Trials / Recruiting
RecruitingNCT05269381
Personalized Neoantigen Peptide-Based Vaccine in Combination With Pembrolizumab for Treatment of Advanced Solid Tumors
A Phase I/II Study of Personalized Neoantigen Peptide-Based Vaccine in Combination With Pembrolizumab in Advanced Solid Tumors (PNeoVCA)
- Status
- Recruiting
- Phase
- Phase 1 / Phase 2
- Study type
- Interventional
- Enrollment
- 132 (estimated)
- Sponsor
- Mayo Clinic · Academic / Other
- Sex
- All
- Age
- 16 Years
- Healthy volunteers
- Not accepted
Summary
This phase I/II trial tests the safety and tolerability of an experimental personalized vaccine when given by itself and with pembrolizumab in treating patients with solid tumor cancers that have spread to other places in the body (advanced). The experimental vaccine is designed target certain proteins (neoantigens) on individuals' tumor cells. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving the personalized neoantigen peptide-based vaccine with pembrolizumab may be safe and effective in treating patients with advanced solid tumors.
Detailed description
PRIMARY OBJECTIVE: I. To evaluate the safety of personalized neoantigen peptide vaccine in combination with pembrolizumab in advanced solid cancers. (Phase I) II. To evaluate and estimate 24-months event-free survival (EFS) rate per Kaplan-Meier method in triple-negative breast cancer (TNBC) patients with residual cancer burden-2 and 3 (RCB-2 and RCB-3) after neoadjuvant pembrolizumab-based chemotherapy treated with neoantigen vaccine in combination with pembrolizumab. (Phase II Cohort 3) III. To evaluate and estimate 24-months event-free survival (DFS) rate per Kaplan-Meier method in stage II/III non-small cell lung cancer (NSCLC) patients after surgery treated with neoantigen vaccine in combination with pembrolizumab. (Phase II Cohort 4) SECONDARY OBJECTIVES: I. To evaluate and estimate the immunogenicity response rate in patients with advanced solid cancers receiving personalized neoantigen peptide vaccine in combination with pembrolizumab. (Phase I) II. To obtain preliminary information on the immunogenicity of neoantigen in induction of specific cellular immune responses and humoral immune response. III. To evaluate and estimate the immunogenicity response rate in TNBC patients with residual cancer burden-2 and 3 (RCB-2 and RCB-3) after neoadjuvant pembrolizumab-based chemotherapy treated with neoantigen vaccine in combination with pembrolizumab. (Phase II Cohort 3) IV. To evaluate adverse event profile in in TNBC patients with residual cancer burden-2 and 3 (RCB-2 and RCB-3) after neoadjuvant pembrolizumab-based chemotherapy treated with neoantigen vaccine in combination with pembrolizumab. (Phase II Cohort 3) V. To evaluate and estimate the vaccine immunogenicity response rate in stage II/III NSCLC patients after surgery treated with neoantigen vaccine in combination with pembrolizumab. (Phase II Cohort 4) VI. To evaluate adverse event profile in stage II/III NSCLC patients after surgery treated with neoantigen vaccine in combination with pembrolizumab. (Phase II Cohort 4) EXPLORATORY OBJECTIVES: I. To obtain preliminary information on the immunogenicity of neoantigen in induction of specific cellular immune responses and humoral immune response in patients with selected advanced solid tumors. (Phase I) II. To obtain preliminary estimates of efficacy as measured by objective response rate (ORR based on Response Evaluation Criteria in Solid Tumors \[RECIST\]) of personalized neoantigen peptide vaccine and pembrolizumab in patients with selected advanced solid tumors. (Phase I) III. To obtain preliminary information of immunity persistence, as well as pre-existing immunity in patients with selected advanced solid tumors. (Phase I) IV. To