Autologous Dendritic Cell Vaccination in Mesothelioma (MESODEC)
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|ClinicalTrials.gov Identifier: NCT02649829|
Recruitment Status : Recruiting
First Posted : January 8, 2016
Last Update Posted : January 19, 2021
|Condition or disease||Intervention/treatment||Phase|
|Malignant Pleural Mesothelioma||Biological: dendritic cell vaccination plus chemotherapy||Phase 1 Phase 2|
Malignant pleural mesothelioma (MPM) is a highly aggressive and in virtually all cases fatal cancer that is tightly associated with prior asbestos exposure. Despite some improvement over time, the prognosis of patient diagnosed with MPM remains dismal with a median overall survival from diagnosis of only 12 months.
In this single arm phase I/II trial the investigators want to demonstrate the feasibility and safety of WT1-targeted dendritic cell vaccination in MPM patients as frontline treatment in conjunction with first line platinum/pemetrexed-based chemotherapy and the induction of both systemic and in situ mesothelioma-specific immune responses. During three years of recruitment the investigators aim at including 20 patients diagnosed with histologically proven epithelial MPM (WHO grade 0-1) who are able to undergo leukapheresis, chemotherapy, immunotherapy and pleurectomy/decortication (P/D; in case of resectable disease). Patients who underwent prior treatment for MPM or with a history of another malignancy within the last five years will be excluded.
The intention of this study is to administer four vaccine doses in combination with standard of care of four 3-weekly cytoreductive platinum/pemetrexed-based chemotherapy cycles to each participant and prior to surgery (P/D) in the case of resectable MPM. Patients will receive four 3-weekly intradermal vaccinations with autologous WT1 messenger (m)RNA-loaded dendritic cells (V1-4), at day 14 after the start of each chemotherapy cycle (CT1-4).
The dendritic cell therapy product will be generated and administered in the Antwerp University Hospital, more specifically the Center for Cell Therapy and Regenerative Medicine (CCRG) and the Division of Hematology, both headed by Prof. Zwi Berneman.
The DC vaccines will be under embargo from release until the safety and quality control test results have become available and all release criteria have been met. A detailed overview of all applicable release criteria is provided in the investigational medicinal product dossier. The embargo period generally lasts 3 weeks counting from the day of cryopreservation (i.e. 8 days after leukapheresis).
Recruitment started in August 2017. Study-related follow-up of the included patients is intended to be until 90 days after final DC vaccine administration or 22 months after diagnosis, whichever occurs later. In addition to feasibility and safety of the chemoimmunotherapy schedule, the investigators will look for the time to progression (TTP), progression-free survival (PFS), overall survival (OS), systemic immunogenicity and local immunogenicity.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||20 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||First-line Immunotherapy Using Wilms' Tumor Protein 1 (WT1)-Targeted Dendritic Cell Vaccinations for Malignant Pleural Mesothelioma|
|Actual Study Start Date :||August 1, 2017|
|Estimated Primary Completion Date :||December 2023|
|Estimated Study Completion Date :||December 2024|
Experimental: Single Arm
dendritic cell vaccination plus chemotherapy
Biological: dendritic cell vaccination plus chemotherapy
B. Surgery: pleurectomy/decortication; in case of resectable disease, 4-6 weeks after start of the last chemotherapy cycle.
Other Name: chemoimmunotherapy
- Number of MPM patients with feasible and safe DC vaccine production [ Time Frame: Vaccine production and quality testing (i.e. 4 weeks after leukapheresis) ]
Production of autologous DC vaccines from newly diagnosed MPM patients will be evaluated for:
- Feasibility, assessed by success of leukapheresis and production of sufficient (i.e. at least 4 vaccines) and qualified (phenotypic and functional requirements) vaccines.
- Safety, assessed by microbiological testing (bacteria, yeast, fungi, mycoplasma, endotoxin) of the DC vaccines.
- Number of patients receiving investigational DC vaccine administration combined with standard of care chemotherapy within the proposed time frame [ Time Frame: After the chemoimmunotherapy treatment (+/- 15 weeks after entry to trial) ]
Administration of 4 autologous DC vaccines combined with four 3-weekly platinum/pemetrexed-based chemotherapy cycles will be evaluated for:
- Feasibility, assessed by successful administration of DC vaccines and prior to surgery in case of resectable disease.
- Safety, assessed by local (e.g. skin reactions at injection site) and systemic (toxicity grading according to the latest version of the CTCAE and CTC ) tolerability to the treatment.
- Objective clinical responses by tumor evaluation (clinical efficacy) [ Time Frame: Through study completion, at least after 4 DC vaccinations, prior to surgery (in case of resectable disease) + three months after the last intervention and within every 12 months during follow-up ]
Objective clinical responses to the chemoimmunotherapy and, in case of resectable disease, after surgery as compared to baseline tumor evaluation prior to treatment (i.e. at diagnosis), will be evaluated with:
- radiographic assessments (CT imaging) of the tumor response using the modified RECIST criteria.
- FDG-PET assessments of the tumor response using the PERCIST criteria.
Patients will be followed for disease progression; time to progression (TTP) and progression-free survival (PFS).
- Overall survival (clinical efficacy) [ Time Frame: Through study completion, an average of 1 year ]Patients will be followed for survival, from diagnosis and from start of treatment, for which the accurate date and reason of death (cancer-related or non-related) will be recorded for every patient.
- Systemic immunogenicity [ Time Frame: After the fourth DC vaccine (i.e. post chemoimmunotherapy, prior to surgery in case of resectable disease) ]
Systemic immunogenicity will be evaluated by:
- Detection of WT1-specific T cell immunity and innate immunity in peripheral blood.
- Response to delayed-type hypersensitivity (DTH) skin testing to the DC vaccine.
- Local immunogenicity [ Time Frame: Upon surgery (P/D) ]Local immunogenicity will be evaluated by detection of immune profile in tumor biopsies and/or pleurectomy specimens (in case of resectable disease).
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): NCT02649829
|Contact: Zwi N Berneman, MD, PhD||0032 3 821 39 firstname.lastname@example.org|
|Contact: Eva Lion, MSc, PhDemail@example.com|
|Antwerp University Hospital||Recruiting|
|Edegem, Antwerp, Belgium, 2650|
|Contact: Zwi N Berneman, MD, PhD firstname.lastname@example.org|
|Contact: Sébastien Anguille, MD, PhD email@example.com|
|Sub-Investigator: Paul Germonpré, MD|
|Sub-Investigator: Koen Deschepper, MD|
|Ghent, Belgium, 9000|
|Contact: Local investigator: Paul Germonpré, MD, PhD|
|Sint-Niklaas, Belgium, 9100|
|Contact: Local investigator: Koen Deschepper, MD|
|Study Director:||Zwi N Berneman, MD, PhD||Antwerp University Hospital, Division of Hematology and Center for Cell Therapy and Regenerative Medicine|
|Principal Investigator:||Eva Lion, MSc, PhD||University of Antwerp, Laboratory of Experimental Hematology|
|Principal Investigator:||Evelien LJ Smits, MSc, PhD||University of Antwerp, Laboratory of Experimental Hematology|
|Principal Investigator:||Sébastien Anguille, MD, PhD||Antwerp University Hospital, Division of Hematology|