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Intermediate Risk Prostate CancerPhase 1/2ADVANCENCT03815942

VAccination in Early and ADvanced Prostate caNCEr

A Phase 1/2 study testing ChAdOx1-MVA 5T4 vaccine and Nivolumab Infusion [Opdivo] in people with Intermediate Risk Prostate Cancer and Castration-resistant Prostate Cancer, run by University of Oxford at 2 sites in United Kingdom.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a clinical trial of a new treatment for prostate cancer that is a type of vaccine that could be a new way to treat cancer. A vaccine that could alert the immune system to the presence of cancer cells in the body may enable the immune system to target and kill those cells effectively. Read more about this study

Who is it for?
Ages 18 years and older, men only
What is being tested?
ChAdOx1-MVA 5T4 vaccine and Nivolumab Infusion [Opdivo]
Could I receive a placebo?
No, everyone receives an active treatment
How many people
23 participants
Where
2 sitesUnited Kingdom
Study dates
10 Dec 2018to 24 Jun 2020
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 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • For all participants:
  • Histologically confirmed adenocarcinoma of the prostate cancer
  • Any antineoplastic therapy must have been completed a minimum of 28 days prior to enrolment
  • Systemic antimicrobial therapy must have been completed a minimum of 7 days prior to enrolment
  • An archival specimen of tumour tissue should be available
  • Baseline laboratory parameters must meet the following criteria:
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  • Haemoglobin ≥ 80 g/L, White cell count ≥ 2.0 x10^9/L, Neutrophils ≥ 1.5 x10^9/L, Lymphocytes ≥ 0.5 x10^9/L, Platelets ≥ 100 x10^9/L, Creatinine Clearance ≥ 40 ml/min by Cockcroft Gault formulation, Total Bilirubin ≤ 1.5 ULN, Alanine Aminotransferase ≤ 1.5 ULN, Amylase ≤ 1.5 ULN
  • For surgical cohort:
  • Clinically localised or locally advanced disease deemed operable by the treating consultant urological surgeon i.e.: Gleason score ≤ 7, local tumour stage ≤T3c and deemed operable, no evidence of metastases (Nx/N0 and Mx/M0), no evidence of high grade Gleason 5 disease, PSA ≤ 20 ng/ml
  • Scheduled for and considered fit for radical prostatectomy
  • For advanced metastatic cohort:
  • Evidence of at least one distant metastasis based on MRI, CT, PET or bone scintigraphy
  • Established on and suitable to continue with androgen deprivation therapy (ADT) using any luteinizing hormone releasing hormone (LHRH) agonist
  • On treatment with anti-androgen therapy using either abiraterone (Zytiga®) or enzalutamide (Xtandi®) and demonstrating evidence of disease progression at the time of enrolment
  • Suitable to continue therapy with either abiraterone or enzalutamide at the time of enrolment at discretion of their managing clinician
  • Patients who have received chemotherapy following progression on androgen-targeting therapies are eligible
  • Satisfactory functional status defined as ECOG Performance Status ≤ 1

Who cannot join

  • For all participants:
  • Any prior diagnosis or clinical suspicion of autoimmune disease
  • History of allergic disease or reaction likely to be exacerbated by any component of the vaccine, e.g. egg products
  • Other prior malignancy with an estimated ≥ 30% chance of relapse within 2 years
  • Participation in another research study involving an investigational product or investigational surgical procedure in the 30 days preceding enrolment, or planned use during the study period
  • Any prior exposure to checkpoint inhibitor drugs including anti-PD-1, anti-PD-L1, or anti-CTLA-4 monoclonal antibodies or any prior treatment with investigational vaccines
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  • Administration of immunoglobulins and/or any blood products within the one month preceding the planned administration of the study drugs
  • Seropositive for hepatitis B surface antigen (HBsAg)
  • Seropositive for hepatitis C virus (antibodies to HCV)
  • Any confirmed or suspected immunocompromised state
  • Any history of hereditary angioedema, acquired angioedema, or idiopathic angioedema
  • History of anaphylaxis in relation to vaccination or any clinically significant allergic disease likely to be exacerbated by any component of the vaccine or checkpoint inhibitor preparations
  • For advanced metastatic cohort:
  • The treating oncologist estimates a subject's life expectancy to be ≤ 6 months
  • Any active, previously treated, or suspected intracranial or leptomeningeal metastases

Trial locations and contacts

2 sites in 1 country.

