This is a Phase 1/2a open label study to evaluate the safety, tolerability, pharmacokinetics and anti-viral activity of PGT121, VRC07-523LS and PGDM1400 for HIV prevention and therapy.
This is a Phase 1/2a open label study to evaluate the safety, tolerability, pharmacokinetics and anti-viral efficacy of PGT121, VRC07-523LS and PGDM1400 antibodies for HIV prevention and therapy. PGT121, VRC07-523LS and PGDM1400 are recombinant human IgG1 monoclonal antibodies that target a V3 glycan-dependent epitope region of the HIV envelope protein and the CD4 binding site (CD4bs) of the HIV envelope protein. PGT121, VRC07-523LS and PGDM1400 mAbs were chosen for this study because of their potency, their ability to neutralize a wide array of cross-clade HIV viruses in a complementary pattern, and their proven antiviral activity in animal studies, e.g., their capacity to robustly prevent and treat simian-human immunodeficiency virus (SHIV) in rhesus monkeys. The potency and breadth of PGT121, VRC07-523LS and PGDM1400 raise the possibility that monoclonal antibodies may be effective for HIV prophylaxis at low doses and against global viruses. Neutralization sensitivity profiles are complementary; and the combination of these mAbs with unique epitope specificities will provide experience assessing the potential additive, synergistic, or antagonistic properties of two bNAbs given sequentially.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
19
PGT121 + VRC07-523LS, dose 30 mg/kg each, given intravenously
PGT121 + VRC07-523LS + PGDM1400, dose 20 mg/kg each, given intravenously
Orlando Immunology Center
Orlando, Florida, United States
Center for Virology and Vaccine Research/ Clinical Trials Unit/ BIDMC
Boston, Massachusetts, United States
Houston AIDS Research Team (HART)
Houston, Texas, United States
Safety and Tolerability - Proportion of volunteers with moderate or greater reactogenicity
Proportion of volunteers with moderate or greater reactogenicity (i.e., solicited adverse events) for 3 days following each IV infusion of PGT121, VRC07-523LS and PGDM1400 as assessed using the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 2.1, July 2017, or the Common Terminology Criteria for Adverse Events (CTCAE,) Version 5.0 27 November 2017 (for reactogenicity observed within the first 24 hours post-infusion.)
Time frame: 3 days post infusion for each infusion
Safety and Tolerability - Proportion of volunteers with adverse events (AEs)
Proportion of volunteers with adverse events (AEs), including safety laboratory (biochemical, hematological) parameters, during the 56 days following IV infusion of PGT121, VRC07-523LS and PGDM1400 that are moderate or greater, and/or considered related to PGT121 and/or VRC07-523LS and/or PGDM1400 as assessed using the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, or the Common Terminology Criteria for Adverse Events (CTCAE,) Version 5.0 27 November 2017 (for reactogenicity observed within the first 24 hours post-infusion.)
Time frame: 56 days
Safety and Tolerability - Proportion of volunteers with serious adverse events (SAEs)
Proportion of volunteers with serious adverse events (SAEs) throughout the study period following IV infusion(s) of PGT121, VRC07-523LS and PGDM1400 that are considered related to PGT121 and/or VRC07-523LS and/or PGDM1400 as assessed using the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, or the Common Terminology Criteria for Adverse Events (CTCAE,) Version 5.0 27 November 2017 (for reactogenicity observed within the first 24 hours post-infusion.)
Time frame: Up to 44 weeks
Pharmacokinetics - Elimination half-life (t1/2)
Pharmacokinetics following IV infusion of PGT121, VRC07-523LS and PGDM1400 in HIV-uninfected and HIV-infected adults: • Elimination half-life (t1/2)
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Time frame: Up to 44 weeks
Pharmacokinetics - Clearance (CL/F)
Pharmacokinetics following IV infusion of PGT121, VRC07-523LS and PGDM1400 in HIV-uninfected and HIV-infected adults: • Clearance (CL/F)
Time frame: Up to 44 weeks
Pharmacokinetics - Volume of distribution (Vz/F)
Pharmacokinetics following IV infusion of PGT121, VRC07-523LS and PGDM1400 in HIV-uninfected and HIV-infected adults: • Volume of distribution (Vz/F)
Time frame: Up to 44 weeks
Pharmacokinetics - Area under the concentration decay curve (AUC)
Pharmacokinetics following IV infusion of PGT121, VRC07-523LS and PGDM1400 in HIV-uninfected and HIV-infected adults: • Area under the concentration decay curve (AUC)
Time frame: Up to 44 weeks
Antiviral Activity - Proportion of volunteers who meet ART re-initiation criteria
Proportion of volunteers who meet ART re-initiation criteria (defined as plasma HIV-1 RNA ≥ 1000 copies/ml and/or CD4 count \< 300 cells/μl) on two consecutive measurements following ART interruption in Group 2
Time frame: Up to 44 weeks
Antiviral Activity - Time to meeting ART re-initiation criteria
Time to meeting ART re-initiation criteria (plasma HIV-1 RNA level ≥ 1000 copies/ml, CD4+ T cell count \< 300 cells/ μl in two consecutive measurements) following ART interruption in Group 2
Time frame: Up to 44 weeks
mAb serum levels at the time of viral rebound in Group 2
Serum levels of PGT121 at time of viral rebound
Time frame: Up to 44 weeks
mAb serum levels at the time of viral rebound in Group 2
Serum levels of VRC07-523LS at time of viral rebound
Time frame: Up to 44 weeks
mAb serum levels at the time of viral rebound in Group 2
Serum levels of PGDM1400 at time of viral rebound
Time frame: Up to 44 weeks
CD4+ T cell count
Change in CD4+ T cell count and frequency compared to baseline as measured by single platform flow cytometry in HIV-infected adults following IV infusion of PGT121, VRC07-523LS and PGDM1400.
Time frame: Up to 44 weeks
Effects of PGT121, VRC07-523LS and PGDM1400 on viral escape mutations in rebound viruses
Phylogenetic comparison of viruses grown from PBMCs collected from volunteers while on ART to rebound viruses collected after ART interruption (Group 2)
Time frame: Up to 44 weeks
Anti-PGT121 antibodies
Serum anti-PGT121 antibody titers
Time frame: Up to 44 weeks
Anti-VRC07-523LS antibodies
Serum anti-VRC07-523LS antibody titers
Time frame: Up to 44 weeks
Anti-PGDM1400 antibodies
Serum anti-PGDM1400 antibody titers
Time frame: Up to 44 weeks