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To Assess the Safety, Immunogenicity and Efficacy of VLPM01 in Healthy, Malaria-Naïve Volunteers

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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03867331
Recruitment Status : Recruiting
First Posted : March 8, 2019
Last Update Posted : April 24, 2019
Sponsor:
Information provided by (Responsible Party):
VLP Therapeutics

Brief Summary:
This study is a proof-of-concept, first in human, Phase I, single center study designed to evaluate the safety, tolerability, immunogenicity and experimental efficacy of VLPM01 in healthy, malaria-naïve adult volunteers. The VLPM01 product will be adjuvanted with alhydrogel. The study design was based on the FDA's guidance "General Principles for the Development of Vaccines to protect Against Global Infectious Diseases" (2011).

Condition or disease Intervention/treatment Phase
Malaria,Falciparum Biological: 5 microgram VLPM01 Biological: 15 microgram VLPM01 Biological: 30 microgram VLPM01 Other: Plasmodium falciparum challenge Phase 1

Detailed Description:

The study will have four (4) phases: Screening, Dose Escalation, Controlled Human Malaria Infection (CHMI) and Follow-Up. The study will be conducted at the Walter Reed Army Institute of Research in Silver Spring, Maryland (WRAIR), as this institute has extensive experience in conducting clinical studies of malaria vaccines with CHMI.

A total of 36 participants will be enrolled in this study. Thirty (30) eligible participants will participate in the Dose Escalation Phase as vaccinees and 6 eligible participants will be added during the CHMI Phase to act as infectivity controls. Up to 6 additional eligible participants will serve as alternate vaccinees during the Dose Escalation Phase and up to 6 eligible participants will as act as alternate infectivity controls during the CHMI Phase. Alternates are only enrolled if a designated vaccinee is not eligible on the day of first vaccination or if a designated infectivity control is not eligible on the Day of Challenge. Withdrawn participants will not be replaced.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 36 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: A Phase I Dose Escalation Study With Controlled Human Malaria Infection (CHMI) to Assess the Safety, Immunogenicity and Efficacy of VLPM01 in Healthy, Malaria-Naïve Volunteers
Actual Study Start Date : March 13, 2019
Estimated Primary Completion Date : December 2020
Estimated Study Completion Date : December 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Malaria

Arm Intervention/treatment
Experimental: 5 microgram VLPM01
5 microgram doses of VLPM01 vaccine, intramuscular administration, n=10
Biological: 5 microgram VLPM01
VLPM01 is an alpha-VLP pre-erythrocytic malaria vaccine which targets circumsporozoite protein (CSP), adjuvanted with 0.75 mg alum.

Experimental: 15 microgram VLPM01
15 microgram doses of VLPM01 vaccine, intramuscular administration, n=10
Biological: 15 microgram VLPM01
VLPM01 is an alpha-VLP pre-erythrocytic malaria vaccine which targets circumsporozoite protein (CSP), adjuvanted with 0.75 mg alum.

Experimental: 30 microgram VLPM01
30 microgram doses of VLPM01 vaccine, intramuscular administration, n=10
Biological: 30 microgram VLPM01
VLPM01 is an alpha-VLP pre-erythrocytic malaria vaccine which targets circumsporozoite protein (CSP), adjuvanted with 0.75 mg alum.

Experimental: Controlled Human Malaria Infection (CHMI) Phase
Infectivity Control Participants, n=6
Other: Plasmodium falciparum challenge
Expose forearms to five (5) Plasmodium falciparum (strain NF54; clone 3D7) bites




Primary Outcome Measures :
  1. Occurrence of solicited local reactogenicity to VLPM01 at 5, 15 and 30 μg in the 7 days following vaccination [ Time Frame: 7 days following vaccination ]
  2. Occurrence of solicited systemic reactogenicity to VLPM01 at 5, 15 and 30 μg in the 7 days following vaccination [ Time Frame: 7 days following vaccination ]
  3. Occurrence of unsolicited adverse events related to VLPM01 at 5, 15 and 30 μg in the 7 days following vaccination [ Time Frame: 7 days following vaccination ]
  4. Occurrence of adverse events of special interest during follow-up period [ Time Frame: through study completion, an average of 18 months ]
  5. Number of participants experiencing any serious adverse event after vaccination. [ Time Frame: through study completion, an average of 18 months ]

