Ovarian Cancer Vaccine for Patients in Remission
- Conditions
- Epithelial Ovarian Cancer
- Interventions
- Biological: Cvac
- Registration Number
- NCT01068509
- Lead Sponsor
- Prima BioMed Ltd
- Brief Summary
The purpose of this study is to determine the safety and efficacy of an investigational therapeutic agent (Cvac) in ovarian cancer patients in first or second remission and to determine its ability to prevent cancer from returning.
Study objectives
Primary objectives:
* To confirm the safety of administering Cvac in this population.
* To determine the effects of Cvac on progression-free survival (PFS).
Secondary objectives:
* To determine overall survival (OS) for ovarian cancer patients who receive Cvac after achieving remission in the first or second-line setting.
* Evaluation of host immunologic response to Cvac administration.
- Detailed Description
An initial cohort of 7 patients were treated with Cvac in an open-label phase to confirm the safety and consistency of manufacturing between Cvac drug product manufactured in the United States (US) and Australia. After the manufacturing characteristics of Cvac were confirmed to be consistent and each patient in the initial cohort had completed 1 injection cycle of Cvac with no serious or treatment-related Grade 3 or 4 adverse events (AEs), 56 patients were enrolled and randomized (1:1) to either Cvac or observational standard of care (OSC).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 63
- Female subjects ≥ 18 years old with histologically confirmed Stage III or IV epithelial ovarian, primary peritoneal or fallopian tube cancer who have previously undergone surgical cytoreduction and received first or second line conventional chemotherapy and are currently in complete remission (based on clinical and radiologic studies).
- Cancer antigen (CA)-125 ≤ upper limit of normal with a prior history of an elevated CA-125.
- Able and willing to undergo mononuclear cell collection.
- Not more than 12 weeks between enrollment and the last dose of chemotherapy that resulted in complete remission.
- No prior surgery to the peritoneum or pleural space within 28 days of enrollment, excluding removal of catheters used for chemotherapy administration.
- No prior treatment with an investigational product within 30 days of enrollment.
- Baseline electrocardiogram within normal limits or any abnormalities deemed not indicative of cardiac disease for which intervention is required.
- Serum creatinine ≤ 2 mg/dL.
- Serum aspartate aminotransferase or serum alanine aminotransferase ≤ 2.5x the upper limit of normal or serum total bilirubin ≤ 1.5x the upper limit of normal.
- White blood cell count ≥ 3.0 K/µL; absolute neutrophil count ≥ 1.5K/µL; hemoglobin ≥ 9.0 g/dL, and platelets ≥ 100,000/mm^3. (These complete blood count results are required for enrollment. It should be noted that complete blood count results, including monocyte count ≥ 0.2 × 10^9/L, will be needed prior to leukapheresis to determine if sufficient dendritic cells can be obtained for Cvac™ manufacture.)
- Life expectancy of at least 12 months.
- Eastern Cooperative Oncology Group Performance Status of 0-1.
- All toxicities from prior therapies, excluding alopecia, must have resolved to Common Terminology Criteria for Adverse Events Grade ≤ 1.
- Must be non-pregnant and, if of childbearing potential, must use adequate birth control (hormonal or barrier method of birth control or abstinence) for the duration of the study and for 3 months after study completion.
- Able to provide written informed consent.
- Coexisting or other malignancies unless in complete remission for not less than 3 years. Does not include in situ carcinoma of the cervix or basal cell or squamous cell carcinoma of the skin for which no restrictions apply, assuming they have been adequately treated.
- Ovarian germ cell, sarcoma, or mixed Mullerian tumors.
- Prior cancer vaccine or cellular therapy.
- Active uncontrolled infections or any organ system toxicity ≥ Grade 2 by Common Terminology Criteria for Adverse Events criteria.
- Inability to provide informed consent or to comply with study-related procedures.
- Concurrent systemic treatment with steroids or other immunosuppressive agents.
- Diagnosed immunodeficiency and/or autoimmune disorders.
- Myocardial infarction in the past 6 months and/or clinically significant heart disease.
