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This cancer vaccine research study involves the injection of the NY-ESO-1b peptide along with 2 other agents to help stimulate the immune system. Peptides are small fragments of protein. NY- ESO-1 peptides are normally found in the testis and the placenta. They have also been found on various types of cancer cells. The purpose is to stimulate the immune system to react against the peptides that are found on cancer cells.
This is a pilot study of patients of HLA-A2 phenotype whose tumor expresses the NY-ESO-1 or LAGE-1 antigen. Patients will receive NY-ESO-1b peptide mixed with 0.5 milliliter (mL) of Montanide® ISA-51 and 1 mg of CpG 7909 given every three weeks for four doses by subcutaneous injection. There will be a three-week follow-up period after the fourth injection making the cycle 13 weeks long. In the absence of toxicity and progressive disease, a second cycle will be offered to patients who have received four vaccinations.
The primary objective is to evaluate the immune response (antibodies, CD8+ T-cells, and DTH) and safety to vaccination with NY-ESO-1b peptide mixed with CpG 7909 and Montanide® in patients with cancer expressing NY-ESO-1 or LAGE-1. The secondary objective is to document tumor responses in patients with evaluable or measurable disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with Cancer Expressing NY-ESO-1 or LAGE-1 Antigen. | Experimental | NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 was administered to patients with cancer expressing NY-ESO-1 or LAGE-1 antigen. The injections were given subcutaneously beginning on week 1 and repeated every three weeks for 4 injections total. There was a 3 week follow-up period after the last injection. In the absence of toxicity and progressive disease (PD), a second cycle was offered to patients who received 4 vaccinations. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NY-ESO-1b peptide plus CpG 7909 and Montanide® ISA-51 | Biological |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients With NY-ESO-1 Specific Humoral Immunity as Determined by an Increase in Antibody Titer From Baseline. | Blood samples were obtained at baseline (prior to the first dose), prior to the second, third and fourth injection and 2 weeks after the fourth injection in both cycles 1 and 2 for the assessment of NY-ESO-1 specific antibodies by an enzyme-linked immunosorbent assay (ELISA). A positive response was a readable optical density at 280 nm. | up to 27 weeks |
| Number of Patients With NY-ESO-1 Specific Cellular Immunity as Measured by an Increase in NY-ESO-1b Specific CD8+ T-cells Following Treatment. | Blood samples were obtained at baseline, prior to the second, third and fourth injection and 2 weeks after the fourth injection in both cycles 1 and 2 for the assessment of NY-ESO-1b specific CD8+ T-cells by ELISPOT assays. | up to 27 weeks |
| Number of Patients With Delayed-Type Hypersensitivity (DTH) Skin Reactions to NY-ESO-1b Peptide | 10 mcg NY-ESO-1b peptide was injected intradermally at a separate site from the vaccination at baseline and after the second and fourth injection of each cycle. Assessment of DTH reactions as evidenced by redness and induration was performed 48 h after injection. The number of patients with DTH positive skin reactions was reported at each timepoint. | up to 25 weeks |
| Safety as Measured by the Number of Patients With Dose Limiting Toxicities (DLT) | DLT was defined as the following toxicities definitely, probably, or possibly related to the administration of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51:
| up to 28 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients With Tumor Responses as Measured by the Response Evaluation Criteria in Solid Tumors (RECIST) | Computed tomography (CT) scans were performed at screening, and during weeks 13 and 28. Response was assessed using RECIST version 1.0 (Therasse et al, J Natl Cancer Inst 2000; 92:205-16). Per RECIST, target lesions are categorized as follows: complete response (CR): disappearance of all target lesions (no evaluable disease); partial response (PR): ≥ 30% decrease in the sum of the longest diameter of target lesions; progressive disease (PD): ≥ 20% increase in the sum of the longest diameter of target lesions; stable disease (SD): small changes that do not meet above criteria. No evidence of disease (NED): no target or non-target lesions at baseline and no new lesions identified on post-baseline scans. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nasser K Altorki, MD | Weill Medical College of Cornell University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Krankenhaus Nordwest | Frankfurt | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10655437 | Background | Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000 Feb 2;92(3):205-16. doi: 10.1093/jnci/92.3.205. | |
| 19728336 |
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| ID | Title | Description |
|---|---|---|
| FG000 | Patients With Cancer Expressing NY-ESO-1 or LAGE-1 Antigen. | NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 was administered to patients with cancer expressing NY-ESO-1 or LAGE-1 antigen. The injections were given subcutaneously beginning on week 1 and repeated every three weeks for 4 injections total. There was a 3 week follow-up period after the last injection. In the absence of toxicity and progressive disease (PD), a second cycle was offered to patients who received 4 vaccinations. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Patients With Cancer Expressing NY-ESO-1 or LAGE-1 Antigen. | NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 was administered to patients with cancer expressing NY-ESO-1 or LAGE-1 antigen. The injections were given subcutaneously beginning on week 1 and repeated every three weeks for 4 injections total. There was a 3 week follow-up period after the last injection. In the absence of toxicity and progressive disease (PD), a second cycle was offered to patients who received 4 vaccinations. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Patients With NY-ESO-1 Specific Humoral Immunity as Determined by an Increase in Antibody Titer From Baseline. | Blood samples were obtained at baseline (prior to the first dose), prior to the second, third and fourth injection and 2 weeks after the fourth injection in both cycles 1 and 2 for the assessment of NY-ESO-1 specific antibodies by an enzyme-linked immunosorbent assay (ELISA). A positive response was a readable optical density at 280 nm. | All patients who received at least one dose of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 and had pre- and post-treatment samples taken. | Posted | Count of Participants | Participants | up to 27 weeks |
|
Up to 28 weeks.
