A multicenter, randomized, parallel-group, placebo-controlled, double-blind, Phase 1/2a clinical study to investigate the safety, tolerability, immunogenicity and exploratory efficacy of a vaccine regimen consisting of an Ad26.Mos4.HIV prime and a boost with Modified Vaccinia Ankara (MVA)-BN-HIV in combination with broadly neutralizing antibodies (bNAb) PGT121, PGDM1400, and VRC07-523LS in human immunodeficiency virus type 1 (HIV-1)-infected study participants on suppressive anti-retroviral therapy (ART).
The study will enroll 36 adults randomized in a 1:1:1 ratio to 3 groups (vaccines+ bNAbs, vaccine+placebo, placebo+bNAbs), respectively. The study population will include HIV-infected adults who are on suppressive ART for at least 48 weeks prior to screening. The study comprises of a screening period of 10 weeks (Stage 0), a 24-week vaccination and follow-up period (Stage 1), a 4-week bNAb administration period and a 20-week bNAb washout period (Stage 2), and a 24-week monitoring period (Stage 3). An analytical antiretroviral treatment interruption (ATI) to assess rates of sustained virologic suppression will be conducted during Stages 2-3. Participants will record solicited signs and symptoms in a diary on the evening after each study drug administration and then daily for the next 7 days. Further safety evaluations will include monitoring of AEs, physical examinations, vital sign measurements, clinical laboratory tests (including urinalysis, CD4 count and HIV RNA), and for women, also pregnancy testing. Blood samples will be taken at specific clinic visits to assess immune and virologic responses as well as the pharmacokinetics and pharmacodynamics of bNAbs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
36
Ad26.Mos4.HIV is a tetravalent vaccine containing Mos1.Env, Mos2S.Env, Mos1.Gag-Pol, and Mos2.Gag-Pol HIV-1 proteins.
MVA-BN-HIV is a monovalent vaccine comprising a single Modified Vaccinia Ankara - Bavarian Nordic (MVA-BN®) vector encoding Mos1.Env, Mos2S.Env, Mos1.Gag-Pol, and Mos2.Gag-Pol HIV-1 proteins.
PGT121 is a human mAb that targets the HIV-1 V3 glycan, centered on N332.
PGDM1400 is a human mAb that targets the HIV-1 V2 glycan, centered on N160.
VRC-HIVMAB075-00-AB (VRC07-523LS) is a human monoclonal antibody (mAb) that targets the HIV-1 CD4 binding site.
UCLA CARE (Center for AIDs Research and Education)
Los Angeles, California, United States
Orlando Immunology Center
Orlando, Florida, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Washington University Clinical Trials Unit
St Louis, Missouri, United States
University Hospitals Cleveland Medical Center
Cleveland, Ohio, United States
University of Washington Positive Research
Seattle, Washington, United States
Percentage of Participants With Solicited Local Adverse Events (AEs) as a Measure of Safety and Tolerability
Solicited local AEs: erythema, swelling/induration, and pain/tenderness will be assessed.
Time frame: 7 days post-investigational product administration
Percentage of Participants With Solicited Systemic AEs as a Measure of Safety and Tolerability
Solicited systemic AEs: fever (temperature measurement), fatigue, headache, nausea, myalgia, and chills will be assessed.
Time frame: 7 days post-investigational product administration
Percentage of Participants With Unsolicited AEs as a Measure of Safety and Tolerability
An Unsolicited AE is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Time frame: Approximately up to 72 weeks
Percentage of Participants With Adverse Events of Special Interest (AESIs)
AESIs and potential AESIs are judged to be of special interest because of clinical importance, known or suspected class effects and include thrombotic events and symptomatic thrombocytopenia.
Time frame: From first vaccination until 6 months after last vaccination.
Frequency of Epitope Recognition by Enzyme-Linked Immunospot (ELISPOT)
Assays of peptide pool sets covering the Gag, Env or Pol will be evaluated by standard enzyme linked immunospot assay (ELISPOT).
Time frame: Up to post-vaccination follow-up period until Week 72
Total IgG and Subclass Specific Antibody Titer
Total immunoglobulin G (IgG) and subclass (IgG1-4) specific antibody titers (binding antibody) to envelope (Env) proteins representing Clades A, B, and C, as well as Mosaic antigens.
Time frame: Up to post-vaccination follow-up period until Week 72 ]
Antiviral activity - Percentage of participants who maintain plasma HIV RNA <1000 copies/mL
Proportion of participants who remain off ART and maintaining plasma HIV RNA \<1000 copies/mL for at least two thirds of the time between 24 and 72 weeks of analytical treatment interruption (ATI).
Time frame: Time between week 24 and week 72 week
Measurement of the HIV-1 reservoir (dQVOA)
Measurement of the HIV-1 reservoir by differential quantitative viral outgrowth assay
Time frame: At baseline, Week 24 and Week 32
Measurement of intact proviral DNA
Measurement of intact proviral DNA, ie by intact proviral DNA assay (IPDA)
Time frame: At baseline, Week 24 and Week 32
Compare the time to viral rebound (defined as confirmed plasma HIV RNA levels ≥1,000 copies/mL) following Ad26.Mos4.HIV, MVA-BN-HIV and placebo with the results of the rates of viral rebound as observed in historical controls.
The proportion of participants in Group 2 who remain off ART maintaining plasma HIV RNA \<1000 cps/mL at Week 48 compared to historical controls
Time frame: Week 48
To evaluate PGT121, VRC07-523LS and PGDM1400 serum levels at which viral rebound is detected during the analytical treatment interruption.
Serum levels of PGT121, VRC07-523LS and PGDM1400 at time of viral rebound.
Time frame: From start of ATI until the date of HIV RNA >1000 copies/ml assessed up to week 72
HIV genotyping of circulating virus
Genotypic analysis: Development of sequence variations in epitopes known to result in reduced PGDM1400 mAb and/or PGT121 mAb and/or VRC07-523LS mAb neutralization susceptibility
Time frame: From start of ATI until the date of HIV RNA >1000 copies/ml assessed up to week 72
HIV phenotyping of circulating virus
Phenotypic analysis: Changes in viral susceptibility to PGDM1400 mAb and/or PGT121 mAb and/or VRC07-523LS mAb neutralization
Time frame: From start of ATI until the date of HIV RNA >1000 copies/ml assessed up to week 72
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