Long-Term TARP Vaccination Using a Multi-Epitope TARP Peptide Autologous Dendritic Cell Vaccination in Previously Vaccinated Men on NCI 09-C-0139
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Prostate Cancer, Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - 99 |
| Updated: | 1/16/2019 |
| Start Date: | May 12, 2015 |
| End Date: | March 1, 2022 |
A Pilot Study of Long Term TARP Vaccination Using A Multi-Epitope TARP Peptide Autologous Dendritic Cell Vaccine in Previously Vaccinated Men on NCI 09-C-0139
Background:
- Few studies or literature are available about the long-term safety of repeated peptide
vaccinations in people over a period of time. Long-term vaccination may be needed to control
tumors. Researchers gave a group of men a series of vaccine injections over 2 years. Now they
want to give those same men the new version of the vaccine. They want to see if it produces
different types of immune responses and also ensure that repeated vaccinations are safe.
Objectives:
- To find out the long-term safety of repeated TARP peptide vaccinations.
Eligibility:
- Men who took part in NCI protocol 09-C-0139.
Design:
- Participants will be screened with blood tests, scans, physical exam, medical history,
and an evaluation of how well they perform everyday activities.
- Participants will have apheresis. Blood will be removed with a needle from one arm. A
machine will separate the white blood cells. The blood, minus the white cells, will be
returned through a needle in the other arm.
- Participants will have 14 visits. At each visit, they will have a physical exam and
blood tests. They will discuss any side effects.
- Participants will get vaccine injections at weeks 3, 6, 9, 12, 15, and 24. The vaccine
will be made from the participants own cells.
- Participants will get a Vaccine Report Card to complete after receiving vaccine.
- The study lasts 96 weeks.
- Few studies or literature are available about the long-term safety of repeated peptide
vaccinations in people over a period of time. Long-term vaccination may be needed to control
tumors. Researchers gave a group of men a series of vaccine injections over 2 years. Now they
want to give those same men the new version of the vaccine. They want to see if it produces
different types of immune responses and also ensure that repeated vaccinations are safe.
Objectives:
- To find out the long-term safety of repeated TARP peptide vaccinations.
Eligibility:
- Men who took part in NCI protocol 09-C-0139.
Design:
- Participants will be screened with blood tests, scans, physical exam, medical history,
and an evaluation of how well they perform everyday activities.
- Participants will have apheresis. Blood will be removed with a needle from one arm. A
machine will separate the white blood cells. The blood, minus the white cells, will be
returned through a needle in the other arm.
- Participants will have 14 visits. At each visit, they will have a physical exam and
blood tests. They will discuss any side effects.
- Participants will get vaccine injections at weeks 3, 6, 9, 12, 15, and 24. The vaccine
will be made from the participants own cells.
- Participants will get a Vaccine Report Card to complete after receiving vaccine.
- The study lasts 96 weeks.
TARP
- T-cell receptor gamma alternate reading frame protein (TARP) is an amino acid protein
expressed by both normal and malignant prostate cancer tissue; 95% of prostate cancer
specimens are positive for TARP expression. TARP is highly expressed in prostate cancers
of all Gleason types, in primary as well as metastatic disease, and in hormone sensitive
and castrate resistant prostate cancer. Therefore, TARP is an ideal tumor antigen target
for a vaccine.
- A prospective, randomized pilot study of 1st generation TARP Peptide vaccination (NCI
09-C- 0139) utilizing TARP WT 27-35 and EE29-37-9V peptides was conducted in HLAA*
0201positive men with stage D0 prostate cancer (PSA biochemical recurrence) and a PSA
doubling time (PSADT) of greater than or equal to 3 months and less than or equal to 15
months. TARP vaccination was found to be immunogenic, safe and well tolerated, with
adverse events limited to injection site reactions less than or equal to Grade 2. TARP
vaccination was also associated with a decreased slope log PSA compared to
pre-vaccination baseline in 72% of subjects reaching 24 weeks and 74% reaching 48 weeks
(p=0.0012 and p=0.0004 for overall changes in slope log PSA, respectively); TARP
vaccination also resulted in a 50% decrease in calculated tumor growth rate constant:
prevaccine g = 0.0042/day, post-vaccine g = 0.0021/day (p=0.003); TARP-specific IFN- >=
ELISPOT responses were detected in the majority of subjects but did not correlate with
decreases in slope log (PSA).
Multi-Epitope (ME) TARP Vaccine
- The vaccine platform includes the original two 9-mer HLA-A*0201 binding TARP peptide
epitopes (WT27-35 and EE29-37-9V) utilized in NCI 09-C-0139 as well as an additional
five 20-mer TARP peptides overlapping by 10 amino acids for a total of 7 peptides that
span the amino acid sequence of the entire TARP protein.
- The advantage of this multi-epitope TARP peptide vaccine platform is that the
overlapping epitopes cover the entire TARP protein, resulting in potential for induction
of a multi-valent anti-TARP response. In addition, these longer synthetic peptides
include TARP-specific MHC class II CD4+ T cell helper epitopes that will allow
generation of better CD8+ T cell responses with improved functional avidity and
longevity as well as humoral anti-TARP antibody responses.
