This is a Phase I, single-arm, open-label, dose-escalation study in patients with stage II or III ovarian cancer after surgery. The study will evaluate the safety, tolerability, immune response, and preliminary clinical activity of NeoOVIV, a personalized mRNA-lipid nanoparticle vaccine, when given with standard adjuvant chemotherapy and a PD-1 antibody.
This is a Phase I, single-arm, open-label, dose-escalation study in patients with stage II or III ovarian cancer after surgery. The study will evaluate the safety, tolerability, immune response, and preliminary clinical activity of NeoOVIV, a personalized mRNA-lipid nanoparticle vaccine, when given with standard adjuvant chemotherapy and a PD-1 antibody. Participants will receive standard postoperative chemotherapy according to clinical guidelines. Tislelizumab, a PD-1 antibody, will be given during treatment. The NeoOVIV vaccine will be made individually for each participant using tumor tissue and blood samples collected after surgery. Genetic testing will be used to identify tumor-specific neoantigens, which will then be included in the personalized vaccine. The study will test three vaccine dose levels: 25 μg, 50 μg, and 100 μg. A traditional 3+3 dose-escalation design will be used. Each dose level will enroll 3 to 6 participants. Dose escalation will depend on whether participants develop dose-limiting toxicities after vaccination. The NeoOVIV vaccine will be given by intramuscular injection. The planned vaccination schedule includes 9 total doses: 4 priming doses during chemotherapy and 5 booster doses after chemotherapy. Participants will be monitored closely for side effects, including injection-site reactions, fever, fatigue, immune-related adverse events, and serious organ toxicities. The study will also assess immune responses to the vaccine using blood tests, including T-cell and B-cell analyses. Exploratory clinical outcomes will include disease-free survival, tumor marker changes, imaging results, and circulating tumor DNA testing for minimal residual disease. Approximately 9 participants are expected to be enrolled. Participants will continue to be followed after treatment to monitor long-term safety, survival status, and disease recurrence.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
Participants will receive the personalized NeoOVIV mRNA-lipid nanoparticle vaccine at a dose of 25 μg, corresponding to an approximate injection volume of 0.2 mL, by intramuscular injection. Vaccination will start approximately 10 weeks after surgery. Each participant will receive 9 planned vaccine doses: 4 priming doses given once every 3 weeks during chemotherapy, followed by 5 booster doses given weekly at weeks 22, 23, 24, 25, and 26 after surgery. Standard adjuvant chemotherapy will start approximately 4 weeks after surgery according to current clinical guidelines. Tislelizumab will start approximately 10 weeks after surgery and will be given for 4 doses, generally 1 day before the corresponding chemotherapy cycle.
Participants will receive the personalized NeoOVIV mRNA-lipid nanoparticle vaccine at a dose of 50 μg, corresponding to an approximate injection volume of 0.4 mL, by intramuscular injection. Vaccination will start approximately 10 weeks after surgery. Each participant will receive 9 planned vaccine doses: 4 priming doses given once every 3 weeks during chemotherapy, followed by 5 booster doses given weekly at weeks 22, 23, 24, 25, and 26 after surgery. Standard adjuvant chemotherapy will start approximately 4 weeks after surgery according to current clinical guidelines. Tislelizumab will start approximately 10 weeks after surgery and will be given for 4 doses, generally 1 day before the corresponding chemotherapy cycle.
Participants will receive the personalized NeoOVIV mRNA-lipid nanoparticle vaccine at a dose of 100 μg, corresponding to an approximate injection volume of 0.8 mL, by intramuscular injection. Vaccination will start approximately 10 weeks after surgery. Each participant will receive 9 planned vaccine doses: 4 priming doses given once every 3 weeks during chemotherapy, followed by 5 booster doses given weekly at weeks 22, 23, 24, 25, and 26 after surgery. Standard adjuvant chemotherapy will start approximately 4 weeks after surgery according to current clinical guidelines. Tislelizumab will start approximately 10 weeks after surgery and will be given for 4 doses, generally 1 day before the corresponding chemotherapy cycle.
West China Hospital
Chengdu, Sichuan, China
RECRUITINGIncidence of Treatment-Emergent Adverse Events Assessed by CTCAE Version 5.0
Adverse events will be assessed according to CTCAE Version 5.0. The number and percentage of participants with treatment-emergent adverse events will be reported. The onset time, grade, duration, seriousness, relationship to study treatment, management, and outcome of adverse events will be documented. Events of special interest will include injection-site reactions, fever, fatigue, headache, immune-related adverse events, and serious organ toxicities.
Time frame: From the first dose of study treatment through the last follow-up, up to 18 months
Disease-Free Survival
Disease-free survival is defined as the time from the date of surgery to the first documented disease recurrence according to RECIST 1.1 or death from any cause, whichever occurs first.
Time frame: From the date of surgery through study completion, up to 24 months
Change in Tumor Marker CA125 Level
Serum CA125 levels will be measured during follow-up to evaluate changes from baseline after treatment.
Time frame: Baseline and every 4 weeks during treatment and follow-up, up to 24 months
Change in Tumor Marker HE4 Level
Serum HE4 levels will be measured during follow-up to evaluate changes from baseline after treatment.
Time frame: Baseline and every 4 weeks during treatment and follow-up, up to 24 months
Neoantigen-Specific T-Cell Response Rate Assessed by IFNγ ELISpot
Neoantigen-specific T-cell responses will be assessed using peripheral blood samples by ex vivo IFNγ ELISpot after stimulation with vaccine neoantigen peptide pools. The response rate will be calculated according to predefined positivity criteria.
Time frame: Baseline preoperatively; 1 week after the third priming dose; 1 week after completion of the priming phase; 1 week after the first booster dose; and 6 months of follow-up
Change in CD8-Positive T-Cell Functional Subsets Assessed by Flow Cytometry
CD8-positive T-cell function, proliferation, and polyfunctional T-cell subsets will be assessed using flow cytometry. Changes from baseline in these immune cell subsets will be summarized.
Time frame: Baseline preoperatively; 1 week after the third priming dose; 1 week after completion of the priming phase; 1 week after the first booster dose; and 6 months of follow-up
Change in T-Cell Transcriptional Profiles Assessed by Single-Cell RNA Sequencing
Single-cell RNA sequencing will be performed on purified T cells after vaccine priming to evaluate changes in T-cell transcriptional profiles associated with vaccination.
Time frame: Baseline preoperatively and 1 week after completion of the priming phase
T-Cell Clonal Expansion Assessed by TCR Sequencing
T-cell receptor sequencing will be performed to assess vaccine-associated T-cell clonal expansion and persistence, including tracking of vaccine-specific T-cell clones.
Time frame: Baseline preoperatively through 12 months after treatment initiation
B-Cell Clonal Expansion Assessed by BCR Sequencing
B-cell receptor sequencing will be performed on CD19-positive B cells isolated from peripheral blood mononuclear cells to assess vaccine-associated B-cell clonal expansion and persistence.
Time frame: Baseline preoperatively through 12 months after treatment initiation
Vaccine Dose Completion Rate
Vaccine dose completion rate is defined as the percentage of participants who complete all 9 planned doses of the NeoOVIV vaccine.
Time frame: From the first vaccine dose through completion of the ninth planned vaccine dose, up to 26 weeks after surgery
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