The primary objective is to assess and characterize the antitumor activity and safety and tolerability of adjuvant treatment with an individualized neoantigen vaccine called GRT-C901/GRT-R902 (chimpanzee adenovirus \[ChAd\] and self-amplifying messenger RNA \[samRNA\] vectors), in combination with checkpoint inhibitors. Antitumor activity will be based on molecular response in patients with colon cancer who have circulating tumor deoxyribonucleic acid (ctDNA) following surgical resection.
Tumors harboring non-synonymous deoxyribonucleic acid (DNA) mutations present peptides containing these mutations as non-self antigens in the context of human leukocyte antigens (HLAs) on the tumor cell surface. A fraction of mutated peptides results in neoantigens capable of generating T cell responses that exclusively target tumor cells. Sensitive detection of these mutations allows for the identification of neoantigens unique to each patient's tumor to be included in a personalized cancer vaccine that targets these neoantigens. This vaccine regimen uses two vaccine vectors as a heterologous prime/boost approach (GRT-C901, ChAd as prime and GRT-R902, samRNA as boost) to stimulate an immune response. This study (GRANITE-ADJUVANT) will explore the anti-tumor activity of this individualized, patient specific immunotherapy in combination with checkpoint inhibitors.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
An individualized neoantigen cancer vaccine using an adenovirus vector administered via intramuscular (IM) injections at Visit 1 and boost at Visit 6.
An individualized neoantigen cancer vaccine using a self-amplifying mRNA (samRNA) vector administered via IM injection at Visits 2, 4, 9, and 12.
Dose of 1680 mg administered once every 4 weeks (Q4W) via intravenous (IV) infusion at Visits 1-13.
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, United States
NYU Langone Health
New York, New York, United States
Christ Hospital Cancer Center
Cincinnati, Ohio, United States
Percentage of Patients with a ≥50% Decrease from Baseline in Circulating Tumor deoxyribonucleic acid (ctDNA)
Time frame: Baseline and up to ~24 months
Incidence and Severity of Adverse Events
The incidence and severity will be assessed for treatment-emergent adverse events (TEAEs), immune-related AEs (irAEs), treatment-related AEs, serious AEs (SAEs), AEs leading to death while patients are on treatment or up to 100 days after the last study treatment, AEs leading to dose delays or dose discontinuation, and AEs leading to discontinuation of study treatment using National Cancer Institute (NCI) Criteria for Adverse Events (CTCAE) v5.0
Time frame: Up to ~100 days after last study treatment (Up to 62 weeks)
Recurrence-free survival (RFS) per Investigator
Time frame: From time of randomization until first recurrence of the same cancer, or death (Up to ~36 months)
Disease-free survival (DFS) per Investigator
Time frame: From time of randomization until first recurrence of any cancer, or death (Up to ~36 months)
Overall Survival (OS)
Time frame: From time of randomization until death due to any cause (Up to ~36 months)
Conversion of Patients with ctDNA at Baseline to Undetectable ctDNA as Assessed via a Polymerase Chain Reaction (PCR)-Based Assay
Time frame: Baseline and up to ~24 months
Longest Duration of Molecular response of ctDNA Decrease from Baseline
Time frame: Baseline and up to ~24 months
Success of Vaccine Manufacture
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Dose of 30 mg administered via subcutaneous (SC) injection only with the first dose of GRT-C901 at Visit 1 and GRTR902 at Visit 2.
Administered according to standard of care.
Vaccine manufacture success measured by the number of patients having sufficient neoantigens identified to warrant vaccine production.
Time frame: Up to 28 days before Day 1 of study drug administration
T-cell response using Peripheral Blood Mononuclear Cells (PBMCs)
Time frame: Up to ~24 months