Response to the SHINGRIX Varicella Zoster Virus (VZV) Vaccine in Chronic Lymphocytic Leukemia (CLL) and CLL Treated With Bruton's Tyrosine Kinase Inhibitor (BTK-I)
Condition: Safety and Tolerability; Compare SHINGRIX Vaccine Response Rates; Chronic Lymphocytic Leukemia (CLL); Small Lymphocytic Lymphoma (SLL)
MeSH terms: Chickenpox; Herpes Zoster; Leukemia; Leukemia, Lymphoid; Leukemia, Lymphocytic, Chronic, B-Cell
Study type: Interventional
Phase: Phase 2

Summary: 
      Background:

      People who have cancer tend to get sick more often. This is in part because of the cancer
      treatments they get. Because of this, they may get shingles. Scientists had thought people
      with chronic lymphocytic leukemia (CLL) should not get the shingles vaccine. Now there is a
      new shingles vaccine that is not live and cannot cause shingles. The new shingles vaccine may
      protect people with weak immune systems from getting shingles. This is currently shown to be
      safe to give people 50 years and older to prevent shingles. Researchers want to test how safe
      the vaccine is and how it works in people with CLL.

      Objective:

      To learn how a new shingles vaccine works in people who have chronic lymphocytic leukemia or
      small lymphocytic lymphoma (SLL).

      Eligibility:

      Adults ages 18 years and older with CLL or SLL who are not being treated for CLL or who are
      getting certain treatments.

      Design:

      Participants will be screened with a chart review or through another protocol.

      Visit 1

      At visit 1, participants may have a pregnancy test, blood test, or physical exam.

      Pregnant participants cannot be in the study.

      Eligible participants will get the shingles vaccine as an injection.

      Participants will receive a diary and write down any symptoms they have for 7 days after the
      vaccines.

      Visit 2

      Visit 2 will be 3 months later. Participants will have blood taken and get another dose of
      the vaccine.

      Participants will receive a diary and write down any symptoms they have for 7 days after the
      vaccines.

      Visit 3

      Visit 3 will be 3 months after visit 2. Participants will have blood taken.

      Participants may be able to get an additional vaccine the same day as the shingles vaccine.
    

Detailed description: 
      This study aims to determine the efficacy of the SHINGRIX varicella zoster virus (VZV)
      vaccine in chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) patients
      that are treatment naive or receiving Bruton s-tyrosine kinase inhibitor (BTK-I). (Note:
      Since CLL and SLL are considered the same disease, CLL/SLL will be referred to as CLL
      hereafter, unless otherwise specified).

      Key Eligibility Criteria:

        -  Diagnosis of CLL or SLL

        -  Cohort 1: Treatment naive CLL or SLL patients

        -  Cohort 2: Subjects must be receiving ibrutinib for at least 6 months prior to
           administration of the first vaccine dose

        -  Cohort 3: Subjects must be receiving acalabrutinib for at least 6 months prior to
           administration of the first vaccine dose

        -  Age greater than or equal to 18 years

        -  ECOG performance status of 0-1

      Design:

      Patients with CLL will enroll on the study for the purpose of determining the SHINGRIX
      vaccine efficacy in patients who are treatment naive or receiving BTK-I therapy. A series of
      2 doses of SHINGRIX will be given at 0- and 3- month schedule by intramuscular injection.
      Subjects will be followed for 6 months and receive assessment of serologic response 6 months
      after the first vaccine dose administration.

      Study Objectives:

      Primary Objective:

      a)Determine the serologic response against VZV after completing the SHINGRIX (RZV) 2-

      dose vaccine series in the following populations:

        -  CLL patients that are treatment naive (n=54)

        -  CLL patients receiving treatment with ibrutinib (n=27)

        -  CLL patients receiving treatment with acalabrutinib (n=27)

      Secondary Objective:

      a) Determine the safety and tolerability of the SHINGRIX vaccine among CLL patients who are
      treatment naive or receiving BTK-Is (ibrutinib or acalabrutinib).
    

Intervention name(s): Zoster Vaccine Recombinant, Adjuvanted
Intervention type(s): Biological
Intervention description(s): A series of 2 doses of SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted) will be given on a 0- and 3-month schedule by intramuscular injection.
Other intervention name(s): SHINGRIX
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: Ibrutinib; Acalabrutinib; Shingles; Herpes