This phase I/II trial evaluates the safety and the immunological efficacy of a cancer vaccine against 2 glioma-associated antigens in newly-diagnosed glioblastomas. The objectives of this study are as follows: Primary objective * phase 1: * to assess the maximum tolerated dose (MTD) and select the recommend Phase 2a dose * phase 2a: * to assess anti- TERT specific T cell responses at 2 months at the selected dose level Secondary objectives: * To assess Short and long-time immunological safety * To assess Evolution of anti-PTPRZ1 and anti-TERT immune T cell responses over time * To assess Progression free survival (RANO 2.0 criteria) * To assess Overall survival * To assess Quality of life by EORTC QLQ30 and BN20 questionnaires * To evaluate cardiac safety and monitor for the potential development of anti-melanin antibodies in a cohort of 8 patients enrolled in the Phase 2a study as well as objective of ancillary study: to determine the mechanism of action of potential tumour escape in GBM (T-cell lymphocyte phenotype; antigen expression and checkpoint inhibitors on tumour cells at relapse, if available), analysis of circulating antibodies against TERT epitope and/or melanin, and identification of predictive biomarkers of response. Ultimately, this trial together will lead to the implementation of future phase III trial in GBM. All patients enrolled in the study will receive standard treatment consisting of surgical resection of the tumor followed by radio-chemotherapy. Immunotherapy will begin 4 weeks after the completion of radiotherapy.
Prospective multicentre Phase I- IIa, non-comparative, non-randomised study with escalating doses for the Phase 1 part. Therapeutic cancer vaccines consisting of 1 or 2 antigenic peptidic formulations combined with an immune adjuvant: * A52-Mel: a TERT peptidic epitope adsorbed on synthetic melanin * A49-Mel: a PTPRZ1 peptidic epitope adsorbed on synthetic melanin (Phase 1 only) * Litenimod, a TLR9 agonist, as an adjuvant Phase 1: Patients will receive subcutaneous injections in the shoulders of both A49 and A52 at one of 3 pre-specified dose levels of peptides (50-100-250µg) + 1mg of Litenimod (fixed dose). Phase 2a: Patients will receive subcutaneous injections in the shoulder of A52 only at the dose selected in the phase 1 part + 1mg of Litenimod
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
35
One month after glioblastoma patients have completed the initial phase of treatment with concurrent radiochemotherapy, patients will be immunized during the adjuvant phase of monthly temozolomide (5 days per month for 6 months). Immunizations will follow the standard schedule of a priming phase (D0, W2, W4, and W6) followed by a boost phase with one immunization every 2 months until progression, unacceptable toxicity, withdrawal of consent, or study end (at 12 months), whichever occurs first.
Department of Neurology, Hopital de la Salpêtrière
Paris, Idf, France
RECRUITINGNeuro-oncology Department, La Timone Hospital
Marseille, Provence-Alpes-Côte d'Azur Region, France
NOT_YET_RECRUITINGDepartment of Neurology, Hopital Saint louis (APHP)
Paris, France
RECRUITINGMaximum tolerated dose (MTD) for Phase 1
the maximum tolerated dose (MTD) based on the occurrence of dose limiting toxicity (DLT)
Time frame: 2 months
anti-TERT specific T cell responses (safety/efficay) for Phase 2
anti-TERT specific T cell responses by using IFN-gamma ELISPOT
Time frame: 2 months
Evolution of anti-PTPRZ1 specific T cell responses
anti-PTPRZ1 specific T cell responses by using IFN-gamma ELISPOT
Time frame: over time
Overall survival
The time interval from the start of treatment to the date of death from any cause.
Time frame: 12 months
Progression free survival
Tumor response will be assessed using RANO 2.0 criteria
Time frame: 12 months
the evaluation of quality of life
EORTC-QLQC30 questionnaire and BN20 module will be completed by each patient (Not all= 1; A little=2; Quite a bit= 3 ; Very Much=4)
Time frame: 5 months
Circulating anti-melanin antibodies
in a cohort of 8 patients enrolled in the Phase 2a study
Time frame: At M2
Cardiac safety
evaluated through 12-lead ECG assessments prior to injection, 3 hours post-injection, Day 7, Week 2, and Month 2), with a focus on QT-interval measurement. Additionally, cardiac biomarkers including troponin and pro-BNP will be monitored at baseline (Day 0), Week 2, and Month 2. assessed using 12-lead ECGs performed 3 hours after injection, on day 7, at week 2 and at
Time frame: At month 2
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