The purpose of this study is to determine whether the new RNActive derived lung cancer vaccine CV9202 in combination with local radiation therapy is safe, tolerable and immunogenic for the consolidation and maintenance treatment of stage IV non small cell lung cancer (NSCLC) after first-line chemotherapy or therapy with an EGFR tyrosine kinase inhibitor.
The Phase Ib study is the first clinical study with the new lung cancer vaccine CV9202. The vaccine is composed of 6 RNActive compounts, each encoding for a different antigen which is overexpressed in NSCLC compared to healthy tissue. In order to enhance the immunogenic effect of the cancer vaccine, the study treatment will include local radiation (4 x 5 Gy), which is a well-established palliative radiation regimen that can be safely applied to metastatic lesions in the lung, bone, and soft tissue, and is well tolerated. Patients will be enrolled into 3 strata based on histologic and molecular subtypes as follows: Stratum 1: Patients with metastatic stage IV NSCLC and non-squamous histology, without activating epidermal growth factor receptor (EGFR) mutations, who have achieved partial response (PR) or stable disease (SD) after at least 4 cycles of platinum- and pemetrexed-based first-line chemotherapy, and an indication for maintenance therapy with pemetrexed. Stratum 2: Patients with stage IV NSCLC and squamous cell histology, who achieved PR or SD after at least 4 cycles of platinum-based and non-platinum compound first-line chemotherapy. Stratum 3: Patients with stage IV NSCLC and non-squamous histology, harboring an activating EGFR mutation, who have achieved PR after up to 6 months or SD after 3 - 6 months of treatment with an EGFR TKI. In each patient, the vaccine will be administered until progression and the need to start a subsequent systemic second-line treatment, or occurrence of unacceptable toxicity requiring treatment discontinuation, whichever comes first.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
26
Intradermal injection of CV9202
Radiotherapy will be administered in 4 daily fractions of 5 GY each to be administered within one week
Innsbruck Medical University, Department of Internal Medicine V (Hematology and Oncology)
Innsbruck, Austria
HELIOS Klinikum Emil von Behring GmbH
Berlin, Germany
Augusta-Kranken-Anstalt gGmbH
Bochum, Germany
Number of participants with treatment related >= grade 3 adverse events (AEs).
Events are graded by the investigator using the NCI CTCAE Scale (version 4.0) which provides a grading scale for each AE term. Grade 3 = Severe Grade 4 = Life-threatening or disabling Interim safety evaluations will be performed: * After treatment and observation of the first 6 patients until Day 43 in a given stratum. \- If \>= 2 out of 6 patients experience treatment-related \>= grade 3 AEs, enrollment in that stratum will be suspended. * After the first 6 patients (enrolled in stratum 1 or 2) have received radiation of thoracic lesions and have been monitored for toxicity until Day 57: * If \>= 2 out of 6 patients experience \>= grade 3 radiation pneumonitis, radiation of thoracic lesions will be suspended for further patients. * For strata 1 and 2, CV9202 administration and radiation of thoracic lesions will be considered safe for further evaluation if ≤ 20% of patients experience a \>= grade 3 radiation pneumonitis and no patients experience grade 4 radiation pneumonitis.
Time frame: up to 40 months
humoral and cellular immune responses against the 6 antigens encoded by CV9202.
Time frame: assessments at baseline, Day 19, Day 61 after start of study treatment
broadening of humoral immune responses (antigen spreading, i.e. change in serum antibody patterns) against a panel of tumor antigens not covered by the vaccine.
Time frame: Assessment at baseline, Day 19, Day 61 and 12 weeks, 24 weeks and 48 weeks after Day 57
overall tumor response.
Time frame: At Screening and every 6 weeks during study treatment until progression up to 18 months after start of treatment of the last patient enrolled
progression free survival (PFS) and time to start of second-line treatment
Time frame: every 6 weeks up to 18 months after start of treatment of the last patient enrolled
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Kliniken der Stadt Köln gGmbH
Cologne, Germany
Klinikum Esslingen GmbH
Esslingen am Neckar, Germany
University Hospital Frankfurt, Department of Medicine II: Hematology/Oncology
Frankfurt, Germany
Thoraxklinik-Heidelberg gGmbH
Heidelberg, Germany
University Medical Center Mainz, III. Medical Clinic and Policlinic
Mainz, Germany
Pius-Hospital Oldenburg
Oldenburg, Germany
University Hospital Basel, Clinic for Oncology
Basel, Switzerland
...and 3 more locations
response to second-line cancer treatment
Time frame: every 3 months after completion of study treatment until death, withdrawal of informed consent, or loss to follow-up or until up to 18 months after start of treatment of the last patient enrolled
overall survival (OS) from time of first vaccination.
Time frame: From first study treatment until time of death assessed up to 40 months