A Pilot Study of a Personalized Neoantigen Cancer Vaccine With and Without Low-Dose Cyclophosphamide or Pembrolizumab in Treatment Naïve, Asymptomatic Patients With IGHV Unmutated Chronic Lymphocytic Leukemia.

Who is this study for? Patients with treatment naïve asymptomatic IGHV unmutated chronic lymphocytic leukemia
Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

This research study is studying a novel type of CLL vaccine as a possible treatment for chronic lymphocytic leukemia (CLL) The names of the study interventions involved in this study are: * Personalized NeoAntigen Vaccine * Poly-ICLC * Cyclophosphamide * Pembrolizumab

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
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• Diagnosis of CLL as per IWCLL 2018 criteria

• Patient's CLL must have an unmutated immunoglobulin heavy chain variable (IGHV) region gene, defined as \< 2% mutated compared to germline.

• Patient must have had no history of CLL-directed therapy due to meeting IWCLL 2018 criteria; no present indication for treatment by iwCLL 2018 criteria; and in the opinion of the treating investigator be anticipated not to require CLL-directed treatment within the next 6 months.

• Patient must have measurable disease (absolute lymphocyte count \> 10K/uL or total white blood cell count ≥ 20K/uL of peripheral blood).

• Patient must have had at least two other absolute lymphocyte counts (ALC) measured since diagnosis of CLL that are at least 2 weeks apart and at least 2 months prior to the one used for initial registration.

• Age ≥ 18 years.

• ECOG performance status 0 or 1

• Participants must have normal organ and marrow function as defined below:

‣ total bilirubin within normal institutional limits

⁃ AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal

⁃ absolute neutrophil count ≥1000 cells/μL

• The effects of NeoVax and poly-ICLC on the developing human fetus are unknown. For this reason, women of childbearing potential (WOCBP) must have a negative pregnancy test (minimum sensitivity 25 IU/L or equivalent of HCG) before entry onto the trial and within 7 days prior to start of study medication. It is the investigators' responsibility to repeat the pregnancy test should start of treatment be delayed.

• Female patients enrolled in the study, who are not free from menses for \>2 years, post hysterectomy / oophorectomy, or surgically sterilized, must be willing to use either 2 adequate barrier methods or a barrier method plus a hormonal method of contraception to prevent pregnancy or to abstain from sexual activity throughout the study, starting with visit 1 through 4 weeks after the last dose of study therapy. Approved contraceptive methods include for example; intra uterine device, diaphragm with spermicide, cervical cap with spermicide, male condoms, or female condom with spermicide. Spermicides alone are not an acceptable method of contraception.

• Patient is agreeable to allow tumor (from peripheral blood) and normal tissue (from saliva) samples to be submitted for complete exome and transcriptome sequencing.

• Ability to understand and the willingness to sign a written informed consent document.

• At least 7 immunizing peptides can be designed.

• Continue to meet inclusion and exclusion criteria for Screening Registration.

Locations
United States
Massachusetts
Dana-Farber Cancer Institute
RECRUITING
Boston
Contact Information
Primary
Oriol Olive Noguer
Oriol_Olive@dfci.harvard.edu
617-632-2581
Time Frame
Start Date: 2021-08-18
Estimated Completion Date: 2028-03-31
Participants
Target number of participants: 15
Treatments
Experimental: NeoVax
* NeoVax will be administered in a priming and booster phase.~* The priming shots will comprise days 1, 4, 8, 15, and 22.~* Booster shots will be given on days 78 and 134.
Experimental: Neovax + Low-dose cyclophosphamide
* NeoVax will be administered in a priming and booster phase.~* The priming shots will comprise days 1, 4, 8, 15, and 22.~* Booster shots will be given on days 78 and 134.~* Low dose cyclophosphamide is administered twice daily on weeks -2, 1, 3, 5
Experimental: Neovax + Low-dose cyclophosphamide + Pembrolizumab
* NeoVax will be administered in a priming and booster phase.~* The priming shots will comprise days 1, 4, 8, 15, and 22.~* Booster shots will be given on days 78 and 134.~* Low dose cyclophosphamide is administered twice daily on weeks -2, 1, 3, 5~* Pembrolizumab will be administered starting on Week 12 Day 78 and for up to 17 cycles (approximately 1 year).
Sponsors
Collaborators: Merck Sharp & Dohme LLC, Oncovir, Inc., BioNTech SE
Leads: Dana-Farber Cancer Institute

This content was sourced from clinicaltrials.gov