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Efficacy, Immunogenicity and Safety of V503 in Chinese Women Aged 20-45 Years (V503-023)

Phase 3
Active, not recruiting
Conditions
Papillomavirus Infections
Interventions
Registration Number
NCT03998254
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

This study will evaluate the efficacy, immunogenicity and safety of 9-valent human papillomavirus (9vHPV; V503) vaccine in Chinese women 20 to 45 years of age. The primary hypotheses are: 9vHPV vaccine reduces the incidence of HPV 31-, 33-, 45-, 52-, and 58-related 12-month persistent infection at least 1 month post Dose 3, compared with quadrivalent HPV (qHPV) vaccine in women 20 to 45 years of age who are seronegative at Day 1 and polymerase chain reaction (PCR) negative Day 1 through Month 7 to the relevant HPV type; and 9vHPV vaccine induces non-inferior competitive luminex immunoassay (cLIA) geometric mean titers (GMTs) for each of HPV 6, 11, 16, and 18 one month post Dose 3, compared with qHPV vaccine in women 20 to 45 years of age who are seronegative at Day 1 and PCR negative Day 1 through Month 7 to the relevant HPV type.

Detailed Description

This study has two stages with the Stage I expected from Day 1 through Month 30, and the Stage II expected post-Month 30 to Month 90. The Stage I study is a case-driven study which aims to accrue at least 20 cases of HPV 31/33/45/52/58-related 12-month persistent infection and at least 39 cases of HPV 31/33/45/52/58-related 6-month persistent infection by completion of Month 30 visit. The Stage II study is a case-driven study which aims to accrue at least 12 cases of HPV 31/33/45/52/58-related cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3), cervical adenocarcinoma in situ (AIS), and cervical cancer observed in both Stage I and Stage II, by completion of Month 90 visit.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
6000
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GardasilGardasilSingle 0.5-mL intramuscular injection at Day 1, Month 2, and Month 6
V503V503Single 0.5-mL intramuscular injection at Day 1, Month 2, and Month 6
Primary Outcome Measures
NameTimeMethod
Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 12-month Persistent Infection1 month post vaccination 3 (Month 7) up to Month 30

A 12-month persistent infection This endpoint is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the LVPP/EEC swabs, biopsy, ECC or definitive therapy samples obtained in 3 or more consecutive visits over a period of at least 12 months. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Percentage of Participants Who Report at Least 1 Solicited Injection-site Adverse Eventup to 8 days post any vaccination

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. AEs such as redness, swelling, and pain/tenderness/soreness at the injection site are recorded.

Stage I: Geometric Mean Titers to HPV Types 6, 11, 16, and 18 Antibodies1-month post vaccination 3 (Month 7)

Serum antibodies to HPV types 6/11/16/18 are measured with a Competitive Luminex Immunoassay (cLIA). Titers are reported in milli Merck Units/mL.

Stage I: Percentage of Participants Who Report at Least 1 Solicited Systemic Adverse Eventup to 30 days post any vaccination

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. Systemic AEs are those not categorized as injection-site AEs.

Stage I: Percentage of Participants Who Experience at Least 1 Serious Adverse Event (SAE)Day 1 up to approximately Month 30

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. An SAE is an AE that results in death, is life threatening, results in a persistent or significant disability or incapacity, results in or prolongs an existing hospitalization, is a congenital anomaly or birth defect, or is another important medical event.

Stage II: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related CIN 2/3, AIS, and cervical cancerMonth 7 up to Month 90

This endpoint is defined to have occurred if on a single cervical biopsy, ECC, LEEP or Conization (cold knife/laser) specimen, there is: (a) a HPV Pathology Panel consensus diagnosis of CIN (grade 2 or 3), AIS, or cervical cancer; AND (b) detection of at least 1 of HPV types 31, 33, 45, 52 or 58 by Thinsection PCR in an adjacent section from the same tissue block. Disease incidence is defined as the number cases per 10,000 person-years of follow-up in a treatment arm.

Stages I/II: Percentage of Participants Who Experience at Least 1 Serious Adverse Event (SAE)Day 1 up to approximately Month 90

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. An SAE is an AE that results in death, is life threatening, results in a persistent or significant disability or incapacity, results in or prolongs an existing hospitalization, is a congenital anomaly or birth defect, or is another important medical event.

Secondary Outcome Measures
NameTimeMethod
Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 6-month Persistent Cervical Infection1 month post vaccination 3 (Month 7) up to Month 30

A 6-month persistent cervical infection is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the EEC swabs, cervical biopsy, ECC or cervical definitive therapy samples obtained in 2 or more consecutive visits over a period of at least 6 months. . Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage II: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related genital warts, CIN 2/3, AIS, cervical cancer, VIN 2/3, VaIN 2/3, vulvar cancer, and vaginal cancerMonth 7 up to Month 90

This endpoint is defined to have occurred if on a single biopsy or excised tissue, there is: (a) a Pathology Panel consensus diagnosis of CIN (grade 2 or 3), AIS, cervical cancer, VIN (grade 2 or 3), VaIN (grade 2 or 3), vulvar cancer, or vaginal cancer; AND (b) detection of at least 1 of HPV types 31, 33, 45, 52 or 58 by Thinsection PCR in an adjacent section from the same tissue block. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage II: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related genital warts, CIN 1/2/3, AIS, cervical cancer, VIN 1/2/3, VaIN 1/2/3, vulvar cancer, and vaginal cancerMonth 7 to Month 90

This endpoint is defined to have occurred if on a single biopsy or excised tissue, there is: (a) a Pathology Panel consensus diagnosis of CIN (grade 1, 2 or 3), AIS, cervical cancer, VIN (grade 1, 2 or 3), VaIN (grade 1, 2 or 3), vulvar cancer, or vaginal cancer; AND (b) detection of at least 1 of HPV types 31, 33, 45, 52 or 58 by Thinsection PCR in an adjacent section from the same tissue block. Disease incidence is defined as the number cases per 10,000 person-years of follow-up in a treatment arm.

Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 12-month Persistent Cervical Infection1 month post vaccination 3 (Month 7) up to Month 30

A 12-month persistent cervical infection is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the EEC swabs, cervical biopsy, ECC or cervical definitive therapy samples obtained in 3 or more consecutive visits over a period of at least 12 months. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 12-month Persistent Non-cervical Infection1 month post vaccination 3 (Month 7) up to Month 30

A 12-month persistent non-cervical infection is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the LVPP swabs, biopsy, or definitive therapy samples obtained from the external genitalia in 3 or more consecutive visits over a period of at least 12 months. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 6-month Persistent Non-cervical Infection1 month post vaccination 3 (Month 7) up to Month 30

A 6-month persistent non-cervical infection is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the LVPP swabs, biopsy, or definitive therapy samples obtained from the external genitalia in 2 or more consecutive visits over a period of at least 6 months. . Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Percentage of Participants Who Seroconvert by cLIA to HPV Types 31, 33, 45, 52 , and 581 Month Post Vaccination 3 (Month 7)

Serum antibody titers for HPV types 31/33/45/52 /58 will be determined using cLIA. The percentage of participants that achieve the serostatus cut-offs for seroconversion for each HPV type will be summarized.

Stage II: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related CIN 1/2/3, AIS, and cervical cancerMonth 7 to Month 90

This endpoint is defined to have occurred if on a single cervical biopsy, ECC, LEEP or Conization (cold knife/laser) specimen, there is: (a) a pathology panel consensus diagnosis of CIN (Grade 1, 2 or 3), AIS, or cervical cancer; AND (b) detection of at least 1 of HPV types 31, 33, 45, 52 or 58 by Thinsection PCR in an adjacent section from the same tissue block. Disease incidence is defined as the number cases per 10,000 person-years of follow-up in a treatment arm.

Stage II: Combined Incidence of HPV 31-, 33-, 45-, 52- , or 58-related Cervical, Vaginal and External Genital Biopsy and Definitive TherapyMonth 7 up to Month 90

This endpoint is defined to have occurred if a participant is found to have: (a) a cervical, vaginal or external genital biopsy or definitive therapy; AND (b) a tissue sample from such procedure was detected as PCR positive for at least 1 of HPV types 31, 33, 45, 52 or 58, regardless of the pathology diagnosis of such tissue sample. Incidence of biopsy and definitive therapy will be summarized as the number of cases per 10,000 person-years of follow-up in a treatment arm.

Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 6-month Persistent Infection1 month post vaccination 3 (Month 7) up to Month 30

A 6-month persistent infection is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the LVPP/EEC swabs, biopsy, ECC or definitive therapy obtained in 2 or more consecutive visits over a period of at least 6 months. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Percentage of Participants Who Seroconvert by cLIA to HPV Types 6, 11, 16, and 181 Month Post Vaccination 3 (Month 7)

Serum antibody titers for HPV types 6, 11, 16, and 18 will be determined using cLIA. The percentage of participants that achieve the serostatus cut-offs for seroconversion for each HPV type will be summarized.

Stage I: Combined Incidence of Papanicolaou (Pap) Test Abnormalities That are Related to HPV 31, 33, 45, 52, or 58Month 7 up to Month 30

This endpoint is defined to have occurred if a participant is found to have: (a) a Pap test result of ASC-US positive for high risk HPV, LSIL, ASC-H, HSIL, atypical glandular cells, or adenocarcinoma in situ, etc.; AND (b) detection of at least 1 of HPV types 31, 33, 45, 52 or 58 by LVPP or EEC swab at the same study visit. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Geometric Mean Titers of HPV 31, 33, 45, 52 , and 58 Antibodies1 Month Post Vaccination 3 (Month 7)

Serum antibodies to HPV types 31/33/45/52 /58 are measured with cLIA. Titers are reported in milli Merck Units/mL.

Trial Locations

Locations (6)

Lingchuan Center for Disease Control and Prevention ( Site 0002)

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Guilin, Guangxi, China

Quanzhou Center for Disease Control and Prevention ( Site 0001)

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Guilin, Guangxi, China

Xiangyuan Center for Disease Control and Prevention ( Site 0003)

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Changzhi, Shanxi, China

Mianyang Center for Disease Control and Prevention ( Site 0005)

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Mianyang, Sichuan, China

Yanhu Center for Disease Control and Prevention of Yuncheng ( Site 0004)

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Yuncheng, Shanxi, China

Santai County Center for Disease Control and Prevention ( Site 0006)

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Mianyang, Sichuan, China

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