Clinical trial NCT04810910: Personalized Neoantigen Vaccine in Pancreatic Cancer Patients Following Surgical Resection and Adjuvant Chemotherapy
Official title: Clinical Study of a Personalized Neoantigen Vaccine in Pancreatic Cancer Patients Following Surgical Resection and Adjuvant Chemotherapy
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
Conditions: Resectable Pancreatic Cancer
Lead sponsor: Zhejiang Provincial People's Hospital
Sponsor class: OTHER
Collaborators: name: Hangzhou Neoantigen Therapeutics Co., Ltd.
First posted: 2021-03-23
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This research study is evaluating a new type of pancreatic cancer vaccine called "Personalized Neoantigen Cancer Vaccine" as a possible treatment for pancreatic cancer patients following surgical resection and adjuvant chemotherapy. The purpose of the clinical study is evaluating the safety, tolerability and partial efficacy of the personalized neoantigen cancer vaccine in the treatment of resectable pancreatic cancer, so as to provide a new personalized therapeutic strategy.

It is known that cancer patients have mutations (changes in genetic material) that are specific to an individual patient and tumor. These mutations can cause the tumor cells to produce proteins that appear very different from the body's own cells. It is possible that these proteins used in a vaccine may induce strong immune responses, which may help the participant's body fight any tumor cells that could cause the cancer to come back in the future. The study will examine the safety of the vaccine when given at several different time points and will examine the participant's blood cells for signs that the vaccine induced an immune response.


Eligibility criteria: Inclusion Criteria：

1. Must freely sign informed consent;
2. Aged 18 to 70 years old;
3. Histologically or cytologically confirmed diagnosis of pancreatic adenocarcinoma;
4. Must provide all exons of tumor tissue sequencing data, transcriptome sequencing data and the peripheral blood of all exons sequencing data;
5. ECOG score is 0 or 1;
6. Completed an R0 or R1 surgical resection as determined by pathology；
7. Completion of at least 4 months of adjuvant chemotherapy with ticgio monotherapy or mFOLFIRINOX;
8. Completion of imaging records 1 week before personalized immunotherapy, including but not limited to full-body PET-CT and brain MRI,
9. The end of chemotherapy is followed by a one-week natural washout period；
10. Haematological index：

    * White blood cells ≥ 3500 / MCL
    * Lymphocytes \> 800/ MCL
    * neutrophils \> 1500/ MCL
    * Platelets \> 100000 / MCL
    * Hemoglobin \>10.0g/dL
    * Total serum bilirubin \<1.5× upper limit of normal value (ULN)
    * AST/ALT\<2.0 times the upper limit of normal
    * Serum creatinine \<1.5 times the upper limit of normal；
11. Pregnant, lactating women and women of child-bearing age must have a negative pregnancy test within 7 days before entering the group, and short-term have no fertility plan, and are willing to take protective measures (contraception or other birth control methods) before and during the clinical trial;
12. Good compliance, able to follow research protocols and follow-up procedures.

Exclusion Criteria:

1. Evidence of disease recurrence or metastasis following surgical resection at any time prior to the first vaccination administration.
2. Diagnosed as other malignant tumor;
3. No neoantigen was found in the sequencing data;
4. There have been bone marrow or stem cell transplants;
5. Received systemic glucocorticoids with immunosuppressants;
6. Received other polypeptide inoculation 4 weeks before treatment; Patients may not be vaccinated with other polypeptides 8 weeks after the last individualized tumor targeted polypeptides trentment;
7. With HIV, HCV, HBV infection, severe asthma, autoimmune disease, immunodeficiency or treated with immunosuppressive drugs;
8. Uncontrolled complications include, but are not limited to, active infection, symptomatic congestive heart failure, unstable angina pectoris, and arrhythmias;
9. Infected with herpes virus (except those with scabs of more than 4 weeks)；
10. Infected with respiratory virus (except those who have recovered for more than 4 weeks);
11. Have severe coronary or cerebrovascular disease, or other conditions considered ineligible by the investigator;
12. Drug abuse. Clinical, psychological or social factor result in affecting informed consent or research implementation;
13. Have a history of drug or polypeptide allergies, or people who are allergic to other potential immunotherapies.

Primary outcomes:
measure: Number of participants experiencing clinical and laboratory adverse events (AEs)
timeFrame: 1 years
measure: Relapse Free Survival(RFS)
timeFrame: 4 years
Secondary outcomes:
measure: Overall Survival(OS)
timeFrame: 4 years
Other outcomes:
measure: Measurement of CD4/CD8 T lymphocyte subsets
timeFrame: 2 years
measure: The polypeptide antigen - induced IFN-γ T cells responses
timeFrame: 2 years
measure: Peripheral blood T cell receptor sequencing analysis
timeFrame: 2 years
Locations:
city: Hangzhou
country: China
facility: Zhejiang Provincial People's Hospital
state: Zhejiang
Study officials:
affiliation: Zhejiang Provincial People's Hospital
name: Yang Liu, Liu
role: PRINCIPAL_INVESTIGATOR
References: