVA-HPV (1 x 10^7 pfu)
Trial vaccine
Trial vaccine
Experimental: Lead-in Group C ChAdOx1-HPV high dose and MVA-HPV high dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^10) vp and MVA-HPV (1 x 10^8 pfu)
Trial vaccine
Trial vaccine
Experimental: Group 1 ChAdOx1-HPV mid dose and MVA-HPV low dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^9 vp) and MVA-HPV (1 x 10^7 pfu)
Trial vaccine
Trial vaccine
Experimental: Group 2 ChAdOx1-HPV high dose and MVA-HPV low dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^10 vp) and MVA-HPV (1 x 10^7 pfu)
Trial vaccine
Trial vaccine
Experimental: Group 3 ChAdOx1-HPV low dose and MVA-HPV high dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^8 vp) and MVA-HPV (1 x 10^8 pfu)
Trial vaccine
Trial vaccine
Experimental: Group 4 ChAdOx1-HPV mid dose and MVA-HPV high dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^9 vp) and MVA-HPV (1 x 10^8 pfu)
Trial vaccine
Trial vaccine
Experimental: Group 5 ChAdOx1-HPV high dose and MVA-HPV high dose
Prime-boost vaccine doses: ChAdOx1-HPV (2 x 10^10 vp) and MVA-HPV (1 x 10^8 pfu)
Trial vaccine
Trial vaccine
Placebo Comparator: Group 6 Placebo Saline
Sodium Chloride (0.9%)
Saline placebo vaccine

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of adverse events to measure safety and reactogenicity
Time Frame: 3 months for the lead-in and 12 months for the main phase
Measure of adverse events, serious adverse events (SAEs), ≥Grade 3 study vaccine-related adverse events reported.
3 months for the lead-in and 12 months for the main phase

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Determine the dose of ChAdOx1-HPV plus MVA-HPV vaccines for further development
Time Frame: 3 months for lead in phase and 12 months for main phase
Measurement of the highest multi-parameter index made of CD4+ magnitude, CD4+ avidity and CD8+ magnitude at peak timepoint
3 months for lead in phase and 12 months for main phase
Determine the effect of ChAdOx1-HPV plus MVA-HPV vaccines on the clearance of high risk HPV infection
Time Frame: 12 months for main phase only
The percentage of hrHPV infection clearance
12 months for main phase only
Determine the effect of ChAdOx1-HPV plus MVA-HPV vaccines on cervical intraepithelial neoplasia (CIN)
Time Frame: 12 months for main phase only
The percentage of cervical lesions cleared as determined by colposcopy
12 months for main phase only

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Assess the complex cellular immune response generated by ChAdOx1-HPV plus MVA-HPV vaccines
Time Frame: 3 months for lead in phase and 12 months for main phase
This will be assessed by measuring the individual phenotypic subsets of CD4+ and CD8+ T cells induced by vaccination
3 months for lead in phase and 12 months for main phase
Assess the complex cellular immune response generated by ChAdOx1-HPV plus MVA-HPV vaccines
Time Frame: 3 months for lead in phase and 12 months for main phase
This will be assessed by measuring the innate immune response after vaccination compared to baseline
3 months for lead in phase and 12 months for main phase
Assess the complex cellular immune response generated by ChAdOx1-HPV plus MVA-HPV vaccines
Time Frame: 3 months for lead in phase and 12 months for main phase
This will be assessed by measuring the T cell breadth of response to the components of the ChAdOx1-HPV plus MVA-HPV vaccines
3 months for lead in phase and 12 months for main phase
Assess the complex cellular immune response generated by ChAdOx1-HPV plus MVA-HPV vaccines
Time Frame: 3 months for lead in phase and 12 months for main phase
Immune responses after prime and boost vaccinations in cytobrush samples compared to baseline
3 months for lead in phase and 12 months for main phase

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 16, 2021

Primary Completion (Actual)

January 16, 2024

Study Completion (Actual)

January 16, 2024

Study Registration Dates

First Submitted

October 22, 2020

First Submitted That Met QC Criteria

October 22, 2020

First Posted (Actual)

October 29, 2020

Study Record Updates

Last Update Posted (Estimated)

January 19, 2024

Last Update Submitted That Met QC Criteria

January 18, 2024

Last Verified

January 1, 2024

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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