Description:
Effective treatments are desperately needed for glioblastoma (GBM) patients. This phase I
clinical trial assesses the safety of a novel personalized dendritic-cell vaccine
administered to GBM patients shortly after completing standard-of-care treatments. Secondary
outcomes will evaluate patient progression-free survival and overall survival.
Title
- Brief Title: Dendritic Cell Vaccination With Standard Postoperative Chemoradiation for the Treatment of Adult Glioblastoma: Phase I Clinical Trial
- Official Title: A Phase I Study of Th-1 Dendritic Cell Immunotherapy in Combination With Standard Chemoradiation for the Adjuvant Treatment of Adult Glioblastoma
Clinical Trial IDs
- ORG STUDY ID:
8148
- NCT ID:
NCT04552886
Conditions
Interventions
Drug | Synonyms | Arms |
---|
TH-1 Dendritic Cell Immunotherapy | | Dendritic cell vaccine dose de-escalation |
Purpose
Effective treatments are desperately needed for glioblastoma (GBM) patients. This phase I
clinical trial assesses the safety of a novel personalized dendritic-cell vaccine
administered to GBM patients shortly after completing standard-of-care treatments. Secondary
outcomes will evaluate patient progression-free survival and overall survival.
Detailed Description
This is a single arm (non-randomized) first-in-man pilot study to evaluate the safety and
feasibility of delivering a dendritic cell vaccine in nine to twenty-four (n=9-24) adult
patients diagnosed with glioblastoma (GBM) after undergoing neurosurgical tumor resection,
and in whom a neuropathological diagnosis has been established. Standard of care chemotherapy
and radiation therapy shall be followed as per routine neuro-oncologic paradigms after which
patients enrolled into this study will receive a personalized vaccine beyond standard of
care. Effective adjuvant therapies are urgently needed for these patients given that standard
of care is rarely successful in preventing recurrence among GBM patients, nor death among
relapsed patients with this very poor-prognosis tumor type. The study is constructed in a 3+3
algorithm for three steps of dose escalation with rigorous and mandatory safety monitoring.
Trial Arms
Name | Type | Description | Interventions |
---|
Dendritic cell vaccine: Starting dose | Experimental | This arm will evaluate the safety of administering a total dendritic cell dose of 3.5 x 10^6. A total of 3-6 patients will be enrolled with this dose. If this dose is associated with unacceptable side effects, as detailed in the study protocol, no further patients will be enrolled at this dose. | - TH-1 Dendritic Cell Immunotherapy
|
Dendritic cell vaccine dose de-escalation | Experimental | If unacceptable side effects, as detailed in the study protocol, are identified at a total dose of 3.5 x 10^6, then a cohort of 3-6 enrolled patients will receive a de-escalated total dendritic cell dose of 1.75 X 10^6. | - TH-1 Dendritic Cell Immunotherapy
|
Dendritic cell vaccine dose escalation one | Experimental | If no unacceptable side effects, as detailed in the study protocol, are identified at a total dose of 3.5 x 10^6, then a cohort of 3-6 enrolled patients will receive an escalated total dendritic cell dose of 7.0 X 10^6. | - TH-1 Dendritic Cell Immunotherapy
|
Dendritic cell vaccine dose escalation two | Experimental | If no unacceptable side effects, as detailed in the study protocol, are identified at a total dose of 7.0 x 10^6, then a cohort of 3-6 enrolled patients will receive an escalated total dendritic cell dose of 1.4 X 10^7. | - TH-1 Dendritic Cell Immunotherapy
|
Eligibility Criteria
Inclusion Criteria:
1. Provision of signed and dated informed consent form
2. Stated willingness to comply with all study procedures and availability for the
duration of the study
3. Male or female, aged 18 years and older
4. Diagnosed with GBM deemed to be potentially resectable and who are deemed to be good
candidate for postoperative adjuvant chemo and radiation therapy. This may include
patients whose tumors are deemed suitable for gross total resection as well as
patients whose tumors are deemed partially resectable and who undergo partial
resection followed by adjuvant therapy. [neoadjuvant therapy is rarely if ever
given]..
5. Ability to adhere to the bi-weekly injections of DC vaccine regimen
6. For females of reproductive potential: use of highly effective contraception for at
least 1 month prior to screening and agreement to use such a method during study
participation and for an additional 12 weeks following discontinuations of last
vaccination. Must have a negative serum pregnancy test prior to first treatment.
7. For males of reproductive potential: use of condoms or other methods to ensure
effective contraception with partner during study participation and for an additional
12 weeks following discontinuations of last vaccination.
8. Presented at Tumor Board for review and consensus of Multidisciplinary group to
proceed with enrollment.
9. Adequate kidney, liver, bone marrow function, and immune function, as follows:
1. Hemoglobin ≥ 8.0 gm/dL
2. Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3
3. Platelet count ≥ 100,000 /mm3
4. Lymphocyte count greater than 500/L
5. Glomerular filtration rate (GFR) > 60 mL/min/m2 and Creatinine < 1.5mg/dl
i. For males = (140 - age[years]) x (body weight [kg]) (72) x (serum creatinine
[mg/dL] ii. For females = 0.85 x male value f. Total bilirubin ≤ 1.5 times upper limit
of normal (ULN), g. Aspartate transaminase AST (SGOT) and alanine aminotransferase ALT
(SGPT) ≤ 2.5 times the ULN h. Albumin >2g/dL i. (IgM), surface antibody and antigen,
Hepatitis B and C antibody. j. Negative HIV status
10. ECOG performance status ≤ 2.
Exclusion Criteria:
1. Locally advanced tumors deemed unresectable and/or recurrent tumors after prior
vaccination.
2. Use of non-standard post-operative treatment regimen, as defined by the Stupp
protocol: postoperative chemoradiation and initiation of TMZ. The use of a TTF device
with adjuvant TMZ is at the discretion of the investigator.
3. Female patients who are pregnant, breast feeding, or of childbearing potential without
a negative pregnancy test prior to baseline. Post-menopausal women must be amenorrheic
for at least 12 months to be considered of non-childbearing potential.
4. Patients unwilling or unable to comply with the protocol or provide informed consent.
5. Any severe or uncontrolled medical condition or other condition that could affect
participation in this study, including but not limited to: hyper/hypothyroidism,
systemic autoimmune disorders, untreated viral hepatitis or autoimmune hepatitis.
6. Concurrent or expected need for therapy with corticosteroids during the vaccination
phase of the study.
7. Treatment with another investigational drug or other intervention outside of the
prespecified standard of care for GBM.
8. Patients suffering from active HIV disease.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety and potential toxicity of Th-1 dendritic cell immunotherapy |
Time Frame: | Two years |
Safety Issue: | |
Description: | Patients will be monitored for adverse events as dictated by CTCAE version 5. |
Secondary Outcome Measures
Measure: | Overall survival of patients receiving Th-1 dendritic cell immunotherapy |
Time Frame: | Minimum 2 years from time of diagnosis |
Safety Issue: | |
Description: | Length of survival for patients who receive this vaccine will be tabulated. |
Measure: | Progression-free survival of patients receiving Th-1 dendritic cell immunotherapy |
Time Frame: | Minimum 2 years from time of diagnosis |
Safety Issue: | |
Description: | If there is tumor recurrence, the time from diagnosis until recurrence will be collected |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Not yet recruiting |
Lead Sponsor: | The Cooper Health System |
Last Updated
September 17, 2020