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Safety, Tolerability, Immunogenicity, and Antitumor Activity of GEN-009 Adjuvanted Vaccine

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ClinicalTrials.gov Identifier: NCT03633110
Recruitment Status : Recruiting
First Posted : August 16, 2018
Last Update Posted : September 11, 2018
Sponsor:
Information provided by (Responsible Party):
Genocea Biosciences, Inc.

Brief Summary:
In this study, Genocea is evaluating an investigational, personalized adjuvanted vaccine, GEN-009, that is being developed for the treatment of patients with solid tumors. A proprietary tool developed by Genocea, called ATLAS™ (Antigen Lead Acquisition System) will be used to identify neoantigens in each patient's tumor that are recognized by their CD4 and/or CD8 T cells. ATLAS-identified neoantigens will then be incorporated into a patient's personalized vaccine in the form of synthetic long peptides (SLPs).

Condition or disease Intervention/treatment Phase
Cutaneous Melanoma Non-small Cell Lung Cancer Squamous Cell Carcinoma of the Head and Neck Urothelial Carcinoma Renal Cell Carcinoma Biological: GEN-009 Adjuvanted Vaccine Drug: Nivolumab Phase 1 Phase 2

Detailed Description:
This first-in-human study of GEN-009 will be conducted in three parts in adult patients with cutaneous melanoma, non-small cell lung cancer (NSCLC), squamous cell carcinoma of the head and neck (SCCHN), urothelial carcinoma, or renal cell carcinoma (Parts B and C only). In Part A, the safety and immunogenicity of single-agent GEN 009 will be evaluated in patients with the above-noted tumor types who have completed treatment with curative intent for their disease (eg, surgical resection, neoadjuvant and/or adjuvant chemotherapy, and/or radiation therapy) and have no evidence of disease (NED) at the time of initiating vaccination with GEN-009. In Part B, up to 15 patients in each disease cohort will be enrolled and evaluated for safety, immunogenicity, and preliminary antitumor activity of GEN-009. Patients in Part B will receive GEN-009 at the schedule selected in Part A, in combination with nivolumab at the approved dose and schedule per the United States Package Insert (USPI). Part C will evaluate the safety, immunogenicity, and objective response rate (ORR) of patients with the above-noted tumor types who have received at least 1 line of standard systemic therapy that included a programmed cell death protein 1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor for advanced, recurrent, or metastatic disease.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 124 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2a Study to Evaluate the Safety, Tolerability, Immunogenicity, and Antitumor Activity of GEN-009 Adjuvanted Vaccine in Adult Patients With Selected Solid Tumors
Actual Study Start Date : August 29, 2018
Estimated Primary Completion Date : December 2022
Estimated Study Completion Date : December 2022


Arm Intervention/treatment
Experimental: Part A

Participants in Part A have no evidence of disease when they begin receiving GEN-009 Adjuvanted Vaccine, and have completed treatment with curative intent for their disease (eg, surgical resection, neoadjuvant and/or adjuvant chemotherapy, and/or radiation therapy).

Part A will consist of approximately 9 participants.

Biological: GEN-009 Adjuvanted Vaccine
GEN-009 Adjuvanted Vaccine consists of GEN-009 Drug Product mixed with Hiltonol (poly-ICLC, adjuvant) and is administered by subcutaneous injection.

Experimental: Part B

Participants in Part B have advanced or metastatic solid tumors, and will receive GEN-009 Adjuvanted Vaccine in combination with nivolumab.

Part B will consist of up to 75 participants.

Biological: GEN-009 Adjuvanted Vaccine
GEN-009 Adjuvanted Vaccine consists of GEN-009 Drug Product mixed with Hiltonol (poly-ICLC, adjuvant) and is administered by subcutaneous injection.

Drug: Nivolumab
Nivolumab is a PD-1 checkpoint inhibitor approved by the FDA to treat the tumor types in this study.
Other Name: OPDIVO

Experimental: Part C

Participants in Part C have relapsed or refractory solid tumors, have received at least 1 line of standard systemic therapy that included a PD-1 or PD-L1 inhibitor for advanced, recurrent, or metastatic disease, and will receive GEN-009 Adjuvanted Vaccine as a monotherapy.

Part C will consist of up to 40 participants.

Biological: GEN-009 Adjuvanted Vaccine
GEN-009 Adjuvanted Vaccine consists of GEN-009 Drug Product mixed with Hiltonol (poly-ICLC, adjuvant) and is administered by subcutaneous injection.




