NCT03163121

Brief Summary

This is a first-in-human, randomized clinical trial of PfSPZ-GA1 Vaccine (genetically attenuated PfSPZ) in healthy malaria-naïve adult volunteers. This Phase 1 trial is divided into two stages, Stage A and B. Stage A is an open label, single center, dose escalation study in 19 volunteers. Stage B is a multi-center, double blind, randomized, placebo-controlled trial in 48 volunteers. The primary objective of this study is to determine the safety and tolerability of direct venous inoculation (DVI) of PfSPZ-GA1 Vaccine in healthy adults.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
67

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started May 2017

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 12, 2017

Completed
7 days until next milestone

First Submitted

Initial submission to the registry

May 19, 2017

Completed
3 days until next milestone

First Posted

Study publicly available on registry

May 22, 2017

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 25, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 25, 2018

Completed
Last Updated

March 5, 2019

Status Verified

March 1, 2019

Enrollment Period

1.5 years

First QC Date

May 19, 2017

Last Update Submit

March 4, 2019

Conditions

Keywords

Plasmodium falciparumPfSPZ VaccinePfSPZ-GA1 VaccineControlled human malaria infection (CHMI)Genetically attenuated sporozoitesPlasmodium falciparum sporozoites (PfSPZ)

Outcome Measures

Primary Outcomes (2)

  • Presence of blood stage parasites after inoculation with PfSPZ-GA1 Vaccine in Stage A

    Presence of blood stage parasites after inoculation with PfSPZ-GA1 vaccine, as assessed by qPCR

    From time of inoculation to till 28 days later

  • Frequency and magnitude of adverse events in study groups in Stage A and B

    Frequency and magnitude of adverse events in study groups

    From time of inoculation to end of study, assessed up to 17 months

Secondary Outcomes (1)

  • Presence of parasitemia after CHMI in Stage B

    From time of inoculation to till 28 days later

Study Arms (7)

Group 1 - PfSPZ-GA1 Vaccine

EXPERIMENTAL

Group 1 will comprise of 3 volunteers who will receive one immunization of 1.35 x 10\^5 PfSPZ of PfSPZ-GA1 Vaccine via DVI. Volunteers will be followed closely for monitoring of adverse events and possible breakthrough blood infections by testing for the presence of parasitemia by qPCR. All volunteers will be treated with a curative regimen of atovaquone/proguanil (A/P) should break-through parasites be detected in the peripheral blood, or at the end of the follow-up period (28 days) if they are not qPCR positive. Six months after the inoculation, a final visit will take place to assess adverse events.

Biological: PfSPZ-GA1 Vaccine

Group 2 - PfSPZ-GA1 Vaccine

EXPERIMENTAL

Group 2 will comprise of 3 volunteers who will receive one immunization of 4.5 x 10\^5 PfSPZ of PfSPZ-GA1 Vaccine via DVI. Volunteers will be followed closely for monitoring of adverse events and possible breakthrough blood infections by testing for the presence of parasitemia by qPCR. All volunteers will be treated with a curative regimen of atovaquone/proguanil (A/P) should break-through parasites be detected in the peripheral blood, or at the end of the follow-up period (28 days) if they are not qPCR positive. Six months after the inoculation, a final visit will take place to assess adverse events.

Biological: PfSPZ-GA1 Vaccine

Group 3 - PfSPZ-GA1 Vaccine

EXPERIMENTAL

Group 3 will comprise of 13 volunteers who will receive one immunization of 9.0 x 10\^5 PfSPZ of PfSPZ-GA1 Vaccine via DVI. Volunteers will be followed closely for monitoring of adverse events and possible breakthrough blood infections by testing for the presence of parasitemia by qPCR. All volunteers will be treated with a curative regimen of atovaquone/proguanil (A/P) should break-through parasites be detected in the peripheral blood, or at the end of the follow-up period (28 days) if they are not qPCR positive. Six months after the inoculation, a final visit will take place to assess adverse events.

Biological: PfSPZ-GA1 Vaccine

Group 4 - PfSPZ-GA1 Vaccine

EXPERIMENTAL

Group 4 will comprise of 13 volunteers who will receive 3 immunizations of 9.0 x 10\^5 PfSPZ of PfSPZ-GA1 Vaccine 8 weeks apart via DVI. 3 weeks after the last injection, volunteers will undergo mosquito-bite CHMI with five NF54-infected mosquitoes. After CHMI, volunteers will be followed closely for monitoring of adverse events and blood stage infections, and will be seen once daily from day 6 until day 21 after infection and on day 28. All volunteers will be treated with a curative regimen of antimalarials, which may be A/P or artemether/lumefantrine, at the time of detection of blood stage parasitemia by qPCR or 28 days after CHMI. Adverse events will be assessed up to 6 months after the CHMI.

