MAVACHE is a sequential dose and schedule optimization trial of intravenous immunization with PfSPZ Vaccine in 18 to 54 malaria-naïve, healthy adult volunteers receiving 9x10\^5, 1.35x10\^6, or 2.7x10\^6 PfSPZ per dose and a total dose between 2.7x10\^6 and 8.1x10\^6 PfSPZ followed by CHMI with 3,200 fully infectious PfSPZ (PfSPZ Challenge). PfSPZ Challenge (7G8) to assess vaccine efficacy, safety, tolerability and infectivity of ascending PfSPZ doses will be assessed in healthy, malaria-naïve volunteers.
The study is to take place at Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen Germany. The study has two phases: 1) dose optimization, and 2) regimen verification. In the first phase groups A, B1, B2, C1, C2 and C3 will be vaccinated sequentially in a pre-specified order, followed by homologous CHMI with 3,200 PfSPZ Challenge (NF54) three weeks after last vaccine injection. Dose optimization phase A: 9x10\^5 PfSPZ on Days 0, 7 and 28 (n = 6) B1: 1.35x10\^6 PfSPZ on Days 0 and 7 (n = 6) B2: 1.35x10\^6 PfSPZ on Days 0, 7, and 28 (n = 6) C1: 2.7x10\^6 PfSPZ on Day 0 (n = 6) C2: 2.7x10\^6 PfSPZ on Day 0 and 7 (n = 6) C3: 2.7x10\^6 PfSPZ on Days 0, 7 and 28 (n = 6) In parallel to CHMI with PfSPZ Challenge (NF54) during the optimization phase, a total of nine volunteers will receive either 800, 1,600 or 3,200 PfSPZ Challenge (7G8) (PfSPZ Challenge (7G8) dose finding) to assess safety, tolerability and infectivity of PfSPZ Challenge (7G8) in malaria-naïve healthy adult volunteers. PfSPZ Challenge (7G8) dose finding/infection D1: 800 PfSPZ (n = 3) D2: 1,600 PfSPZ (n = 3) D3: 3,200 PfSPZ (n = 3) Subsequently, the shortest efficacious regimen (V1) and a three-dose regimen (Day 0, 7 and 28) of the highest safe dose (V2) will be selected and verified against placebo (normal saline (NS)). Groups V1 and V2 will be vaccinated at approximately the same time and undergo repeat CHMI three and eight weeks after the last immunization. Volunteers will either receive PfSPZ Vaccine or NS as placebo. Allocation will be random and double blind. Repeat CHMI will be done with PfSPZ Challenge (NF54) and PfSPZ Challenge (7G8), given in a randomized sequence. All immunizations are given by direct venous inoculation (DVI). Regimen verification phase V1: Shortest efficacious regimen (n = 12) against placebo (n = 6) V2: Maximum regimen (n = 12) against placebo (n = 6) P1: Placebo for V1 group (n=6) P2 Placebo for V2 group (n=6)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
45
Aseptic, purified, vialed, cryopreserved, radiation-attenuated, Plasmodium falciparum sporozoites, strain NF54
Live, infectious, aseptic, purified, vialed, cryopreserved, Plasmodium falciparum sporozoites, strain NF54
Live, infectious, aseptic, purified, vialed, cryopreserved, Plasmodium falciparum sporozoites, strain 7G8
Institute of Tropical Medicine, University of Tuebingen, Wilhelmstr. 27
Tübingen, Germany
Number or occurrence of at least possibly related Grade 3 AEs and serious adverse events (SAEs) for PfSPZ Vaccine
Number or occurrence of at least possibly related Grade 3 AEs and SAEs from time of first administration of PfSPZ Vaccine to the end of the follow-up period.
Time frame: Around 14 months (from day of first immunization through study completion)
PfSPZ Challenge (7G8) dose finding - Number or occurrence of at least possibly related Grade 3 AEs and SAEs
Number or occurrence of at least possibly related Grade 3 AEs and SAEs from time of first administration of PfSPZ Challenge (7G8) to the end of the follow-up period.
Time frame: Around 140 days (from day of first PfSPZ Challenge (7G8) CHMI through end of follow-up)
Number of adverse events following immunization (AEFI) for PfSPZ Vaccine
Number of adverse events following immunization (AEFI) from time of first administration of PfSPZ Vaccine to first administration of PfSPZ Challenge for CHMI consistent with a causal relationship.
Time frame: About 7 weeks (from day of first vaccination until 3 weeks after last vaccination)
Proportion of volunteers who become parasitemic will be recorded, detected by thick blood film microscopy or qPCR
Thick blood film microscopy and quantitative polymerase chain reaction (qPCR) assays will be performed during CHMI follow-up. The proportion of volunteers who become parasitemic will be recorded, detected by thick blood film microscopy or qPCR, within 28 days following CHMI with 3,200 PfSPZ, given either as a single dose of 3,200 PfSPZ Challenge (NF54) (optimization phase) or as two subsequent injections of 3,200 PfSPZ Challenge (NF54) and PfSPZ Challenge (7G8), respectively in the verification phase.
Time frame: Up to 4 weeks (from day of CHMI until 28 days)
Proportion of volunteers who do not become parasitemic (protected) against homologous (NF54) and heterologous (7G8) CHMI, respectively.
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0.9% sodium chloride
This endpoint can only be assessed during the verification phase of the trial.
Time frame: About 28 days (from day of first CHMI till 28 days)