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COVID-19 Supplemental Vaccine Boost to Enhance T Cell Protection in Those Who Have Already Received EUA S-Based Vaccines

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04843722
Recruitment Status : Withdrawn (The sponsor has changed the development plans which is not for safety reasons.)
First Posted : April 13, 2021
Last Update Posted : January 4, 2022
Sponsor:
Information provided by (Responsible Party):
ImmunityBio, Inc.

Brief Summary:
This is a phase 1/2 study in adult healthy subjects that have previously been vaccinated with an FDA-authorized vaccine against COVID-19. This clinical trial is designed to assess the safety, efficacy, reactogenicity, and immunogenicity of hAd5-S-Fusion+N-ETSD formulated for subcutaneous, sublingual, and oral (capsule) administration.

Condition or disease Intervention/treatment Phase
Covid19 Biological: hAd5-S-Fusion+N-ETSD vaccine Phase 1 Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: Open label 2 Cohort Phase 1 Study leading to Randomized Phase 2 Study
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Phase 1/2 Study of the Safety, Reactogenicity, and Immunogenicity of a Supplemental Spike & Nucleocapsid-targeted COVID-19 Vaccine to Enhance T Cell Based Immunogenicity in Participants Who Have Already Received Prime + Boost Vaccines Authorized For Emergency Use
Estimated Study Start Date : December 2021
Estimated Primary Completion Date : March 2022
Estimated Study Completion Date : August 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Cohort 1: hAd5-S-Fusion+N-ETSD at 5 × 10e10 IU/dose Subcutaneous
Cohort 1 (n=20): hAd5-S-Fusion+N-ETSD at 5 × 10e10 IU/dose Subcutaneous on Day 1
Biological: hAd5-S-Fusion+N-ETSD vaccine
Vaccine containing both full length wild type SARS-CoV-2 spike gene optimized for better spike protein expression, and full length wild type SARS-CoV-2 nucleocapsid gene modified to also contain an enhanced T cell stimulation domain (ETSD) to enhance cell-mediated immunity.

Experimental: Cohort 2: hAd5-S-Fusion+N-ETSD at 5 × 10e10 IU/dose Subcutaneous and 1 × 10e10 IU/dose Sublingual
Cohort 2 (n=20): hAd5-S-Fusion+N-ETSD at 5 × 10e10 IU/dose Subcutaneous and 1 × 10e10 IU/dose Sublingual on Day 1
Biological: hAd5-S-Fusion+N-ETSD vaccine
Vaccine containing both full length wild type SARS-CoV-2 spike gene optimized for better spike protein expression, and full length wild type SARS-CoV-2 nucleocapsid gene modified to also contain an enhanced T cell stimulation domain (ETSD) to enhance cell-mediated immunity.




Primary Outcome Measures :
  1. Phase 1 Safety: Incidence of MAAEs and SAEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence of MAAEs and SAEs through 1 week post final vaccine administration

  2. Phase 1 Safety: Incidence and severity of solicited local reactogenicity AEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence and severity of solicited local reactogenicity AEs through 1 week post final vaccine administration

  3. Phase 1 Safety: Incidence and severity of solicited systemic reactogenicity AEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence and severity of solicited systemic reactogenicity AEs through 1 week post final vaccine administration

  4. Phase 1 Safety: Incidence and severity of unsolicited AEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence and severity of unsolicited AEs through 1 week post final vaccine administration

  5. Phase 1 Safety: Incidence of MAAEs and SAEs [ Time Frame: through 30 days and 6 months post final vaccine administration ]
    Incidence of MAAEs and SAEs through 30 days and 6 months post final vaccine administration

  6. Phase 1 Safety: Incidence and severity of unsolicited AEs [ Time Frame: through 30 days post final vaccine administration ]
    Incidence and severity of unsolicited AEs through 30 days post final vaccine administration

  7. Phase 1 Safety: Incidence of changes of laboratory safety examinations [ Time Frame: Day 365 ]
    Incidence of abnormal changes of laboratory safety examinations

  8. Phase 1 Safety: Vital Sign - Temperature [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    measured in (°C) or (°F)


  9. Phase 1 Safety: Vital Sign - Heart Rate [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    measured by how many heart beats per minute


  10. Phase 1 Safety: Vital Sign - Blood Pressure [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    systolic/diastolic - measured in mm Hg