Primary Outcome Measures :
  1. Incidence of Treatment-Emergent Adverse Events [ Time Frame: 1.5 years after first GEN-009 vaccination ]
    Adverse events will be graded according to the NC Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0

  2. T-cell responses to GEN-009 adjuvanted vaccine [ Time Frame: 1.5 years after first GEN-009 vaccination ]
    Immunogenicity based on T-cell responses to GEN-009


Secondary Outcome Measures :
  1. Antitumor activity of GEN-009 in Part B [ Time Frame: 48 weeks after first GEN-009 vaccination ]
    Evaluation conducted based on RECIST v1.1 (and immune-related RECIST [irRECIST], where appropriate)

  2. Antitumor activity of GEN-009 in Part C [ Time Frame: 48 weeks after first GEN-009 vaccination ]
    Evaluation conducted based on RECIST v1.1


Other Outcome Measures:
  1. Long-term clinical outcomes of Part A participants [ Time Frame: 1.5 years after first GEN-009 vaccination ]
    Disease recurrence

  2. Additional cellular responses after vaccination with GEN-009 [ Time Frame: 1 year after first GEN-009 vaccination ]
    Cytokine secretion

  3. Phenotype of circulating immune cells after vaccination with GEN-009 [ Time Frame: 1 year after first GEN-009 vaccination ]
    Measured by flow cytometry

  4. Tumor-infiltrating T cells after vaccination with GEN-009 [ Time Frame: 1 year after first GEN-009 vaccination ]
    Will be examined in tumor biopsies



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

General Inclusion Criteria:

  • Diagnosis of 1 of the following tumor types:

    1. Melanoma (cutaneous).
    2. NSCLC.
    3. SCCHN (oral, oropharyngeal, hypopharyngeal, or laryngeal).
    4. Urothelial carcinoma.
    5. Renal cell carcinoma (Parts B and C only).
  • Understand the study, be willing to comply with all study procedures and sign the informed consent
  • Adequate tumor tissue available
  • ECOG performance status of 0 or 1
  • Negative pregnancy test (females of childbearing potential)
  • Agree to use of contraception during the study until at least 90 days after final GEN-009 dose
  • Adequate hematologic, liver, and kidney function

Part A-specific Inclusion:

  • Have completed or will complete treatment for their disease with curative intent
  • Have no evidence of disease

Part B-specific Inclusion:

  • Receiving or will initiate treatment with full-dose nivolumab per disease as listed below:

    1. NSCLC: Patients with metastatic NSCLC with disease progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have had disease progression on FDA-approved therapy for these aberrations prior to receiving nivolumab
    2. SCCHN: Patients with recurrent or metastatic SCCHN with disease progression on or after a platinum-based therapy
    3. Cutaneous Melanoma: Patients with unresectable or metastatic cutaneous melanoma regardless of BRAF mutation status
    4. Urothelial Carcinoma: Patients with locally advanced or metastatic urothelial carcinoma who:

      1. Have had disease progression during or following platinum-containing chemotherapy
      2. Have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy
    5. Renal Cell Carcinoma: Patients with advanced renal cell carcinoma who have received prior anti-angiogenic therapy.
  • Disease assessment by CT or MRI
  • Have at least 1 lesion that is measureable by RECIST 1.1
  • Agree to a tumor biopsy 50 days after first GEN-009 vaccination
  • Participants with hypothyroidism must be on thyroid replacement treatment

Part C-specific Inclusion:

  • Have received at least 1 line of standard systemic therapy for advanced, relapsed, or metastatic disease
  • Have received a PD-1 or PD-L1 inhibitor either as a single-agent or in combination, and have had disease progression on the checkpoint inhibitor or disease that is considered by the Investigator to be refractory to the checkpoint inhibitor
  • In addition, Part C participants should have received the following chemotherapy:

    1. NSCLC: A platinum-containing chemotherapy regimen
    2. SCCHN: A platinum-containing chemotherapy regimen
    3. Cutaneous Melanoma with a BRAF V600 mutation: An FDA-approved BRAF inhibitor
    4. Urothelial carcinoma: A platinum-containing chemotherapy regimen.
    5. Renal Cell Carcinoma: An anti-angiogenic therapy
  • Have at least 1 lesion that is measureable by RECIST 1.1
  • Agree to a tumor biopsy 50 days after first GEN-009 vaccination

