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GlioblastomaPhase 1NCT02149225

GAPVAC Phase I Trial in Newly Diagnosed Glioblastoma Patients

A Phase 1 study testing APVAC1 vaccine plus Poly-ICLC and GM-CSF and APVAC2 vaccine plus Poly-ICLC and GM-CSF in people with Glioblastoma, run by Immatics Biotechnologies GmbH at 6 sites in 5 countries.

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

The primary objective of this study is to assess the safety and tolerability, feasibility and biological activity (immunogenicity) of the actively personalized vaccination (APVAC) concept in newly diagnosed glioblastoma (GB) patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Glioblastoma
What is being tested?
APVAC1 vaccine plus Poly-ICLC and GM-CSF and APVAC2 vaccine plus Poly-ICLC and GM-CSF
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
6 sitesin 5 countries
Study dates
Oct 2014to Jun 2018
Phase
Phase 1
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

  • Histologically confirmed, newly diagnosed GB (astrocytoma WHO grade IV)
  • HLA phenotype defined by warehouse composition (HLA-A*02:01 or HLA-A*24:02 positive patients only; both as determined by a PCR-based 4-digit typing method)
  • Gross total resection (as defined by less than 1 cm2 residual tumor mass on the largest perpendicular axes in post-operative scan taken within 48 h post-surgery; standard MRI conformable to the present national and international guidelines is sufficient)
  • At least 0.5 g tumor tissue freshly cryopreserved during surgery
  • Age ≥18 years
  • KPS ≥70%
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  • Life expectancy > 6 months
  • Patient is a candidate for and willing to receive standard CRT with TMZ followed by maintenance TMZ cycles
  • Patient is not on steroids or on stable or decreasing steroid levels not exceeding 2 mg/day dexamethasone (or equivalent doses of other steroids) during the last 3 days prior to enrollment
  • Absolute lymphocyte count (ALC) >1.0 x109/L (re-screening of lymphocyte counts is allowed)
  • Ability of subject to understand and the willingness to sign written informed consent for study participation. Written consent by a legally authorized representative is not sufficient.
  • Availability of an APVAC analysis and manufacturing slot confirmed by the sponsor
  • Female patients who are post-menopausal (no menstrual period for a minimum of 1 year), or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), practice one of the following medically acceptable methods of birth control (hormonal methods, intrauterine device or double-barrier methods) or practice total abstinence
  • Male patients willing to use contraception (condoms with spermicidal jellies or cream) upon study entry and during the course of the study, have undergone vasectomy or are practicing total abstinence

Who cannot join

  • Abnormal (≥ Grade 2 CTCAE v4.0) laboratory values for hematology, liver and renal function (serum creatinine). In detail the following values apply as exclusion criteria:
  • Hemoglobin < 10 g/dL (6.2 mmol/L)
  • White blood cell count (WBC) decrease (<3.0 x109/L) or increase (>10.0 x109/L)
  • Absolute neutrophil count (ANC) decrease < 1.5 x109/L
  • Platelet count decrease < 75 x109/L
  • Bilirubin > 1.5 x ULN (upper limit of normal according to the performing lab's reference range)
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  • ALAT > 3 x ULN
  • ASAT > 3 x ULN
  • GGT6 > 2.5 x ULN
  • Serum creatinine increased > 1.5 x ULN
  • HIV infection or active Hepatitis B or C infection, or active infections requiring oral or intravenous antibiotics or that can cause a severe disease and pose a severe danger to lab personnel working on patients' blood or tissue (e.g. rabies).
  • Prior therapy for glioma (except surgery and steroids) including but not limited to carmustine wafers and immunotherapy
  • Any condition contraindicating leukapheresis from peripheral veins
  • Concurrent participation in another interventional clinical trial studying a drug or treatment regimen.
  • Clinically relevant autoimmune diseases (with the exception of thyroid diseases)
  • Immunosuppression, not related to prior treatment for malignancy, or prior drug reaction
  • Any condition that in the judgment of the investigator interferes with the probability that an individual patient may receive and benefit from APVAC vaccinations (e.g. high risk of early disease progression / recurrence; immunocompromised status; anticipated compliance problems)
  • Serious illness or condition, which according to the investigator, poses an undue risk for the patient when participating in the trial, including, but not limited to, any of the following:
  • Clinically significant cardiovascular disease
  • New York Heart Association class III-IV congestive heart failure
  • Symptomatic peripheral vascular disease
  • Severe pulmonary dysfunction
  • Severe diabetes
  • Severe mental retardation
  • History of other malignancies (except for adequately treated basal or squamous cell carcinoma or carcinoma in situ) within the last 5 years unless the patient has been disease-free for 5 years
  • Pregnancy or breastfeeding

Trial locations and contacts

6 sites in 5 countries.

6 sites in 5 countries

Germany2 sites
  • Neurologische Klinik & Nationales Centrum für Tumorerkrankungen Heidelberg

    Heidelberg, 69120

  • Zentrum für Neurologie und Klinik für Neurochirurgie

    Tübingen, 72076

Other trials in Germany

Denmark1 site
  • Rigshospitalet, The Finsen Centre, Department of Oncology

    Copenhagen, 2100

Other trials in Denmark

Netherlands1 site
  • Leiden University Medical Center, Department of Medical Oncology

    Leiden, 2333ZA

Other trials in Netherlands

Spain1 site
  • Vall d'Hebron University Hospital

    Barcelona, 08035

Other trials in Spain

Switzerland1 site
  • Hôpitaux Universitaires de Genève

    Geneva, 1211

Other trials in Switzerland

About this study

Official title: A Phase I Trial of Actively Personalized Peptide Vaccinations Plus Immunomodulators in Patients With Newly Diagnosed Glioblastoma Concurrent to First Line Temozolomide Maintenance Therapy

The primary objective of this study is to assess the safety and tolerability, feasibility and biological activity (immunogenicity) of the actively personalized vaccination (APVAC) concept in newly diagnosed glioblastoma (GB) patients.

Read the detailed description

This is a multicenter, open-label, single arm, first-in-man phase I trial to investigate the safety, feasibility and immunogenicity of the novel APVAC approach in patients with newly diagnosed GB.

Primary Endpoints:

  • Safety: Determine the safety and tolerability profile of patient-tailored APVAC vaccines when administered with immunomodulators concurrent to maintenance temozolomide (TMZ) cycles.
  • Feasibility: Determine duration and success rates for APVAC1 and APVAC2 processes and for vaccinations with APVAC drug products.
  • Biological activity: Descriptive analysis of induced T-cell responses after vaccinations with APVAC1 and APVAC2 drug products plus immunomodulators.

Secondary Study Objectives:

  • Identification of biomarkers putatively predictive for immunological response and/or associated with clinical success or failure. Analyzed biomarkers may include non-cellular parameters measured from tumor, plasma or serum, and cellular parameters measured from peripheral blood mononuclear cells (PBMCs), leukapheresis samples or isolated tumor-infiltrating lymphocytes (TILs).
  • Description of potential clinical activity of the APVAC drug products. Descriptive analysis of clinical outcome in patients will be reported including OS and PFS. Correlation analysis of these parameters with immune response data may provide first hints on clinical activity of the vaccine.

After the standard chemoradiotherapy with TMZ has been completed and as soon as the start of the first maintenance TMZ cycle the vaccination phase begins. It starts with the first APVAC1 vaccination, followed by additional APVAC2 vaccinations at a later time point and ends with the Last Endpoint Evaluation Visit (LEEV) of a patient.

Single vaccinations with APVAC vaccines consist of an intradermal (i.d.) injection of the personalized APVAC drug product into the skin of the thigh, shoulder or abdomen followed by subcutaneous (s.c.) injection of 1.5 mg poly-ICLC (Hiltonol®) in close proximity to the vaccination site. The second immunomodulator GM-CSF (75 μg) will be applied i.d. to the APVAC vaccination site 10-30 min before injection of the APVACs.

Conditions
Glioblastoma
Being tested
APVAC1 vaccine plus Poly-ICLC and GM-CSF, APVAC2 vaccine plus Poly-ICLC and GM-CSF
Keywords
Actively personalized peptide vaccinations, Newly diagnosed Glioblastoma, Concurrent to first line temozolomide maintenance therapy
Medical subject headings
Glioblastoma

What participants receive

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

  • APVAC1 vaccine plus Poly-ICLC and GM-CSFDrug

    Also called Actively Personalized Vaccine, Hiltonol, Leukine

    APVAC1 vaccines (i.d.) will be individually assembled for each patient and can be applied to the patient approx. 3 months after enrollment. APVAC1 drug products are composed of 5 to 10 peptides from the GAPVAC warehouse. The APVAC1 vaccine will be applied concurrent to maintenance TMZ cycles after completion of chemoradiation therapy (CRT). Beginning on day 15 of the first maintenance TMZ cycle, patients will receive 11 vaccinations with APVAC1 drug products during 22 weeks. 578 μg per peptide per vial are used.

    Poly ICLC (1.5 mg s.c.) will be used as immunomodulator with all vaccinations except the second applications of APVAC1 (Day 2) and APVAC2 vaccines (Day 2*) to avoid dose accumulation on consecutive days.

