Colorectal CancerPhase 1/2NCT01461148
Vaccination Against MSI Colorectal Cancer
A Phase 1/2 study testing FSP peptides in people with Colorectal Cancer, run by Oryx GmbH & Co. KG at 1 site in Germany.
Trial summary
Patients with advanced microsatellite unstable (MSI-H) colorectal cancer will be vaccinated with three so called frame shift peptides (FSPs), AIM2(-1), HT001(-1) and TAF1B(-1) combined with Montanide® ISA-51 VG. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Colorectal Cancer
- What is being tested?
- FSP peptides
- Type of treatment
- Vaccines
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 22 participants
- Where
- 1 siteGermany
- Study dates
- Aug 2011to May 2015
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Phase I part inclusion criteria (inclusion criteria for phase IIa part will be defined later using a study amendment):
- Histologically confirmed, surgically resected colorectal cancer of advanced stage (UICC stage III/UICC stage IV). This comprises patients with lymph node metastases (UICC stage III), metastasis to one distant organ (UICC IV, M1a), to more than one distant organ, or patients with peritoneal carcinosis (UICC IV, M1b)
- Detection of high level microsatellite instability (MSI-H) in the resected tumor sample according to the international consensus criteria (multiplex PCR of quasi-monomorphic microsatellite markers BAT25, BAT26, CAT25), see Appendix 1.
- Prior adjuvant standard therapy (chemotherapy with 5-fluorouracil/folinic acid, oxaliplatin, irinotecan or combinations of these) OR Prior palliative standard therapy in the first, second and third line (chemotherapy with 5-fluorouracil, oxaliplatin, irinotecan or combinations of these and/or treatment with anti-EGFR antibodies cetuximab or panitumumab alone or in combination with chemotherapy) with either complete or partial remission, stable disease, or disease progression under therapy; OR Patient has refused adjuvant or palliative standard therapy (chemotherapy using 5-fluorouracil, oxaliplatin, or regimens combining these).
- Expected survival of at least six months.
- Full recovery from surgery or radiation therapy
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- ECOG performance status 0, 1 or 2.
- The following laboratory results:
- Neutrophil count ≥ 1.5 x 109/L
- Lymphocyte count ≥ 0.5 x 109/L
- Platelet count ≥ 100 x 109/L
- Serum bilirubin < 2mg/dL
- Male or female patients ≥ 18 years old
- Last therapy discontinued at least 4 weeks prior to vaccination.
- Patient´s written informed consent for participation in the trial
Who cannot join
- Prior treatment with FSPs AIM2(-1), HT001(-1) and TAF1B(-1)
- Clinically significant heart disease (NYHA Class IV).
- Other serious illnesses, eg, serious infections requiring antibiotics or bleeding disorders.
- History of immunodeficiency disease or autoimmune disease.
- Metastatic disease to the central nervous system for which other therapeutic options, including radiotherapy, may be available.
- HBV, HCV or HIV positivity.
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- Chemotherapy, any type of radiation therapy, or immunotherapy within 4 weeks before study entry
- Concomitant treatment with steroids, antihistaminic drugs, or nonsteroidal anti-inflammatory drugs (unless used in low doses for prevention of an acute cardiovascular event or for pain control). Topical or inhalational steroids are permitted.
- Participation in any other clinical trial
- Pregnancy or lactation.
- Women of childbearing potential who are not using a medically acceptable means of contraception.
- Psychiatric or addictive disorders that may compromise the ability to give informed consent.
- Lack of availability of a patient for immunological and clinical follow-up assessment.
