Description:
This phase I trial studies the safety of SVN53-67/M57-KLH peptide vaccine in incomplete
Freund's adjuvant together with sargramostim in treating patients with newly diagnosed
multiple myeloma who are receiving lenalidomide maintenance therapy. Vaccines made from
survivin peptide may help the body build an effective immune response to kill cancer cells
that express survivin. Incomplete Freund's adjuvant may help stimulate the body's immune
response to a vaccine treatment. Colony-stimulating factors, such as sargramostim, may
increase the production of blood cells. Lenalidomide may stop the growth of cancer cells by
blocking some of the enzymes needed for cell growth. Giving SVN53-67/M57-KLH peptide vaccine
in incomplete Freund's adjuvant and sargramostim before or after the start of lenalidomide
maintenance therapy may be a better treatment for multiple myeloma.
Title
- Brief Title: SVN53-67/M57-KLH Peptide Vaccine in Treating Patients With Newly Diagnosed Multiple Myeloma Receiving Lenalidomide Maintenance Therapy
- Official Title: A Phase I Study of Safety, Tolerability and Immunological Effects of SVN53-67/M57-KLH in Patients With Multiple Myeloma Receiving Lenalidomide Maintenance Therapy
Clinical Trial IDs
- ORG STUDY ID:
I 247913
- SECONDARY ID:
NCI-2014-02621
- SECONDARY ID:
I 247913
- NCT ID:
NCT02334865
Conditions
- Partial Response of Multiple Myeloma or Plasma Cell Leukemia
- Plasma Cell Myeloma
Interventions
Drug | Synonyms | Arms |
---|
Incomplete Freund's Adjuvant | Freund's Incomplete Adjuvant, IFA, ISA-51, Montanide ISA 51, Montanide ISA-51 | Group A (vaccine and week-4 lenalidomide maintenance therapy) |
Lenalidomide | CC-5013, CC5013, CDC 501, Revlimid | Group A (vaccine and week-4 lenalidomide maintenance therapy) |
Sargramostim | 23-L-Leucinecolony-Stimulating Factor 2, DRG-0012, Leukine, Prokine, rhu GM-CFS, Sagramostim, Sargramostatin | Group A (vaccine and week-4 lenalidomide maintenance therapy) |
SVN53-67/M57-KLH Peptide Vaccine | | Group A (vaccine and week-4 lenalidomide maintenance therapy) |
Purpose
This phase I trial studies the safety of SVN53-67/M57-KLH peptide vaccine in incomplete
Freund's adjuvant together with sargramostim in treating patients with newly diagnosed
multiple myeloma who are receiving lenalidomide maintenance therapy. Vaccines made from
survivin peptide may help the body build an effective immune response to kill cancer cells
that express survivin. Incomplete Freund's adjuvant may help stimulate the body's immune
response to a vaccine treatment. Colony-stimulating factors, such as sargramostim, may
increase the production of blood cells. Lenalidomide may stop the growth of cancer cells by
blocking some of the enzymes needed for cell growth. Giving SVN53-67/M57-KLH peptide vaccine
in incomplete Freund's adjuvant and sargramostim before or after the start of lenalidomide
maintenance therapy may be a better treatment for multiple myeloma.
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the toxicity profile of the SVN53-67/M57-KLH peptide (SVN53-67/M57-KLH
peptide vaccine) in Montanide ISA 51 (incomplete Freund's adjuvant) plus GM-CSF
(sargramostim) (vaccine), given before or after the start of lenalidomide maintenance in
patients with multiple myeloma.
SECONDARY OBJECTIVES:
I. To measure the immune responses induced by SVN53-67/M57-KLH with Montanide ISA 51 plus
GM-CSF, either alone or with lenalidomide maintenance added either before or after the
vaccine.
TERTIARY OBJECTIVES:
I. To collect preliminary data on therapeutic efficacy of this combination against multiple
myeloma, including response rate, time to progression and disease progression slope.
II. To test if human leukocyte antigen (HLA) types and survivin positivity affect the immune
responses induced by SVN53-67/M57-KLH with Montanide ISA 51 plus GM-CSF.
OUTLINE: Patients are assigned to 1 of 2 groups.
GROUP A: Patients receive SVN53-67/M57-KLH peptide vaccine in incomplete Freund's adjuvant
subcutaneously (SC) and sargramostim SC every 2 weeks at weeks 0, 2, 4, and 6 for up to 4
doses and then receive a booster in week 12. Beginning in week 4, patients receive
lenalidomide maintenance therapy orally (PO) once daily (QD) in the absence of disease
progression or unacceptable toxicity.
GROUP B: Patients receive SVN53-67/M57-KLH peptide vaccine in incomplete Freund's adjuvant SC
and sargramostim SC every 2 weeks at weeks 4, 6, 8, and 10 for up to 4 doses and then receive
a booster in week 16. Beginning in week 0, patients receive lenalidomide maintenance therapy
PO QD in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up at 16, 20, and 24 weeks and
then every 3 months for up to 5 years.