United Kingdom2 sites
  • Department of Oncology, The Christie NHS Foundation Trust

    Manchester, M20 4BX

  • Cancer and Haematology Centre, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust

    Oxford, OX3 7LE

Other trials in United Kingdom

About this study

Official title: Phase I/II Open Label Non-randomised Safety and Efficacy Study of the Viral Vectored ChAd-MVA 5T4 Vaccine in Combination With PD-1 Checkpoint Blockade in Low- or Intermediate-risk Localized or Locally Advanced Prostate Cancer and Advanced Metastatic Prostate Cancer

This is a clinical trial of a new treatment for prostate cancer that is a type of vaccine that could be a new way to treat cancer. A vaccine that could alert the immune system to the presence of cancer cells in the body may enable the immune system to target and kill those cells effectively. This vaccine is intended to work by making the immune system kill cells that have a special protein (called 5T4) that is present on the surface of cancer cells. The vaccine is made up of two recombinant viruses ("ChAdOx1"- chimpanzee adenovirus Ox1 and "MVA" - modified vaccinia Ankara) that have been designed to produce the 5T4 protein and have been modified so that they are weakened and cannot reproduce themselves within the body like normal viruses. Once injected into the body, these viruses make the 5T4 protein and help the body's immune system to learn to target this protein and destroy cancer cells.

This vaccine will be used in combination with the immunotherapy drug called nivolumab which is an anti-PD-1 (Programmed Death protein-1) monoclonal antibody. This is a molecule that releases the brakes on the immune system and helps the immune system to kill cancer cells more efficiently. Nivolumab as a monotherapy was approved for treatment of several tumour types but not for the prostate cancer.

This study will evaluate the safety and efficacy of ChAdOx1-MVA 5T4 vaccine in combination with nivolumab in low and intermediate risk prostate cancer patients who have elected to have their prostate removed and in patients with advanced metastatic prostate cancer.

Read the detailed description

The purpose of this study was to evaluate the safety and efficacy of a combination of two new vaccines (ChAdOx1.5T4 and MVA.5T4) with a monoclonal antibody (PD-1 mAb, also known as Nivolumab and Opdivo®) against Prostate Cancer.

A vaccine that alerts the immune system to the presence of cancer cells in the body may enable the immune system to target and kill those cells effectively. This vaccine is intended to work by making the immune system kill cells that have a special protein (called 5T4) that is present on the surface of cancer cells. The use of two different forms of the vaccine has been shown to generate a more effective immune response.

ChAdOx1.5T4 consists of a virus (ChAdOx1), which is a weakened version of a chimpanzee adenovirus that has been genetically altered so that it is impossible for it to grow in humans. Modified Vaccinia virus Ankara (MVA) is licensed as third-generation vaccine against smallpox and serves as a potent vector system for development of new candidate vaccines against infectious diseases and cancer.

To both viruses we have added genes that make the 5T4 protein that is present in prostate cancer cells and which is essential to the cancer. By vaccinating, we are hoping to make the body recognise and develop an immune response to these proteins that will neutralise the effects of the cancer in human cells and therefore prevent the infection responsible for the disease.

Nivolumab (PD-1 mAb) is an immune checkpoint inhibitor. Immune checkpoints are a normal part of the immune system. Their role is to prevent an immune response from being so strong that it destroys healthy cells in the body. Immune checkpoints engage when proteins on the surface of immune cells called T cells recognize and bind to partner proteins on other cells, such as some tumour cells. These proteins are called immune checkpoint proteins. When the checkpoint and partner proteins bind together, they send an "off" signal to the T cells. This can prevent the immune system from destroying the cancer. Immunotherapy drugs called immune checkpoint inhibitors work by blocking checkpoint proteins from binding with their partner proteins. This prevents the "off" signal from being sent, allowing the T cells to kill the cancer cells. Nivolumab as a monotherapy has been approved for treatment of several tumour types but not currently for prostate cancer.

The intent was to have two cohorts of participants: Group 1 were patients who had been diagnosed with low- or intermediate-risk non-metastatic prostate adenocarcinoma and who were scheduled for radical prostatectomy; Group 2 comprised patients with metastatic castration resistant prostate cancer (mCRPC) with evidence of progression on anti-androgens.

Unfortunately, it proved impossible to recruit participants into Group 1, so the trial proceeded with just Group 2.

It was planned that the results would be measured by a composite response rate defined as one of the following:

  • reduction of circulating tumour DNA of ≥50%
  • serum PSA decrease of ≥50%

However, the analysis to measure the circulating tumour DNA (ctDNA) was not done for any of the participants due to the trial ending prematurely because of the COVID-19 pandemic in 2020.

The trial and the follow-up of participants was severely hampered by the Covid-19 pandemic.