- Infection with human immunodeficient virus (HIV), hepatitis B or C virus.
- Pregnant or breastfeeding.
- Evidence or history of central nervous system metastases.
- Full dose anticoagulation therapy administered within 7 days of leukapheresis procedure.
- Hematopoietic growth factors administered within 14 days of enrollment.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Non-randomized Cvac Cvac Participants received 6-8 intradermal injections of Cvac at 4 sites along both upper arms and both thighs. The 6-8 injections contained \~ 60 × 10\^6 dendritic cells. Following evaluation after the first dose, participants received additional injections as described for the randomized Cvac group below. Randomized Cvac Cvac Participants received 6-8 intradermal injections of Cvac at 4 sites along both upper arms and both thighs every 4 weeks for 24 weeks (7 doses at Weeks 8, 12, 16, 20, 24, 28, and 32), and then every 8 weeks for 24 weeks (3 doses at Weeks 40, 48, and 56). The 6-8 injections contained \~ 60 × 10\^6 dendritic cells.
- Primary Outcome Measures
Name Time Method Progression-free Survival Baseline to 48 weeks after the last visit or dose of Cvac (up to 104 weeks) Progression-free survival was defined as the time from randomization to the date of documented disease progression or death from any cause, whichever occurred earlier. Disease progression occurred when a patient met either the Gynecologic Cancer Intergroup (GCIG) cancer-antigen (CA)-125 definition or the Response Evaluation Criteria in Solid Tumors (RECIST) radiological definition of progressive disease. The GCIG CA-125 definition of disease progression was defined as a CA-125 level ≥ 2 × the upper limit of normal documented on 2 occasions at least 1 week apart. The radiological RECIST criteria of disease progression was defined as the appearance of new lesions or an overall increase ≥ 20% or at least 5 mm in existing tumors.
- Secondary Outcome Measures
Name Time Method Change From Baseline in Mucin 1 Antibody Levels at Weeks 20, 56, and 104 Baseline to Week 104 Mucin 1 antibodies were assessed in serum samples using a quantitative enzyme-linked immunosorbent assay (ELISA). Detection was achieved with electrochemiluminescence.
Change From Baseline in ICS of IL2, IL4, IL17, TNF, and IFNg in CD4+ and CD8+ Cells at Weeks 20, 56, and 104 Baseline to Week 104 Intracellular cytokine staining (ICS) for IL2, IL4, IL17, tumor necrosis factor (TNF), and interferon gamma (IFNg) was done in both CD4+ and CD8+ cells from serum samples collected at Weeks, 20, 56, and 104. Intracellular cytokine staining data were acquired with 8-color flow cytometry on a BD LSR II flow cytometer and a high-throughput screening microplate reader.
Overall Survival Baseline to the end of the study (up to 4 years 10 months) Overall survival was defined as the time from randomization until death from any cause.
Trial Locations
- Locations (18)
Marin Cancer Care, Inc.
🇺🇸Greenbrae, California, United States
Scripps Cancer Center
🇺🇸La Jolla, California, United States
Stanford University School of Medicine
🇺🇸Palo Alto, California, United States
New York Downtown Hospital
🇺🇸New York, New York, United States
Greenslopes Private Hospital
🇦🇺Greenslopes, Queensland, Australia
Gold Coast Hospital
🇦🇺Southport, Queensland, Australia
Collaborative Research Group
🇺🇸Boca Raton, Florida, United States
Northside Hospital
🇺🇸Atlanta, Georgia, United States
Indiana University Simon Cancer Center
🇺🇸Indianapolis, Indiana, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
Royal Adelaide Hospital
🇦🇺Adelaide, South Australia, Australia
University of California, San Francisco
🇺🇸San Francisco, California, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
University of Washington Medical Center
🇺🇸Seattle, Washington, United States
Morristown Medical Center
🇺🇸Morristown, New Jersey, United States
Peter MacCallum Cancer Cetnre
🇦🇺East Melbourne, Victoria, Australia
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
Austin Health Cancer Centre
🇦🇺Heidelberg, Victoria, Australia