obtain preliminary information on the immunogenicity of neoantigen in induction of specific cellular immune responses and humoral immune response in Cohort 1 (TNBC patients with RCB-2 and RCB-3) and 2 (stage II/III NSCLC patients) separately. (Phase II) V. To obtain preliminary information of immunity persistence, as well as pre-existing immunity in Cohort 1 (TNBC patients with RCB-2 and RCB-3) and 2 (stage II/III NSCLC patients) separately. (Phase II) OUTLINE: This is a phase I, dose-escalation study of personalized neoantigen vaccine followed by a phase II study. Patients are assigned to 1 of 4 cohorts. COHORT 1- \*NO LONGER ENROLLING\*: Patients receive cyclophosphamide intravenously (IV) on day -3. Patients then receive personalized neoantigen vaccine with sargramostim (GM-CSF) subcutaneously (SC) on days 1, 4, 8, and 15 of cycle 1 and on day 1 of cycle 2 in the absence of disease progression or unacceptable toxicity. COHORT 2 - \*NO LONGER ENROLLING\*: Patients receive cyclophosphamide IV on day -3. Patients then receive personalized neoantigen vaccine with GM-CSF SC on days 1, 4, 8, and 15 of cycle 1 and then on day 1 of cycles 2, 5, and 8. Patients also receive pembrolizumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 2 years in the absence of disease progression or unacceptable toxicity. COHORT 3: Patients with TNBC receive cyclophosphamide IV on day -3. Patients then receive personalized neoantigen vaccine with GM-CSF SC on days 1, 4, 8, and 15 of cycle 1 and then on day 1 of cycles 2, 5, and 8. Patients also receive pembrolizumab IV over 30 minutes on day 1 of each cycle or as clinically indicated. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. COHORT 4: Patients with NSCLC receive cyclophosphamide IV on day -3. Patients then receive personalized neoantigen vaccine with GM-CSF SC on days 1, 4, 8, and 15 of cycle 1 and then on day 1 of cycles 2, 5, and 8. Patients also receive pembrolizumab IV over 30 minutes on day 1 of each cycle or as clinically indicated. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. All patients may undergo tumor biopsy throughout the study. Additionally, patients undergo blood sample collection as well as computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study. After completion of study treatment, patients are followed up at 30 days and then every 3 months up to 2 years from study enrollment.
Conditions
- Anatomic Stage III Breast Cancer AJCC v8
- Anatomic Stage IIIA Breast Cancer AJCC v8
- Anatomic Stage IIIB Breast Cancer AJCC v8
- Anatomic Stage IIIC Breast Cancer AJCC v8
- Anatomic Stage IV Breast Cancer AJCC v8
- Clinical Stage III Cutaneous Melanoma AJCC v8
- Clinical Stage III Gastric Cancer AJCC v8
- Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8
- Clinical Stage III Merkel Cell Carcinoma AJCC v8
- Clinical Stage IV Cutaneous Melanoma AJCC v8
- Clinical Stage IV Gastric Cancer AJCC v8
- Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8
- Clinical Stage IV Merkel Cell Carcinoma AJCC v8
- Clinical Stage IVA Gastric Cancer AJCC v8
- Clinical Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Clinical Stage IVB Gastric Cancer AJCC v8
- Clinical Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Locally Advanced Cervical Carcinoma
- Locally Advanced Endometrial Carcinoma
- Locally Advanced Gastric Adenocarcinoma
- Locally Advanced Gastroesophageal Junction Adenocarcinoma
- Locally Advanced Head and Neck Squamous Cell Carcinoma
- Locally Advanced Hepatocellular Carcinoma
- Locally Advanced Lung Non-Small Cell Carcinoma
- Locally Advanced Malignant Solid Neoplasm
- Locally Advanced Melanoma
- Locally Advanced Merkel Cell Carcinoma
- Locally Advanced Renal Cell Carcinoma
- Locally Advanced Skin Squamous Cell Carcinoma