In this study, we have shown that the candidate 5TA vaccines given were safe and well-tolerated. No serious adverse reactions occurred during the follow-up period. Most adverse events reported were mild or moderate in severity and all resolved spontaneously. The profile of adverse events reported in this trial is similar to other ChAdOx1 vectored vaccines.

Being tested
ChAdOx1-MVA 5T4 vaccine, Nivolumab Infusion [Opdivo]

What participants receive

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

  • ChAdOx1-MVA 5T4 vaccineBiological

    ChAdOx1.5T4 will be administered intramuscularly in an extremity (e.g. thigh) at a dose of 2.5 x10^10 virus particles followed by MVA.5T4 administered via the same route at the dose of 2x10^8 plaque forming units

  • Nivolumab Infusion [Opdivo]Drug

    Also called anti-PD-1 monoclonal antibody

    Nivolumab is to be administered as a flat dose of 480 mg over approximately 60-minutes via IV infusion

Study groups in NCT03815942
Study groupRoleWhat they receive
Intermediate risk prostate cancerExperimentalChAdOx1.5T4 on week 0 followed by booster injection of MVA.5T4 and nivolumab infusion on week 1. Patients will undergo radical prostatectomy on week 6.
Receives: Biological: ChAdOx1-MVA 5T4 vaccine; Drug: Nivolumab Infusion [Opdivo]
Advanced metastatic prostate cancerExperimentalChAdOx1.5T4 on week 0 followed by booster injections of MVA.5T4 on week 4, ChAdOx1.5T4 on week 12 and MVA.5T4 on week 16. Nivolumab infusions are to be administered on week 4, 8 and 12.
Receives: Biological: ChAdOx1-MVA 5T4 vaccine; Drug: Nivolumab Infusion [Opdivo]

What is being measured

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

  1. Safety - Incidence of Treatment-related Adverse Events.

    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0.

    Note: All participants had one or more adverse events during the period they were monitored.

    Measured: From baseline to 12 months

  2. Efficacy - Measure Composite Response Rate Defined as One of the Following: 1) Change in Circulating Tumour DNA 2) Change in Serum PSA

    Evaluate the efficacy by assessing the number of participants with 50% or more change in ctDNA or PSA concentration in the blood from baseline to 12 months post treatment.

    Change in serum PSA was analysed for this outcome as one the two alternative methods planned.

    As described in the trial overview, no ctDNA analysis was done due to the trial closing prematurely because of COVID-19 - by the time the pandemic had finished, the facility to perform the ctDNA analysis option was no longer available. Because no laboratory analysis was done, there is no data to report.

    Measured: From baseline to 12 months

Secondary outcomes (4)
  1. Evaluate Immune Responses to the Vaccine Antigen in the Periphery

    Number of participants with peripheral 5T4-specific T cell responses secondary to treatment

    Measured: From baseline to 12 months

  2. Evaluate Immune Cell Subsets in the Prostate Secondary to Treatment (for Surgical Cohort)

    Number of participants with intraprostatic infiltration of CD3+CD8+ T cells secondary to treatment

    Measured: From baseline to radical prostatectomy, an expected average of 6 weeks

  3. Evaluate Progression-free Survival Following Study Treatment (for Advanced Metastatic Cancer Cohort)

    Evaluating the number of participants experiencing progression-free survival at 6 and 12 months post treatment

    Measured: 6-12 months

  4. Evaluate Overall Survival Following Study Treatment (for Advanced Metastatic Cancer Cohort)

    Evaluating the number of participants experiencing overall survival at 6 and 12 months post treatment

    Measured: 6-12 months

Timeline

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

  1. First posted24 Jan 2019
  2. Study start10 Dec 2018
  3. Primary completion24 Jun 2020
  4. Study completion24 Jun 2020

Why it stopped: COVID stopped all trials - and ADVANCE could not restart again after the pandemic

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
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
23 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03815942
Sponsor's protocol ID
ADVANCE
Acronym
ADVANCE
Status last verified
Jun 2025
First submitted
4 Jan 2019
Last updated
25 Jun 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The results in anonymised summary will be shared in publications resulting from the trial.

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing ChAdOx1-MVA 5T4 vaccine and Nivolumab Infusion [Opdivo] in people with Intermediate Risk Prostate Cancer and Castration-resistant Prostate Cancer, run by University of Oxford at 2 sites in United Kingdom.

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 17 inclusion and 15 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: stopped early, as of the sponsor's last update on 25 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United Kingdom. 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?

Yes. Results are posted in the registry (first posted 25 Jun 2025). 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?

Safety - Incidence of Treatment-related Adverse Events. (time frame: From baseline to 12 months). 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 25 Jun 2025.

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