Tg01 Vaccine / Qs-21 Stimulon™ With Or Without Balstilimab As Maintenance Therapy Following Adjuvant Chemotherapy In Patients With Resected Pancreatic Cancer

NCT05638698 | Active Not Recruiting Phase 2 DMC FDA Drug

• 1 other identifier: STUDY00149222
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 5

Brief Summary

Researchers want to discover if the new drug "TG01" will work with participants' bodies to help their immune system attack any cancer cells that might still be in the blood stream after surgery for pancreatic cancer. The researchers will also investigate whether or not "TG01" combined with the other study drug, "Balstilimab", will show even greater efficacy. TG01 and Balstilimab are both experimental treatments and are not approved by the US Food and Drug Administration (FDA) as treatment in the United States, or elsewhere, for pancreatic cancer or any other type of cancer. Balstilimab has been studied in other cancers and has shown signs of efficacy. Another drug will be used in this study called "QS-21". It is not intended to treat any disease but is used in this study to improve the action of the study drug TG01. QS-21 has been approved by the US Food and Drug Administration (FDA) to be mixed with a vaccine used to prevent shingles. It has not been approved to be mixed with the study drug, TG01. Participants will undergo eligibility screening, weekly visits during treatment when receiving the study drug or study drug combination, two safety follow-up visits, at about 30 and 90 days after the last dose of study treatment, and long term follow up for about 12 months after the last dose of study treatment.

Conditions

Pancreas Cancer

Outcome Measures

Primary Outcomes (1)

• Molecular disease control rate

  To assess 6-month molecular disease control rate in each cohort as defined by ctDNA stability, decrease or clearance.

  6 months

Secondary Outcomes (4)

• Incidence of Treatment-Emergent Adverse Events

  6 months

• Disease free survival rate

  12 months

• Complete molecular response rate

  6 months

• Correlation between molecular response and disease free survival

  6 months

Study Arms (2)

TG01/QS-21 (Vaccine arm)

EXPERIMENTAL

TG01 is mixed with adjuvant QS-21 and given subcutaneously. After six administrations given once every two weeks of TG01 vaccine (+adjuvant QS-21) over 12 weeks during weeks 1,3,5,7,9,11, \[priming/booster phase\]), the treatment will then switch to a maintenance phase of TG01 vaccine (+adjuvant QS-21) once every 8 weeks for up to 51 weeks: The maintenance treatments will occur during weeks 19, 27, 35, 43, and 51. Maintenance treatments will end on week 51 or at the time of disease recurrence; whichever is the earliest.

Biological: TG01 Vaccine; Drug: QS-21

TG01/QS-21 + Balstilimab (Vaccine + PD-1 arm)

EXPERIMENTAL

TG01 is mixed with adjuvant QS-21 and given subcutaneously. Balstilimab is given intra-venously as infusion and begins week 3, then given every 2 weeks for up to 51 weeks. After six administrations given once every two weeks of TG01 vaccine (+adjuvant QS-21) over 12 weeks during weeks 1,3,5,7,9,11, \[priming/booster phase\]), the treatment will then switch to a maintenance phase of TG01 vaccine (+adjuvant QS-21) given once every 8 weeks for up to 51 weeks: The maintenance treatments will occur during weeks 19, 27, 35, 43, and 51. Maintenance treatments will end on week 51 or at the time of disease recurrence; whichever is the earliest.

Biological: TG01 Vaccine; Drug: QS-21; Drug: Balstilimab

Interventions

TG01 Vaccine BIOLOGICAL

used to assess molecular disease control rate when combined with other interventional methods.

TG01/QS-21 (Vaccine arm); TG01/QS-21 + Balstilimab (Vaccine + PD-1 arm)

QS-21 DRUG

used to assess molecular disease control rate when combined with other interventional methods.

TG01/QS-21 (Vaccine arm); TG01/QS-21 + Balstilimab (Vaccine + PD-1 arm)

Balstilimab DRUG

used to assess molecular disease control rate when combined with other interventional methods.

TG01/QS-21 + Balstilimab (Vaccine + PD-1 arm)

Eligibility Criteria

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

You may qualify if:

• Ability of participant OR Legally Authorized Representative (LAR) to understand this study, and participant or LAR willingness to sign a written informed consent
• Males and females age ≥ 18 years
• ECOG Performance Status 0 - 1 within 28 days prior to registration (Appendix A)
• Surgically resected stage I/II/III Pancreatic Cancer
• Life expectancy of at least 6 months
• Screening tumor tissue positive or known pathogenic or likely pathogenic RAS mutation resulting in amino acid substitution in codon 12A, 12C, 12D, 12R, 12S or 13D . Mutations must be considered pathogenic or likely pathogenic by a reference database such as ClinVar or OncoKb.org.(https://www.ncbi.nlm.nih.gov/clinvar/variation;https://www.oncoKb.org). Local RAS test results are acceptable and central confirmation is not required prior to treatment.
• No evidence of recurrent cancer on screening imaging studies
• Positive for Minimal Residual Disease (MRD) as assessed by Signatera circulating tumor DNA (ctDNA) despite prior standard therapy including surgery and chemotherapy/radiation therapy where applicable
• Prior cancer treatment must be completed at least 14 days prior to registration and the subject must have recovered from all reversible acute toxic effects of the regimen (other than alopecia) to Grade ≤ 1 or baseline.
• Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to initiating treatment. See also section with title CHILD BEARING POTENTIAL /PREGNANCY
• Adequate organ function, measured within 28 days prior to enrollment and defined as follows:
• Hgb ≥ 8g/dL
• Creatine clearance ≥ 50ml/min (measured or calculated by the Cockroft-Gault method)
• Leukocytes \>1.5K/UL
• Absolute Neutrophil Count \>1.5K/UL NOTE: Patients with established diagnosis of benign neutropenia are eligible to participate with ANC between 1000-1500 if in the opinion of treating physician the trial treatment does not pose excessive risk of infection to the patient.

You may not qualify if:

• Simultaneously enrolled in any therapeutic clinical trial
• Current or anticipating use of other anti-neoplastic or investigational agents while participating in this study
• Diagnosed with a psychiatric illness or is in a social situation that would limit compliance with study requirements
• Is pregnant, planning pregnancy, or breastfeeding
• Has a known allergic reaction to any excipient contained in the study drug formulation
• Has received an investigational drug within 4 weeks prior to study drug administration
• Is currently receiving any agent with a known effect on the immune system, unless at dose levels that are not clinically immunosuppressive (e.g. Prednisone at 10 mg/day or less, or as inhaled steroid at doses used for the treatment of asthma
• Has any other serious illnesses or medical conditions such as, but not limited to:
• Any uncontrolled infection
• Uncontrolled cardiac failure classification New York Heart Association (NYHA) III or IV
• Uncontrolled systemic and gastro-intestinal inflammatory conditions
• Inadequate bone marrow function with suspected inability to mount an immune response to vaccination
• Severe intercurrent disease which might affect immunocompetence
• Unacceptable values of the hematological or chemical tests (in relation to the ability to generate an immune response), as judged by the investigator
• Active or prior documented autoimmune disease within the past 2 years. Note: subjects with vitiligo, Grave's disease, psoriasis not requiring systemic treatment or hypothyroidism (i.e.

Sponsors & Collaborators

• University of Kansas Medical Center: lead
• Targovax ASA: collaborator

Study Sites (5)

University of Kansas Cancer Center - Clinical Research Center

Fairway, Kansas, 66208, United States

Location

University of Kansas Cancer Center - Overland Park

Overland Park, Kansas, 66210, United States

Location

University of Kansas Cancer Center - Westwood

Westwood, Kansas, 66205, United States

Location

University of Kansas Cancer Center - North

Kansas City, Missouri, 64154, United States

Location

University of Kansas Cancer Center - Lee's Summit

Lee's Summit, Missouri, 64064, United States

Location

MeSH Terms

Conditions

Pancreatic Neoplasms

Interventions

saponin QA-21V1; balstilimab

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Endocrine Gland Neoplasms; Digestive System Diseases; Pancreatic Diseases; Endocrine System Diseases

Study Officials

• Anup Kasi

  The University of Kansas Cancer Center

  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: This is a two arm, open-label, phase II randomized trial of TG01 vaccine and QS- 21 (vaccine arm) or TG01 vaccine and QS-21 plus Balstilimab (Vaccine + PD1i arm) in patients with surgically resected Stage 1-3 RAS mutant pancreatic cancer who have positive circulating tumor DNA (ctDNA+) in the blood despite prior standard therapy including chemotherapy/radiation therapy where applicable; no evidence of disease by imaging.

Study Record Dates

• First Submitted: November 16, 2022
• First Posted: December 6, 2022
• Study Start: December 15, 2022
• Primary Completion: December 1, 2024
• Study Completion: December 1, 2025
• Last Updated: September 23, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (5)