  11. Phase 1 Safety: Vital Sign - Respiratory Rate [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    measured in how many breaths per minute


  12. Phase 2 Efficacy: Percent of subjects that show an increase in N-reactive T cells [ Time Frame: from baseline to Day 365 ]
    Percent of subjects that show an increase in N-reactive T cells as assayed by N-Tiferon assay (≥ 25 pg/mL increase in cytokine concentration from baseline)


Secondary Outcome Measures :
  1. Phase 1 Humoral Immunogenicity: GMT of S-specific and N-specific antibodies [ Time Frame: Day 365 ]
    GMT of S-specific and N-specific antibodies against 2019 novel coronavirus

  2. Phase 1 Humoral Immunogenicity: GMT of neutralizing antibody [ Time Frame: Day 365 ]
    GMT of neutralizing antibody

  3. Phase 1 Mucosal Immunogenicity: GMT of IgA antibody levels [ Time Frame: Day 365 ]
    GMT of IgA antibody levels

  4. Phase 1 Cellular Immunogenicity: T cell activity [ Time Frame: Day 365 ]
    T cell activity against SARS-CoV-2 S protein and N protein. ImmunityBio has developed a rapid assay (N-Tiferon) to detect SARS-CoV-2-specific T cell responses directly in whole blood from participants in QUILT-4.001 vaccinated with hAd5 S-Fusion+N-ETSD targeting the S and N antigens of SARS-CoV-2. This assay detected interferon-γ (IFN-γ)-secreting S- and N-specific T cells directly in whole blood post-vaccination.

  5. Phase 2 Efficacy: Incidence and severity of COVID-19 ≥14 days after vaccination [ Time Frame: ≥14 days after vaccination ]
    Incidence and severity of COVID-19 ≥14 days after vaccination in subjects with no evidence of past SARS-CoV-2 infection. It applies to ≥3 for injection site reaction, fever, and other AEs. It also includes signs and symptoms of hypersensitivity which may include red rash (excluding site of injection), swollen throat or swollen areas of the body, wheezing, fainting, chest tightness, difficulty breathing, hoarse voice, difficulty swallowing, vomiting, diarrhea, and stomach cramping.

  6. Phase 2 Efficacy: Mean SARS-CoV-2 viral load [ Time Frame: Day 365 ]
    Mean SARS-CoV-2 viral load for subjects with confirmed COVID-19 ≥14 days after vaccination

  7. Phase 2 Efficacy: Humoral Immunogenicity - GMT of S-specific and N-specific antibodies [ Time Frame: Day 365 ]
    GMT of S-specific and N-specific antibodies against 2019 novel coronavirus

  8. Phase 2 Efficacy: Humoral Immunogenicity - GMT of neutralizing antibody [ Time Frame: Day 365 ]
    GMT of neutralizing antibody

  9. Phase 2 Efficacy: Mucosal Immunogenicity - GMT of IgA antibody levels [ Time Frame: Day 365 ]
    GMT of IgA antibody levels

  10. Phase 2 Efficacy: Cellular Immunogenicity - T cell activity [ Time Frame: Day 365 ]
    T cell activity against SARS-CoV-2 S protein and N protein measured

  11. Phase 2 Safety: Incidence of MAAEs and SAEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence of MAAEs and SAEs through 1 week post final vaccine administration

  12. Phase 2 Safety: Incidence and severity of solicited local reactogenicity AEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence and severity of solicited local reactogenicity AEs through 1 week post final vaccine administration

  13. Phase 2 Safety: Incidence and severity of solicited systemic reactogenicity AEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence and severity of solicited systemic reactogenicity AEs through 1 week post final vaccine administration

  14. Phase 2 Safety: Incidence and severity of unsolicited AEs [ Time Frame: through 1 week post final vaccine administration ]
    Incidence and severity of unsolicited AEs through 1 week post final vaccine administration

  15. Phase 2 Safety: Incidence of MAAEs and SAEs [ Time Frame: through 30 days and 6 months post final vaccine administration ]
    Incidence of MAAEs and SAEs through 30 days and 6 months post final vaccine administration

  16. Phase 2 Safety: Incidence and severity of unsolicited AEs [ Time Frame: through 30 days post final vaccine administration ]
    Incidence and severity of unsolicited AEs through 30 days post final vaccine administration

