This is a single institution, open-label, single arm, study assessing the safety, feasibility, and immunogenicity of a personalized neoantigen-based vaccine in subjects with newly diagnosed, unmethylated glioblastoma.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
-The neoantigen DNA vaccines are also known as DNA plasmid vector expressing tumor-specific antigens.
CELLECTRA® 2000 Device is a system indicated for use to enhance the uptake and expression of plasmid-based biologics in order to enhance vaccine efficacy.
The INO-9012 vials will be supplied by Geneos Therapeutics
Washington University School of Medicine
St Louis, Missouri, United States
Safety and Tolerability of a Personalized Neoantigen DNA Vaccine as Measured by Number of Participants With Dose-limiting Toxicities (DLTs)
A DLT will be defined as any grade 3 toxicity or greater according to CTCAE v5 considered at least possibly related to study treatment. The DLT observation period begins with Cycle 1 Day 1 (date of first vaccine administration) and continues for 30 days
Time frame: Up to 30 days
Feasibility of Generating a Personalized Neoantigen DNA Vaccine for Patients With Newly Diagnosed, Unmethylated GBM as Measured by the Number of Participants Who Had Candidate Tumor-specific Neoantigens Identified
The number of enrolled participants where at least one candidate tumor-specific neoantigen was identified for vaccine inclusion. Candidate neoantigen identification was done through tumor sequencing and in silico prediction algorithms prioritizing expressed (inferred by RNAseq) and presented (patient specific HLA class 1 molecule-restricted) peptides.
Time frame: 4 weeks post-completion of radiotherapy (day 1 of cycle 1)
Feasibility of Generating a Personalized Neoantigen DNA Vaccine for Patients With Newly Diagnosed, Unmethylated GBM as Measured by the Number of Participants With a Manufactured Neoantigen-based DNA Vaccine
The number of enrolled participants with identifiable candidate tumor-specific neoantigen(s) who had a personalized DNA vaccine successfully manufactured.
Time frame: 4 weeks post-completion of radiotherapy (day 1 of cycle 1)
Feasibility of Generating a Personalized Neoantigen DNA Vaccine for Patients With Newly Diagnosed, Unmethylated GBM as Measured by the Number of Participants Who Had the First Vaccine Administered at 4 Weeks Post-completion of Radiotherapy
The number of enrolled participants with identifiable candidate tumor-specific neoantigen(s) who had a personalized DNA vaccine successfully manufactured and administered by 4 weeks post-completion of radiation therapy.
Time frame: 4 weeks post-completion of radiotherapy (estimated to be day 1 of cycle 1)
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Immunogenicity of a Personalized Neoantigen DNA Vaccine as Measured by the Number of Participants With a Measurable Neoantigen-specific CD8 T Cell Response
CD8 T cells will be isolated from peripheral blood samples and will be stimulated with pooled peptides corresponding to the patient-specific neoantigen candidates included in the respective DNA vaccine. Response will be measured by IFN gamma production via ELISPOT assay.
Time frame: Week 10 following vaccination on day 1 of cycle 1
Immunogenicity of a Personalized Neoantigen DNA Vaccine as Measured by the Number of Individual Neoantigens Per Number of Neoantigens Vaccinated Against, With Which a Measurable CD8 T Cell-specific Response is Identified
CD8 T cells will be isolated from peripheral blood samples and will be stimulated with individual peptides corresponding to the patient-specific neoantigen candidates included in the respective DNA vaccine. Response will be measured by IFN gamma production via ELISPOT assay.
Time frame: Week 10 following vaccination on day 1 of cycle 1
Number of High Quality Candidates Neoantigens Present in Participants With Newly Diagnosed GBM
-High quality neoantigens will be defined as those that meet criteria for inclusion in a vaccine
Time frame: 4 weeks post-completion of radiotherapy (day 1 of cycle 1)
The Percentage of Participants Who Did Not Progress or Expire by 6 Months From Time of Diagnosis
-Progression is defined as any of the following * ≥ 25% increase in sum products of perpendicular diameters of enhancing lesions compared with the smallest tumor measurement obtained either at baseline or best response, on stable or increasing doses of corticosteroids\*. The absolute increase in any dimension must be at least 5mm when calculating the products. * Significant increase in T2/FLAIR nonenhancing lesion on stable/increasing doses of corticosteroids compared with baseline scan or best response after initiation of therapy\* not caused by comorbid events * New measurable lesion. * Clear clinical deterioration not attributable to other causes apart from the tumor (e.g. seizures, medication adverse effects, complications of therapy, cerebrovascular events, infection, and so on) or changes in corticosteroid dose.
Time frame: 6 months
The Percentage of Participants Who Did Not Expire by 12 Months From Time of Diagnosis
Time frame: 12 months
Immunogenicity of a Personalized Neoantigen DNA Vaccine as Measured by the Number of Participants That Had the T-cell Phenotype, Myeloid Derived Suppressor Cell Frequency by Flow Cytometry Analysis Performed
Time frame: Up to week 24 post-vaccination (day 1 of cycle 1)
Immunogenicity of a Personalized Neoantigen DNA Vaccine as Measured by the Number of Participants That Had the Diversity of Clonality From T Cell Receptor Sequencing Analysis Performed
Measured by the number of patients that the analysis was able to be performed.
Time frame: Up to week 24 post-vaccination (day 1 of cycle 1)
Immunogenicity of a Personalized Neoantigen DNA Vaccine as Measured by Putative Antigen Specificity From T Cell Receptor Sequencing
Time frame: Up to week 24 post-vaccination (day 1 of cycle 1)