Multiple Myeloma Clinical Trial
Official title:
Phase I/II Combination Immunotherapy After ASCT for Advanced Myeloma to Study HTERT Vaccination Followed by Adoptive Transfer of Vaccine-Primed Autologous T Cells
The purpose of this study is:
1. To evaluate the safety of activated T cell infusions and immunization with hTERT
multi-peptide vaccine in the post-transplant setting and whether the combination can
delay hematopoietic recovery or induce other autoimmune events.
2. To determine whether the strategy of infusing vaccine-primed T-cells early after
transplant in conjunction with post-transplant boosters leads to the induction of
cellular immune responses to hTERT.
This protocol proposes to combine two different investigational products to test the
hypothesis that autologous T cell therapy can augment the potency of a putative tumor vaccine
post- stem cell transplant, and lead to a myeloma-directed T-cell mediated "graft vs.
myeloma" effect in patients with advance myeloma. The hope is that this combination therapy
approach will result in a more rapid recovery of acquired immunity and consequently increased
cure rates and better clinical outcomes. The two investigational products to be evaluated in
this Phase I/II study include:
1. hTERT Vaccine (the putative tumor vaccine)- a multi-peptide vaccine consisting of 3
peptides against the catalytic subunit of telomerase (hTERT D988Y, I540, and R572Y), 1
survivin peptide (Sur1M2- an antiapoptotic protein), and 1 CMV (cytopeptide (N495).
2. T cell therapy- T-cells isolated from the patient and activated/expanded ex vivo by
antiCD3/28 beads.
This is a two-site study at the University of Pennsylvania and University of Maryland to
recruit a total of fifty-six study patients. The key eligibility criteria are patients who
have systemic or multifocal myeloma requiring autologous stem cell transplantation. After
enrollment, patients will be divided into two arms (A and B) according to their HLA A2 status
(A = HLA A2 +, B = HLA A2-). Patients in ARM A will be initially immunized with the hTERT
vaccine along with a pneumococcal conjugate vaccine (PCV); patients in ARM B will be
initially immunized and given boosters of PCV only. All patients will undergo T-cell harvest,
stem cell mobilization and collection, high-dose chemotherapy, autologous stem cell
transplant (ASCT), and an infusion of expanded T cells at day 2 after ASCT. Patients in ARM A
will then receive three hTERT/PCV vaccine boosters at day 14, 42, and 90 after ASCT.
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