- Brain metastases (symptomatic and non-symptomatic)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Phase I/IIa Study of Immunization With Frameshift Peptides Administered With Montanide® ISA-51 VG in Patients With Advanced MSI-H Colorectal Cancer
Patients with advanced microsatellite unstable (MSI-H) colorectal cancer will be vaccinated with three so called frame shift peptides (FSPs), AIM2(-1), HT001(-1) and TAF1B(-1) combined with Montanide® ISA-51 VG. By this, an immune response directed against MSI-induced FSPs that are shared by the majority of MSI-H colorectal cancers can be induced. The aim is to show that vaccination against MSI-induced FSPs is safe and can induce or enhance immune responses against MSI-H colorectal cancer-associated antigens.
Read the detailed description
The present study is initiated to evaluate vaccination with MSI-specific FSPs in patients with MSI-H colorectal cancer. Specifically, the present study aims at the following questions:
- Evaluation of potential toxicity of the FSP AIM2(-1), HT001(-1), TAF1B(-1)
- Evaluation of the immune response in patients with advanced MSI-H colorectal cancer before vaccination and after vaccination with the FSP AIM2(-1), HT001(-1), TAF1B(-1)
In this context, the present study shall demonstrate whether application of FSP in a vaccination approach is associated with the induction of peptide-related toxicity. Hence, the study marks the first step towards the application of FSP in humans, as it provides information on the safety of FSP as vaccination agents for the first time. Moreover, the study shall provide initial information, whether vaccination with FSP can induce FSP-specific immune responses in patients with MSI-H colorectal cancer. Thus, it shall provide information, whether FSPs AIM2(-1), HT001(-1), and TAF1B(-1) have the potential to elicit peptide-specific immune responses and therefore represent suitable targets for the induction of tumor antigen-specific immune responses in patients with MSI-H tumors.
The present study marks an important milestone towards a potential application of MSI-specific FSP as therapeutic agents in the management of patients with MSI-H tumors, particularly patients with MSI-H colorectal cancer. Long-term goal of this approach is to develop novel tools for (1) the palliative and/or adjuvant therapy of patients with advanced MSI-H colorectal cancer and (2) the preventive application of FSPs in mutation carriers of the HNPCC/Lynch syndrome.
- Conditions
- Colorectal Cancer
- Being tested
- FSP peptides
- Keywords
- UICC stage III/IV MSI-H colorectal cancer
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FSP peptidesBiological
100 ug of each FSP (TAF1B(-1), HT001(-1) and AIM2(-1), weekly for 4 consecutive weeks and repeated every four weeks up to a total of 3 cycles.
| Study group | Role | What they receive |
|---|---|---|
| FSP peptides | Experimental | Vaccination with three FSP peptides Receives: Biological: FSP peptides |
What is being measured
The primary outcome is the main question the study is designed to answer.
immune response against FSP peptides
A positive immune response is defined as positive delayed-type hypersensitivity (DTH) response against at least one of the peptides or a humoral (ELISA for the detection of FSP-specific IgG/IgM/IgA) and/or CD8 and/or CD4 cellular (IFN gamma ELISpot for the detection of FSP-specific T cells) immune response exceeding the assay specific cut-off values for a positive response against at least one of the three peptides
Measured: every two weeks
Secondary outcomes (2)
Tumor response
Tumor response is assessed by CT or MRI scans according to RECIST.
Measured: every 8 weeks
safety
Safety as assessed by number and severity of adverse events categorized according to CTC criteria v4.0 and the probability of the induction of immune tolerance. Immune tolerance is defined as significant and sustained decline of antigen-specific cellular immune responses after vaccination compared to the antigen-specific cellular immune response measured before vaccination , as assessed by Interferon-gamma (IFN-g) ELISpot using assay-specific cut-off values.
