Vacc-4x + Lenalidomide vs. Vacc-4x +Placebo in HIV-1-infected Subjects on Antiretroviral Therapy (ART) (IMID)
A Double-blind Placebo Controlled Immunogenicity Study of Vacc-4x + Lenalidomide Versus Vacc-4x With an Initial Open-label Dose Escalation Assessment of Lenalidomide in HIV-1-infected Subjects on Antiretroviral Therapy (ART).
調査の概要
詳細な説明
Human immunodeficiency virus (HIV) infects the CD4 subset of T-cells that are critical for initiating immune responses to infection. The level of CD4 cells in the blood is a marker of a patient's immunological status. The number of CD4 cells decreases in the course of the HIV infection and results in a reduced immunological response and eventually immune deficiency.
Vacc-4x is one of the few peptide-based therapeutic vaccines tested, and consists of four, slightly modified HIV Gag p24 consensus peptides. Vacc-4x was first tested by intradermal injections using GM-CSF as adjuvant. A recent multinational placebo-controlled study found improvement of vaccine-specific T cell immunity and decrease in viral loads (presented at the AIDS vaccine 2011 conference, Bangkok).
Lenalidomide (CC-5013) is a substance in the class of immunomodulatory agents. The lenalidomide mechanism of action includes anti-neoplastic, pro-erythropoietic, and immunomodulatory properties. Lenalidomide inhibits proliferation of certain hematopoietic tumor cells, enhances T cell- and Natural Killer (NK) cell-mediated immunity and increases the number of NK T cells.
The anti-HIV p24 immune response resulting from Vacc-4x immunization could in combination with ART potentially improve immune reconstitution in patients who have not fully regained a healthy CD4 level (> 600 x106/L). Adding the immunomodulatory agent Lenalidomide (CC-5013) to Vacc-4x immunization could enhance the immune response to Vacc-4x and further strengthen immune reconstitution.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
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Berlin、ドイツ、12157
- EIPMED - Gesellschaft fűr epidemiologische und klinische Forschung in der Medizin mbH Rubensstrasse 125
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Berlin、ドイツ、13353
- Charite Campus, Virchow-Klinikum Medizinische Klinik mit Schwerpunkt Infektiologie Station 59 (Suedring 11) Augustenburger Platz 1
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Hamburg、ドイツ、20246
- University Medical Center Hamburg-Eppendorf
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Köln、ドイツ、50937
- Klinik I für Innere Medizin Klinikum Der Universität zu Köln
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Men, age ≥ 18 and ≤ 55 years at the time of screening.
- Women, age ≥ 50 and ≤ 55 years at the time of screening, who are not of childbearing potential (see Exclusion criteria, point 9). Childbearing status must be documented.
- Clinically stable on ART for the last 18 months (changes in therapy are allowed as long as the viral load is stable).
- Well controlled with no treatment failure due to ART resistance in the past
- Screening plasma viral load (HIV-1 RNA) less than 50 copies/mL for the last six months. If screening value is between 50-500 copies/mL rescreening is allowed. Single blips (up to 500 copies/mL) are allowed.
- Screening CD4 cell count ≥ 200x10^6 cells/L and ≤500x10^6 cells/L. (Rescreening is allowed)
- Laboratory test results within these ranges: Absolute neutrophil count (ANC) >1.0x10^9 /L, Platelet count >75x10^9 /L and eGRF (MDRD) >60 mL/min
- Signed informed consent
- Willingness to adhere to Global Pregnancy Prevention Risk Management Plan Lenalidomide
Exclusion Criteria:
- Reported pre-study AIDS-defining illness within the previous year
- Malignant disease.
- On chronic treatment with immunosuppressive therapy.
- Autoimmune disorders, present or in the past if there is an increased risk of disease exacerbation.
- Unacceptable values of the hematologic and clinical chemistry parameters (including those associated with hemophilia), as judged by the Investigator or the Sponsor (or designee), including creatinine values >1.5x upper limit of normal (ULN), and AST (SGOT), ALT (SGPT), and alkaline phosphatase values >2.5x ULN.
- Concurrent chronic active infection such as viral hepatitis B or C or tuberculosis.
- Previous thromboembolic events or patient is currently immobilized
- Sexually active subjects who do not adhere to Global Pregnancy Prevention Risk Management Plan Lenalidomide
- Current participation in other clinical therapeutic studies.
- Females of childbearing potential will be excluded from this trial. A female of childbearing potential (FCBP) is a sexually mature female who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e. has had menses at any time in the preceding 24 consecutive months).
- The development of erythema nodosum if characterized by a desquamating rash while previously
- Incapability of compliance to the treatment protocol, in the opinion of the Investigator.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:支持療法
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:Part A: lenalidomide dose escalation
All patient receive intradermal Vacc-4x (1.2 mg) given with Leukine® (rhu-GM-CSF) (0.06 mg) and oral lenalidomide in a dose escalation (3+3) design. Dose level -1: 2.5 mg Lenalidomide (CC-5013) in the event Dose level 1 is non tolerated dose (NTD) Dose level 1(start): 5 mg Lenalidomide (CC-5013) Dose level 2: 10 mg Lenalidomide (CC-5013) Dose level 3: 25 mg Lenalidomide (CC-5013) |
In Part A a dose escalation design is used (2,5; 5; 10; 25 mg).
