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Bloqueio de PD-1 em conjunto com as vacinas de células dendríticas/mieloma após transplante de células-tronco

4 de novembro de 2026 atualizado por: David Avigan, Beth Israel Deaconess Medical Center

The purpose of this research study is to determine the safety of CT-011 alone, as well as the combination of the Dendritic cell fusion vaccine and CT-011, after autologous stem cell transplantation (ASCT). We are also trying to find out what effect the combination has on the disease, including if it is more successful in preventing or delaying the disease from coming back, compared to treatment with autologous transplantation alone. ASCT is a standard therapy for multiple myeloma that is often successful in significantly decreasing the amount of cancer in the body. CT-011 is an investigational monoclonal antibody. Monoclonal antibodies are a type of drug given by infusion into a vein and are known to target specific cells (in this case, cells in the immune system). The dendritic cell fusion vaccine is an investigational agent that tries to help the immune system to recognize and fight against cancer cells. Unlike a standard vaccine that is used to prevent infections, cancer vaccines are being studied to see if they can fight cancers that are already in the body.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

  • There are two groups in this study: Group 1: All participants in this study group will receive infusions of CT-011 starting one to three months following autologous transplant. Participants in this group will receive a total of 3 doses of CT-011 at 6 week intervals. Group 2: All participants in this group will receive infusions of CT-011 starting one to three months following autologous transplant. Participants in this group will receive a total of 3 doses of CT-011 at 6 week intervals. In addition, they will receive a vaccination of the Dendritic Cell Fusion Vaccine one week following each infusion of CT-011.
  • All participants (Group 1 and Group 2) will receive the following procedures: 1) Initial therapy for multiple myeloma: All participants will receive standard therapy to reduce the number of multiple myeloma cells in the body. 2) Prior to stem cell mobilization participants will undergo a physical exam, medical history, and blood tests to measure blood counts, liver and kidney function, multiple myeloma protein level, and research testing to measure the immune response against the multiple myeloma cells. A small amount of bone marrow will be removed from the participants hip. Participants will also undergo a skin test called "delayed-type hypersensitivity (DTH). 3) Prior to the autologous stem cell transplant, we will harvest stem cells from the participants blood and store then for the future transplant through a process called leukapheresis. 4) Within a few weeks of successful stem cell collection, participants will be admitted to the hospital for high dose chemotherapy with autologous stem cell transplantation (ASCT). 5) Approximately 1-3 months following ASCT, participants will undergo additional tests to assess their eligibility to proceed with treatment with CT-011 alone (group 1) or the combination of CT-011 and vaccination (group 2).
  • If the post-transplant eligibility results meet the study requirements participants will receive 3 infusions of CT-011 at 6 week intervals. Prior to each infusion of CT-011, participants will undergo the following procedures: blood tests, urine sample, physical exam and EKG. Participants will be seen weekly to review any side effects, what medications they are taking, and will have a blood test an physical exam.
  • For Group 2 participants only: Prior to autologous transplant, Group 2 participants will undergo several procedures to make the Dendritic Cell Fusion Vaccine. 1) Dendritic Cell Collection via leukapheresis 2) Tumor cell collection from the participants bone marrow. One week after receiving the CT-011 infusion, Group 2 participants will receive the study vaccine for a total of 3 vaccines.
  • After the final treatment both Group 1 and Group 2 participants will receive a tumor DTH injection and DTH to Candida into the skin. At one, three and six months following the last study treatment participants will have blood tests, urine test, bone marrow aspirate/biopsy and a skeletal survey. At two, four and five months, participants will have a blood test.

Tipo de estudo

Intervencional

Inscrição (Estimado)

35

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02115
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Estados Unidos, 02115
        • Beth Israel Deaconess Medical Center
      • Haifa, Israel
        • Rambam Medical Center

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  • Patients with multiple myeloma who are potential candidates for high doses chemotherapy with stem cell rescue
  • Patients must not have active of history of autoimmune disorders/conditions including Type I diabetes, Type II diabetes, vitiligo or stable hypothyroidism will not be considered exclusion criteria
  • Patients with measurable disease as defined by a history of an elevated M component in plasma, urine, or free kappa/lambda light chains in the serum
  • 18 years of age or older
  • ECOG Performance Status of 0-1 with a greater than nine week life expectancy
  • >20% bone marrow involvement in plasmacytoma amenable to resection under local anesthesia
  • Negative pregnancy test and adequate contraception method(s)
  • DLCO (adjusted) > 50%
  • Cardiac Ejection Fraction > 45%
  • Laboratory results as defined in protocol

Exclusion Criteria:

  • History of clinically significant venous thromboembolism
  • Clinically significant autoimmune disease
  • HIV positive
  • Serious intercurrent illness such as infection requiring IV antibiotics, or significant cardiac disease characterized by significant arrhythmia, ischemic coronary disease or congestive heart failure
  • Pregnant or lactating women
  • History of allogeneic bone marrow/stem cell transplant

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Não randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: Group 1

Monoclonal antibody CT-011 will be given 1-3 months following autologous transplant. 3 doses will be given at 6 week intervals.