All adverse events (AEs) occurring after signed informed consent were to be documented in the source records and on the respective AE case report form (CRF), regardless of causal relationship. Toxicity was evaluated according to the National Cancer Institute CTCAE Scale (Version 3.0).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Patients With Cancer Expressing NY-ESO-1 or LAGE-1 Antigen. | NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 was administered to patients with cancer expressing NY-ESO-1 or LAGE-1 antigen. The injections were given subcutaneously beginning on week 1 and repeated every three weeks for 4 injections total. There was a 3 week follow-up period after the last injection of peptide. In the absence of toxicity and PD, a second cycle was offered to patients who received 4 vaccinations. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Angina pectoris | Cardiac disorders | MedDRA 7.1 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jonathan Skipper PhD | Ludwig Institute for Cancer Research | 12124501539 | jskipper@lcr.org |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C483020 | ProMune |
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| up to 28 weeks |
| Result |
| Karbach J, Gnjatic S, Bender A, Neumann A, Weidmann E, Yuan J, Ferrara CA, Hoffmann E, Old LJ, Altorki NK, Jager E. Tumor-reactive CD8+ T-cell responses after vaccination with NY-ESO-1 peptide, CpG 7909 and Montanide ISA-51: association with survival. Int J Cancer. 2010 Feb 15;126(4):909-18. doi: 10.1002/ijc.24850. |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Primary | Number of Patients With NY-ESO-1 Specific Cellular Immunity as Measured by an Increase in NY-ESO-1b Specific CD8+ T-cells Following Treatment. | Blood samples were obtained at baseline, prior to the second, third and fourth injection and 2 weeks after the fourth injection in both cycles 1 and 2 for the assessment of NY-ESO-1b specific CD8+ T-cells by ELISPOT assays. | All patients who received at least one dose of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 and had pre- and post-treatment samples taken were included in the Cycle 1 results. Cycle 2 results include all patients who received Cycle 2 treatment. | Posted | Count of Participants | Participants | up to 27 weeks |
|
|
|
| Primary | Number of Patients With Delayed-Type Hypersensitivity (DTH) Skin Reactions to NY-ESO-1b Peptide | 10 mcg NY-ESO-1b peptide was injected intradermally at a separate site from the vaccination at baseline and after the second and fourth injection of each cycle. Assessment of DTH reactions as evidenced by redness and induration was performed 48 h after injection. The number of patients with DTH positive skin reactions was reported at each timepoint. | All patients who received at least one dose of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 and had pre- and post-treatment assessments at the given timeframes. One patient did not have post-injection DTH testing. | Posted | Count of Participants | Participants | up to 25 weeks |
|
|
|
| Primary | Safety as Measured by the Number of Patients With Dose Limiting Toxicities (DLT) | DLT was defined as the following toxicities definitely, probably, or possibly related to the administration of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51:
| All patients who received at least one dose of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51. | Posted | Count of Participants | Participants | up to 28 weeks |
|
|
|
| Secondary | Number of Patients With Tumor Responses as Measured by the Response Evaluation Criteria in Solid Tumors (RECIST) | Computed tomography (CT) scans were performed at screening, and during weeks 13 and 28. Response was assessed using RECIST version 1.0 (Therasse et al, J Natl Cancer Inst 2000; 92:205-16). Per RECIST, target lesions are categorized as follows: complete response (CR): disappearance of all target lesions (no evaluable disease); partial response (PR): ≥ 30% decrease in the sum of the longest diameter of target lesions; progressive disease (PD): ≥ 20% increase in the sum of the longest diameter of target lesions; stable disease (SD): small changes that do not meet above criteria. No evidence of disease (NED): no target or non-target lesions at baseline and no new lesions identified on post-baseline scans. | All patients who received at least one dose of NY-ESO-1b peptide, 100 μg mixed with 1 mg CpG 7909 and 0.5mL of Montanide® ISA-51 and had at least one tumor response assessment. | Posted | Count of Participants | Participants | up to 28 weeks |
|
|
|
| 2 |
| 14 |
| 6 |
