NCT06614140

Brief Summary

This clinical trial aims to evaluate the safety, immunogenicity, and preliminary efficacy of a personalized neoantigen peptide vaccine in patients with advanced cancer or at high risk of recurrence. The study is designed for patients whose tumors have specific mutations identifiable through genomic sequencing. These mutations, known as neoantigens, are unique to each patient's cancer and serve as the target for the personalized vaccine. Eligible patients will undergo genomic analysis, including whole exome sequencing and RNA sequencing, to identify these neoantigens. A custom peptide vaccine will then be produced and formulated to target these neoantigens. The trial consists of a preparation phase, a treatment phase with priming and booster vaccinations, and a follow-up/maintenance period of one year. The study will assess immune responses, clinical efficacy, and potential toxicities. By leveraging the immune system's ability to recognize and attack cancer cells, this vaccine aims to provide a new treatment option for patients with limited alternatives.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
8

participants targeted

Target at below P25 for phase_1 cancer

Timeline
Completed

Started Nov 2022

Geographic Reach
1 country

1 active site

Status
completed

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 24, 2022

Completed
1.8 years until next milestone

First Submitted

Initial submission to the registry

September 19, 2024

Completed
7 days until next milestone

First Posted

Study publicly available on registry

September 26, 2024

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 15, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 15, 2025

Completed
Last Updated

April 22, 2026

Status Verified

April 1, 2026

Enrollment Period

2.7 years

First QC Date

September 19, 2024

Last Update Submit

April 21, 2026

Conditions

Keywords

neoantigenvaccinepersonalizedcancerpeptide

Outcome Measures

Primary Outcomes (2)

  • Safety of the Personalized Neoantigen Peptide Vaccine

    Safety will be assessed by monitoring the incidence, frequency, severity, and type of adverse events (AEs) and serious adverse events (SAEs) throughout the study, graded according to the Common Terminology Criteria for Adverse Events (CTCAE).

    From the start of treatment through the follow-up phase (up to 18 months).

  • Immunogenicity of the Personalized Neoantigen Peptide Vaccine

    Immunogenicity will be measured by evaluating T-cell responses specific to the neoantigen peptides in the peripheral blood of patients. Assays such as ELISpot and flow cytometry will be used to quantify neoantigen-specific T cells before and after vaccine administration to assess the vaccine's ability to stimulate an immune response.

    From the start of treatment through the follow-up phase (up to 18 months).

Secondary Outcomes (3)

  • Tumor Response Rate (Objective Response Rate) based on mRECIST 1.1

    From the start of treatment until disease progression or up to 18 months, whichever occurs first.

  • Progression-Free Survival (PFS)

    From the start of treatment until disease progression, death, or up to 24 months, with follow-up beyond the primary study time frame for long-term evaluation.

  • Overall Survival (OS)

    From the start of treatment until death, last follow-up, or up to 5 years, with long-term follow-up beyond the primary study time frame to assess overall survival trends.

Study Arms (1)

Personalized Neoantigen Peptide Vaccine with Poly-ICLC and Checkpoint Inhibitors

EXPERIMENTAL

Participants will receive a personalized neoantigen peptide vaccine based on tumor-specific mutations identified through genomic analysis. The treatment has three phases: Preparation Phase: Poly-ICLC, an immune adjuvant, is given intramuscularly twice weekly for four weeks before the first vaccine dose to enhance immune readiness. Treatment Phase: The neoantigen vaccine is administered with Poly-ICLC on days 1, 4, 8, 15, and 22. A checkpoint inhibitor (e.g., anti-PD-1 or anti-PD-L1) will be introduced after neoantigen-specific T cell responses are detected to counteract immune exhaustion. Booster injections are given at weeks 12 and 20. Follow-up Phase: Checkpoint inhibitors (per standard regimen) and Poly-ICLC (twice monthly) will be continued to maintain the immune response. Safety, immune activity, and clinical outcomes will be closely monitored.

Biological: Personalized Neoantigen Peptide Vaccine with Poly-ICLC and Checkpoint Inhibitors

Interventions

This intervention involves a personalized neoantigen peptide vaccine composed of peptides containing tumor-specific mutations, such as SNVs, indels, and frameshift mutations. Neoantigens are selected based on criteria that enhance expression and immunogenicity. The vaccine is administered alongside Poly-ICLC, a TLR3 agonist, to enhance immune activation. After the initial vaccine doses, checkpoint inhibitors (e.g., anti-PD-1 or anti-PD-L1) are introduced once neoantigen-specific T-cell responses are detected, preventing immune exhaustion and sustaining a strong immune response. During the follow-up phase, both checkpoint inhibitors and Poly-ICLC are continued to maintain immune activity and ensure a lasting anti-tumor effect.

Personalized Neoantigen Peptide Vaccine with Poly-ICLC and Checkpoint Inhibitors

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Cancer patients will be selected from those receiving treatment at the Cancer Center, Vejthani Hospital. All participants must meet the following criteria:
  • Cancer patients must be aged 18 years or older.
  • Patients must provide informed consent and voluntarily agree to participate in the study.
  • Patients must have an estimated life expectancy of at least 6 months.
  • Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 and normal functioning of internal organs.
  • Patients must have been diagnosed with cancer based on clinical presentation and confirmed by pathological evidence, including diagnostic imaging.
  • Specific criteria for the cancer type under study:
  • Advanced-stage cancer: No available standard treatment, resistant to standard therapies, and/or the patient is ineligible or refuses standard treatments.
  • Early-stage cancer with high recurrence risk: Even after surgery and/or radiation therapy and completion of standard treatment, the cancer has a high risk of recurrence, and there is no clear adjuvant treatment available.
  • Patients must have tumor tissue suitable for analysis and production of neoantigen peptides.
  • For advanced-stage cancer (not in the adjuvant setting), patients must have radiologic evidence that can be used to assess response according to mRECIST1.1 criteria for solid tumors.
  • Patients must have normal liver, kidney, and laboratory function, as indicated by the following criteria:
  • Lymphocyte count ≥ 800 cells/µL
  • Neutrophil count ≥ 1,500 cells/µL
  • Platelet count ≥ 150,000 cells/µL
  • +8 more criteria

You may not qualify if:

  • Cancer patients will not be eligible to participate in the study if they meet any of the following conditions:
  • Patients with a known history of allergy to peptide vaccines.
  • Patients with a history of autoimmune disease.
  • Patients who have received chemotherapy or radiation therapy less than 4 weeks prior to enrollment or as determined by the physician. This also includes patients with unresolved side effects from previous treatment graded ≥2 (CTCAE v4.0).
  • Patients with cancer that has metastasized to the brain or central nervous system, unless they have been treated and the metastases are controlled, and have been off steroids for at least 4 weeks.
  • Patients with a history of another malignancy within the past 2 years, except for locally treated basal cell or squamous cell skin cancer.
  • Patients with a history of Human Immunodeficiency Virus (HIV) infection.
  • Patients with a history of Hepatitis B or C infection. For those without prior history, screening will be conducted. Patients who test positive for Hepatitis B (HBsAg) or Hepatitis C (HCV) will be excluded unless:
  • Hepatitis B is controlled with antiviral treatment, as evidenced by an undetectable viral load.
  • Hepatitis C has been treated and the viral load is undetectable.
  • Patients with symptomatic or uncontrolled heart disease, including unstable angina, acute myocardial infarction, heart failure (New York Heart Association Class III or IV), or arrhythmias requiring treatment.
  • Patients with pacemakers may be eligible if their heart rhythm has been stable for at least one month before receiving the neoantigen peptide vaccine.
  • Patients who have received live attenuated or killed vaccines within 28 days prior to the first dose of the neoantigen peptide vaccine.
  • Patients receiving immunosuppressive drugs or corticosteroids at a dose of more than 10 mg of prednisolone (except for inhaled or intranasal corticosteroids) within the last 4 weeks before enrollment.
  • Patients with underlying medical conditions that may interfere with the efficacy or safety of the peptide vaccine.
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Vejthani Hospital

Bangkok, 10240, Thailand

Location

MeSH Terms

Conditions

Neoplasms

Interventions

poly ICLC

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 19, 2024

First Posted

September 26, 2024

Study Start

November 24, 2022

Primary Completion

August 15, 2025

Study Completion

August 15, 2025

Last Updated

April 22, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Locations