The primary objective of this study is to answer the question "Is it possible to inject the COMBIG-DC vaccine in a hepatic tumor without getting unacceptable side effects"?
Patients diagnosed with hepatocellular carcinoma will get COMBIG-DC vaccinations at three occasions with 2-3 weeks and 3-5 weeks between vaccination 2 and 3 respectively. Adverse events will be registered until 6 months after last vaccination, as well as changes in vital signs (heart rate, blood pressure and body temperature) and lab parameters. Immunologic response will be evaluated by measuring immunologic markers in blood. The size of the tumor/tumors will be evaluated after 3 and 6 months and thereafter every three months until tumor progression. For patients included after approval of Amendment 3 (2015-12-10), COMBIG-DC will be given as add on to standard treatment; sorafenib or Transarterial Chemoembolization (TACE).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Allogenic dendrite-cell based therapeutic vaccine
Dept. of Transplantation and Liver Surgery, Sahlgrenska University Hospital
Gothenburg, Sweden
Registration of adverse events as a measure of safety and tolerability
* Changes in vital signs from baseline (heart rate, blood pressure, body temperature) * Changes in lab parameters from baseline * Short term worsening in ECOG and/or Child Pugh and/or MELD score * Local procedural injuries, assessed by MRI or ultrasound
Time frame: Up to 6 months after last patient's last vaccination
To evaluate systemic inflammatory response
Potential systemic release of relevant cytokines, chemokines and other inflammatory parameters in blood;IL-1R, IL-2,IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, IL-17A, G-CSF. GM-CSF, IFN-gamma, MCP-1, MIP-1 beta and TNF-alpha.
Time frame: Until 3 months after last vaccination
To evaluate tumor control
* CT/MRI evaluation 3 and 6 months after first vaccination. Patients with stable disease or tumor response will continue tumor evaluation every 3rd month until progress or until last study patient has had his/her 6 month visit. * Measuring number of tumor specific T cells with flow cytometry after in vitro stimulation with different pools of HCC-associated tumor peptides (Alpha-feto protein (AFP), and hTERT) * Measuring AFP (alpha-feto protein) levels in blood * Measuring the level of circulating tumor cell, identified as tested positive for MICA, EpCAM, CD133, CD34, CK18
Time frame: Until 6 months after last patient's last vaccination
Long term changes in ECOG scores
Time frame: 3 and 6 months after last vaccination
Change in body weight
Time frame: 3 and 6 months after last vaccination
To evaluate systemic immunological response
* Vaccine cell tracking; PBMCs will be stained with antibodies specific for one HLA class I or one HLA-class II antigen that is selectively expressed on donor vaccine cells. * vaccine-induced alloimmunization; screening of alloantibodies against HLA-A, B, C (MHC-class I) and HLA-DR, DQ, DP (MHC-class II) antigens * autoimmune events; screening of autoantibodies against autoantigens, including nuclear antigens (ANA, SSA, SSB, Sm, RNP, Scl-70, Centromeres and Jo-1) and liver parenchyma-associated autoantigens (liver-kidney microsomal antigens and mitochondrial antigens) * complement activation; classical/alternative complement function, C3, C4, C3d, and Factor-B. * immune cell occurrence and activation state; CD3+ , CD3+4+ and CD3+8+ T cells, CD19+ B-cells CD3-16+56+ NK-cells, CD3-16+56+69+ NK cells, CD3+16+56+ NKT-cells, CD3+16+56+69+ NKT-cells and CD3+HLA-DR+ T cells.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Up to 3 months after last vaccination
Long term changes in Quality of Life scores
Time frame: 3 and 6 months after last vaccination
To evaluate immunological response
* complement activation; classical/alternative complement function, C3, C4, C3d, and Factor-B. * immune cell occurrence and activation state; CD3+ , CD3+4+ and CD3+8+ T cells, CD19+ B-cells CD3-16+56+ NK-cells, CD3-16+56+69+ NK cells, CD3+16+56+ NKT-cells, CD3+16+56+69+ NKT-cells and CD3+HLA-DR+ T cells.
Time frame: Up to 3 months after last vaccination
Changes in HBV, HCV virus titers
Changes in HBV, HCV virus titers vs baseline, for patients that are tested positive at screening
Time frame: Day 8 after each injection and at the 3 and 6 months visit
To study time to progress (TTP)
TTP measured as time from first dose of COMBIG-DC until radiologically proven progress according to mRECIST.
Time frame: Measured every 3 months until progression
To study overall survival (OS)
OS measured as survival time from first dose of COMBIG-DC until end of study or death (whichever comes first)
Time frame: Up to 6 months after last patient's last vaccination