This is a multicentered, open label, randomized phase II trial of PROSTVAC or ipilimumab or the combination of PROSTVAC and ipilimumab as neoadjuvant therapy in patients with localized prostate cancer. Eligible patients will be randomized to PROSTVAC monotherapy (Arm A), ipilimumab monotherapy (Arm B), or combination therapy with both PROSTVAC and ipilimumab (Arm C), prior to RP. In arms A and C, PROSTVAC-V will be administered subcutaneously as the primary vaccine on Day 1, which will be followed 2 weeks later with a series of 2 PROSTVAC-F subcutaneous administrations, given 3 weeks apart. In arms B and C, ipilimumab will be administered twice, at a dose of 3mg/kg, 3 weeks apart. In the combination arm, ipilimumab administration will coincide with the PROSTVAC-F administration. In arm B, ipilimumab will begin on Day 1. In all three arms, radical prostatectomy (RP) will occur 21 days, or three weeks, following final treatment administration of PROSTVAC or ipilimumab. No further therapy will be administered on study following RP.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
PROSTVAC-V/F is a prostate-specific antigen(PSA)-based immunization strategy. It is intended to generate immune responses to prostate specific antigens and prostate cancer cells. It uses poxviral vectors to introduce modified PSA to the patient in an immunogenic manner to break self-tolerance, and thereby induce immune responses directed against prostate cancer cells.
University of California, San Francisco
San Francisco, California, United States
Proportion of Participants With Positive CD3+ T Cell Immune Response
The proportion of participants who demonstrated a positive response following neoadjuvant therapy as measured by change from baseline in CD3+ T cell infiltration within prostate tumor tissue by immunohistochemistry (IHC) assessment following treatment will be reported. The change in the number of CD3+ T cell infiltration within prostate tissue between the biopsy and radical prostatectomy (RP) specimen will be quantified using immunohistochemistry (IHC),with a positive result if there is \>=2 fold increase in the number of CD3+T cell infiltration.
Time frame: Up to 2 years
Proportion of Participants With Any Positive Change in Immunologic Infiltration (CD3)
The proportion of participants who demonstrated any change in the number of infiltrating T cells/μm2 of CD3 within the prostatic tumor tissue from the diagnostic core biopsy specimens to the post treatment prostatectomy tissue specimens will be assessed, based upon IHC analysis following neoadjuvant PROSTVAC, ipilimumab, or the combination of the two treatments.
Time frame: Up to 2 years
Proportion of Participants With Any Positive Change in Circulating Effector T Cells
The proportion of participants who demonstrated any change in the number of circulating effector T cells/μm2 within the prostatic tumor tissue from the diagnostic core biopsy specimens to the post treatment prostatectomy tissue specimens will be assessed, based upon IHC analysis following neoadjuvant PROSTVAC, ipilimumab, or the combination by flow cytometry assessment of peripheral blood mononuclear cells
Time frame: Up to 2 years
Proportion of Participants With a Positive Change in Regulatory T Cells
The proportion of participants who demonstrated a change in the number of Regulatory T Cells/μm2 within the prostatic tumor tissue from the diagnostic core biopsy specimens to the post treatment prostatectomy tissue specimens will be assessed, based upon IHC analysis following neoadjuvant PROSTVAC, ipilimumab, or the combination by flow cytometry assessment of peripheral blood mononuclear cells
Time frame: Up to 2 years
Number of Participants With Treatment-Related Adverse Events
Safety analyses will be performed for all participants having received at least one dose of study drug. The investigator will use the NCI Common Terminology Criteria for Adverse Events (CTCAE) v.4.03 for reporting the number of participants with treatment-related, non-hematologic, adverse events and modified criteria for hematologic adverse events defined as having an attribute of possible, probable, or definite by toxicity and treatment group.
Time frame: Up to 2 years
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