- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04879888
Personalized Vaccine for Cancer Immunotherapy
Estudio clínico Fase I de Inmunoterapia Con Vacunas sintéticas Personalizadas en Pacientes Con cáncer de Mama Triple Negativo
Due to their genetic instability, breast tumors that do not express receptors for Estrogens, Progestagens or amplify the Her2 / neu oncogene [called triple-negative breast cancer (TNTC)] and other tumors such as melanoma, non-small cell lung cancer, accumulate numerous mutations that make them highly resistant to different regimens of chemo- or radiotherapy, thereby generating high morbidity and mortality. However, immunology can turn the genetic instability of tumors into the Achilles' tendon. Evidence of this has been revealed in Phase I clinical studies in patients with melanoma and lung cancer in an advanced stage of metastasis treated with Ipilimumab (anti-CTLA4) to decrease immunosuppression, in whom peptides containing mutations presented in Major Complex molecules Histocompatibility of Class I (HCM I) of the tumor itself results in their recognition as "foreign" neo-antigens leading to the efficient destruction of the tumor by anti-tumor CD8 + T lymphocytes that are amplified when they are vaccinated with these peptides.
For this reason, the identification of non-synonymous mutations of single amino acid and vaccination with 25 amino acid peptides that incorporate these mutations (synthetic vaccines) is emerging today as an alternative for immunotherapy of cancers responsible for high mortality in humans. In an approach that takes 16 weeks, today, it is possible to go from the analysis of the tumor's transcriptome (which allows identifying the universe of tumor mutations) to the patient's vaccination with a personalized vaccine that contains neo-antigens of his tumor.
TNBC is the most aggressive breast tumor, representing around 25% of breast cancers in our environment. While generally, at least 30% of women with other types of metastatic breast cancer survive 5 years after diagnosis, most patients diagnosed with metastatic CMTN die within this time. The lack of selective therapies and the poor prognosis of patients with NTMC make their therapeutic management difficult, so the implementation of new therapies for this type of tumor is the main focus of researchers who seek more effective and selective treatments to improve the life expectancy of patients without compromising their quality of life. The genetic instability and high rate of mutations of the TNBC most likely favor the generation of neo-epitopes. Still, due to the immunosuppressive environment of the tumor, it escapes the immunosurveillance of the immune system. Despite the high mortality induced by this tumor, a percentage of patients treated with neoadjuvant chemotherapy with agents such as Doxorubicin and Cyclophosphamide (AC) + Taxanes respond to this chemotherapy regimen. In particular, the anti-tumor effect of AC is attributed to two things: (i) the direct cytotoxic effect on the tumor cell, (ii) the immunostimulation of T lymphocytes promoted by Immunogenic Cell Death (ICM) selectively induced by these drugs. Therefore, in this project, we propose to carry out the first clinical study in Colombia of vaccination of patients with TNBC with synthetic peptides that contain mutations of their own tumor to evaluate the immunogenicity and safety of this type of personalized vaccine as a therapeutic alternative for this tumor. Achieving the specific objectives set out in this project would mean that we have been validated in Colombia the experimental design necessary to identify unique epitopes in tumors and demonstrate the safety and immunogenicity of these vaccines. We consider that having achieved the above; we will have taken an important step towards the implementation in our country of the use of this type of vaccine for immunotherapy not only of TNBC but of other tumors such as glioblastoma, gastric, esophagus, and pancreas, highly fatal due to its high mutation rate.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Cundinamarca
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Bogota, Cundinamarca, Colombia, 111321
- Facultad de Medicina - Universidad Nacional de Colombia
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with a diagnosis of ductal cancer who enter the primary or neoadjuvant chemotherapy regimen treated with Doxorubicin or Cyclophosphamide.
- Patients with breast cancer with the HLA-A * 02: 01 haplotype.
- Women of legal age who are not pregnant or breastfeeding (patients or controls).
- Patients who have histologically confirmed primary breast carcinoma of the ductal type.
- Karnofsky index greater than 70%
- Voluntary acceptance of informed consent.
Exclusion Criteria:
- Patients with a diagnosis of triple-negative breast cancer.
- Pregnant patients
- Patients under age or over 70 years
- Patients diagnosed with autoimmune diseases
- The patient has a Karnofsky lower than 70% or an ECOG higher than 1.
- Patients who have received some therapy as a treatment for their tumor pathology (radiotherapy, chemotherapy, immunotherapy, or gene therapy).
- Active autoimmune disease requiring treatment or a history of autoimmune disease that could be exacerbated by treatment. Patients with endocrine disease controlled by replacement therapy, including thyroid disease, adrenal disease, and vitiligo, can be included.
- Presence of a chronic or acute infection, such as HIV, viral hepatitis, or tuberculosis, before or after signing the informed consent.
- Use of immunosuppressants within 4 weeks before the trial (e.g., corticosteroids), such as azathioprine, prednisone, or cyclosporine A. The use of local steroids (topical, nasal, or inhaled) may be acceptable.
- Clinically significant cardiomyopathy, which requires treatment.
- Splenectomized patients.
- Patients who do not receive the neoadjuvant chemotherapy regimen with Doxorubicin and cyclophosphamide for three cycles or receive some other type of complementary therapy such as taxanes.
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: Vacuna
Triple-negative breast cancer patients with specific tumor mutation, with six doses of peptide-pulsed autologous dendritic cells after surgery.
|
Intradermal vaccination with peptide-pulsed autologous dendritic cells in 200 µL of patient's serum in six doses weekly after surgery.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of adverse effects
Time Frame: From day 0 (vaccination 1) until 1 month after last vaccination
|
Evaluation of number and severity of the adverse effects in the vaccinated patients
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From day 0 (vaccination 1) until 1 month after last vaccination
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Carlos A Parra-López, MD, PhD, Full time professor
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- VP-CMTN-UN-2017
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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