  17. Phase 2 Safety: Incidence of changes of laboratory safety examinations [ Time Frame: Day 365 ]
    Incidence of abnormal changes of laboratory safety examinations

  18. Phase 2 Safety: Vital Sign - Temperature [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    measured in (°C) or (°F)


  19. Phase 2 Safety: Vital Sign - Heart rate [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    measured by how many heart beats per minute


  20. Phase 2 Safety: Vital Sign - Blood Pressure [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    systolic/diastolic - measured in mm Hg


  21. Phase 2 Safety: Vital Sign - Respiratory rate [ Time Frame: Day 365 ]

    Changes in vital signs from Grades 1-4:

    measured in how many breaths per minute




Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Healthy adults, age ≥ 18 years, inclusive, at time of enrollment, that have previously received an FDA-authorized COVID-19 vaccine (both prime and boost) ≥14 days and

    ≤ 6 months before enrollment.

  2. Able to understand and provide a signed informed consent that fulfills the relevant Institutional Review Board (IRB) or Independent Ethics Committee (IEC) guidelines.
  3. Agrees to the collection of biospecimens (eg, NP swabs and/or saliva sample) and venous blood per protocol.
  4. Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
  5. Ability to swallow a capsule.
  6. Temperature < 38°C.
  7. Agreement to practice effective contraception for female subjects of childbearing potential and non-sterile males. Female subjects of childbearing potential must agree to use effective contraception while on study until at least 1 month after the last dose of vaccine. Non-sterile male subjects must agree to use a condom while on study until at least 1 month after the last dose of vaccine. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, IUDs, oral contraceptives, and abstinence.

Exclusion Criteria:

  1. Persistent grade ≥ 2 AEs related to previous COVID-19 vaccination at the time of enrollment.
  2. Allergy to any component of the investigational vaccine, or a more severe allergic reaction and history of allergies in the past.
  3. Pregnant and nursing women. A negative serum or urine pregnancy test during screening and on the day of and prior to each dose must be documented before the vaccine is administered to a female subject of childbearing potential.
  4. Chronic lung disease including chronic obstructive pulmonary disease (COPD) or moderate to severe asthma.
  5. Pulmonary fibrosis.
  6. Bone marrow or organ transplantation.
  7. Extreme obesity (defined as BMI of 35 kg/m2 or higher).
  8. Diabetes.
  9. Chronic kidney disease.
  10. Liver disease.
  11. Sickle cell disease.
  12. Thalassemia.
  13. Any disease associated with acute fever, or any infection.
  14. Self-reported history of SARS.
  15. History of hepatitis B or hepatitis C.
  16. HIV or other acquired or hereditary immunodeficiency.
  17. Serious cardiovascular diseases, such as heart failure, coronary artery disease, cardiomyopathies, arrhythmia, conduction block, myocardial infarction, pulmonary hypertension, severe hypertension without controllable drugs, etc.
  18. Cerebrovascular disease.
  19. Cystic fibrosis.
  20. Neurologic conditions, such as dementia.
  21. Hereditary or acquired angioneurotic edema.
  22. No spleen or functional asplenia.
  23. Platelet disorder or other bleeding disorder that may cause injection contraindication.
  24. Chronic use (more than 14 continuous days) of any medications that may be associated with impaired immune responsiveness within 3 months before administration of study vaccine. (Including, but not limited to, systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators. The use of low dose topical, ophthalmic, inhaled and intranasal steroid preparations will be permitted.)
  25. Prior administration of blood products in last 4 months.
  26. Currently receiving treatment for cancer or history of cancer in the last five years (except basal cell carcinoma of the skin and cervical carcinoma in situ).
  27. According to the judgement of investigator, various medical, psychological, social or other conditions that could affect the subjects ability to sign informed consent.
  28. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
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Responsible Party: ImmunityBio, Inc.
ClinicalTrials.gov Identifier: NCT04843722    
Other Study ID Numbers: COVID-4.006
First Posted: April 13, 2021    Key Record Dates
Last Update Posted: January 4, 2022
Last Verified: April 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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COVID-19
Respiratory Tract Infections
Infections
Pneumonia, Viral
Pneumonia
Virus Diseases
Coronavirus Infections
Coronaviridae Infections
Nidovirales Infections
RNA Virus Infections
Lung Diseases
Respiratory Tract Diseases