Part B will use the dose confirmed by Part A
他の名前:
Vacc-4x is a peptide-based HIV immunotherapy administered intradermally.
Vacc-4x peptides are reconstituted in sterile water.
他の名前:
Granulocyte macrophage colony stimulating factor as a local adjuvant
他の名前:
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実験的:Part B: lenalidomide
Intradermal Vacc-4x (1.2 mg) given with Leukine® (rhu-GM-CSF) (0.06 mg) and oral lenalidomide for 6 immunizations (visit 2, 3, 4, 5, 6 and 7) & lenalidomide (dose determined in Part A) two days prior to and at the day of immunization.
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In Part A a dose escalation design is used (2,5; 5; 10; 25 mg).
Part B will use the dose confirmed by Part A
他の名前:
Vacc-4x is a peptide-based HIV immunotherapy administered intradermally.
Vacc-4x peptides are reconstituted in sterile water.
他の名前:
Granulocyte macrophage colony stimulating factor as a local adjuvant
他の名前:
|
プラセボコンパレーター:Part B: lenalidomide placebo
Intradermal Vacc-4x (1.2 mg) given with Leukine® (rhu-GM-CSF) (0.06 mg) and oral lenalidomide for 6 immunizations (visit 2, 3, 4, 5, 6 and 7) & lenalidomide placebo two days prior to and at the day of immunization.
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Vacc-4x is a peptide-based HIV immunotherapy administered intradermally.
Vacc-4x peptides are reconstituted in sterile water.
他の名前:
Granulocyte macrophage colony stimulating factor as a local adjuvant
他の名前:
Capsules are identical to the active Lenalidomide capsules used.
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Part A: To Establish Highest Tolerated Dose of Lenalidomide, Dose-Limiting Toxicity
時間枠:31 days
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Number of participants in each of the three groups that experienced any dose-limiting toxicity.
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31 days
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Part A: To Establish Highest Tolerated Dose of Lenalidomide, CD4 Counts Over Time
時間枠:31 days
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31 days
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Part B: Change in CD4 Count
時間枠:Week 26
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Change in CD4 count from baseline to Week 26.
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Week 26
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Part B: Change in CD8 Count
時間枠:26 weeks
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Change in CD8 count from baseline to week 26.
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26 weeks
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Part B: Evaluate the Effect on HIV Viral Load
時間枠:26 weeks
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Results BLQ (<20 HIV copies/mL) have been replaced with BLQ/2 = 10 HIV copies/mL while 'not detected' results have been replaced with 0 HIV copies/mL.
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26 weeks
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Part B: Incidents of Delayed-type Hypersensitivity
時間枠:26 weeks
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Delayed-type hypersensitivity measured by induration and erythema.
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26 weeks
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Part A and B: Safety and Tolerability
時間枠:Part A: 31 days and Part B: 26 weeks
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Part A: 31 days and Part B: 26 weeks
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協力者と研究者
スポンサー
捜査官
- スタディディレクター:Kim Krogsgaard、Bionor Pharma ASA, Kronprinsesse Märthas Plass 1, P.O. Box 1477 Vika, NO-0116 Oslo, Norway
出版物と役立つリンク
一般刊行物
- Asjo B, Stavang H, Sorensen B, Baksaas I, Nyhus J, Langeland N. Phase I trial of a therapeutic HIV type 1 vaccine, Vacc-4x, in HIV type 1-infected individuals with or without antiretroviral therapy. AIDS Res Hum Retroviruses. 2002 Dec 10;18(18):1357-65. doi: 10.1089/088922202320935438.
- Kran AM, Sorensen B, Nyhus J, Sommerfelt MA, Baksaas I, Bruun JN, Kvale D. HLA- and dose-dependent immunogenicity of a peptide-based HIV-1 immunotherapy candidate (Vacc-4x). AIDS. 2004 Sep 24;18(14):1875-83. doi: 10.1097/00002030-200409240-00003.
- Kvale D, Kran AM, Sommerfelt MA, Nyhus J, Baksaas I, Bruun JN, Sorensen B. Divergent in vitro and in vivo correlates of HIV-specific T-cell responses during onset of HIV viraemia. AIDS. 2005 Mar 24;19(6):563-7. doi: 10.1097/01.aids.0000163932.76531.c6.
- Sommerfelt MA, Nyhus J, Sorensen B. Novel peptide-based HIV-1 immunotherapy. Expert Opin Biol Ther. 2004 Mar;4(3):349-61. doi: 10.1517/14712598.4.3.349.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- CT-BI Vacc-4x/IMiD-2010/1
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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