Clinical Trials /

0804 GCC: MAGE-A3/HPV 16 Vaccine for Squamous Cell Carcinoma of the Head and Neck

NCT00257738

Description:

Squamous Cell Carcinoma of the Head and Neck (SCCHN) is a devastating illness, the treatment of which is associated with significant morbidity. This type of cancer affects 43,000 individuals each year with an estimated survival rate of 50%. A potential treatment alternative for this patient population is the use of peptide-based immunotherapy. This clinical tial will be using a vaccines comprised on the Trojan peptides MAGE-A3 and HPV 16 to treat patients with Squamous Cell Carcinoma of the Head and Neck who have recurrent, progressive or metastatic SCCHN.

Related Conditions:
  • Head and Neck Squamous Cell Carcinoma
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: 0804 GCC: MAGE-A3/HPV 16 Vaccine for Squamous Cell Carcinoma of the Head and Neck
  • Official Title: A Phase 1 Open Label, Dose Escalation Study to Evaluate the Effect of Four Doses of MAGE-A3/HPV 16 Trojan Peptides 0001 and 0002 Administered Subcutaneously in Combination With Montanide and GM-CSF on Immunological Response, Safety, Tolerability, and Preliminary Efficacy in Patients With Squamous Cell Carcinoma of the Head and Neck

Clinical Trial IDs

  • ORG STUDY ID: HP-00041372
  • SECONDARY ID: R01DE015324
  • NCT ID: NCT00257738
  • NCT ALIAS: NCT00704041

Conditions

  • Squamous Cell Carcinoma of the Head and Neck

Interventions

DrugSynonymsArms
MAGE-A3MAGE -A3 vaccine
HPV-16 vaccineHPV 16 vaccine

Purpose

Squamous Cell Carcinoma of the Head and Neck (SCCHN) is a devastating illness, the treatment of which is associated with significant morbidity. This type of cancer affects 43,000 individuals each year with an estimated survival rate of 50%. A potential treatment alternative for this patient population is the use of peptide-based immunotherapy. This clinical tial will be using a vaccines comprised on the Trojan peptides MAGE-A3 and HPV 16 to treat patients with Squamous Cell Carcinoma of the Head and Neck who have recurrent, progressive or metastatic SCCHN.

Detailed Description

      Squamous Cell Carcinoma of the Head and Neck affects 43,000 individuals in the United States
      annually with an estimated overall survival rate of 50%. In order to improve both the
      survival rate and quality of life for patients who develop unresectable disease recurrence,
      new therapeutic alternatives are mandated. One potential treatment alternative for this
      patient population is the use of peptide-based immunotherapy. Despite the success fo
      preclinical studies using peptide vaccines, therapeutic responses in patients have been
      sporadic. The reasons for failure are multifactorial and include problems with patient
      selection, a limited number of antigenic targets, and an inability to correlate immunologic
      response with therapeutic efficacy. Specifically, patients with disseminated SCCHN have
      defects in antigen processing, presentation and effector mechanisms that limit their ability
      to respond to T cell based immunotherapy. Additionally, a paucity of antigenic peptide
      epitopes are defined for SCCHN, and immunologic monitoring does not correlate well with
      clinical response.

      Recently several investigators, including our research team, have identified a high
      prevalence of MAGE-A3 and HPV 16 on SCCHN, and characterized several putative cytolytic and
      helper epitopes. Additionally, we have defined a novel method to enhance the immune response
      to therapeutic peptide vaccines using Trojan complexes composed of CD4 and CD8 T-cell
      epitopes, connected by furin cleavable linkers.

      In order to define the feasibility and safety of these agents in combination with GM-CSF and
      montanide ISA 51 for the immunotherapy of SCCHN, in this proposed trial, we will screen
      patients for immunologic competence based on specific eligibility criteria including both
      antigen and HLA-A2 expression on tumors. In registered patients, we will test the ability of
      two novel Trojan peptide complexes, composed of MAGE-A3 and human papilloma virus 16 (HPV 16)
      epitopes, to stimulate antigen-specific CD 4 and CD 8 T-cell responses. Finally, we will
      correlate immunologic response with cell dose and the generation of both HPV 16 and MAGE-A3
      antigen loss and HLA-A2 loss variants on tumors by evaluating patients for: 1) Changes in
      tumor size by both physical measurement and CT plus PET measurement; 2) Determining what
      proportions of individuals who achieve a complete response (CR), partial response (PR), or
      have stable disease (SD); 3) Progression-free survival; 4) Survival. Successful completion of
      this clinical trial will result in the development of a strong foundation for a Phase II/III
      clinical trial using HPV 16 and MAGE-A3 Trojan peptides for the immunotherapy of SCCHN.
    