Measured: up to 8 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Oct 2011 (estimated)
- Study startAug 2011
- Primary completionMar 2015
- Study completionMay 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Colorectal CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 22 participants (actual)
Sponsor and investigators
- Lead sponsor
- Oryx GmbH & Co. KG
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Elke Jäger, Prof. Dr., Principal investigator, Krankenhaus Nordwest Frankfurt
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01461148
- Sponsor's protocol ID
- MicOryx
- Status last verified
- Jun 2015
- First submitted
- 25 Oct 2011
- Last updated
- 23 Jun 2015
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Kloor M, Reuschenbach M, Pauligk C, Karbach J, Rafiyan MR, Al-Batran SE, Tariverdian M, Jager E, von Knebel Doeberitz M. A Frameshift Peptide Neoantigen-Based Vaccine for Mismatch Repair-Deficient Cancers: A Phase I/IIa Clinical Trial. Clin Cancer Res. 2020 Sep 1;26(17):4503-4510. doi: 10.1158/1078-0432.CCR-19-3517. Epub 2020 Jun 15.
PubMed 32540851Reuschenbach M, Dorre J, Waterboer T, Kopitz J, Schneider M, Hoogerbrugge N, Jager E, Kloor M, von Knebel Doeberitz M. A multiplex method for the detection of serum antibodies against in silico-predicted tumor antigens. Cancer Immunol Immunother. 2014 Dec;63(12):1251-9. doi: 10.1007/s00262-014-1595-y. Epub 2014 Aug 21.
PubMed 25143232
Study at a glance
From the registry record, last updated by the sponsor on 23 Jun 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase I/IIa Study of Immunization With Frameshift Peptides Administered With Montanide® ISA-51 VG in Patients With Advanced MSI-H Colorectal Cancer
- ClinicalTrials.gov ID
- NCT01461148
- Acronym / sponsor ID
- MicOryx
- Conditions
- Colorectal Cancer
- Keywords
- UICC stage III/IV MSI-H colorectal cancer
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 22 participants (actual)
- Lead sponsor
- Oryx GmbH & Co. KGIndustry (pharma, biotech, devices)
- Study start
- Aug 2011
- Primary completion
- Mar 2015 (actual)
- Study completion
- May 2015 (actual)
- First posted
- 27 Oct 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Patients with advanced microsatellite unstable (MSI-H) colorectal cancer will be vaccinated with three so called frame shift peptides (FSPs), AIM2(-1), HT001(-1) and TAF1B(-1) combined with Montanide® ISA-51 VG. By this, an immune response directed against MSI-induced FSPs that are shared by the majority of MSI-H colorectal cancers can be induced. The aim is to show that vaccination against MSI-induced FSPs is safe and can induce or enhance immune responses against MSI-H colorectal cancer-associated antigens.
Detailed description
The present study is initiated to evaluate vaccination with MSI-specific FSPs in patients with MSI-H colorectal cancer. Specifically, the present study aims at the following questions:
- Evaluation of potential toxicity of the FSP AIM2(-1), HT001(-1), TAF1B(-1)
- Evaluation of the immune response in patients with advanced MSI-H colorectal cancer before vaccination and after vaccination with the FSP AIM2(-1), HT001(-1), TAF1B(-1)
In this context, the present study shall demonstrate whether application of FSP in a vaccination approach is associated with the induction of peptide-related toxicity. Hence, the study marks the first step towards the application of FSP in humans, as it provides information on the safety of FSP as vaccination agents for the first time. Moreover, the study shall provide initial information, whether vaccination with FSP can induce FSP-specific immune responses in patients with MSI-H colorectal cancer. Thus, it shall provide information, whether FSPs AIM2(-1), HT001(-1), and TAF1B(-1) have the potential to elicit peptide-specific immune responses and therefore represent suitable targets for the induction of tumor antigen-specific immune responses in patients with MSI-H tumors.
The present study marks an important milestone towards a potential application of MSI-specific FSP as therapeutic agents in the management of patients with MSI-H tumors, particularly patients with MSI-H colorectal cancer. Long-term goal of this approach is to develop novel tools for (1) the palliative and/or adjuvant therapy of patients with advanced MSI-H colorectal cancer and (2) the preventive application of FSPs in mutation carriers of the HNPCC/Lynch syndrome.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| FSP peptides | Experimental | Biological: FSP peptidesVaccination with three FSP peptides |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (15 listed)
- Phase I part inclusion criteria (inclusion criteria for phase IIa part will be defined later using a study amendment):
- Histologically confirmed, surgically resected colorectal cancer of advanced stage (UICC stage III/UICC stage IV). This comprises patients with lymph node metastases (UICC stage III), metastasis to one distant organ (UICC IV, M1a), to more than one distant organ, or patients with peritoneal carcinosis (UICC IV, M1b)
- Detection of high level microsatellite instability (MSI-H) in the resected tumor sample according to the international consensus criteria (multiplex PCR of quasi-monomorphic microsatellite markers BAT25, BAT26, CAT25), see Appendix 1.
- Prior adjuvant standard therapy (chemotherapy with 5-fluorouracil/folinic acid, oxaliplatin, irinotecan or combinations of these) OR Prior palliative standard therapy in the first, second and third line (chemotherapy with 5-fluorouracil, oxaliplatin, irinotecan or combinations of these and/or treatment with anti-EGFR antibodies cetuximab or panitumumab alone or in combination with chemotherapy) with either complete or partial remission, stable disease, or disease progression under therapy; OR Patient has refused adjuvant or palliative standard therapy (chemotherapy using 5-fluorouracil, oxaliplatin, or regimens combining these).
- Expected survival of at least six months.
Key exclusion criteria (14 listed)
- Prior treatment with FSPs AIM2(-1), HT001(-1) and TAF1B(-1)
- Clinically significant heart disease (NYHA Class IV).
- Other serious illnesses, eg, serious infections requiring antibiotics or bleeding disorders.
- History of immunodeficiency disease or autoimmune disease.
- Metastatic disease to the central nervous system for which other therapeutic options, including radiotherapy, may be available.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| FSP peptides100 ug of each FSP (TAF1B(-1), HT001(-1) and AIM2(-1), weekly for 4 consecutive weeks and repeated every four weeks up to a total of 3 cycles. | Biological | FSP peptides |
Primary outcome
immune response against FSP peptides
Time frame: every two weeks
A positive immune response is defined as positive delayed-type hypersensitivity (DTH) response against at least one of the peptides or a humoral (ELISA for the detection of FSP-specific IgG/IgM/IgA) and/or CD8 and/or CD4 cellular (IFN gamma ELISpot for the detection of FSP-specific T cells) immune response exceeding the assay specific cut-off values for a positive response against at least one of the three peptides
2 secondary outcomes
Tumor response
Time frame: every 8 weeks
safety
Time frame: up to 8 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Jun 2015.
- Derived from this study: PubMed 32540851Kloor M, Reuschenbach M, Pauligk C, Karbach J, Rafiyan MR, Al-Batran SE, Tariverdian M, Jager E, von Knebel Doeberitz M. A Frameshift Peptide Neoantigen-Based Vaccine for Mismatch Repair-Deficient Cancers: A Phase I/IIa Clinical Trial. Clin Cancer Res. 2020 Sep 1;26(17):4503-4510. doi: 10.1158/1078-0432.CCR-19-3517. Epub 2020 Jun 15.
- Derived from this study: PubMed 25143232Reuschenbach M, Dorre J, Waterboer T, Kopitz J, Schneider M, Hoogerbrugge N, Jager E, Kloor M, von Knebel Doeberitz M. A multiplex method for the detection of serum antibodies against in silico-predicted tumor antigens. Cancer Immunol Immunother. 2014 Dec;63(12):1251-9. doi: 10.1007/s00262-014-1595-y. Epub 2014 Aug 21.
- trial background informationLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Elke Jäger, Prof. Dr. principal investigator
Krankenhaus Nordwest Frankfurt
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing FSP peptides in people with Colorectal Cancer, run by Oryx GmbH & Co. KG at 1 site in Germany.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 15 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 23 Jun 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
immune response against FSP peptides (time frame: every two weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01461148, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jun 2015.