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AzTrials

HIV-1 InfectionPhase 1/2IMIDNCT01704781

Vacc-4x + Lenalidomide vs. Vacc-4x +Placebo in HIV-1-infected Subjects on Antiretroviral Therapy (ART)

A Phase 1/2 study testing Lenalidomide, Vacc-4X and rhuGM-CSF in people with HIV-1 Infection, run by Bionor Immuno AS at 4 sites in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

During the course of HIV infection the number of CD4 cells decreases, resulting in a reduced immunological response and ultimately immune deficiency. Vacc-4x is a peptide-based HIV immunotherapy and the primary objective is to strengthen the immune system's response to HIV p24. Read more about this study

Who is it for?
Ages 18 to 55 years
Conditions the study is for
HIV-1 Infection
What is being tested?
Lenalidomide, Vacc-4X and rhuGM-CSF
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
36 participants
Where
4 sitesGermany
Study dates
Sep 2012to Aug 2014
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • 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)
Show all 9Show fewer
  • 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

Who cannot join

  • 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.
Show all 12Show fewer
  • 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.

Trial locations and contacts

4 sites in 1 country.

Germany4 sites
  • EIPMED - Gesellschaft fűr epidemiologische und klinische Forschung in der Medizin mbH Rubensstrasse 125

    Berlin, State of Berlin, 12157

  • Charite Campus, Virchow-Klinikum Medizinische Klinik mit Schwerpunkt Infektiologie Station 59 (Suedring 11) Augustenburger Platz 1

    Berlin, State of Berlin, 13353

  • Klinik I für Innere Medizin Klinikum Der Universität zu Köln

    Cologne, 50937

  • University Medical Center Hamburg-Eppendorf

    Hamburg, Free and Hanseatic City of Hamburg, 20246

Other trials in Germany

About this study

Official title: 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).

During the course of HIV infection the number of CD4 cells decreases, resulting in a reduced immunological response and ultimately immune deficiency. Vacc-4x is a peptide-based HIV immunotherapy and the primary objective is to strengthen the immune system's response to HIV p24. By adding Lenalidomide, an immunomodulatory agent, as a supporting drug, it is anticipated that the effect of Vacc-4x might be enhanced.

Read the detailed description

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.

Conditions
HIV-1 Infection
Being tested
Lenalidomide, Lenalidomide placebo, Vacc-4X, rhuGM-CSF
Keywords
CD4, Clinical trial, Dose escalation assessment lenalidomide, Human immunodeficiency virus-1 (HIV-1), HIV, Immunomodulatory, Infection, Lenalidomide, Phase I/II, Vaccine, Vacc-4x
Medical subject headings
Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • LenalidomideDrug

    Also called Lenalidomide capsule

    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

  • Lenalidomide placeboDrug

    Also called placebo

    Capsules are identical to the active Lenalidomide capsules used.

  • Vacc-4XDrug

    Also called Combination of Vacc-10, Vacc-11, Vacc-12 and Vacc-13.

    Vacc-4x is a peptide-based HIV immunotherapy administered intradermally. Vacc-4x peptides are reconstituted in sterile water.

  • rhuGM-CSFDrug

    Also called Leukine®

    Granulocyte macrophage colony stimulating factor as a local adjuvant

Study groups in NCT01704781
Study groupRoleWhat they receive
Part A: lenalidomide dose escalationExperimentalAll 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)
Receives: Drug: Lenalidomide; Drug: Vacc-4X; Drug: rhuGM-CSF
Part B: lenalidomideExperimentalIntradermal 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.
Receives: Drug: Lenalidomide; Drug: Vacc-4X; Drug: rhuGM-CSF
Part B: lenalidomide placeboPlacebo comparatorIntradermal 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.
Receives: Drug: Lenalidomide placebo; Drug: Vacc-4X; Drug: rhuGM-CSF

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Part A: To Establish Highest Tolerated Dose of Lenalidomide, Dose-Limiting Toxicity

    Number of participants in each of the three groups that experienced any dose-limiting toxicity.

    Measured: 31 days

  2. Part A: To Establish Highest Tolerated Dose of Lenalidomide, CD4 Counts Over Time

    Measured: 31 days

  3. Part B: Change in CD4 Count

    Change in CD4 count from baseline to Week 26.

    Measured: Week 26

Secondary outcomes (4)
  1. Part B: Change in CD8 Count

    Change in CD8 count from baseline to week 26.

    Measured: 26 weeks

  2. Part B: Evaluate the Effect on HIV Viral Load

    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.

    Measured: 26 weeks

  3. Part B: Incidents of Delayed-type Hypersensitivity

    Delayed-type hypersensitivity measured by induration and erythema.

    Measured: 26 weeks

  4. Part A and B: Safety and Tolerability

    Measured: Part A: 31 days and Part B: 26 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Oct 2012 (estimated)
  2. Study startSep 2012
  3. Primary completionAug 2014
  4. Study completionAug 2014

Resources

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01704781
Sponsor's protocol ID
CT-BI Vacc-4x/IMiD-2010/1
Acronym
IMID
Status last verified
Oct 2014
First submitted
11 Sep 2012
Last updated
8 Mar 2017
Data monitoring committee
Yes
Individual data sharing
No: Participants have not provided informed consent for their anonymized individual data to be made available beyond that described in the patient information sheet.

Publications

  • 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.

    PubMed 12487807
  • 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.

    PubMed 15353973
  • 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.

    PubMed 15802974
  • 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.

    PubMed 15006729

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Lenalidomide, Vacc-4X and rhuGM-CSF in people with HIV-1 Infection, run by Bionor Immuno AS at 4 sites 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 9 inclusion and 12 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 8 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites 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. Some participants in this study may receive a placebo. 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?

Yes. Results are posted in the registry (first posted 8 Mar 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Part A: To Establish Highest Tolerated Dose of Lenalidomide, Dose-Limiting Toxicity (time frame: 31 days). The study lists 3 primary outcomes in all. 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 NCT01704781, which also lists 4 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 8 Mar 2017.

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