General Exclusion Criteria:

  • Received a live vaccine ≤ 28 days, or a non-live vaccine ≤ 14 days, prior to the first dose of GEN-009
  • Acute or chronic skin disorders that would interfere with injection
  • Receiving immunosuppressive therapies or systemic corticosteroids. Note: Use of topical corticosteroids or inhaled corticosteroids is acceptable
  • Allergy to the vaccine adjuvant Hiltonol (poly-ICLC)
  • Active hepatitis B or hepatitis C infection
  • HIV Positive
  • History of clinically significant cardiac condition
  • History of leptomeningeal carcinomatosis
  • Had clinically active immune-mediated disease within 5 years
  • Received a prior allogeneic stem cell transplant
  • Has primary immune deficiency
  • Received a prior solid organ transplant
  • Has malignant disease, other than the tumor types being treated in this study
  • Female patient who is pregnant, breastfeeding, or who plans to become pregnant from the signing of the informed consent until ≥ 90 days from last dose of GEN-009
  • Any condition that in the judgment of the PI would make the patient inappropriate for enrollment in the study

Part A-specific Exclusion Criteria:

  • Has received or requires additional anticancer treatment prior to first GEN-009 vaccination
  • Has not recovered or stabilized from any clinically significant toxicity associated with any prior procedure or anticancer therapy

Part B-specific Exclusion Criteria:

  • Has received or requires additional anticancer treatment prior to first GEN-009 vaccination (however, these participants may be eligible for Part C)

Part C-specific Exclusion Criteria:

  • Has received or requires additional anticancer treatment within 14 days of first GEN-009 vaccination
  • Has not recovered or stabilized from any clinically significant toxicity associated with any prior procedure or anticancer therapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03633110


Contacts
Contact: Jennifer LaVin 617-876-8191 jennifer.lavin@genocea.com

Locations
United States, Arizona
Scottsdale Healthcare Hospitals DBA HonorHealth Recruiting
Scottsdale, Arizona, United States, 85258
Contact: Joyce Schaffer, RN    480-323-1339    clinicaltrials@honorhealth.com   
Principal Investigator: Michael S. Gordon, MD         
Sub-Investigator: Jasgit Sachdev, MD         
Sub-Investigator: Erkut H. Borazanci, MD         
Sub-Investigator: Sunil Sharma, MD         
Sub-Investigator: Frank Y. Tsai, MD         
United States, California
John Wayne Cancer Institute - Providence Saint John's Health Center Recruiting
Santa Monica, California, United States, 90404
Contact: Hunter Cole    310-449-5224    ColeH@jwci.org   
Principal Investigator: Przemyslaw Twardowski, MD         
Sub-Investigator: Steven J. O'Day, MD         
United States, Tennessee
The Sarah Cannon Research Institute Recruiting
Nashville, Tennessee, United States, 37203
Contact: Ask Sarah    615-339-4214    asksarah@sarahcannon.com   
Principal Investigator: Melissa L. Johnson, MD         
Sub-Investigator: Todd M. Bauer, MD         
Sub-Investigator: Johanna C. Bendell, MD         
Sub-Investigator: Howard A. Burris, III, MD         
Sub-Investigator: Erika P. Hamilton, MD         
Sponsors and Collaborators
Genocea Biosciences, Inc.
Investigators
Study Director: Arthur P. DeCillis, MD

Additional Information:
Responsible Party: Genocea Biosciences, Inc.
ClinicalTrials.gov Identifier: NCT03633110     History of Changes
Other Study ID Numbers: GEN-009-101
First Posted: August 16, 2018    Key Record Dates
Last Update Posted: September 11, 2018
Last Verified: September 2018

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Genocea Biosciences, Inc.:
Vaccine
Personalized
Immunotherapy
Solid Tumor
Personal
Skin
Lung
Cancer
Bladder
Kidney
Melanoma
Carcinoma

Additional relevant MeSH terms:
Carcinoma
Carcinoma, Non-Small-Cell Lung
Melanoma
Carcinoma, Squamous Cell
Carcinoma, Renal Cell
Head and Neck Neoplasms
Carcinoma, Transitional Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Carcinoma, Bronchogenic
Bronchial Neoplasms
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Nevi and Melanomas
Neoplasms, Squamous Cell
Adenocarcinoma
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Kidney Diseases
Urologic Diseases