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This study is a first-in-human, Phase 1 study of the safety, tolerability, and immunogenicity of PanChol in healthy volunteers. There will be three modules in this clinical trial assessing dosing, safety, and immunogenicity:
The primary objectives of this study are:
The secondary objectives of this study are:
Participants will be enrolled at the Brigham and Women's Hospital (BWH). For the first days of the trial, participants will be inpatients in BWH, for optimal safety monitoring and for fecal and blood samples collection. PanChol or placebo will be administered on Day 1. On Day 6, participants will be starting doxycycline to eradicate the shedding of the vaccine organisms. On Day 7, those who are no longer excreting PanChol in their stool will be discharged. After discharge, volunteers will return on days 15, 29, 57, and 180 for monitoring of general health, AE assessment, immune responses, and fecal microbiota composition. Approximately 53 adult healthy volunteers are planned to be enrolled in this study if all planned treatment groups are conducted.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fixed Dose-Ranging | Experimental | The first, fixed dose-ranging module utilizes a classical "3+3 design". The name is derived from the typical cohort size at a given dose [3], and the typical expansion size at that dose [3] if 1 dose-limiting side effect is observed. This module will address the uncertainty regarding the relationship between dose and adverse events (AEs). A set of pre-specified doses (log10 values 6, 7, 8, 9, and 10) will be employed, based on animal experiments and other live OCV trials. Three participants will be administered each dose (15 participants total). |
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| Adaptive Dose-finding/Optimization | Experimental | A modified continual reassessment method (CRM) adaptive design will guide the dose optimization module. CRM cohorts comprise 3 participants treated concurrently at each dose. All three subjects in each cohort will receive a single dose based on the CRM model fit to all the available dose-response data. |
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| Expansion module - active product | Active Comparator | The purpose of the expansion cohort is to gather additional clinical experience at the optimal dose of PanChol and increase the precision with which the rate of AEs is estimated. The expansion module will be randomized, double blind and placebo-controlled (20 receiving active product, 6 receiving placebo, 26 participants total). |
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| Expansion module - placebo | Placebo Comparator | The purpose of the expansion cohort is to gather additional clinical experience at the optimal dose of PanChol and increase the precision with which the rate of AEs is estimated. The expansion module will be randomized, double blind and placebo-controlled (20 receiving active product, 6 receiving placebo, 26 participants total). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PanChol | Biological | PanChol is a new second generation live-attenuated oral cholera vaccine (OCV) that circumvents limitations of previous live-attenuated OCVs. In contrast to other live OCVs, PanChol is derived from a current circulating pandemic V. cholerae strain, thus eliminating the risk of vaccine-derived genes from extinct V. cholerae strains (such as CVD 103-HgR) recombining with circulating V. cholerae strains. |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of solicited and unsolicited adverse events, including serious adverse events, following PanChol vaccination. | 180 days | |
| The seroconversion (4-fold rise titer over baseline) of the vibriocidal titers to both Inaba and Ogawa V. cholerae between pre- and post-vaccination with PanChol. | 180 days |
| Measure | Description | Time Frame |
|---|---|---|
| The magnitude of pre- and post-vaccination serum vibriocidal titers to both Inaba and Ogawa V. cholerae. | 180 days | |
| The stool shedding of PanChol organisms using stool cultures. | 180 days |
| Measure | Description | Time Frame |
|---|---|---|
| The changes of antibodies targeting cholera specific polysaccharides. | 180 days | |
| The changes of antibody secreting cell response. | 180 days | |
| The stool microbiota modification according to 16S rRNA sequencing and/or metagenomics. |
Inclusion Criteria:
Healthy adults aged from 18 to 55 years old.
Considered healthy, as judged by the clinical investigator, according to medical history, physical examination, vital signs, screening laboratories, and medication history.
Understanding and agreeing to comply with the study protocol including the inpatient period.
Female participants must be non-pregnant and non-lactating and either
Acceptable methods of contraception include barrier methods (such as condom, diaphragm, or cervical cap used in conjunction with spermicide), intrauterine device, hormonal contraception (that may be taken or administered by oral, intravaginal, transdermal, subdermal or IM route), vasectomized partner (the vasectomized partner should be the sole partner for that participant).
Exclusion Criteria:
Each participant must not meet any of the following exclusion criteria to be eligible for enrollment in the study:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lindsey Baden, MD | Contact | 617-525-8418 | lbaden@bwh.harvard.edu |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Brigham and Women's Hospital Vaccine Unit | Recruiting | Boston | Massachusetts | 02115 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41519137 | Derived | Leitner DR, Walsh SR, Suzuki M, Desjardins M, Hannaford A, Sherman AC, Levine H, Carr L, Hammerness E, Osaki A, Sullivan E, Wang B, Balazs GI, Park Chang JB, Slater DM, Puri N, Kuehl CJ, Chen WH, Harris JB, Piantadosi S, Baden LR, Waldor MK; PanChol study group. Safety and immunogenicity of PanChol, a single-dose live-attenuated oral cholera vaccine: results from a phase 1a, double-blind, randomised, placebo-controlled trial. Lancet Infect Dis. 2026 May;26(5):497-509. doi: 10.1016/S1473-3099(25)00682-6. Epub 2026 Jan 7. |
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| ID | Term |
|---|---|
| D002771 | Cholera |
| ID | Term |
|---|---|
| D014735 | Vibrio Infections |
| D016905 | Gram-Negative Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
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| 180 days |
| D007239 | Infections |