FusionVAC22_01: Fusion Transcript-based Peptide Vaccine Combined With Immune Checkpoint Inhibition

Studien-Informationen Einschlusskriterien Studien-Rationale Geprüfte Regime

Rekrutierend

NCT-Nummer:
NCT05937295

Studienbeginn:
September 2023

Letztes Update:
29.09.2023

Wirkstoff:
Fusion-VAC-XS15

Indikation (Clinical Trials):
Carcinoma, Carcinoma, Hepatocellular

Geschlecht:
Alle

Altersgruppe:
Erwachsene (18+)

Phase:
Phase 1

Sponsor:
University Hospital Tuebingen

Collaborator:
-

Studienleiter

Salih, Prof. Dr.
Principal Investigator
CCU Translational Immunology

Kontakt

Juliane Walz, Prof. Dr.
Kontakt:
Phone: +49(0)707129
Phone (ext.): 83275
E-Mail: kketi@med.uni-tuebingen.de» Kontaktdaten anzeigen

Studienlocations
(1 von 1)

University Hospital Tuebingen
72076 Tuebingen
(Baden-Württemberg)
GermanyRekrutierend» Google-Maps
Ansprechpartner:
Juliane Walz, Prof. Dr.
Phone: +49 (0)707129
Phone (ext.): 83275
E-Mail: kketi@med.uni-tuebingen.de

Hackenbruch
Phone: +49 (0)707129
Phone (ext.): 83275» Ansprechpartner anzeigen

Studien-Informationen

Brief Summary:

The aim of this clinical trial is to evaluate the immunogenicity along with safety and

toxicity as well as first efficacy of a DNAJB1-PRKACA fusion transcript-based peptide vaccine

(Fusion-VAC-XS15) in combination with anti-programmed cell death-ligand 1 immune checkpoint

inhibition (ICI) by Atezolizumab (TecentriqTM) in patients with Fibrolamellar hepatocellular

carcinoma (FL-HCC) or other cancer entities carrying the DNAJB1-PRKACA fusion transcript.

Ein-/Ausschlusskriterien

Inclusion Criteria:

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

- Histologically confirmed FL-HCC or other malignant disease that is locally advanced or

metastatic.

- Non-FL-HCC patients can be included

- in case of disease progression after therapy and fulfilling at least one of the

following criteria: i. no further standard therapy is available. ii. patient is

considered unsuitable for further available standard therapy. iii. patient is

unwilling to receive treatment with available standard therapy.

- if no standard therapy exists.

- Presence of DNAJB1-PRKACA fusion transcript, assessed by RNA-based next-generation

sequencing (NGS) or realtime-polymerase chain reaction amplification (RT-PCR).

- Age ≥18 years.

- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.

- Patients must have measurable disease per iRECIST (Response Evaluation Criteria in

Solid Tumours).

- Negative SARS-CoV-2 rapid antigen test (as long as World Health Organization declares

pandemic spread of SARS-CoV-2).

- Adequate organ function laboratory values

1. Absolute Lymphocyte Count > 500/μl

2. Platelets > 50.000/μl

3. Creatinine clearance glomerular filtration rate > 30 ml/min

4. Liver function Child-Pugh index class A or B7

5. Alanine aminotransferase (ALT) and aminotransferase (AST) ≤ 5 times upper limit

range

6. Bilirubin ≤ 3 mg/dl

- Negative serological Hepatitis B test or negative PCR in case of positive serological

test without evidence of an active infection, negative testing of Hepatitis C RNA,

negative HIV test within 6 weeks prior to study inclusion.

- Female patients of child bearing potential (FCBP) and male patients with partners of

child bearing potential, who are sexually active, must agree to the use of two

effective forms (at least one highly effective method) of contraception. This should

be started from the signing of the informed consent and be continued until 5 months

(both female and male patients) after last dose of an Atezolizumab (TecentriqTM) or

vaccination.

- For FCBP two negative pregnancy tests (sensitivity of at least 25 mIU/mL) prior to

first application of a study drug (vaccination at visit V1), one at screening and the

other one at visit V1 prior (<24h) to first vaccination.

