A Clinical Trial to Evaluate Safety, Tolerability, and Immunogenicity of Adjuvanted HIV-1 Fusion Peptide Conjugate Vaccine Alone or in Prime-Boost Regimens With Adjuvanted HIV-1 Envelope Trimer 4571 and HIV-1 Trimer 6931 Vaccines in Healthy Adults

Phase 1

Completed

• Conditions: HIV
• Interventions: Biological: Trimer 6931 (100 mcg); Biological: FP conjugate vaccine (200 mcg); Biological: Trimer 6931 (200 mcg); Biological: Trimer 4571 (200 mcg); Biological: FP conjugate vaccine (25 mcg); Biological: Trimer 4571 (100 mcg)

• Registration Number: NCT05470400
• Lead Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)

Brief Summary

This is an open-label, dose-escalation study to examine the safety, tolerability, and immunogenicity of adjuvanted Fusion Peptide Vaccine alone or in prime-boost regimens with adjuvanted Trimer 4571 and Trimer 6931 vaccines in healthy adults. The hypothesis is that the vaccines will be safe, and well tolerated when administered alone, and when co-administered with HIV-1 Trimer 4571, in prime-boost regimens, and will induce detectable immune response.

Detailed Description

This study has two parts. Part A will evaluate the safety, tolerability, and immunogenicity of single doses of the FP conjugate, Trimer 4571 and Trimer 6931 vaccines, in a dose-escalation design. Each product must be assessed as safe prior to use in Part B. Trimer 4571 with alum adjuvant has been previously evaluated in humans but will be tested in Part A with Adjuplex. Part B will evaluate the safety, tolerability, and immunogenicity of FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, or Trimer 6931, or both alone and then both Trimers combined.

Total study duration is 36 months (includes enrollment, planned safety holds and follow-up).

Study Timeline

• Study First Submitted: 2022-06-29
• Study First Submitted QC: 2022-07-19
• Study First Posted: 2022-07-22
• Study Start: 2022-08-15
• Primary Completion: 2024-01-24
• Study Completion: 2024-01-24
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-19
• Last Update Posted: 2024-08-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

1. Able and willing to complete the informed consent process, including an Assessment of Understanding (AoU): volunteer demonstrates understanding of this study, completes a questionnaire prior to first vaccination with verbal demonstration of understanding of all questionnaire items answered incorrectly.

2. 18-50 years old, inclusive, on day of enrollment.

3. Agrees to comply with planned study procedures and be available for clinic follow-up through the last clinic visit.

4. Agrees not to enroll in another study of an investigational agent during participation in the trial, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) investigational agents that may subsequently obtain emergency use authorization (EUA) or undergo licensure by the FDA. If a potential participant is already enrolled in a SARS-CoV-2 clinical trial, prior approvals from the SARS-COV-2 study sponsor and HVTN 303 PSRT are required prior to enrollment in HVTN 303.

5. In good general health without clinically significant medical history.

6. Physical examination and laboratory results without clinically significant findings that would interfere with assessment of safety or reactogenicity.

7. Body Mass Index (BMI) ≤ 40.

8. Assessed as low risk for HIV acquisition.

9. Suitable injection sites in the deltoid muscle of each arm, as assessed by a clinician.

10. White blood cells (WBCs) 2,500-12,000/mm3

11. WBC differential either within institutional normal range or approved by the Investigator of Record (IoR) as "not clinically significant."

12. Platelets = 125,000 - 500,000/mm3

13. Hemoglobin

    • ≥ 11.0 g/dL for volunteers who were assigned female sex at birth
    • ≥ 13.0 g/dL for volunteers who were assigned male sex at birth and transgender males who have been on hormone therapy for more than 6 consecutive months
    • ≥ 12.0 g/dL for transgender females who have been on hormone therapy for more than 6 consecutive months
    • For transgender participants who have been on hormone therapy for less than 6 consecutive months, determine hemoglobin eligibility based on the sex assigned at birth

14. Serum creatinine ≤ 1.1 x upper limit of normal (ULN) based on the institutional normal range.

15. Alanine aminotransferase (ALT) ≤1.25 x ULN based on the institutional normal range.

16. Negative for HIV infection by an (US) Food and Drug Administration (FDA)-approved enzyme immunoassay (EIA) or chemiluminescent microparticle immunoassay (CMIA).

17. Negative for anti-Hepatitis C antibodies (anti-HCV) or negative HCV nucleic acid test (NAT) if anti-HCV antibodies are detected.

18. Negative for Hepatitis B surface antigen.

19. Agrees to use effective means of birth control from at least 21 days prior to enrollment through 12 weeks after the last product administration.

20. Negative β-HCG (beta human chorionic gonadotropin) pregnancy test (urine or serum) at screening and prior to each study product administration on the day of study product administration.

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Exclusion Criteria

1. Active duty and reserve US military personnel.

2. Breast-feeding or planning to become pregnant from at least 21 days prior to enrollment through 12 weeks after the last product administration.

3. An investigational HIV vaccine (previous placebo recipients are not excluded).

4. Immunosuppressive medications received within 168 days before first vaccination (Not exclusionary: [1] corticosteroid nasal spray; [2] inhaled corticosteroids; [3] topical corticosteroids for mild, uncomplicated dermatologic condition; or [4] a single course of oral/parenteral prednisone or equivalent at doses ≤ 60 mg/day and length of therapy < 11 days with completion at least 30 days prior to enrollment).

5. Blood products within 60 days prior to enrollment

6. Monoclonal antibodies (mAbs), whether licensed or investigational. Exceptions may be made by the HVTN 303 PSRT on a case-by-case basis

7. Receipt of any of the following:

   • Within 4 weeks prior to enrollment:

     • Any licensed live, attenuated vaccine
     • Any adenoviral-vectored SARS-CoV-2 vaccine with FDA Emergency Use Authorization (EUA), FDA licensure or World Health Organization (WHO) Emergency Use Listing (EUL)

   • Within 2 weeks prior to enrollment:

     • Any licensed killed/subunit/inactivated vaccine
     • Any mRNA based or protein SARS-CoV-2 vaccines with FDA EUA, FDA licensure, or WHO EUL

8. Investigational research agents with a half-life of 7 or fewer days within 4 weeks prior to enrollment. If a potential participant has received investigational agents with a half-life greater than 7 days (or unknown half-life) within the past year, PSRT approval is required for enrollment.

9. Current allergen immunotherapy with antigen injections, unless on maintenance schedule.

10. Current anti-TB prophylaxis or therapy.

11. Serious adverse reactions to vaccines or vaccine components.

12. Hereditary angioedema, acquired angioedema, or idiopathic forms of angioedema.

13. Hypertension that is not well controlled.

14. Asthma is excluded if the participant has ANY of the following:

    • Required either oral or parenteral corticosteroids for an exacerbation two or more times within the past year; OR
    • Needed emergency care, urgent care, hospitalization, or intubation for an acute asthma exacerbation within the past year (eg, would NOT exclude individuals with asthma who meet all other criteria but sought urgent/emergent care solely for asthma medication refills or co-existing conditions unrelated to asthma); OR
    • Uses a short-acting rescue inhaler more than 2 days/week for acute asthma symptoms (ie, not for preventive treatment prior to athletic activity); OR
    • Uses medium-to-high-dose inhaled corticosteroids (greater than 250 mcg fluticasone or therapeutic equivalent per day), whether in single-therapy or dual-therapy inhalers (ie, with a long-acting beta agonist [LABA]); OR
    • Uses more than one medication for maintenance therapy daily. Inclusion of anyone on a stable dose of more than one medication for maintenance therapy daily for greater than two years requires PSRT approval.

15. Autoimmune disease, current or history, including psoriasis.

16. Clinically significant immunodeficiency.

17. AESIs: Volunteers who currently have, or have a history of, any condition that could be considered an AESI for the product(s) administered in this protocol.

18. History of generalized urticaria, angioedema, or anaphylaxis. (Not exclusionary: angioedema or anaphylaxis to a known trigger with at least 5 years since last reaction to demonstrate satisfactory avoidance of trigger.).

19. Diabetes mellitus type 1 or type 2.

20. Bleeding disorder diagnosed by a doctor (eg, factor deficiency, coagulopathy, or platelet disorder requiring special precautions) or significant bruising or bleeding difficulties with IM injections or blood draws.

21. Seizure disorder other than: 1) febrile seizures, 2) seizures secondary to alcohol withdrawal more than 3 years ago, or 3) seizures that have not required treatment within the last 3 years.

22. Asplenia or functional asplenia.

23. Malignancy (Not excluded from participation: Volunteer who has had malignancy excised surgically and who, in the investigator's estimation, has a reasonable assurance of sustained cure, or who is unlikely to experience recurrence of malignancy during the period of the study).

24. Any other chronic or clinically significant condition that in the clinical judgement of the investigator would jeopardize the safety or rights of the study participant, including, but not limited to: clinically significant forms of drug or alcohol abuse, serious psychiatric disorders, or cancer that, in the clinical judgement of the site investigator, has a potential for recurrence (excluding basal cell carcinoma).

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Prime Boost Regimen - Group 6	Trimer 6931 (100 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Dose Escalation - Group 2	FP conjugate vaccine (200 mcg)	Dose Escalation will evaluate the safety, tolerability, and immunogenicity of single adjuvanted doses of the FP conjugate, Trimer 4571 or Trimer 6931 vaccines, in a dose-escalation design. Each product must be assessed as safe prior to use in Prime Boost Regimen.
Dose Escalation - Group 4	Trimer 6931 (200 mcg)	Dose Escalation will evaluate the safety, tolerability, and immunogenicity of single adjuvanted doses of the FP conjugate, Trimer 4571 or Trimer 6931 vaccines, in a dose-escalation design. Each product must be assessed as safe prior to use in Prime Boost Regimen.
Dose Escalation - Group 5	Trimer 4571 (200 mcg)	Dose Escalation will evaluate the safety, tolerability, and immunogenicity of single adjuvanted doses of the FP conjugate, Trimer 4571 or Trimer 6931 vaccines, in a dose-escalation design. Each product must be assessed as safe prior to use in Prime Boost Regimen.
Dose Escalation - Group 1	FP conjugate vaccine (25 mcg)	Dose Escalation will evaluate the safety, tolerability, and immunogenicity of single adjuvanted doses of the FP conjugate, Trimer 4571 or Trimer 6931 vaccines, in a dose-escalation design. Each product must be assessed as safe prior to use in Prime Boost Regimen.
Dose Escalation - Group 3	Trimer 6931 (100 mcg)	Dose Escalation will evaluate the safety, tolerability, and immunogenicity of single adjuvanted doses of the FP conjugate, Trimer 4571 or Trimer 6931 vaccines, in a dose-escalation design. Each product must be assessed as safe prior to use in Prime Boost Regimen.
Prime Boost Regimen - Group 7	Trimer 6931 (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 7	Trimer 4571 (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 8	Trimer 6931 (100 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 6	Trimer 6931 (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 6	Trimer 4571 (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 6	Trimer 4571 (100 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 7	FP conjugate vaccine (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 7	Trimer 4571 (100 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 7	Trimer 6931 (100 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 8	FP conjugate vaccine (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 8	Trimer 6931 (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 8	Trimer 4571 (200 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.
Prime Boost Regimen - Group 8	Trimer 4571 (100 mcg)	Prime Boost Regimen will evaluate the safety, tolerability, and immunogenicity of adjuvanted vaccines: FP conjugate prime, Trimer 4571 prime, or an FP plus Trimer 4571 prime, all followed by subsequent doses of Trimer 4571, Trimer 6931 and both Trimers combined.

Primary Outcome Measures

Name	Time	Method
Systemic reactogenicity signs and symptoms collected for all participants	Measured for a minimum of seven days following receipt of any study product	Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, except as defined in the protocol
Response rate of serum antibody binding of FP and envelope trimer antigens as measured by the MSD assay 2 weeks after the last vaccination.	36 months	To evaluate the ability of FP-conjugate, Trimer 4571, and Trimer 6931 vaccines to elicit FP-specific binding antibodies.
Local reactogenicity signs and symptoms collected for all participants	Measured for a minimum of seven days following receipt of any study product	Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, except as defined in the protocol
Adverse events collected for all participants	Collected for thirty days after any receipt of study vaccination	Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, except as defined in the protocol
Magnitude of serum antibody binding of FP and envelope trimer antigens as measured by the MSD assay 2 weeks after the last vaccination.	36 months	To evaluate the ability of FP-conjugate, Trimer 4571, and Trimer 6931 vaccines to elicit FP-specific binding antibodies.

Secondary Outcome Measures

Name	Time	Method
Response rate of serum antibody neutralization, as measured by the TZM-bl assay.	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Mapping of FP specific serum neutralizing activity via characterization of specific epitopes (such as base of trimers, V3, internal epitopes).	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Magnitude of CD4+ T-cell responses as assessed by intracellular cytokine staining assays (ICS).	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Magnitude of serum antibody neutralization, as measured by the TZM-bl assay.	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Response rate of CD4+ T-cell responses as assessed by intracellular cytokine staining assays (ICS).	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Breadth of serum antibody neutralization, as measured by the TZM-bl assay.	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Magnitude of serum IgG binding antibodies to FP, Trimer 4571, and Trimer 6931.	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.
Response rate of serum IgG binding antibodies to FP, Trimer 4571, and Trimer 6931.	36 months	To evaluate the peak and durability of humoral and cellular immune response to vaccination regimens including FP-conjugate vaccine, Trimer 4571, and Trimer 6931, and to compare responses between the regimens.

Trial Locations

Locations (6)

BIDMC Vcrs [32077]; 🇺🇸 Boston, Massachusetts, United States

New York Blood Center CRS [31801]; 🇺🇸 New York, New York, United States

Atlanta - Hope Clinic; 🇺🇸 Atlanta, Georgia, United States

University of Rochester Vaccines to Prevent HIV Infection CRS [31467]; 🇺🇸 Rochester, New York, United States

Columbia P&S CRS [30329]; 🇺🇸 New York, New York, United States

University of Pittsburgh CRS [1001]; 🇺🇸 Pittsburgh, Pennsylvania, United States