| 14 |
| 14 |
| 14 |
| Asthenia | General disorders | MedDRA 6.0 | Systematic Assessment |
|
| Brain metastases | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 7.1 | Systematic Assessment |
|
| Cholecystitis | Hepatobiliary disorders | MedDRA 6.0 | Systematic Assessment |
|
| Pancreatitis | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Convulsion | Nervous system disorders | MedDRA 7.1 | Systematic Assessment |
|
| Overdose | Injury, poisoning and procedural complications | MedDRA 7.1 | Systematic Assessment |
|
| Gastroenteritis | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Cardiac failure | Cardiac disorders | MedDRA 7.1 | Systematic Assessment |
|
| Tachyarrhythmia | Cardiac disorders | MedDRA 7.1 | Systematic Assessment |
|
| Anemia | Blood and lymphatic system disorders | MedDRA 7.1 | Systematic Assessment |
|
| Application site eczema | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 7.1 | Systematic Assessment |
|
| Ascites | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Axillary pain | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 7.1 | Systematic Assessment |
|
| Blood lactate dehydrogenase increased | Investigations | MedDRA 7.1 | Systematic Assessment |
|
| Brain edema | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Catheter placement | Surgical and medical procedures | MedDRA 7.1 | Systematic Assessment |
|
| Chills | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Depression | Psychiatric disorders | MedDRA 7.1 | Systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Dyspnea exertional | Cardiac disorders | MedDRA 7.1 | Systematic Assessment |
|
| Eczema | Skin and subcutaneous tissue disorders | MedDRA 7.1 | Systematic Assessment |
|
| Fatigue | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Flu-like symptoms | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Gamma glutamyl transferase elevated | Hepatobiliary disorders | MedDRA 7.1 | Systematic Assessment |
|
| Gastric ulcer | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Gastrointestinal infection | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA 7.1 | Systematic Assessment |
|
| Hepatomegaly | Hepatobiliary disorders | MedDRA 7.1 | Systematic Assessment |
|
| Herpes simplex | Infections and infestations | MedDRA 7.1 | Systematic Assessment |
|
| Hypertonia | Musculoskeletal and connective tissue disorders | MedDRA 7.1 | Systematic Assessment |
|
| Hypotension | Vascular disorders | MedDRA 7.1 | Systematic Assessment |
|
| Hypothermia | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Inflammation | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Injection site induration | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Injection site reaction | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Karnofsky scale worsened | Investigations | MedDRA 7.1 | Systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA 7.1 | Systematic Assessment |
|
| Nasopharyngitis | Respiratory, thoracic and mediastinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Pain | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Pharyngolaryngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Pyrexia | General disorders | MedDRA 7.1 | Systematic Assessment |
|
| Resection of metastasis | Surgical and medical procedures | MedDRA 7.1 | Systematic Assessment |
|
| Restlessness | Psychiatric disorders | MedDRA 7.1 | Systematic Assessment |
|
| Sinus tachycardia | Cardiac disorders | MedDRA 7.1 | Systematic Assessment |
|
| Sleep disturbance | Psychiatric disorders | MedDRA 7.1 | Systematic Assessment |
|
| Thermal burn | Injury, poisoning and procedural complications | MedDRA 7.1 | Systematic Assessment |
|
| Trigeminal neuralgia | Nervous system disorders | MedDRA 7.1 | Systematic Assessment |
|
| Upper respiratory tract infection | Respiratory, thoracic and mediastinal disorders | MedDRA 7.1 | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | MedDRA 7.1 | Systematic Assessment |
|
| Weight decreased | Investigations | MedDRA 7.1 | Systematic Assessment |
|
| Wheezes | Respiratory, thoracic and mediastinal disorders | MedDRA 7.1 | Systematic Assessment |
|
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|
| Number of patients with an increase in NY-ESO-1b specific CD8+ T-cells during cycle 2 |
|
|
| Week 4 |
|
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| Week 10 |
|
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| Week 19 |
|
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| Week 25 |
|
|
| Title | Measurements |
|---|---|
|
| No Evidence of Disease |
|
| Progressive Disease |
|