    The 2. immunomodulator GM-CSF (75 μg) will be applied i.d. with the first six vaccinations with both vaccines, APVAC1 and APVAC2. A total of 12 GM-CSF doses will be applied. GM-CSF will be applied to the APVAC vaccination site 10-30 min before injection of the APVACs.

  • APVAC2 vaccine plus Poly-ICLC and GM-CSFDrug

    Also called Actively Personalized Vaccine, Hiltonol, Leukine

    APVAC2 vaccines (i.d.) will be ready for use ca. 6 months after enrollment, as these peptides have to be newly synthesized for each patient following identification of the mutanome and corresponding mutated peptides in the HLA ligandome. APVAC2 drug products are composed of 1 or 2 peptides de novo synthesized for an individual patient. Patients will be repeatedly vaccinated with APVAC2 drug products beginning on day 15 of the 4. maintenance TMZ cycle. Patients will receive 8 vaccinations within 10 weeks. 578 μg per peptide per vial are used.

    Poly-ICLC (1.5 mg s.c.) will be used as immunomodulator with all vaccinations except the second applications of APVAC1 (Day 2) and APVAC2 vaccines (Day 2*) to avoid dose accumulation on consecutive days.

    GM-CSF (75 μg) will be applied i.d. with the first six vaccinations with both vaccines, APVAC1 and APVAC2. A total of 12 GM-CSF doses will be applied. GM-CSF will be applied to the APVAC vaccination site 10-30 min before injection of the APVACs.

Study groups in NCT02149225
Study groupRoleWhat they receive
APVAC1 and 2 vaccine plus polyICLC and GMCSF concurrent to TMZExperimentalNot described
Receives: Drug: APVAC1 vaccine plus Poly-ICLC and GM-CSF; Drug: APVAC2 vaccine plus Poly-ICLC and GM-CSF

What is being measured

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

  1. Safety profile of patient-tailored APVAC vaccines when administered with immunomodulators concurrent to maintenance TMZ cycles

    Number of Adverse Events (AEs) and Serious Adverse Events (SAEs) and percentage of patients with AEs and SAEs (listed per grade and MedDRA (Medical Dictionary for Regulatory Activities ) preferred terms) will be reported.

    Measured: Continously for about 40 weeks plus follow-up

  2. Frequency of CD8 T cells specific for vaccinated APVAC peptides as measure of immunological response to and biological activity of the vaccine

    To analyze whether vaccinations with APVAC drug products plus poly-ICLC and GM-CSF induce immune responses in the patients. Peripheral blood mononuclear cells will be analyzed for the presence and functionality of T cells recognizing the peptides vaccinated within the individualized APVACs.

    • Immunogenicity rate: Number of vaccine induced T-cell responses normalized to the number of peptides vaccinated.
    • Immune responder rate: Number of patients with at least one vaccine induced T-cell response
    • Multi-TUMAP responder rate: Number of patients with at least two vaccine induced T-cell response
    • Average number of immune responses per patient

    Measured: Till 17 weeks of vaccination

Secondary outcomes (3)
  1. Frequency of immune cell populations in the blood and concentrations of a large panel of serum and plasma proteins with immunological relevance as a measure of the immune status of the patient

    Putatively predictive for immunological response and/or associated with clinical success or failure. Analyzed biomarkers may include non-cellular parameters measured from tumor, plasma or serum, and cellular parameters measured from peripheral blood mononuclear cells (PBMCs), leukapheresis samples or isolated tumor-infiltrating lymphocytes (TILs).

    Measured: Up to 10 months

  2. Overall survival

    Median OS, the survival rate at one and at two years will be reported

    Measured: 2018 (estimated)

  3. Progression-free survival

    Median progression free survival (PFS) and PFS rates at 6 months will be described for patients in the safety and per protocol populations

    Measured: At 6 months

Timeline

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

  1. First posted29 May 2014 (estimated)
  2. Study startOct 2014
  3. Primary completionJun 2018
  4. Study completionJun 2018

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
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02149225
Sponsor's protocol ID
GAPVAC-101
Other IDs
2013-002801-71
Status last verified
Aug 2018
First submitted
16 May 2014
Last updated
7 Aug 2018
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing APVAC1 vaccine plus Poly-ICLC and GM-CSF and APVAC2 vaccine plus Poly-ICLC and GM-CSF in people with Glioblastoma, run by Immatics Biotechnologies GmbH at 6 sites in 5 countries.

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 14 inclusion and 26 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 7 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Germany, Denmark, Netherlands, Spain, Switzerland. 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 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.

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?

Safety profile of patient-tailored APVAC vaccines when administered with immunomodulators concurrent to maintenance TMZ cycles (time frame: Continously for about 40 weeks plus follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 7 Aug 2018.

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