Biological: PfSPZ-GA1 VaccineBiological: Mosquito-bite CHMI

Group 5 - PfSPZ-GA1 Vaccine

EXPERIMENTAL

Group 5 will comprise of 13 volunteers who will receive 3 immunizations of 4.5 x 10\^5 PfSPZ of PfSPZ-GA1 Vaccine 8 weeks apart via DVI. 3 weeks after the last injection, volunteers will undergo mosquito-bite CHMI with five NF54-infected mosquitoes. After CHMI, volunteers will be followed closely for monitoring of adverse events and blood stage infections, and will be seen once daily from day 6 until day 21 after infection and on day 28. All volunteers will be treated with a curative regimen of antimalarials, which may be A/P or artemether/lumefantrine, at the time of detection of blood stage parasitemia by qPCR or 28 days after CHMI. Adverse events will be assessed up to 6 months after the CHMI.

Biological: PfSPZ-GA1 VaccineBiological: Mosquito-bite CHMI

Group 6 - PfSPZ Vaccine

EXPERIMENTAL

Group 6 will comprise of 13 volunteers who will receive 3 immunizations of 4.5 x 10\^5 PfSPZ of PfSPZ Vaccine 8 weeks apart via DVI. 3 weeks after the last injection, volunteers will undergo mosquito-bite CHMI with five NF54-infected mosquitoes. After CHMI, volunteers will be followed closely for monitoring of adverse events and blood stage infections, and will be seen once daily from day 6 until day 21 after infection and on day 28. All volunteers will be treated with a curative regimen of antimalarials, which may be A/P or artemether/lumefantrine, at the time of detection of blood stage parasitemia by qPCR or 28 days after CHMI. Adverse events will be assessed up to 6 months after the CHMI.

Biological: PfSPZ VaccineBiological: Mosquito-bite CHMI

Group 7 - Normal Saline Placebo control

PLACEBO COMPARATOR

Group 7 will comprise of 9 volunteers who will receive 3 injections of normal saline placebo 8 weeks apart via DVI. 3 weeks after the last injection, volunteers will undergo mosquito-bite CHMI with five NF54-infected mosquitoes. After CHMI, volunteers will be followed closely for monitoring of adverse events and blood stage infections, and will be seen once daily from day 6 until day 21 after infection and on day 28. All volunteers will be treated with a curative regimen of antimalarials, which may be A/P or artemether/lumefantrine, at the time of detection of blood stage parasitemia by qPCR or 28 days after CHMI. Adverse events will be assessed up to 6 months after the CHMI.

Other: Normal SalineBiological: Mosquito-bite CHMI

Interventions

Aseptic, purified, cryopreserved, genetically attenuated P. falciparum sporozoites (Pf∆b9∆slarp), strain NF54

Group 1 - PfSPZ-GA1 VaccineGroup 2 - PfSPZ-GA1 VaccineGroup 3 - PfSPZ-GA1 VaccineGroup 4 - PfSPZ-GA1 VaccineGroup 5 - PfSPZ-GA1 Vaccine
PfSPZ VaccineBIOLOGICAL

Aseptic, purified, cryopreserved, radiation attenuated P. falciparum sporozoites (PfSPZ Vaccine), strain NF54

Group 6 - PfSPZ Vaccine

0.9% sodium chloride

Group 7 - Normal Saline Placebo control

Bites of 5 infected mosquitoes of NF54 strain

Group 4 - PfSPZ-GA1 VaccineGroup 5 - PfSPZ-GA1 VaccineGroup 6 - PfSPZ VaccineGroup 7 - Normal Saline Placebo control

Eligibility Criteria

Age18 Years - 35 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Subject is aged ≥ 18 and ≤ 35 years and in good health.
  • Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby.
  • Subject is able to communicate well with the investigator, is available to attend all study visits.
  • Furthermore, the subject will remain within the Netherlands from day -1 till day +28 after each parasite exposure. After CHMI, subjects have to be reachable by phone (24/7) from day -1 until day 35.
  • Subject agrees to inform his/her general practitioner (GP) about participation in the study and to sign a request to release by the GP, and medical specialist when necessary, any relevant medical information concerning possible contra-indications for participation in the study.
  • Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period and for a defined period thereafter according to Sanquin guidelines (3 years minimum, depending on serology).
  • Non-pregnant, non-lactating females of reproductive potential (i.e., have a uterus and are neither surgically sterilized nor post-menopausal) should agree to use adequate contraception and not to breastfeed for the duration of study.
  • Subject agrees to refrain from intensive physical exercise (disproportionate to the subjects' usual daily activity or exercise routine) for twenty-one days following each immunization and during the malaria challenge period.
  • Subject has signed informed consent.