Infusions starting one to three months following autologous transplant at 6 week intervals for a total of 3 doses

Comparador Ativo: Group 2

Vaccination with DC/myeloma fusion cells will be given 1-3 months following autologous transplant. Vaccination will be given at 6 weeks intervals. The monoclonal antibody CT-011 will be given 1 week following each vaccination. 3 doses of CT-011 will be given at 6 week intervals.

Infusions starting one to three months following autologous transplant at 6 week intervals for a total of 3 doses

One week following each infusion of CT-011

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
First Stage: To explore immunological response to Pidilizumab (MDV9300) in the post-transplant period.
Prazo: 3 years

Immune response will be measured by assessing percentage of T cells that express IFNγ following ex-vivo exposure to tumor lysate, as determined by the ratio of the maximum IFNγ expression to the baseline level pre-transplantation. A threshold response of a 10 fold increase in T cells expressing IFNγ will be considered significant.

In the pilot phase, summary statistics (mean, median, range, standard error) will be used to report immunologic response on the entire patient cohort. In order to increase precision and provide more information about the immunologic response, the original sample size of 10 patients for the pilot study was increased up to 20. With 20 patients on this stage, the 90% C.I. will be no wider than 39.7%.

3 years
Second Stage: To determine if cellular immunity is induced by treatment with monoclonal antibody Pidilizumab (MDV9300)and DC/myeloma fusion cells in conjunction with stem cell transplant.
Prazo: 3 years

Cellular immunity will be determined by measuring fold increase in IFNγ expression.

The combination of vaccination and Pidilizumab (MDV9300) will be considered promising if the study shows evidence of at least 75% patients with >10-fold increase in IFNγ expression, and would not be considered promising if >10-fold increase is observed in 50% or less patients. With total n=25 patients, the combination will be considered promising for further study if 17 or more patients demonstrate significant immune response.

3 years

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
First Stage: Secondary objective: To assess the toxicity associated with treating multiple myeloma patients with Pidilizumab (MDV9300)in the post-autologous transplant setting.
Prazo: 3 years

Toxicity will be monitored and will be summarized for each grade.

3 years
Second Stage: To assess the toxicity associated with treating multiple myeloma patients with the combination with DC/myeloma fusion vaccine following autologous transplant.
Prazo: 3 years

Toxicity will be monitored and will be summarized for each grade.

3 years
To correlate levels of circulating activated and regulatory T cells with immunologic response
Prazo: 3 years

Levels of circulating activated and regulatory T cells and CD14+PD-L1+ cells will be measured at pre-transplantation, post-transplantation and several times after Pidilizumab (MDV9300) with or without vaccination. We will measure the level and the ratio of activated T cells/regulatory T cells and CD14+PD-L1+ monocytes at each time point. We will evaluate the profile of the ratio across time, several possible metrics (fold-change among successive time point) will be explored to evaluate the trend in the ratio across time.

The correlation between the ratio and immunologic response (fold increase in IFNγ expression) will be assessed and reported using Spearman rank correlation at each time for 10 and 25 patients from each stage and total 35 patients from the study, by treating all measurement as continuous variables. At post-transplant time points, we will also compare the ratio of activated T cells/regulatory T cells for patients with and without significance immunologic response.

3 years
To define anti-tumor effects using serum markers, radiological studies, and time to disease progression.
Prazo: 3 years

The percent of patients achieving a complete response (CR) following completion of therapy, including those converting from PR to CR after immunotherapy, will be reported for the phase II trial with descriptive statistics. Time to disease progression will also be characterized for with Kaplan-Meier curves.

3 years

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: David Avigan, MD, Beth Israel Deaconess Medical Center

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de março de 2010

Conclusão Primária (Real)

1 de setembro de 2025

Conclusão do estudo (Real)

1 de junho de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

29 de julho de 2009

Enviado pela primeira vez que atendeu aos critérios de CQ

10 de fevereiro de 2010

Primeira postagem (Estimado)

11 de fevereiro de 2010

Atualizações de registro de estudo

Última Atualização Postada (Real)

6 de novembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

4 de novembro de 2026

Última verificação

1 de novembro de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 09-061

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