Study Objectives
Primary Objective:
-To assess the long-term safety of repeated TARP peptide vaccination following the use of a
1st generation bivalent (09-C-0139) and a 2nd generation ME TARP peptide vaccine.
Specifically, to document if less than 10% of enrolled patients experience a vaccine-related
Grade 3 adverse event (local injection site reactions or systemic reactions).
Eligibility Criteria All Patients
- Males greater than or equal to 18 years of age with histologically confirmed
adenocarcinoma of the prostate.
- Prior enrollment in NCI protocol 09-C-0139 with receipt of at least 5 doses of TARP
peptide vaccine (i.e. completion of primary vaccination series).
- Performance Status: ECOG 0-1 and life expectancy greater than or equal to 1 year.
- Hemoglobin greater than or equal to 10.0 gm/dL, WBC greater than or equal to 2,500/mm3,
ALC greater than or equal to 500/ mm3, ANC greater than or equal to 1,000/mm3, platelet
count greater than or equal to 100,000/mm3, and PT/PTT less than or equal to 1.5X ULN unless
receiving clinically indicated anticoagulant therapy; SGPT/SGOT less than or equal to 2.5X
ULN, total bilirubin less than or equal to 1.5X ULN; creatinine less than or equal to 1.5X
ULN and estimated GFR (eGFR) greater than or equal to 60 ml/min.
- Hepatitis B and C negative (unless the result is consistent with prior vaccination or
prior infection with full recovery); HIV negative.
- No use of investigational agents within 4 weeks of study enrollment or use of
immunosuppressive or immunomodulating agents within 8 weeks of study entry.
- Standard of care medical management of current prostate cancer disease status by the
patient s local oncologist e.g. androgen deprivation therapy is allowed.
- Must be able/willing to adhere to protocol requirements and vaccination timeline.
Exclusion Criteria All Patients
- Patients with active infection or other significant or uncontrolled medical illness.
Patients with a remote history of asthma or active mild asthma may participate.
- Patients on immunosuppressive therapy including systemic corticosteroid therapy for any
reason. Patients receiving inhaled or topical corticosteroids may participate.
- Patients who, in the opinion of the Principal Investigator, have significant medical or
psychosocial problems that warrant exclusion.
Study Design
- Open label, prospective, non-randomized, long-term follow-up pilot study of 96 weeks to
assess the long-term safety of repeated TARP vaccination in patients that have already
received the first generation TARP vaccine. Sample size: N equals 40 maximum.
- All patients will undergo an 18L apheresis for mononuclear cell collection at Week 0.
- All patients will receive a total of 6 doses of autologous ME TARP peptide DC vaccine:
20
x106 viable cells/dose) delivered intradermally at Weeks 3, 6, 9, 12, 15, and 24.
- T-cell receptor gamma alternate reading frame protein (TARP) is an amino acid protein
expressed by both normal and malignant prostate cancer tissue; 95% of prostate cancer
specimens are positive for TARP expression. TARP is highly expressed in prostate cancers
of all Gleason types, in primary as well as metastatic disease, and in hormone sensitive
and castrate resistant prostate cancer. Therefore, TARP is an ideal tumor antigen target
for a vaccine.
- A prospective, randomized pilot study of 1st generation TARP Peptide vaccination (NCI
09-C- 0139) utilizing TARP WT 27-35 and EE29-37-9V peptides was conducted in HLAA*
0201positive men with stage D0 prostate cancer (PSA biochemical recurrence) and a PSA
doubling time (PSADT) of greater than or equal to 3 months and less than or equal to 15
months. TARP vaccination was found to be immunogenic, safe and well tolerated, with
adverse events limited to injection site reactions less than or equal to Grade 2. TARP
vaccination was also associated with a decreased slope log PSA compared to
pre-vaccination baseline in 72% of subjects reaching 24 weeks and 74% reaching 48 weeks
(p=0.0012 and p=0.0004 for overall changes in slope log PSA, respectively); TARP
vaccination also resulted in a 50% decrease in calculated tumor growth rate constant:
prevaccine g = 0.0042/day, post-vaccine g = 0.0021/day (p=0.003); TARP-specific IFN- >=
ELISPOT responses were detected in the majority of subjects but did not correlate with
decreases in slope log (PSA).
Multi-Epitope (ME) TARP Vaccine
- The vaccine platform includes the original two 9-mer HLA-A*0201 binding TARP peptide
epitopes (WT27-35 and EE29-37-9V) utilized in NCI 09-C-0139 as well as an additional
five 20-mer TARP peptides overlapping by 10 amino acids for a total of 7 peptides that
span the amino acid sequence of the entire TARP protein.
- The advantage of this multi-epitope TARP peptide vaccine platform is that the
overlapping epitopes cover the entire TARP protein, resulting in potential for induction
of a multi-valent anti-TARP response. In addition, these longer synthetic peptides
include TARP-specific MHC class II CD4+ T cell helper epitopes that will allow
generation of better CD8+ T cell responses with improved functional avidity and
longevity as well as humoral anti-TARP antibody responses.
