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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT03793829
Other study ID # 16-010561
Secondary ID W81XWH-16-1-0266
Status Recruiting
Phase Phase 1/Phase 2
First received
Last updated
Start date May 1, 2019
Est. completion date December 31, 2022

Study information

Verified date July 2021
Source Mayo Clinic
Contact Lisa R Seymour, BA
Phone 507-293-7698
Email seymour.lisa@mayo.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This interventional clinical study will examine the safety and efficacy of a degenerate subdominant HER2 specific helper T cell epitope vaccine (H2NVAC) in patients with HER2-expressing ductal carcinoma in situ (DCIS). The ultimate goal of this vaccine is to prevent future invasive breast cancer among patients who are diagnosed with DCIS. However, the focus of this study is safety and efficacy.


Description:

This is an interventional clinical study examining the safety and efficacy of a degenerate subdominant HER2 specific helper T cell epitope vaccine (H2NVAC) in patients with HER2-expressing ductal carcinoma in situ (DCIS). The ultimate goal of this vaccine is to prevent future invasive breast cancer among patients who are diagnosed with DCIS. However, the focus of this study is safety and efficacy. The vaccine consists of 4 peptide epitopes (15-18 amino acids in length) derived from the HER2 protein. These peptides are derived from HER2 and were selected based upon their recognition by lymphocytes from women with prior HER-2 positive breast cancer. To enhance immunity, the peptides are admixed with the adjuvant GM-CSF. Patients will receive four bi-monthly vaccinations followed by surgery as diagrammed below; observation includes periodic blood draws to assess toxicity and immune responses, as well as periodic echocardiography to assess left ventricular ejection fraction.


Recruitment information / eligibility

Status Recruiting
Enrollment 43
Est. completion date December 31, 2022
Est. primary completion date December 31, 2022
Accepts healthy volunteers No
Gender Female
Age group 18 Years and older
Eligibility Eligibility Criteria: Inclusion Criteria - Female age = 18 years. - Eastern Cooperative Oncology Group (ECOG) performance status = 2 - Patients must not have received any prior therapy for current DCIS. - Note: Patients who received tamoxifen or raloxifene or another agent for prevention of breast cancer may be included as long as the patient has discontinued the treatment at least 2 months prior to baseline study biopsy. - Note: Concurrent use of endocrine therapy during the vaccination/preoperative period is not allowed. However, standard adjuvant endocrine therapy with tamoxifen or aromatase inhibitor after completion of vaccination and surgery is allowed. - Patients must be agreeable to have an additional research biopsy prior to the first vaccination. - Patients must have evidence of at least 1.0 cm of disease extent based on mammogram or ultrasound imaging. - Patients must have adequate organ and marrow function less than or equal to 28 days prior to Pre-Registrationas defined below: - Absolute neutrophil count (ANC) = 1500/mm3 - Platelet count = 75,000/mm3 - Hemoglobin = 9.0 g/dL - Creatinine =2 x ULN - SGOT (AST) = 2 x ULN - Albumin = 3 g/dL - Negative serum pregnancy test done = 7 days prior to Pre-registration, for women of childbearing potential only. - Willing to employ adequate contraception from the time of Pre-registration through 6 months after the final vaccine cycle. - Note: Adequate contraception methods include birth control pills, barrier device, intrauterine device. - Capable of understanding the investigative nature, potential risks, and benefits of the study. - Capable of providing valid informed consent. - Willing to return to enrolling institution for all study visits (immunizations, blood draws, etc). - Willing to provide blood samples for correlative research purposes - Willing to receive a tetanus vaccination if subject has not had one within the past year. Exclusion Criteria - Any of the following because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown: - Pregnant women - Nursing women unwilling to stop breast feeding - Women of child bearing potential who are unwilling to employ adequate contraception from the time of registration through 6 months after the final vaccine cycle. - Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens. - Immunocompromised patients including patients known to be HIV positive or those on chronic steroids. - Note: Must be off systemic steroids greater than or equal to 90 days prior to Pre-registration. However, topical steroids, inhalants or steroid eye drops are permitted. - Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. - Uncontrolled acute or chronic medical conditions including, but not limited to the following: - Active infection requiring antibiotics - Congestive heart failure with New York Heart Association class III or IV; moderate to severe objective evidence of cardiovascular disease - Myocardial infarction or stroke less than or equal to 6 months prior to Pre-Registration - Receiving any other investigational agent. - Other active malignancy at time of Pre-registration or less than or equal to the last three years prior to Pre-registration. EXCEPTIONS: Non-melanoma skin cancer or carcinoma-in-situ (e.g. of cervix, prostate). NOTE: If there is a history of prior malignancy, they must not be receiving other specific treatment (cytotoxics, monoclonal antibodies, small molecule inhibitors) for their cancer. - Known history of autoimmune disease, including Type I diabetes. - Any prior hypersensitivity or adverse reaction to GM-CSF. - History of trastuzumab-related cardiac toxicity requiring interruption or discontinuation of therapy, even if LVEF fully recovered. - Baseline LVEF with a value below 55%. - Failure to fully recover from acute, reversible effects of prior chemotherapy regardless of interval since last treatment. - History of myocardial infarction = 168 days (6 months) prior to Pre-registration, or congestive heart failure requiring use of ongoing maintenance therapy for life threatening ventricular arrhythmias.

