Pooled Mutant KRAS-Targeted Long Peptide Vaccine Combined With Nivolumab and Ipilimumab for Patients With Resected MMR-p Colorectal and Pancreatic Cancer
试验速览
- 阶段
- 1 期
- 状态
- 进行中(未招募)
- 入组人数
- 27
- 试验地点
- 1
- 主要终点
- Fold change in interferon-producing mutant-KRAS-specific cytotoxic (CD8) and helper (CD4) T cells at 16 weeks
研究概览
简要总结
Phase 1 study for patients with resected PDAC after neoadjuvant and/ or adjuvant chemotherapy and/or radiation, as well as patients with metastatic colorectal cancer who have exposure to 2 or more lines of chemotherapy, to evaluate safety and the immune response to pooled mutant-KRAS peptide vaccine (KRAS peptide vaccine) with poly-ICLC adjuvant in combination with nivolumab and ipilimumab.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •PDAC or metastatic MSS CRC Cohort:
- •Have histologically or cytologically - proven cancer of the pancreas (PDA) or MSS colorectal (CRC) in one of the following categories:
- •PDAC must have no evidence of disease and last dose of neoadjuvant and/or adjuvant chemotherapy/radiation therapy/or surgery must be < 6 months from study entry.
- •Metastatic MSS CRC after exposure to 2 more lines of chemotherapy in the metastatic setting including 5-flurouracil, irinotecan, and oxaliplatin exposure. Patients treated with FOLFOXIRI may enroll after progression or intolerance to that regimen.
- •For metastatic MSS CRC cohort, must have tumor lesions amenable to repeated biopsy, and patient's acceptance to have a tumor biopsy of an accessible lesion at baseline and on treatment if the lesion can be biopsied with acceptable clinical risk (as judged by the Principal Investigator).
- •For metastatic MSS CRC patients, must have measurable disease per RECIST 1.
- •Reinduction Treatment Cohort:
- •Have a single site of locoregional recurrence or distant metastasis noted on imaging > 12 months after the first dose of the mutant KRAS peptide vaccine with poly-ICLC adjuvant.
- •Have completed definitive treatment for solitary recurrence per standard-of-care (e.g. surgical resection, radiation, and/or chemotherapy) <6 months prior to screening for reinduction treatment.
- •Both Cohorts:
- •*Age ≥18 years.
- •Have sufficient archival tumor tissue for next-generation sequencing (NGS) and immune-phenotyping.
- •Have one of the KRAS mutations included in the vaccine at the time of vaccination expressed in tumor.
- •Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- •Life expectancy of greater than 6 months.
- •Patients must have adequate organ and marrow function defined by study-specified laboratory tests prior to initial study drug.
- •Woman of childbearing potential must have a negative pregnancy test and follow contraceptive guidelines as defined per protocol.
- •Men must use acceptable form of birth control while on study.
- •Ability to understand and willingness to sign a written informed consent document.
排除标准
- •If expected to require any other form of systemic or localized antineoplastic therapy while on study.
- •Within 2 weeks prior to first dose of study drug.
- •Systemic or topical steroids corticosteroids at immunosuppressive doses (> 10 mg/day of prednisone or equivalent). Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.
- •Any palliative or adjuvant radiation or gamma knife radiosurgery.
- •Any chemotherapy.
- •Within 4 weeks prior to first dose of study drug.
- •Any investigational cytotoxic drug.
- •Any investigational device.
- •Has received a live vaccine.
- •Received any allergen hyposensitization therapy.
- •Received any growth factors, e.g. granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage-colony stimulating factor (GM-CSF), erythropoietin.
- •Any major surgery.
- •PDAC or metastatic MSS CRC Cohort: Prior treatment with immunotherapy agents (including, anti-PD-1, anti-PD-L1, anti-PD-L2, anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4), etc.).
- •Hypersensitivity reaction to any monoclonal antibody.
- •Known history or evidence of brain metastases.
- •Has active autoimmune disease that has required systemic treatment in the past 2 years, or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents.
- •Known history or concurrent interstitial lung disease.
- •Has a pulse oximetry < 92% on room air.
- •Requires the use of home oxygen.
- •Infection with HIV or hepatitis B or C.
- •Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia, metastatic cancer, or psychiatric illness/social situations that would limit compliance with study requirements.
- •Has been diagnosed with another cancer or myeloproliferative disorder within the past 5 year.
- •Has a diagnosis of immunodeficiency.
- •Presence of any tissue or organ allograft, regardless of need for immunosuppression, including corneal allograft. Patients with a history of allogeneic hematopoietic stem cell transplant will be excluded.
- •Any other sound medical, psychiatric, and/or social reason as determined by the Investigator.
- •Unwilling or unable to follow the study schedule for any reason.
- •Are pregnant or breastfeeding.
- •For metastatic MSS CRC and Reinduction Treatment Cohorts, any peritoneal involvement by the tumor.
- •For metastatic MSS CRC and Reinduction Treatment Cohorts, any radiological or clinical pleural effusions or ascites.
- •For metastatic MSS CRC and Reinduction Treatment Cohorts, patients on parenteral nutrition.
- •For metastatic MSS CRC and Reinduction Treatment Cohorts, patients with any single liver metastases greater than 5 cm or greater > 50% liver involvement.
- •For metastatic MSS CRC and Reinduction Treatment Cohorts, history of malignant bowel obstruction.
研究组 & 干预措施
Treatment Phase
KRAS Vaccine Peptide, Nivolumab and Ipilimumab
干预措施: KRAS peptide vaccine (Drug)
Treatment Phase
KRAS Vaccine Peptide, Nivolumab and Ipilimumab
干预措施: Nivolumab (Drug)
Treatment Phase
KRAS Vaccine Peptide, Nivolumab and Ipilimumab
干预措施: Ipilimumab (Drug)
Reinduction Treatment Phase
KRAS Vaccine Peptide, Nivolumab and Ipilimumab
干预措施: KRAS peptide vaccine (Drug)
Reinduction Treatment Phase
KRAS Vaccine Peptide, Nivolumab and Ipilimumab
干预措施: Nivolumab (Drug)
Reinduction Treatment Phase
KRAS Vaccine Peptide, Nivolumab and Ipilimumab
干预措施: Ipilimumab (Drug)
结局指标
主要结局
Fold change in interferon-producing mutant-KRAS-specific cytotoxic (CD8) and helper (CD4) T cells at 16 weeks
时间窗: Baseline, 16 weeks
Evaluated by the fold change in interferon-producing mutant-KRAS-specific CD8 and CD4 T cells after vaccination at 16 weeks compare to pre-vaccination baseline.
Number of participants experiencing study drug-related toxicities
时间窗: 2 years
Number of participants experiencing study drug-related adverse events Grade 3 or higher as defined by CTCAE v5.0
次要结局
- Disease Free Survival (DFS)(4 years)
- Percentage change of interferon (IFN)-γ-producing mutant-KRAS-specific CD8 and CD4 T cells(2 years)
- Progression-free Survival (PFS) for RECIST 1.1(4 years)
- Objective Response Rate (ORR) per RECIST 1.1(4 years)
- Overall Survival (OS)(4 years)