Trial Arms
Name | Type | Description | Interventions |
---|
Group A (vaccine and week-4 lenalidomide maintenance therapy) | Experimental | Patients receive SVN53-67/M57-KLH peptide vaccine in incomplete Freund's adjuvant SC and sargramostim SC every 2 weeks at weeks 0, 2, 4, and 6 for up to 4 doses and then receive a booster in week 12. Beginning in week 4, patients receive lenalidomide maintenance therapy PO QD in the absence of disease progression or unacceptable toxicity. | - Incomplete Freund's Adjuvant
- Lenalidomide
- Sargramostim
- SVN53-67/M57-KLH Peptide Vaccine
|
Group B (vaccine and week-0 lenalidomide maintenance therapy) | Experimental | Patients receive SVN53-67/M57-KLH peptide vaccine in incomplete Freund's adjuvant SC and sargramostim SC every 2 weeks at weeks 4, 6, 8, and 10 for up to 4 doses and then receive a booster in week 16. Beginning in week 0, patients receive lenalidomide maintenance therapy PO QD in the absence of disease progression or unacceptable toxicity. | - Incomplete Freund's Adjuvant
- Lenalidomide
- Sargramostim
- SVN53-67/M57-KLH Peptide Vaccine
|
Eligibility Criteria
Inclusion Criteria:
- Able to adhere to the study visit schedule and other protocol requirements
- Patients with newly diagnosed multiple myeloma who have at least a partial response
after induction therapy based on the International Working Group (IWG) Uniform
Response Criteria
- Eastern Cooperative Oncology Group (ECOG) performance status of =< 2 at study entry
- Must be free of systemic infection; subjects with active infections (whether or not
they require antibiotic therapy) may be eligible after complete resolution of the
infection; subjects on antibiotic therapy must be off antibiotics for at least 7 days
before beginning treatment
- Absolute neutrophil count >= 750/mm^3
- Platelet count >= 30,000/mm^3
- Creatinine clearance >= 30 mL/minutes
- Total bilirubin =< 2 mg/dL
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and
alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3 x
upper limit of normal (ULN)
- All study participants must be registered into the mandatory Revlimid Risk Evaluation
and Mitigation Strategy (REMS)®, and be willing and able to comply with the
requirements of the Revlimid REMS®
- Females of reproductive potential must adhere to the scheduled pregnancy testing as
required in the Revlimid REMS® program
- Able to take aspirin (81 or 325 mg) daily for prophylactic anticoagulation (patients
intolerant to acetylsalicylic acid, ASA, may use warfarin or low molecular weight
heparin or other anticoagulants as deemed appropriate by physician)
- Disease free of prior malignancies for > 2 years with exception of currently treated
basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma "in situ" of
the cervix or breast
- All study participants must have one of the HLA alleles: HLA-A*02, HLA-A*03, HLAA*11,
or HLA-A*24
- Participant must understand the investigational nature of this study and sign an
Independent Ethics Committee/Institutional Review Board approved written informed
consent form prior to receiving any study related procedure.
Exclusion Criteria:
- Any serious medical condition, laboratory abnormality, or psychiatric illness that
would prevent the subject from signing the informed consent form
- Pregnant or breast feeding females; (lactating females must agree not to breast feed
while taking lenalidomide)
- Any condition, including the presence of laboratory abnormalities, which places the
subject at unacceptable risk if he/she were to participate in the study or confounds
the ability to interpret data from the study as determined by the Principal
Investigator
- Chemotherapy, immunotherapy, radiotherapy, radiosurgery, interferon (e.g. Intron-A®),
allergy desensitization injections, growth factors (e.g. Procrit®, Aranesp®,
Neulasta®), interleukins (e.g. Proleukin®) or any investigational therapeutic
medication within 4 weeks of study entry
- Known hypersensitivity to thalidomide, lenalidomide, Keyhole Limpet Hemocyanin (KLH),
or granulocyte colony-macrophage stimulating factor (GM-CSF)
- The development of erythema nodosum if characterized by a desquamating rash while
taking thalidomide or similar drugs
- Known seropositive for or active viral infection with human immunodeficiency virus
(HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV); patients who are
seropositive because of hepatitis B virus vaccine are eligible
- Any prior autoimmune disorders requiring cytotoxic or immunosuppressive therapy or
autoimmune disorders with visceral involvement
- Patients with a known diagnosis of plasma cell leukemia
- Systemic corticosteroid therapy > 2 mg of dexamethasone or equivalent per day at study
entry
- Patients had prior autologous or allogeneic stem cell transplant; prior stem cell
collection is allowed
- Life expectancy less than 4 months
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Toxicity profile of the SVN53-67/M57-KLH peptide vaccine in incomplete Freund's adjuvant plus sargramostim, given before or after the start of lenalidomide maintenance |
Time Frame: | Up to 24 weeks |
Safety Issue: | |
Description: | The National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 will be used to evaluate toxicity. The maximum grade of toxicity for each category of interest will be recorded for each patient and the summary results will be tabulated by category and grade. The frequency of toxicities will also be tabulated for the regimen estimated to be the regimen-limiting toxicity. |
Secondary Outcome Measures
Measure: | Immune response using interferon (IFN)-gamma enzyme-linked immunospot (ELISPOT) and multimer assays |
Time Frame: | Up to 24 weeks |
Safety Issue: | |
Description: | A responder is defined as a patient who has responded in either IFN-gamma ELISPOT or multimer assays. For both the ELISPOT and multimer assays, time course and magnitude of responses will be plotted and data will be treated using mixed-effect modeling. In addition, Kendall's tau-b will be used to determine whether ELISPOT and multimer responses are associated. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Roswell Park Cancer Institute |
Last Updated
June 22, 2021