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This is a clinical trial of a new treatment for prostate cancer that is a type of vaccine that could be a new way to treat cancer. A vaccine that could alert the immune system to the presence of cancer cells in the body may enable the immune system to target and kill those cells effectively. This vaccine is intended to work by making the immune system kill cells that have a special protein (called 5T4) that is present on the surface of cancer cells. The vaccine is made up of two recombinant viruses ("ChAdOx1" and "MVA") that have been designed to produce the 5T4 protein and have been modified so that they are weakened and cannot reproduce themselves within the body like normal viruses. Once injected into the body, these viruses make the 5T4 protein and help the body's immune system to learn to target this protein and destroy cancer cells.
This is a first-in-human study to evaluate the safety and immunogenicity of ChAdOx1.5T4-MVA.5T4 vaccination regime. It is evaluated in neo-adjuvant setting in low and intermediate risk localised prostate cancer patients who have either decided to have their prostate removed or are stable on active surveillance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CHAMVA standard regime | Experimental | ChAdOx1.5T4 prime followed by two boost of MVA.5T4 vaccine at 4 week intervals until radical prostatectomy |
|
| CHAMVA+CTX standard regime | Experimental | One week of low dose cyclophosphamide pre-conditioning before each vaccination. ChAdOx1.5T4 prime followed by two boost of MVA.5T4 at 4 week intervals until radical prostatectomy. |
|
| MVA standard regime | Active Comparator | Three MVA.5T4 vaccinations at 4 week intervals until radical prostatectomy |
|
| MVA+CTX standard regime | Active Comparator | One week of low dose cyclophosphamide pre-conditioning before each vaccination.Three MVA.5T4 vaccinations at 4 week intervals until radical prostatectomy |
|
| CHAMVA accelerated regime | Experimental | ChAdOx1.5T4 prime followed by one boost of MVA.5T4 one week later until radical prostatectomy. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ChAdOx1.5T4 | Biological | A recombinant simian adenovirus encoding human tumour-associated antigen 5T4 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Vaccine safety and immunogenicity | Development or increase in anti-5T4 cellular and humoral responses in patients treated with CHAMVA or CHAMVA + CTX | Up to 52 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Cellular and humoral immune response with CHAMVA | Development or increase in anti-5T4 cellular and humoral responses in patients treated with the CHAMVA vaccination regimes | Up to 52 weeks |
| Cellular and humoral immune response with MVA |
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Inclusion Criteria(Radical Prostatectomy patients):
Males aged 18 years and older
Histologically confirmed prostate cancer diagnosed on biopsy within 6 months
Clinically localised, low or intermediate risk prostate cancer, i.e.:
Scheduled for and considered fit for radical prostatectomy
Absence of any indication to perform urgent surgery that would not allow administration of the vaccine during the 12 week period prior to radical prostatectomy
No invasive treatment for prostatic disease within the last 2 years
Subject is free of clinically apparent/active autoimmune disease (no prior confirmed diagnosis or treatment for autoimmune disease including Systemic Lupus Erythematosis, Grave's Disease, Hashimoto's Thyroiditis, Multiple Sclerosis, and Insulin Dependent Diabetes Mellitus). Note subjects with Non-Insulin Dependent Diabetes Mellitus can be included.
Subject has adequate bone marrow function as defined by an Absolute Lymphocyte Count (ALC) ≥ 500/µL, Absolute Neutrophil Count (ANC) >1200/µL, Platelet Count >100,000/µL.
Subject must practice a reliable form of contraception (barrier or vasectomy) while they are being treated with vaccines and another effective method of birth control must also be used by their partner
Inclusion Criteria (Active Surveillance patients)
Males aged 18 and older
Histologically confirmed prostate cancer diagnosed on biopsy within 6 months
Clinically localised, low or intermediate risk prostate cancer, i.e.:
Stable disease on Active Surveillance for a minimum of 12 months previously
Suitable to remain on Active Surveillance at time of last clinical assessment
No invasive treatment for prostatic disease within the last 2 years
Subject is free of clinically apparent/active autoimmune disease (no prior confirmed diagnosis or treatment for autoimmune disease including Systemic Lupus Erythematosis, Grave's Disease, Hashimoto's Thyroiditis, Multiple Sclerosis, and Insulin Dependent Diabetes Mellitus). Note subjects with Non-Insulin Dependent Diabetes Mellitus can be included.
Subject has adequate bone marrow function as defined by an Absolute Lymphocyte Count (ALC) ≥ 500/µL, Absolute Neutrophil Count (ANC) >1200/µL, Platelet Count >100,000/µL.
Subject must practice a reliable form of contraception (barrier or vasectomy) while they are being treated with vaccines and another effective method of birth control must also be used by their partner
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Freddie Hamdy | Oxford University Hospitals NHS Trust | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Oxford | Oxford | OX3 7DQ | United Kingdom | |||
| Royal Hallamshire Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32591433 | Derived | Cappuccini F, Bryant R, Pollock E, Carter L, Verrill C, Hollidge J, Poulton I, Baker M, Mitton C, Baines A, Meier A, Schmidt G, Harrop R, Protheroe A, MacPherson R, Kennish S, Morgan S, Vigano S, Romero PJ, Evans T, Catto J, Hamdy F, Hill AVS, Redchenko I. Safety and immunogenicity of novel 5T4 viral vectored vaccination regimens in early stage prostate cancer: a phase I clinical trial. J Immunother Cancer. 2020 Jun;8(1):e000928. doi: 10.1136/jitc-2020-000928. |
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| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C504058 | TroVax |
| D003520 | Cyclophosphamide |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
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|
| CHAMVA+CTX accelerated regime | Experimental | One week of low dose cyclophosphamide pre-conditioning before each vaccination. ChAdOx1.5T4 prime followed by one boost of MVA.5T4 one week later until radical prostatectomy. |
|
| CHAMVA accelerated regime AS | Experimental | ChAdOx1.5T4 prime followed by one boost of MVA.5T4 one week later. Patients continue on active surveillance. |
|
| CHAMVA+CTX accelerated regime AS | Experimental | One week of low dose cyclophosphamide pre-conditioning before each vaccination. ChAdOx1.5T4 prime followed by one boost of MVA.5T4 one week later. Patients continue on active surveillance. |
|
| MVA.5T4 | Biological | A recombinant replication deficient Modified Vaccinia Ankara virus encoding human tumour-associated antigen 5T4 |
|
| Cyclophosphamide | Drug | Metronomic cyclophosphamide (50mg bd) |
|
|
Development or increase in anti-5T4 cellular and humoral response in patients treated with the MVA vaccination regimes.
| Up to 52 weeks |
| PSA level change secondary to vaccination | PSA level decrease in patients treated with CHAMVA or MVA vaccination at week 4,8 or 12. | Participants will be followed for the duration of the study, up to 52 weeks |
| MRI or Gleason score change secondary to vaccination | Reduction of tumour burden or Gleason score at weeks 4, 8 or 12. | Participants will be followed for the duration of the study, up to 52 weeks |
| Regulatory T-cell response | Change in the frequency of regulatory T-cells measured in blood or tumour samples from patients treated with metronomic cyclophosphamide compared to patients not receiving cyclophosphamide | Participants will be followed for the duration of the study, up to 52 weeks |
| Sheffield |
| S10 2IF |
| United Kingdom |
| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |