a study of cmv vaccine (hb-101) in kidney transplant patients

Conditions: Cytomegalovirus (CMV) Infection; Kidney Transplantation

Summary: hb-101 is a bivalent recombinant vaccine against human cmv infection. this is a randomized, placebo-controlled, phase 2 study to assess the safety, reactogenicity, immunogenicity, and efficacy of hb-101 in cmv-seronegative patients receiving a kidney transplant from a cmv-seropositive living donor and cmv-seropositive patients.patients enrolled should have a living donor kidney transplantation ideally planned between two to four months after the first injection of study drug (hb-101 or placebo).

this is a randomized, placebo-controlled, phase 2 study to assess the safety, reactogenicity, immunogenicity, and efficacy of hb-101 in adult patients awaiting kidney transplantation. for groups 1 and 2, adult cmv-seronegative (-) patients awaiting kidney transplant from a cmv-seropositive (+) living donor will be enrolled according to treatment intent with regard to the method of cmv prevention after transplant (either preemptive or prophylactic). this will be defined at study enrollment by the investigator and institutional standards. patients enrolled in group 1 and 2 will be randomized to receive hb-101 or placebo. for group 3, adult cmv-seropositive (+) patients awaiting kidney transplant from either cmv-seropositive(+) or cmv-seronegative(-) living donors will be enrolled. group 3 will be open label where all patients will receive hb-101. the post transplant management for group 3 patients will also follow either preemptive or prophylactic method per the institution standards. the intent of the study is to administer three doses of the study drug (hb-101 or placebo) prior to transplantation and within proximity to the time of transplantation. however, two doses of study drug will be sufficient for the patients to be included in the efficacy analyses if a third dose of study drug is not feasible due to transplantation timelines. patients will not receive study drug after transplantation. patients will be recruited globally from transplant centers. the total duration of the study of each patient participating in the study will be approximately 15 months.

Eligibility criteria:
inclusion criteria: patients who meet all of the following key inclusion criteria will be eligible to participate in the study: 1. male or female patients 18 years of age or older. 2. patients must be eligible to undergo kidney transplantation from a living donor as per institutional standards. 3. for groups 1 and 2 only: patients must be cmv immunoglobulin g (igg) seronegative (-) and receiving kidney for transplantation from donors who are cmv igg seropositive (+). 4. for group 3 only: patients must be cmv immunoglobulin g (igg) seropositive (+) and receiving kidney for transplantation from donors who are either cmv igg seronegative (-) or seropositive (+). 5. patients who would comply with the requirements of this protocol (e.g., return for follow up visits), as judged by the investigator. exclusion criteria: patients who meet any of the following key criteria will be excluded from the study: 1. patients planning to undergo multi-organ transplantation. 2. patients participating in another interventional clinical study. 3. previous vaccination with an investigational cmv vaccine. 4. any confirmed or suspected immunodeficiency disorder (based on medical history and physical examination) that could interfere with the immune response or that presents a risk for the patient to receive a vaccine candidate in development. 5. treatment with any chronic immunosuppressive medication or other immuno modifying drugs within 6 months prior to study entry. however, inhaled and topical steroids and low-dose oral corticosteroids (\<10 milligrams a day of prednisone or equivalent) are allowed. 6. prior history of cmv disease or cmv infection requiring anti-viral therapy 7. patients with a rash, dermatological condition, or tattoo in the area of the injection site(s) that could interfere with administration site reaction rating. (note: the injection site(s) can be the non-dominant arm \[most preferred injection site\], dominant arm, or either thigh \[least preferred injection site\], as judged by the investigator). 8. it is anticipated that the patient will be unavailable to complete the study follow-up. 9. patients who are highly sensitized or who are likely to undergo desensitization at time of transplant (e.g., donor-specific antibody titers at the local laboratory \>2000).

Keywords: solid organ transplantation vaccine