You may not qualify if:

  • Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric or other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following:
  • Body weight \< 50 kg or Body Mass Index (BMI) \< 18.0 or \> 30.0 kg/m\^2 at screening
  • A heightened risk of cardiovascular disease, defined as: i) an estimated ten-year risk of fatal cardiovascular disease of = 5% at screening, as determined by the Systematic Coronary Risk Evaluation (SCORE), ii) history, or evidence at screening, of clinically significant arrhythmia's, prolonged QT-interval or other clinically relevant ECG abnormalities, or iii) a positive family history of cardiac events in first or second degree relatives (according to the system used in medical genetics) \< 50 years old
  • Functional asplenia, sickle cell trait/disease, thalassaemia trait/disease or G6PD deficiency
  • History of epilepsy in the period of five years prior to study onset, even if no longer on medication
  • Positive HIV, HBV or HCV screening tests
  • Chronic use of i) immunosuppressive drugs, ii) antibiotics, or iii) other immune modifying drugs within three months prior to study onset (excluding inhaled and topical corticosteroids and incidental use of oral anti-histamines) or expected use of such during the study period
  • History of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past five years
  • Any history of treatment for severe psychiatric disease by a psychiatrist in the past year
  • History of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset, positive urine toxicology test for cocaine or amphetamines at screening or prior to infection or positive urine toxicology test for cannabis prior to infection.
  • For female subjects: breastfeeding, or positive urine pregnancy test at screening or prior to immunization or prior to CHMI.
  • Any history of malaria, positive serology for P. falciparum, or previous participation in any malaria (vaccine) study or CHMI.
  • Known hypersensitivity to or contra-indications (including co-medication) for use of atovaquone/ proguanil or artemether/lumefantrine, or history of severe (allergic) reactions to mosquito bites.
  • Receipt of any vaccinations in the 3 months prior to the start of the study or plans to receive any other vaccinations during the study period or up to 8 weeks thereafter.
  • Participation in any other clinical study in the 30 days prior to the start of the study or during the study period.
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Leiden University Medical Center, Albinusdreef 2

Leiden, 2333 ZA, Netherlands

Location

Radboud University Medical Center, Geert Grooteplein 28

Nijmegen, 6525 GA, Netherlands

Location

Related Publications (1)

  • van Schaijk BC, Ploemen IH, Annoura T, Vos MW, Foquet L, van Gemert GJ, Chevalley-Maurel S, van de Vegte-Bolmer M, Sajid M, Franetich JF, Lorthiois A, Leroux-Roels G, Meuleman P, Hermsen CC, Mazier D, Hoffman SL, Janse CJ, Khan SM, Sauerwein RW. A genetically attenuated malaria vaccine candidate based on P. falciparum b9/slarp gene-deficient sporozoites. Elife. 2014 Nov 19;3:e03582. doi: 10.7554/eLife.03582.

    PMID: 25407681BACKGROUND

MeSH Terms

Conditions

MalariaMalaria, Falciparum

Interventions

Saline Solution

Condition Hierarchy (Ancestors)

Protozoan InfectionsParasitic DiseasesInfectionsMosquito-Borne DiseasesVector Borne Diseases

Intervention Hierarchy (Ancestors)

Crystalloid SolutionsIsotonic SolutionsSolutionsPharmaceutical Preparations

Study Officials

  • Robert W. Sauerwein, MD

    Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands

    PRINCIPAL INVESTIGATOR
  • Leo G Visser, MD

    Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Stage A is an open label study. Stage B of the clinical study will be double-blinded.
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 19, 2017

First Posted

May 22, 2017

Study Start

May 12, 2017

Primary Completion

October 25, 2018

Study Completion

October 25, 2018

Last Updated

March 5, 2019

Record last verified: 2019-03

Data Sharing

IPD Sharing
Will not share

Locations