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Mutantní KRAS – cílená vakcína s dlouhými peptidy pro pacienty s vysokým rizikem rozvoje rakoviny pankreatu

This Phase 1 study will evaluate safety and the immune response to pooled mutant-KRAS peptide vaccine with poly-ICLC adjuvant for patients who have been identified to be at risk of developing pancreatic cancer.

Přehled studie

Postavení

Aktivní, ne nábor

Podmínky

Intervence / Léčba

Detailní popis

This study will evaluate safety and the immune response to pooled mutant-KRAS peptide vaccine (KRAS peptide vaccine) with poly-ICLC adjuvant. The primary endpoints of this study are to determine the safety of administering the KRAS peptide vaccine with poly-ICLC adjuvant and to assess the maximal percent change of IFN-γ-producing mutant-KRAS-specific T cells per patient at any time after vaccination. Twenty five patients will be enrolled to achieve 20 evaluable patients for Cohort A. Twelve patients will be enrolled to achieve 10 evaluable patients for Cohort B.

For all patients, the study will consist of a screening phase, treatment phase, and a follow-up visit. All subjects will have the option remaining on study with annual follow-up visits that begin approximately one year after the last vaccine dose and continue annually thereafter until study closure.

Typ studie

Intervenční

Zápis (Aktuální)

31

Fáze

  • Fáze 1

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Maryland
      • Baltimore, Maryland, Spojené státy, 21231
        • Sidney Kimmel Comprehensive Cancer Center

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

40 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ano

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

Cohort A: Must fall into one of the three categories defined as high risk of developing pancreatic cancer and are undergoing pancreatic surveillance AND 2) have documented radiographic evidence of a pancreatic abnormality such as a pancreatic cyst.

  • High Risk Group 1 (familial pancreatic cancer relatives):

    • >/=55 years old or 10 years younger than the age of youngest relative with pancreatic cancer, and
    • Come from a family with 2 or more members with a history of pancreatic cancer (2 of which have a first-degree relationship consistent with familial pancreatic cancer), and
    • Have a first-degree relationship with at least one of the relatives with pancreatic cancer.
    • If there are 2 or more affected blood relatives, at least 1 must be a first-degree relative of the individual being screened.
  • High Risk Group 2 (Germline mutation carriers with an associated with an estimated lifetime risk of pancreatic cancer of ~10% or higher):

    • >/=40 years old and the Patient is a carrier of FAMMM (p16/CDKN2A) mutation regardless of family pancreas cancer history.

OR

  • >/= 50 years old or 10 years younger than the age of the youngest relative with pancreatic cancer, and the Patient is a carrier of a known BRCA2, ATM, PALB2 mutation.

  • Persons with known genetic mutation should have proof of mutation status. Those who had research-related genetic testing must have confirmation by a clinical CLIA-certified laboratory.

    o High Risk Group 3 (Germline mutation carriers with an associated with an estimated lifetime risk of pancreatic cancer of ~5%):

  • >/= 50 years old or 10 years younger than the age of the youngest relative with pancreatic cancer, and

  • The patient is a carrier of a known, BRCA1, or HNPCC (hereditary non-polyposis colorectal cancer or Lynch syndrome, hMLH1, hMSH2, PMS1, hMSH6, EpCAM) gene mutation, and there is > 1 pancreatic cancer in the family, one of whom is a first- or second-degree relative of the subject to be screened.

  • Persons with known genetic mutation should have proof of mutation status. Those who had research-related genetic testing must have confirmation by a clinical CLIA-certified laboratory.

  • Cohort A: Patients must have a pancreatic imaging abnormality that is being followed by pancreatic imaging surveillance (EUS and/or MRI and /or CT), such as a pancreatic cyst consistent with an IPMN or parenchymal abnormalities consistent with PanIN.

    • Cohort B: Patients must have clinical, radiographic, or histologic evidence of pancreatic cystic neoplasm with high-risk features warranting surgical resection per the discretion of the treating hepatobiliary surgeon.
    • Cohort B: Patients must have cystic fluid testing that demonstrates the presence of one of the six KRAS mutations included in the study vaccine.
  • Patients must have adequate organ and marrow function defined by study-specified laboratory tests prior to initial study drug.

  • Ability to understand and willingness to sign a written informed consent document.

  • Woman of childbearing potential must have a negative pregnancy test and follow contraceptive guidelines as defined per protocol.

  • Men must use acceptable form of birth control while on study.

Exclusion Criteria:

  • If expected to require any other form of systemic or localized antineoplastic therapy while on study.

  • Within 4 weeks prior to first dose of study drug.

    o Any systemic or topical corticosteroids at immunosuppressive agents.

  • Within 4 weeks prior to first dose of study drug.

    • Any investigational device.
    • Has received a live vaccine.
    • Received any allergen hyposensitization therapy.
    • Any major surgery.
  • Infection with HIV or hepatitis B or C.

  • Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia, metastatic cancer, or psychiatric illness/social situations that would limit compliance with study requirements monoclonal antibody.

  • Has a diagnosis of immunodeficiency.

  • Any other sound medical, psychiatric, and/or social reason as determined by the Investigator.

  • Unwilling or unable to follow the study schedule for any reason.

  • Are pregnant or breastfeeding.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Prevence
  • Přidělení: Nerandomizované
  • Intervenční model: Sekvenční přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Cohort A: Patients at high risk of developing pancreatic cancer.

Patients will include those who have undergone pancreatic imaging with MRI or CT or EUS and found to have one or more pancreatic imaging abnormalities such as a pancreatic cyst consistent with an intraductal papillary mucinous neoplasm (IPMN) or parenchymal changes consistent with pancreatic intraepithelial neoplasia (PanIN). additionally patients with:

  1. familial pancreatic cancer relatives
  2. germline mutation carriers with an estimated lifetime risk of pancreatic cancer of ~10% or higher
  3. germline mutation carriers with an estimated lifetime risk of pancreatic cancer of ~5%, all detailed in Section 3.1.1. These patients must also (as defined in Section 3.1.2).
  1. KRAS peptide vaccine with poly-ICLC adjuvant will be administered on Prime week 1, 3, and 5. Boost vaccinations with will be administered at week 13. All subjects will return to the study site approximately 28 days (+ 7 days) after the last vaccination for an End of Treatment (EOT) and safety evaluation.
  2. Drug: up to 1.8 mg KRAS peptide vaccine + 0.5mg Poly-ICLC
Ostatní jména:
  • Hiltonol® (Poly-ICLC)
Experimentální: Cohort B: Patients must have evidence of a pancreatic cystic neoplasm

Patients must have clinical, radiographic, or histologic evidence of a pancreatic cystic neoplasm with high-risk features warranting surgical resection per the discretion of the treating hepatobiliary surgeon. In addition, cyst fluid analysis must demonstrate the presence of one of the six KRAS mutations included in the study vaccine. Germline mutation testing or a positive family history of pancreatic cancer is not required for enrollment in Cohort B.

Patients will receive KRAS peptide vaccine with poly-ICLC adjuvant as two prime vaccinations on weeks 1 and 2. Surgery is considered standard of care. Surgery will occur at the discretion of the treating hepatobiliary surgeon and is not dictated by this protocol. Subjects will return to the study site approximately at week 4 (+ 7 days) for a safety evaluation prior to surgery. Subjects will have an End of Treatment (EOT) visit at study Week 8 (+ 7 days).

Ostatní jména:
  • Hiltonol® (Poly-ICLC)

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Number of participants experiencing study drug-related toxicities
Časové okno: 1.5 years

Number of participants experiencing study drug-related adverse events Grade 3 or higher as defined by CTCAE v5.0

1.5 years
Maximal percentage of change of interferon (IFN-γ) producing mutant-KRAS-specific CD8 and CD4 T cells
Časové okno: 17 weeks

Maximal percent change per patient within 17 weeks after vaccination.

17 weeks

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 5 weeks.
Časové okno: Baseline, 5 weeks (Cohort A)

Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 5 weeks after vaccination compared to pre-vaccination baseline.

Baseline, 5 weeks (Cohort A)
Fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 13 weeks.
Časové okno: Baseline, 13 weeks (Cohort A)

Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 13 weeks after vaccination compared to pre-vaccination baseline.

Baseline, 13 weeks (Cohort A)
Fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 17 weeks.
Časové okno: Baseline,17 weeks (Cohort A)

Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 17 (EOT) weeks after vaccination compared to pre-vaccination baseline.

Baseline,17 weeks (Cohort A)

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 1 weeks.
Časové okno: Baseline, 1 week (Cohort B)

Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 5 weeks after vaccination compared to pre-vaccination baseline.

Baseline, 1 week (Cohort B)
Fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 4 weeks.
Časové okno: Baseline, 4 weeks (Cohort B)

Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 13 weeks after vaccination compared to pre-vaccination baseline.

Baseline, 4 weeks (Cohort B)
Fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 8 weeks.
Časové okno: Baseline, 8 weeks (Cohort B)

Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells at 17 (EOT) weeks after vaccination compared to pre-vaccination baseline.

Baseline, 8 weeks (Cohort B)

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Spolupracovníci

Vyšetřovatelé

  • Vrchní vyšetřovatel: Nilofer Azad, MD, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Medical Institution

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

11. dubna 2022

Primární dokončení (Odhadovaný)

1. října 2027

Dokončení studie (Odhadovaný)

1. května 2031

Termíny zápisu do studia

První předloženo

18. srpna 2021

První předloženo, které splnilo kritéria kontroly kvality

18. srpna 2021

První zveřejněno (Aktuální)

19. srpna 2021

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

6. října 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

5. října 2026

Naposledy ověřeno

1. října 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • J2177
  • IRB00288752 (Jiný identifikátor: Johns Hopkins Medical Institution)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ano

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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