- Locally Advanced Triple-Negative Breast Carcinoma
- Locally Advanced Unresectable Breast Carcinoma
- Locally Advanced Unresectable Cervical Carcinoma
- Locally Advanced Unresectable Gastric Adenocarcinoma
- Locally Advanced Unresectable Gastroesophageal Junction Adenocarcinoma
- Locally Advanced Unresectable Renal Cell Carcinoma
- Locally Advanced Urothelial Carcinoma
- Metastatic Cervical Carcinoma
- Metastatic Endometrial Carcinoma
- Metastatic Gastric Adenocarcinoma
- Metastatic Gastroesophageal Junction Adenocarcinoma
- Metastatic Head and Neck Squamous Cell Carcinoma
- Metastatic Hepatocellular Carcinoma
- Metastatic Lung Non-Small Cell Carcinoma
- Metastatic Malignant Solid Neoplasm
- Metastatic Melanoma
- Metastatic Merkel Cell Carcinoma
- Metastatic Renal Cell Carcinoma
- Metastatic Skin Squamous Cell Carcinoma
- Metastatic Triple-Negative Breast Carcinoma
- Metastatic Urothelial Carcinoma
- Skin Squamous Cell Carcinoma
- Stage III Cervical Cancer AJCC v8
- Stage III Hepatocellular Carcinoma AJCC v8
- Stage III Lung Cancer AJCC v8
- Stage III Renal Cell Cancer AJCC v8
- Stage IIIA Cervical Cancer AJCC v8
- Stage IIIA Hepatocellular Carcinoma AJCC v8
- Stage IIIA Lung Cancer AJCC v8
- Stage IIIA Uterine Corpus Cancer AJCC v8
- Stage IIIB Cervical Cancer AJCC v8
- Stage IIIB Hepatocellular Carcinoma AJCC v8
- Stage IIIB Lung Cancer AJCC v8
- Stage IIIB Uterine Corpus Cancer AJCC v8
- Stage IIIC Lung Cancer AJCC v8
- Stage IIIC Uterine Corpus Cancer AJCC v8
- Stage IIIC1 Uterine Corpus Cancer AJCC v8
- Stage IIIC2 Uterine Corpus Cancer AJCC v8
- Stage IV Cervical Cancer AJCC v8
- Stage IV Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8
- Stage IV Hepatocellular Carcinoma AJCC v8
- Stage IV Lung Cancer AJCC v8
- Stage IV Renal Cell Cancer AJCC v8
- Stage IVA Cervical Cancer AJCC v8
- Stage IVA Hepatocellular Carcinoma AJCC v8
- Stage IVA Lung Cancer AJCC v8
- Stage IVA Uterine Corpus Cancer AJCC v8
- Stage IVB Cervical Cancer AJCC v8
- Stage IVB Hepatocellular Carcinoma AJCC v8
- Stage IVB Lung Cancer AJCC v8
- Stage IVB Uterine Corpus Cancer AJCC v8
- Triple-Negative Breast Carcinoma
- Unresectable Cervical Carcinoma
- Unresectable Endometrial Carcinoma
- Unresectable Gastric Adenocarcinoma
- Unresectable Gastroesophageal Junction Adenocarcinoma
- Unresectable Head and Neck Squamous Cell Carcinoma
- Unresectable Hepatocellular Carcinoma
- Unresectable Lung Non-Small Cell Carcinoma
- Unresectable Malignant Solid Neoplasm
- Unresectable Melanoma
- Unresectable Merkel Cell Carcinoma
- Unresectable Renal Cell Carcinoma
- Unresectable Skin Squamous Cell Carcinoma
- Unresectable Triple-Negative Breast Carcinoma
- Unresectable Urothelial Carcinoma
- Breast Adenocarcinoma
- Stage III Uterine Corpus Carcinoma or Carcinosarcoma AJCC v8
- Stage IV Uterine Corpus Carcinoma or Carcinosarcoma AJCC v8
- Stage III Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8
- Stage IV Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8
Interventions
| Type | Name | Description |
|---|---|---|
| DRUG | Cyclophosphamide | Given IV |
| BIOLOGICAL | Neoantigen Peptide Vaccine | Receive personalized neoantigen vaccine SC |
| BIOLOGICAL | Pembrolizumab | Given IV |
| BIOLOGICAL | Sargramostim | Given SC |
| PROCEDURE | Biospecimen Collection | Undergo blood sample collection |
| PROCEDURE | Biopsy | Undergo tissue biopsy |
| PROCEDURE | Computed Tomography | Undergo CT |
| PROCEDURE | Magnetic Resonance Imaging | Undergo MRI |
Timeline
- Start date
- 2022-03-31
- Primary completion
- 2028-03-31
- Completion
- 2028-03-31
- First posted
- 2022-03-08
- Last updated
- 2026-03-12
Locations
1 site across 1 country: United States
Regulatory
- FDA-regulated drug study
Source: ClinicalTrials.gov record NCT05269381. Inclusion in this directory is not an endorsement.