This is a single institution, open-label, multi-arm, pilot study assessing the safety, feasibility, and immunogenicity of a personalized neoantigen-based vaccine plus poly-ICLC (NeoVax) combined with immune checkpoint inhibitors in subjects with newly diagnosed, unmethylated glioblastoma.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
3
At each vaccination time point, patients will receive up to 20 synthetic long peptides co-administered with 1.5 mg of poly-ICLC divided into a maximum of four injections (pools). Each pool (of vaccine + poly IC:LC) will be administered to one of the four limbs (right axilla, left axilla, right inguina, left inguina) by subcutaneous injection.
Nivolumab is a programmed death receptor-1 (PD-1) blocking antibody
Ipilimumab is a recombinant, human monoclonal antibody that binds to the cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4)
Washington University School of Medicine
St Louis, Missouri, United States
Safety and tolerability of regimen as measured by a <= 33% dose-limiting toxicity (DLT) rate for a given cohort
* The DLT observation period is 60 days after C1D1 for patients enrolled to Cohorts A, C, and D and is 90 days after C1D1 for patients enrolled to Cohorts B and E. * DLT is defined as any grade 3 or greater event that occurs during the DLT observation period that is considered at least possibly related to the study treatment.
Time frame: Up to 90 days after start of treatment
Feasibility of generating a personalized neoantigen peptide vaccine as measured by the ability to identify candidate tumor-specific neoantigens
Time frame: From time of resection to 4 weeks post-radiation therapy (approximately 14 weeks)
Feasibility of generating a personalized neoantigen peptide vaccine as measured by the the ability to manufacture a neoantigen-based synthetic long peptide vaccine
Time frame: From time of resection to 4 weeks post-radiation therapy (approximately 14 weeks)
Feasibility of generating a personalized neoantigen peptide vaccine as measured by the ability to administer the vaccine to a patient at 4 weeks post-completion of radiotherapy
Time frame: From time of resection to 4 weeks post-radiation therapy (approximately 14 weeks)
Immunogenicity of a personalized neoantigen peptide vaccine as measured by the ability to generate a measurable neoantigen-specific T cell response in vaccinated patients
Time frame: Week 4 post-vaccination
Immunogenicity of a personalized neoantigen peptide vaccine as measured by the ability to generate a measurable neoantigen-specific T cell response in vaccinated patients
Time frame: Week 16 post-vaccination
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-Baseline, cycle 2 day 1, cycle 4 day 1, and time of progression or discontinuation of treatment
-Baseline, cycle 4 day 1, and time of progression or discontinuation of treatment
Immunogenicity of a personalized neoantigen peptide vaccine as measured by the number of individual neoantigens per number of neoantigens vaccinated against, with which a measurable T cell-specific response
Time frame: Week 4 post-vaccination
Immunogenicity of a personalized neoantigen peptide vaccine as measured by the number of individual neoantigens per number of neoantigens vaccinated against, with which a measurable T cell-specific response
Time frame: Week 16 post-vaccination
Number of high quality candidate neoantigens present in patients with newly diagnosed glioblastoma
High quality neoantigens will be defined as those that meet criteria for inclusion in a vaccine
Time frame: Up to 2 weeks post sequencing
Progression-free (PFS) survival rate
Time frame: 6 months
Overall survival (OS) rate
Time frame: 12 months