Trial Arms

NameTypeDescriptionInterventions
MAGE -A3 vaccineExperimentalfor those individuals in which tumor tests positive for MAGE-A3
  • MAGE-A3
HPV 16 vaccineExperimentalfor patients with HPV 16 positive tumor
  • HPV-16 vaccine

Eligibility Criteria

        Inclusion Criteria:

          1. Age 18 or older

          2. Biopsy proven progressive, recurrent (post-surgical, radiation therapy, chemotherapy,
             combination therapy),or metastatic SCC of the head and neck which, in the judgment of
             the attending physician, is incurable by standard treatment modalities, OR Biopsy
             proven SCC which the patient is unwilling to have treated with surgery, chemotherapy
             or radiation therapy

          3. One or more of the following: -MAGE-A3 positive tumor -HPV 16 positive tumor.

          4. Laboratory values obtained less than or equal to 30days prior to registration:
             -Alkaline phosphatase less than or equal to 3x upper normal limit (UNL) -AST less than
             or equal to 3x UNL -Creatinine less than or equal to 1.5 x UNL -Hemoglobin greater
             than or equal to 9.0 g/dL -Albumin greater than or equal to 3 mg/dL

          5. The subject must be capable of understanding the investigational nature, potential
             risks and benefits of the study and capable of providing valid informed consent.

          6. The subject must be willing to return to the University of Maryland Medical center for
             treatment and study related follow up procedures including blood and tumor collections
             and completion of imaging studies as required by the protocol.

          7. ECOG performance status 0-2.

          8. Tumor that is biopsy accessible and measurable. This includes, but is not limited to,
             open biopsy, endoscopic biopsy, image guided biopsy, core biopsy and fine needle
             aspiration.

        EXCLUSION

          1. Any of the following:

             a. Known HIV infection, b. Other circumstances (i.e. concurrent use of systemic
             immunosuppressants and immunocompromising condition) that in the opinion of the
             physician renders the patient a poor candidate for this trial. c. Patients with ANY
             malignant or metastatic SCC mass or lesion within the Central Nervous System (CNS).
             (e.g. Intraparenchymal/ Brain, Intracordal / Spinal Canal, Bony masses or lesions with
             extension into the CNS parenchyma) d. Patients with ANY malignant or metastatic SCC
             mass or lesion or a volume of a mass or lesion in a location that in the judgment of
             the investigator may significantly impair the health of or threaten the patients life,
             should an Inflammatory Response occur.

          2. Any of the following prior therapies: Chemotherapy less than or equal to 4 weeks prior
             to registration Immunotherapy less than or equal to 4 weeks prior to registration
             Biologic therapy less than or equal to 4 weeks prior to registration Radiation therapy
             less than or equal to 4 weeks prior to registration

          3. Any of the following: Pregnant women Nursing women unwilling to stop breastfeeding Men
             or women of childbearing potential who are unwilling to employ adequate contraception
             (condoms, diaphragm, birth control pills, injections, intrauterine device [IUD], or
             abstinence, etc.) NOTE:This study involves an investigational agent whose genotoxic,
             mutagenic and teratogenic effects on the developing fetus and newborn are unknown.

          4. Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy
             considered investigational (utilized for a non-FDA-approved indication and in the
             context of a research investigation).

          5. Either of the following: Other active cancer requiring therapy to control the disease
             History of other malignancy (i.e. excluding disease under study) within 3 years
             Exceptions to the above include: adequately treated basal cell or squamous cell skin
             cancer, prostate cancer.
      
Maximum Eligible Age:80 Years
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of participants experiencing toxicity
Time Frame:2 year
Safety Issue:
Description:Maximum grade of each toxicity and percentage of patients experiencing toxicity as assessed by CTCAE v4.0

Secondary Outcome Measures

Measure:Tumor response
Time Frame:4 years
Safety Issue:
Description:Tumor response as assessed by RECIST
Measure:Tumor infiltrating lymphocytes
Time Frame:4 years
Safety Issue:
Description:analysis will be performed to assess the degree of tumor infiltration by lymphocytes per- and post treatment (if possible)

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:University of Maryland, Baltimore

Last Updated

October 17, 2019