Efficiency of Vaccination with Lysate-loaded Dendritic Cells in Patients with Newly Diagnosed Glioblastoma

NCT03395587 | Active Not Recruiting Phase 2 DMC

• 1 other identifier: GlioVax
• Study Type: interventional
• Target: 136
• Locations: 1 country
• Sites: 6

Brief Summary

The primary objective of the study is to determine whether overall survival of newly diagnosed glioblastoma patients treated with lysate-loaded, mature dendritic cell vaccines as add-on to the standard of care consisting of resection, radiotherapy with concomitant temozolomide chemotherapy and subsequent adjuvant temozolomide chemotherapy is superior to the treatment with the standard of care alone.

Conditions

Glioblastoma

Keywords

glioblastoma,; immunotherapy; dendritic cells; vaccination

Outcome Measures

Primary Outcomes (1)

• Overall survival (OS)

  Overall survival as measured from the day of surgery until death from any cause assessed up to 34 months

  Day of surgery until death of any cause assessed up to 34 months

Secondary Outcomes (10)

• Progression free survival (PFS)

  Day of surgery until day of diagnosis of tumor progression assessed upto 34 months

• OS rates

  6, 12 and 24 months after the day of surgery

• PFS rates

  6, 12 and 24 months after the day of surgery

• Frequency and severity of adverse events

  34 months

• Karnofsky Performance Status

  34 months

Study Arms (2)

Experimental intervention

EXPERIMENTAL

Fluorescence-guided surgery (day 0) Leukapheresis (wk4) Fractionated radiotherapy (60 Gy: 2 Gy/d, 5/7 d, 6 wks; wk5 10) and concomitant TMZ chemotherapy (75 mg/m2/d; 6 wks; wk5-10) vaccination with autologous, tumor lysate-loaded, mature dendritic cells (DC) (7x, 2 - 10 x 106 DC each, intradermal injection, weekly wk11-14, wk17, 21, 25)Adjuvant TMZ chemotherapy (150-200 mg/m2/d, 6x, days 1 5 of 28 d cycle: wk15, 19, 23, 27, 31, 35)

Biological: Autologous, tumor lysate-loaded, mature dendritic cells (DC)

Control intervention

OTHER

Standard therapy: Fluorescence-guided surgery (day 0) Fractionated radiotherapy (60 Gy: 2 Gy/d, 5/7 d, 6 wks; wk5 10) and concomitant TMZ chemotherapy (75 mg/m2/d; 6 wks; wk5-10) Adjuvant TMZ chemotherapy (150-200 mg/m2/d, 6x, days 1 5 of 28 d cycle: wk15, 19, 23, 27, 31, 35)

Drug: standard therapy

Interventions

Autologous, tumor lysate-loaded, mature dendritic cells (DC) BIOLOGICAL

Advanced therapy medicinal product (ATMP) produced at the University Hospital Düsseldorf according to Good Manufacturing Practice (GMP) with production permission according §13 AMG (German Drug Law) of the local authorities (Bezirks¬regierung Düsseldorf)

Also known as: dendritic cell vaccination

Experimental intervention

standard therapy DRUG

temozolomide, fractionated radiochemotherapy

Also known as: temozolomide, fractionated radiochemotherapy

Control intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Determined at pre-screening (prior to surgery; wk-3 - wk-1):
• Patients ≥ 18 years of age at surgery.
• Patients must be in a cognitive state to understand and sign the informed consent indicating that they are aware of the investigational nature and procedures of the study.
• First written informed consent for screening for eligibility, including tumor tissue collection, transfer and processing, central neuropathological evaluation of Tumor sample, central neuroradiological assessment of extent of resection, infectious disease (HIV, HBV, HCV, Treponema pallidum) testing, determination of MGMT promoter methylation status and pregnancy testing.
• Determined at screening (at and post-surgery; d0 - wk3):
• Newly diagnosed, monofocal GBM, IDH wildtype (WHO grade IV), including the histological variants of gliosarcoma and giant cell glioblastoma, confirmed by central neuropathologist according to the WHO classification of central nervous System tumors 2016. Tumors may cross into, but not beyond the corpus callosum.
• Near-complete resection (≤ 5 ml residual contrast enhancing tumor volume) confirmed by central neuroradiologist on MRI scan within 72 h postoperative; awake surgery and second look surgery are possible, if medically indicated.
• Sterile tumor sample of ≥ 150 mg with tumor cell frequency ≥ 60% as determined by central neuropathologist available for vaccine production.
• Successful production of sterile, avital tumor lysate.
• Karnofsky performance status ≥ 70%.
• Adequate hepatic (serum glutamate pyruvate transferase/alanine transaminase (SGPT/ALT), serum glutamic oxaloacetate transaminase/aspartate transaminase (SGOT/AST) and alkaline phosphatase ≤ 3-times upper limit of normal (ULN); bilirubin ≤ 1.5-times ULN) and renal functions (creatinine ≤ 1.5-times ULN).
• Adequate bone marrow function (hemoglobin ≥ 10 g/dl, thrombocytes ≥ 100,000/μl, white blood cell count ≥ 3,000/μl; neutrophil count ≥ 1,500/μl).
• Prothrombin time (PT) and activated partial thromboplastin time (PTT) ≤ 1.6x ULN unless therapeutically warranted. International normalized ratio (INR) (in absence of anticoagulation treatment) ≤ 1.5.
• Systemic corticosteroids tapered down to ≤ 2 mg of dexamethasone or equivalent per day within 7 days postoperative (use of corticosteroids during the treatment period should be avoided, however it is possible if clinically indicated, but may require interruption of dendritic cell vaccination).
• Female patients with reproductive potential and male generative patients and their female partners must agree to be true abstinent or to use a highly effective form of contraception (pearl index \< 1%) during the trial.

You may not qualify if:

• determined at pre-screening (prior to surgery; wk-3 - wk-1):
• Medical history of severe acute or chronic disease with poor prognosis, e.g. severe coronary heart disease, heart failure (New York Heart Association classes III/IV), severe poorly controlled diabetes, severe mental retardation or other serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator).
• Medical history of severe autoimmune disorder or immunodeficiency or patients with organ allograft.
• Medical history of bleeding diathesis or coagulopathy.
• Prior malignancy during the last three years except non-melanoma skin cancer, in situ cervical cancer, treated superficial bladder cancer or cured, early-stage prostate cancer in a patient with prostate-specific antigen (PSA) level less than ULN.
• Previous radiotherapy to head and neck.
• Known allergy or intolerability to TMZ, dacarbazine, the contrast agent or to components of the dendritic cell vaccine.
• Current treatment of glioblastoma in another clinical trial with therapeutic intervention or current use of any other investigational agent.
• Known pregnancy or breast feeding.
• No known severe infection requiring treatment.
• Accommodation in an institution due to legal orders (§40(4) AMG).
• Evidence of current drug or alcohol abuse. determined at screening (at and post-surgery; d0 - wk3):
• Infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) or Treponema pallidum or other severe infection requiring treatment.
• Accommodation in an institution due to legal orders (§40(4) AMG).
• Pregnant or breast feeding female patients. From pre-menopausal female patients with childbearing potential a negative pregnancy test must be obtained.

Sponsors & Collaborators

• Heinrich-Heine University, Duesseldorf: lead
• German Federal Ministry of Education and Research: collaborator

Study Sites (6)

Klinik für Neurologie, Knappschaftskrankenhaus Bochum

Bochum, North Rhine-Westphalia, 44829, Germany

Location

Klinik für Neurochirurgie, Sana Kliniken Duisburg

Duisburg, North Rhine-Westphalia, 47055, Germany

Location

Neurochirurgische Klinik, Universitätsklinikum Düsseldorf

Düsseldorf, North Rhine-Westphalia, 40225, Germany

Location

St. Marien Hospital Lünen, Klinik für Neurochirurgie

Lünen, North Rhine-Westphalia, 44534, Germany

Location

Klinik für Allgemeine Neurologie, Universitätsklinikum Münster

Münster, North Rhine-Westphalia, 48149, Germany

Location

Helios Klinikum Krefeld, Klinik für Neurochirurgie

Krefeld, 47805, Germany

Location

Related Publications (2)

• Naulaerts S, Datsi A, Borras DM, Antoranz Martinez A, Messiaen J, Vanmeerbeek I, Sprooten J, Laureano RS, Govaerts J, Panovska D, Derweduwe M, Sabel MC, Rapp M, Ni W, Mackay S, Van Herck Y, Gelens L, Venken T, More S, Bechter O, Bergers G, Liston A, De Vleeschouwer S, Van Den Eynde BJ, Lambrechts D, Verfaillie M, Bosisio F, Tejpar S, Borst J, Sorg RV, De Smet F, Garg AD. Multiomics and spatial mapping characterizes human CD8+ T cell states in cancer. Sci Transl Med. 2023 Apr 12;15(691):eadd1016. doi: 10.1126/scitranslmed.add1016. Epub 2023 Apr 12.

  PMID: 37043555 DERIVED

• Rapp M, Grauer OM, Kamp M, Sevens N, Zotz N, Sabel M, Sorg RV. A randomized controlled phase II trial of vaccination with lysate-loaded, mature dendritic cells integrated into standard radiochemotherapy of newly diagnosed glioblastoma (GlioVax): study protocol for a randomized controlled trial. Trials. 2018 May 25;19(1):293. doi: 10.1186/s13063-018-2659-7.

  PMID: 29801515 DERIVED

MeSH Terms

Conditions

Glioblastoma

Interventions

Standard of Care; Temozolomide

Condition Hierarchy (Ancestors)

Astrocytoma; Glioma; Neoplasms, Neuroepithelial; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Glandular and Epithelial; Neoplasms, Nerve Tissue

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation; Dacarbazine; Triazenes; Organic Chemicals; Imidazoles; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Study Officials

• Michael Sabel, Prof. MD

  Department of Neurosurgery

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: prospective, multicenter, open-label, randomized phase 2 study with two parallel groups

Study Record Dates

• First Submitted: October 26, 2017
• First Posted: January 10, 2018
• Study Start: March 6, 2018
• Primary Completion (Estimated): May 1, 2027
• Study Completion (Estimated): May 1, 2027
• Last Updated: December 2, 2024

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will not share

Locations

DE (6)