We updated the design of this site on September 25th. Learn more.
Show more
ClinicalTrials.gov
ClinicalTrials.gov Menu

Safety and Efficacy of Romidepsin and the Therapeutic Vaccine Vacc-4x for Reduction of the Latent HIV‐1 Reservoir (REDUC)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT02092116
First Posted: March 19, 2014
Last Update Posted: March 1, 2017
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.
Collaborator:
Celgene Corporation
Information provided by (Responsible Party):
Bionor Immuno AS
  Purpose
The REDUC trial's objective is to address one of the core issues with the treatment of HIV, which is that some HIV infected cells hide in so-called latent reservoirs. The reservoirs are unaffected by conventional HIV medication and invisible to the immune system. HDACi have the potential to activate these latently infected cells. This will make the HIV infected cells visible to the immune system; the immune response generate by Vacc-4x will be able to attack and eliminate the infected cells.

Condition Intervention Phase
HIV I Infection Drug: Romidepsin Biological: Vacc-4x Biological: rhuGM-CSF Phase 1 Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open Phase I/IIa Study to Evaluate the Safety and Effect of Therapeutic HIV-1 Immunization Using Vacc-4x + rhuGM-CSF and HIV-1 Reactivation Using Romidepsin on the Viral Reservoir in Virologically Suppressed HIV-1 Infected Adults on cART

Resource links provided by NLM:


Further study details as provided by Bionor Immuno AS:

Primary Outcome Measures:
  • Part A: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) [ Time Frame: 3 weeks ]
    Safety and tolerability evaluation as measured by adverse events (AE) and serious adverse events (SAE).

  • Part B: Changes From Baseline in HIV-1 Reservoir (Total HIV-1DNA; Integrated HIV-1 DNA in Unfractionated CD4+ T Cells and Replication Competent Provirus. [ Time Frame: Day 161/175 ]

    Total HIV-1 DNA and integrated HIV-1 DNA were analysed by MMRM analysis (copies/10^6 CD4+ T cells). To estimate the frequency of infectious units per 10^6 resting memory CD4+ T cells a quantitative viral outgrowth assay (qVOA) was used.

    Blood samples were obtained at Day 0, Day 105 and Day 161.



Secondary Outcome Measures:
  • Part A: Changes From Baseline in HIV-1 Reservoir (Total HIV-1DNA; Integrated HIV-1 DNA in Unfractionated CD4+ T Cells and Replication Competent Provirus. Estimates of Change From Baseline of the Size of the Latent HIV-1 Reservoir in CD4+ Cells. [ Time Frame: Day 56/84 ]

    Total HIV-1 DNA and integrated HIV-1 DNA were analysed by MMRM analysis (copies/10^6 CD4+ T cells). To estimate the frequency of infectious units per 10^6 resting memory CD4+ T cells a quantitative viral outgrowth assay (qVOA) was used.

    Total HIV-1 DNA was measured at Day 84


  • Part B: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) [ Time Frame: 287 days ]
    Safety and tolerability evaluation of romidepsin and Vacc-4x in combination with GM-CSF as measured by adverse events (AE) and serious adverse events (SAE).

  • Part B: Level of HIV-1 Transcription. [ Time Frame: Day 105, 112 and 119 ]
    At day 105, 112 and 119 patients receive romidepsin and 4 hours after each administration HIV transcription is measured as unspliced HIV-1 RNA.


Enrollment: 26
Study Start Date: March 2014
Study Completion Date: December 2015
Primary Completion Date: August 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Part A

Pre-treatment phase of 2-4 weeks (Visit 1- Visit 2a) followed by viral reactivation phase of 3 weeks (Visit 2 to Visit 7) consisting of one cycle of romidepsin infusions at a dosing of 5 mg/m2 on days 0, 7, and 14.

Post-activation phase of ~9 weeks (Visit 8 to Visit 11) to assess the effect of romidepsin on the size of latent HIV-1 reservoir.

Drug: Romidepsin
Latency reversing agent
Other Name: Istodax®
Part B

Pre-treatment phase of 2-4 weeks (Visit 1-Visit 2) followed by a therapeutic HIV-1 immunization phase of 12 weeks (Visit 2 to Visit 7) in which 1.2 mg Vacc-4x was administered together with 0.06 mg rhuGM-CSF at Visits 2, 3, 4, 5, 6 and 7 follow by a follow-up period of 2 weeks (Visit 8).

A viral reactivation phase of 3 weeks (Visit 9-Visit 11) consisting of one cycle of 3 romidepsin infusions (5 mg/m2) followed by a post-treatment observation phase of ~9 weeks (Visit 12-Visit 13) to assess the effect of the investigational treatment on the size of the latent HIV-1 reservoir.

A monitored antiretroviral pause of up to 16 weeks (Visit 14-Visit 33).

Drug: Romidepsin
Latency reversing agent
Other Name: Istodax®
Biological: Vacc-4x
Vacc-4x is a peptide-based HIV immunotherapy administered intradermally. Vacc-4x peptides are reconstituted in sterile water.
Other Name: A combination of Vacc-10, Vacc-11, Vacc-12 and Vacc-13
Biological: rhuGM-CSF
Granulocyte macrophage colony stimulating factor as a local adjuvant
Other Name: Leukine®

Detailed Description:

The study is divide into two parts. In Part A the safety and tolerability of romidepsin will be evaluated and the effect of romidepsin treatment on HIV-1 transcription in HIV-infected patients virologically suppressed on cART will be determined.

In Part B the effect of treatment with Vacc-4x + rhuGM-CSF and romidepsin treatment on the HIV-1 latent reservoir in HIV-infected patients virologically suppressed on cART will be measured.

Six patients will be enrolled for part A and the safety and tolerability profile evaluated before enrolling 20 patients in B.

  Eligibility

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, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age >18 years
  2. Currently receiving cART and having received cART for a minimum of 1 year
  3. HIV-1 plasma RNA <50 copies/mL for at least 1 year (excluding viral load blips)
  4. CD4 T cell count ≥500 cells/mm3

Exclusion Criteria:

  1. CD4 T cell count nadir <200 cells/mm3
  2. Previous treatment with an HDACi (Histone deacetylase inhibitor) within the previous 6 months
  3. Any evidence of an active AIDS-defining opportunistic infection, active HBV or HCV co-infection, significant cardiac disease, malignancy, transplantation, insulin dependent diabetes mellitus or other protocol defined excluded medical condition
  4. Use of any protocol defined contraindicated medication or vaccination
  5. Unacceptable values of the hematologic and clinical chemistry parameters as defined in the protocol.
  6. Males or females who are unwilling or unable to use protocol defined methods of contraception
  Contacts and Locations
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): NCT02092116


Locations
Denmark
Aarhus University Hospital, Skejby Sygehus
Aarhus N, Denmark, 8200
Sponsors and Collaborators
Bionor Immuno AS
Celgene Corporation
Investigators
Principal Investigator: Lars Jørgen Østergaard, MD, PhD Aarhus University Hospital
  More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Bionor Immuno AS
ClinicalTrials.gov Identifier: NCT02092116     History of Changes
Other Study ID Numbers: BPC01-001
2013-004747-23 ( EudraCT Number )
First Submitted: March 3, 2014
First Posted: March 19, 2014
Results First Submitted: November 8, 2016
Last Update Posted: March 1, 2017
Last Verified: January 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Participants have not provided informed consent for their anonymized individual data to be made available beyond that described in the patient information sheet.

Additional relevant MeSH terms:
Romidepsin
Antibiotics, Antineoplastic
Antineoplastic Agents