Study Objectives
Primary Objective:
-To assess the long-term safety of repeated TARP peptide vaccination following the use of a
1st generation bivalent (09-C-0139) and a 2nd generation ME TARP peptide vaccine.
Specifically, to document if less than 10% of enrolled patients experience a vaccine-related
Grade 3 adverse event (local injection site reactions or systemic reactions).
Eligibility Criteria All Patients
- Males greater than or equal to 18 years of age with histologically confirmed
adenocarcinoma of the prostate.
- Prior enrollment in NCI protocol 09-C-0139 with receipt of at least 5 doses of TARP
peptide vaccine (i.e. completion of primary vaccination series).
- Performance Status: ECOG 0-1 and life expectancy greater than or equal to 1 year.
- Hemoglobin greater than or equal to 10.0 gm/dL, WBC greater than or equal to 2,500/mm3,
ALC greater than or equal to 500/ mm3, ANC greater than or equal to 1,000/mm3, platelet
count greater than or equal to 100,000/mm3, and PT/PTT less than or equal to 1.5X ULN unless
receiving clinically indicated anticoagulant therapy; SGPT/SGOT less than or equal to 2.5X
ULN, total bilirubin less than or equal to 1.5X ULN; creatinine less than or equal to 1.5X
ULN and estimated GFR (eGFR) greater than or equal to 60 ml/min.
- Hepatitis B and C negative (unless the result is consistent with prior vaccination or
prior infection with full recovery); HIV negative.
- No use of investigational agents within 4 weeks of study enrollment or use of
immunosuppressive or immunomodulating agents within 8 weeks of study entry.
- Standard of care medical management of current prostate cancer disease status by the
patient s local oncologist e.g. androgen deprivation therapy is allowed.
- Must be able/willing to adhere to protocol requirements and vaccination timeline.
Exclusion Criteria All Patients
- Patients with active infection or other significant or uncontrolled medical illness.
Patients with a remote history of asthma or active mild asthma may participate.
- Patients on immunosuppressive therapy including systemic corticosteroid therapy for any
reason. Patients receiving inhaled or topical corticosteroids may participate.
- Patients who, in the opinion of the Principal Investigator, have significant medical or
psychosocial problems that warrant exclusion.
Study Design
- Open label, prospective, non-randomized, long-term follow-up pilot study of 96 weeks to
assess the long-term safety of repeated TARP vaccination in patients that have already
received the first generation TARP vaccine. Sample size: N equals 40 maximum.
- All patients will undergo an 18L apheresis for mononuclear cell collection at Week 0.
- All patients will receive a total of 6 doses of autologous ME TARP peptide DC vaccine:
20
x106 viable cells/dose) delivered intradermally at Weeks 3, 6, 9, 12, 15, and 24.
- INCLUSION CRITERIA:
- Males greater than or equal to 18 years of age with histologically confirmed
adenocarcinoma of the prostate.
- Prior enrollment in NCI protocol 09-C-0139 with receipt of at least 5 doses of TARP
peptide vaccine (i.e. completion of primary vaccination series).
- Performance Status: ECOG 0-1, life expectancy of greater than or equal to 1 year.
- Hemoglobin greater than or equal to 10.0 gm/dL, WBC greater than or equal to
2,500/mm3, ALC greater than or equal to 500/mm3, ANC greater than or equal to
1,000/mm3, platelet count greater than or equal to 100,000/mm3.
- PT/PTT less than or equal to 1.5X ULN unless receiving clinically indicated
anticoagulant therapy.
- SGOT/SGPT less than or equal to 2.5X ULN, total bilirubin less than or equal to 1.5X
ULN, Cr less than or equal to 1.5X ULN, estimated GFR (eGFR) greater than or equal to
60 ml/min.
- Hepatitis B and C negative, unless the result is consistent with prior vaccination or
prior infection with full recovery.
- HIV negative
- No use of investigational agents within 4 weeks of study enrollment or use of
immunosuppressive or immunomodulating agents (including IVIG) within 8 weeks of study
entry. Note: Use of topical, inhaled and intranasal steroid therapy is permitted.
- Greater than or equal to 6 weeks since the receipt of chemotherapy or radiation
therapy.
- Standard of care medical management of current prostate cancer disease status by the
patient s local oncologist, e.g. androgen deprivation therapy is allowed.
- Able to understand and provide Informed Consent.
- Must be able and willing to adhere to protocol requirements, visits and vaccination
timeline.
EXCLUSION CRITERIA:
- Patients with a second malignancy requiring active treatment.
- Patients with an active infection.
- Patients on immunosuppressive therapy including:
--Systemic corticosteroid therapy for any reason. Patients receiving inhaled,
intranasal or topical corticosteroids may participate.
- Other significant or uncontrolled medical illness. Patients with a remote history of
or active mild asthma may participate.
- Patients who, in the opinion of the Principal Investigator, have significant medical
or psychosocial problems that warrant exclusion including:
- Other serious non-malignancy-associated medical conditions that may be
expected to limit life expectancy to less than 2 years.
We found this trial at
1
site
9000 Rockville Pike
Bethesda, Maryland 20892
Bethesda, Maryland 20892
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