Secondary Outcome Measures :
  1. Anti-CSP IgG levels measured by ELISA [ Time Frame: day 113 after third dose ]
  2. Positive thick blood smear test for P. falciparum malaria following CHMI [ Time Frame: day 6 to day 20 post challenge ]
  3. Time to first positive thick blood smear test for P. falciparum following CHMI [ Time Frame: day 6 to day 20 post challenge ]
    Number of subjects with Plasmodium Falciparum parasitemia defined by a positive blood slide, following sporozoite challenge

  4. Percentage of participants with a minimum threshold of >20 μg/ml anti-CSP IgG after vaccination as measured by ELISA. [ Time Frame: day 15 to post day 113 after third dose ]


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.


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Ages Eligible for Study:   18 Years to 49 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria: It should say meet all the following criteria:

  1. Healthy adults between the ages 18-49 (inclusive);
  2. Able and willing to provide written, informed consent;
  3. Able and willing to comply with all research requirements, in the opinion of the Investigator;
  4. Agreement to refrain from blood donation during the course of the study. Volunteers who have undergone CHMI can donate to other research once the study is complete but cannot donate to the American Red Cross for at least three (3) years after the CHMI event;
  5. Laboratory Criteria within 56 days before enrollment:

    • Hemoglobin ≥ 11.7 g/dL for women; ≥ 12.0 g/dL for men;
    • White Blood Cell count = 3,800-10,800 cells/mm3;
    • Platelets = 140,000-400,000/mm3;
    • Alanine aminotransferase (ALT; SGPT) 9-46 U/L male and 6-29 U/L female;
    • Serum creatinine ≤ 1.5 mg/dL;
    • Negative HIV testing (HIV Ab / antigen 4th generation screen with reflex confirmatory RNA testing);
    • Negative hepatitis B surface antigen (HBsAg) and hepatitis C antibody testing;
  6. Birth control requirements:

    Female participants must meet one of the following two (2) criteria:

    • No reproductive potential due to post-menopausal status (12 months of natural [spontaneous] amenorrhea) or hysterectomy, bilateral oophorectomy or tubal ligation;
    • Women of childbearing potential should agree to practice highly effective contraception at least 30 days before enrollment and through 60 days post-CHMI or post-last vaccination (whichever is latest), using one of the following methods: condoms (male or female) with spermicide; diaphragm, or cervical cap with spermicide; intrauterine device; contraceptive pills, patch, injection, intravaginal ring or other FDA-approved contraceptive method; male partner has previously undergone a vasectomy; abstinence.

    Male participants are encouraged but not required to practice highly effective contraception to avoid pregnancy in their partner from 30 days prior to enrollment through 60 days post-CHMI.

  7. For all female participants a negative β-HCG pregnancy test (urine) on day of enrollment, each day of vaccination, and the day of CHMI;
  8. Reachable (24/7) by mobile phone during the period between CHMI and 28 days post-CHMI, per volunteer report;
  9. No plans to travel outside the Washington DC metro area between the day of challenge and 28 days post-challenge;
  10. If a participant is active duty military, he or she must obtain approval from his or her supervisor per WRAIR Policy 11-45;
  11. Must have low (<10%) cardiac risk factors according to clinical Gaziano criteria assessed at screening, and a normal or normal variant ECG;
  12. Completion of Study Comprehension Quiz (minimum passing score of 70% with 3 attempts permitted).

Exclusion Criteria: Should meet anyone of the following criteria:

  1. History of malaria infection (any species) or residence in a malaria-endemic area for more than 5 years
  2. History of serology-confirmed or suspected chikungunya virus (CHIKV) infection;
  3. Previous travel to malaria endemic regions within the past three (3) months before study enrollment defined as first vaccination or day of challenge (for infectivity controls) or planned travel to malaria endemic regions during the vaccination, CHMI and follow-up period;
  4. Any history of receiving a malaria vaccine or chikungunya vaccine;
  5. Received an investigational product in the 30 days before enrollment, or planned to receive during the study period;
  6. Participation in another clinical research study that would require excessive blood draws in conjunction with this study (as determined by the investigator)
  7. Receipt of immunoglobulins or blood products within three (3) months before enrollment;
  8. Any history of anaphylaxis;
  9. History of sickle cell trait or disease, or any condition that could affect susceptibility to malaria infection, per patient verbal report;
  10. Pregnancy, lactation or intention to become pregnant during the study;
  11. Contraindications or allergies to the use of all three (3) proposed anti-malarial medications; Malarone (atovaquone/proguanil), Coartem (artemether/lumefantrine) and Chloroquine; contraindication to one or two is not exclusionary;
  12. History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ);
  13. History of autoimmune disease;
  14. Significant (e.g. systemic anaphylaxis) hypersensitivity reactions to mosquito bites (local reactions at the site of mosquito bites are not an exclusion criterion);
  15. Suspected or known current alcohol or drug abuse as defined by an alcohol intake of greater than three (3) drinks a day on average for a man, and greater than two (2) drinks a day on average for a woman for a period of 12 months before enrollment;
  16. Any medical, psychiatric, social condition, occupational reason or other responsibility that, in the judgment of the investigator, is a contraindication to protocol participation or impairs a volunteer's ability to give informed consent;
  17. Any clinically significant abnormal finding on chemistry or hematology blood tests or clinical examination, not already specified, as determined by the Investigator;
  18. Any other significant disease, disorder or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data, in the opinion of the Investigator;
  19. Current anti-tuberculosis prophylaxis or treatment;
  20. History of splenectomy;
  21. History of confirmed or suspected immunodeficiency;
  22. Hereditary angioedema (HAE), acquired angioedema (AAE), or idiopathic forms of angioedema;
  23. Asthma that is unstable or required emergent care, urgent care, hospitalization or intubation during the past two (2) years;
  24. Diabetes mellitus (type I or II), with the exception of gestational diabetes;
  25. Thyroid disease;
  26. Idiopathic urticaria within the past year;
  27. Hypertension that is not well controlled by medication or is more than 150/95 at enrollment;
  28. Bleeding disorder diagnosed by a doctor (e.g., factor deficiency, coagulopathy, or platelet disorder requiring special precautions) or significant bruising or bleeding difficulties with IM injections or blood draws;
  29. Chronic or active neurologic disease to include seizure disorder and chronic migraine headaches. Exceptions are: i) childhood febrile seizures, or ii) seizures secondary to alcohol withdrawal more than three [3] years ago;
  30. Participants receiving any of the following substances:

    • Systemic immunosuppressive medications or cytotoxic medications within 12 weeks before enrollment [with the exception of a short course of corticosteroids (≤14 days duration or a single injection) for a self-limited condition at least two (2) weeks before enrollment; inhaled, intranasal or topical steroids are not considered exclusionary];
    • History of receipt of malaria prophylaxis within eight (8) weeks of CHMI;
    • Live attenuated vaccines within 28 days before initial study vaccine administration;
    • Medically indicated subunit or killed vaccines, e.g. influenza, pneumococcal, or allergy treatment with antigen injections, planned for administration seven (7) days before or after study vaccine administration;
  31. History of arthritis diagnosis, either rheumatoid, osteoarthritis or any other type
  32. History of other diagnosed rheumatoid disorders.

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): NCT03867331


Contacts
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Contact: Wataru Akahata, Ph.D 240-801-4456 wakahata@vlptherapeutics.com

Locations
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United States, Maryland
Walter Reed Army Institute of Research Recruiting
Bethesda, Maryland, United States, 20889
Contact: For more information contact the WRAIR Clinical Trials Center Recruitment Office    866-428-2788      
Principal Investigator: Christine Lee, MD         
Sponsors and Collaborators
VLP Therapeutics

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Responsible Party: VLP Therapeutics
ClinicalTrials.gov Identifier: NCT03867331    
Other Study ID Numbers: VLPM01-01 WRAIR #2568
First Posted: March 8, 2019    Key Record Dates
Last Update Posted: April 24, 2019
Last Verified: April 2019

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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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Malaria
Malaria, Falciparum
Protozoan Infections
Parasitic Diseases
Vaccines
Immunologic Factors
Physiological Effects of Drugs