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
(H2NVAC)
Intervention: Biological/Vaccine: (H2NVAC) Dose levels: In phase I, there are 3 dose levels of H2NVAC Nine patients will be treated in each dose level starting dose level 1. a total of 27 patients will be enrolled in this phase. Dose Levels H2NVAC Dose 1.500 µg/peptide 2.1000 µg/peptide 3.1500 µg/peptide The dose with acceptable safety and tolerability & maximum immune response will be used in the expansion cohort of this trial. A total of 16 additional patients will be enrolled in this portion of this trial. Dose limiting toxicities (DLT) are defined to be any of the following criteria using the National Cancer Institute's Cancer Therapy Evaluation Program (CTEP) Common Terminology Criteria for Adverse Events, version 4.0

Locations

Country Name City State
United States Mayo Clinic in Florida Jacksonville Florida
United States Mayo Clinic in Rochester Rochester Minnesota

Sponsors (1)

Lead Sponsor Collaborator
Mayo Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Adverse Events Number of adverse events reported 2 years
Primary Dose limiting toxicities Measured using criteria from the National Cancer Institute's Cancer Therapy Evaluation Program (CTEP) Common Terminology Criteria for Adverse Events, version 4.0 with Grade = 2 allergic reaction, Grade = 2 autoimmune reaction, Grade = 2 injection site reaction manifesting as an ulceration, Grade = 2 neurologic problem, Grade 3+ toxicity, or any one of following changes in LVEF 14 days post vaccination, 2 years
See also
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Completed NCT03931928 - Genotype and Phenotype Guided Supplementation of TAMoxifen Standard Therapy With ENDOXifen in Breast Cancer Patients Phase 2
Terminated NCT03535506 - Preoperative Palbociclib in Patients With DCIS of the Breast That Are Candidates for Surgery Phase 2
Recruiting NCT04797299 - Prospective Evaluation of Breast-Conserving Surgery Alone in Low-Risk Ductal Carcinoma in Situ (DCIS)
Completed NCT02637024 - Trial of Radiation Fractionation Schedules for Once-a-Day Accelerated Partial Breast Irradiation Phase 2
Completed NCT00148655 - Educational Interventions for Patients With DCIS N/A
Suspended NCT03936478 - Real-Time MRI-Guided 3-Fraction Accelerated Partial Breast Irradiation in Early Breast Cancer Phase 2
Recruiting NCT03878342 - Radiotherapy Omission in Low Risk Ductal in Situ Carcinoma Breast N/A
Active, not recruiting NCT04245150 - Assessing the Impact of the Microbiome on Breast Cancer Radiotherapy Toxicity
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Not yet recruiting NCT06217458 - The Added Value of Contrast Enhanced Mammography to Standard Mammography in Assessing the Extent of DCIS N/A
Recruiting NCT04722692 - Delayed Sentinel Lymph Node Biopsy in Ductal Cancer in Situ Phase 3
Enrolling by invitation NCT05868252 - Molecular Analysis of the Sloane Project
Recruiting NCT05912569 - Delayed Selective Sentinel Node Biopsy for Patients Undergoing Mastectomy for DCIS N/A
Recruiting NCT04049214 - Perioperative Mindfulness Proposal N/A
Completed NCT02061332 - DC Vaccine for Patients With Ductal Carcinoma In Situ Phase 1/Phase 2
Recruiting NCT04916808 - The AUS-PREDICT Registry for DCIS Patients With DCISionRT Testing
Withdrawn NCT05436808 - Partial Chest Wall Radiation Therapy After Surgery for Lymph Node Negative Breast Cancer Early Phase 1
Recruiting NCT05900986 - LS301-IT in Partial Mastectomy and Sentinel Lymph Node Biopsy (SLNB) for DCIS or Stage I-II Primary Invasive Breast Cancer Phase 1/Phase 2
Suspended NCT03448926 - The PREDICT Registry for DCIS Patients With DCISionRT Testing

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