- Postmenopausal or evidence of non-child-bearing status.

Exclusion Criteria:

- Pregnant or breastfeeding.

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

- Chemotherapy or other systemic therapy or radiotherapy, up to 14 days prior to the

first dose of study drug.

- Concurrent or previous treatment within 30 days in another interventional clinical

trial with an investigational anticancer therapy or any other investigational therapy,

which would interfere with the study's primary and secondary endpoints.

- Major surgery within 28 days of dosing of study drug.

- Have not recovered from adverse events to grade ≤ 2 or baseline due to previous agents

administered excluding alopecia and neurotoxicity (≤ 2 grade).

- History of autoimmune phenomena due to treatment with immunotherapy agents (including,

anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA4 antibodies, etc.) (≥ grade 3).

- Treatment with immunotherapy agents (including, anti-PD-1, anti-PD-L1, anti-PD-L2,

anti-CTLA4 antibodies, etc.) within 28 days prior of dosing of study drug.

- Have received any live vaccine within 28 days prior to study treatment.

- Known sensitivity to or history of allergic reactions to any of the investigational

drugs or known hypersensitivity to Chinese hamster ovary cell products.

- History of severe allergic anaphylactic reactions to chimeric, human or humanized

antibodies, or fusion proteins.

- Has active autoimmune disease that requires or has required systemic immunosuppressive

treatment in the past 2 years.

- Presence of any tissue or organ allograft, regardless of need for immunosuppression,

including corneal allograft. Patients with a history of allogeneic hematopoietic stem

cell transplant will be excluded.

- Has a diagnosis of immunodeficiency.

- Systemic treatment with either corticosteroids (>10 mg daily prednisone equivalents)

or other immunosuppressive medications within 7 days prior to study drug

administration.

- Symptomatic interstitial lung disease.

- Active or untreated brain metastases or leptomeningeal metastases.

- Uncontrolled intercurrent illness including, but not limited to, uncontrolled

infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia,

different metastatic cancer than the one leading to study enrollment, or psychiatric

illness/social

Studien-Rationale

Primary outcome:

1. To assess immunogenicity in terms of induction of peptide specific T-cell responses (Time Frame - through study completion, an average of 1 year):
The percentage of patients with an induction of T-cell response until 28 days after second vaccination will be the primary endpoint for efficacy. Peptide stimulated Peripheral Blood Mononuclear Cells (PBMCs) are analyzed by enzyme-linked immunospot (ELISPOT).

2. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] of the peptide vaccine in combination with anti-PD-L1 immune checkpoint inhibition (Time Frame - through study completion, an average of 1 year):
The safety and toxicity of the personalized multi-peptide vaccine in combination with the toll-like receptor1/2 ligand XS15 with anti-PD-L1 immune checkpoint inhibition (ICI) will be determined based on the Common Terminology Criteria for Adverse Events (CTCAE version 5.0) and assessed in a descriptive manner.

Geprüfte Regime

Fusion-VAC-XS15:
FusionVAC-22 peptide will be administered subcutaneously (s.c.) adjuvanted with the Toll-like receptor 1/2 ligand XS15 (50 μg) emulsified in Montanide ISA 51 VG (1:1). Vaccination will take place every 4 weeks at the beginning of Cycle 1 and 2. A total of two vaccinations are planned. After 11 months a booster vaccination can be applied depending on T-cell responses. Immune checkpoint inhibition (ICI): Atezolizumab (TecentriqTM, Roche Pharma AG) is a humanized immunoglobulin (Ig) G1 monoclonal antibody that targets PD-L1 and will be applied intravenously (i.v.). The anti-PD-L1 antibody Atezolizumab (TecentriqTM) 1680 mg will be applied every 4 weeks as a 30-minute infusion (60-minute first dose) starting on day 15 after the first vaccination. Anti-PD-L1 treatment will be continued after the end of vaccination phase throughout the complete study period until End of Treatment (EOT) or until disease progression or other reasons for study termination.

Quelle: ClinicalTrials.gov

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