MIDRIX4-LUNG is a novel tetravalent autologous dendritic cell vaccine in metastatic non-small cell lung cancer patients. This first-in-human study aims to primarily establish maximal tolerated dose of MIDRIX4-LUNG administered i.v.
Immunotherapy, in the shape of immune checkpoint inhibitors, is transforming the therapeutic landscape of non-small cell lung cancer. Checkpoint inhibitors can deliver durable tumor regressions, however only a minority of patients derive this kind of benefit, even with recent combinatorial approaches. It is clear from these clinical results that the full anti-tumoral power of the immune system is not being leveraged yet. Vaccination aims to prime and/or expand tumor antigen-targeting T-cells and induce immunological memory against later disease relapse. Whereas immune checkpoint blockade boosts inactivated responses of effector T cells, vaccination can potentially activate naive T cells with tumor specificity and in this way broaden the tumor-specific immune responses that are the target of immune checkpoint inhibition. However, the optimal vaccination modality for NSCLC still needs to be established. Dendritic cells (DCs) are specialized antigen presenting leukocytes that are now recognized as the central controllers of the immune response. The DCs unique capacity to induce robust, highly antigen-specific cytotoxic T-cell responses has led to the use of in vitro-generated autologous DCs as cancer vaccines. The investigators have developed a method for the rapid production of DCs with all the required features for the induction of anti-tumor immunity. The cells are particularly potent in inducing type 1-polarized T-helper cell and antigen-specific cytolytic T-cell responses. The DCs are loaded with a proprietary selection of 4 antigens that cover \>90% of all NSCLC patients. With the objective of ultimately combining this DC vaccine with immune checkpoint inhibition, the investigators will first establish feasibility and maximal tolerated dose of DC vaccination as monotherapy using an intra-patient dose escalation scheme.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
7
Intravenous infusions of MIDRIX4-LUNG DCs every 2 weeks, using an intra-patient dose escalation scheme progressing along the following range: 10 x10E6 DCs (minimal dose), 20 x 10E6 DCs, 40 x 10E6 DCs, 80 x 10E6 DCs, 100 x 10E6 DCs (maximal dose), until exhaustion of the batch or occurrence of grade ≥3 toxicity event
Intradermal injection of 1 x 10E6 MIDRIX4-LUNG DCs at baseline and after completion of all i.v. DC vaccination rounds. This is used for assessment of induction of antigen-specific immune responses as part of in vivo immunomonitoring (delayed-type hypersensitivity cutaneous reaction as test read-out)
Intradermal injection of 1 x 10E6 MIDRIX-CTRL DCs at baseline and after completion of all i.v. DC vaccination rounds. This is used for assessment of background (i.e. non-antigen-specific) reactivity (delayed-type hypersensitivity cutaneous reaction as test read-out)
Ghent University Hospital
Ghent, Belgium
Toxicity as defined by common toxicity criteria v5.0
Safety and tolerability of preparing and administrating an autologous dendritic cell-based vaccine in advanced non-small cell lung cancer patients.
Time frame: From the day of leukapheresis until 3-4 weeks after the last vaccine dose level, i.e. 3 to 5 months depending on the number of doses that can be administered
Maximal tolerated dose
The maximal tolerated dose will be defined from the intra-patient dose excalation scheme
Time frame: From the day of leukapheresis until 3-4 weeks after the last vaccine dose level, i.e. 3 to 5 months depending on the number of doses that can be administered
Success rate (%) of producing sufficient dendritic cells for vaccination
Feasibility of producing sufficient dendritic cell for vaccination in advanced NSCLC
Time frame: From the day of leukapheresis until the last vaccine dose level, i.e. 2 to 4 months depending on the number of doses that can be administered
Number of vaccine-induced immunological responses as measured by in vitro immunomonitoring assays.
Biological activity of the vaccine (elicitation of immune responses against vaccine antigens) using a series of in vitro assays probing for antigen-specific T-cell reactivity
Time frame: From the day of leukapheresis until 3-4 weeks after the last vaccine dose level, i.e. 3 to 5 months depending on the number of doses that can be administered. Whenever possible, repeat testing will be performed 3 and 6 months after the last vaccine dose.
Number of vaccine-induced immunological responses as measured by in vivo immunomonitoring test.
Vaccine-induced antigen-specific immunological responses as measured by delayed-type hypersensitivity skin reaction
Time frame: From the day of leukapheresis until 3-4 weeks after the last vaccine dose level, i.e. 3 to 5 months depending on the number of doses that can be administered. Whenever possible, repeat testing will be performed 3 and 6 months after the last vaccine dose.
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Clinical activity of this type of vaccine as reflected by relapse-free survival
Relapse-free survival (months), based on objective tumor measurements per RECIST 1.1
Time frame: From the day of leukapheresis onwards during 1 year
Clinical activity of this type of vaccine as reflected by median progression-free survival
Median progression-free survival (months), based on objective tumor measurements per RECIST 1.1
Time frame: From the day of leukapheresis onwards during 1 year
Clinical activity of this type of vaccine as reflected by progression-free survival at landmark timepoints (%)
Progression-free survival at landmark timepoints (%), based on objective tumor measurements per RECIST 1.1
Time frame: From the day of leukapheresis onwards during 1 year