ATTAC-IIATTAC-II: A Phase II Randomized, Blinded, and Placebo-controlled Trial of CMV RNA-Pulsed Dendritic Cells With Tetanus-Diphtheria Toxoid Vaccine in Patients With Newly-Diagnosed Glioblastoma
pp65-shLAMP DC with GM-CSF
+ Td
+ unpulsed PBMC and saline
Astrocytoma+7
+ Glioblastoma
+ Glioma
Treatment Study
Summary
Study start date: August 9, 2016
Actual date on which the first participant was enrolled.Dendritic cells (DC) are involved in activating, or turning-on, your body's immune system. Your immune system helps guard your body from germs, viruses, and other threats. Although dendritic cells are very strong, the number of them in the body is not high enough to cause a powerful immune response; therefore, more DC are made in a laboratory with cells collected from an individual's blood. In this study, we will make a vaccine that we hope will educate immune cells to target the pp65 antigen, a type of immune marker in GBM, thus resulting in what we call the pp65 DC vaccine. Use of a vaccine that activates your immune system is a type of immunotherapy. It is hoped that by giving the pp65 DC vaccine as a shot under the skin, the immune system will be activated to attack tumor cells in the brain while leaving normal cells alone. To see if the pp65 DC vaccine is effective for the treatment of GBM, subjects will be assigned to different treatment groups. Two groups of subjects will receive the pp65 DC vaccine and one group will receive a placebo.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.175 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
Abbreviated Inclusion Criteria: To be assessed at study enrollment prior to standard of care chemo-radiation therapy: * Age ≥ 18 years. * Histopathologically proven newly-diagnosed de novo GBM (WHO Grade IV glioma) * The tumor must have a supratentorial component. * Must have undergone definitive surgical resection of tumor with less than approximately 3cm x 3cm residual enhancing tumor as product of longest perpendicular planes by MRI. * Recovery from the effects of surgery, postoperative infection, and other complications. * Diagnostic contrast-enhanced MRI or CT scan of the brain preoperatively and postoperatively. * Karnofsky Performance Status of ≥ 70. * Signed informed consent. * For females of childbearing potential, negative serum pregnancy test. * Women of childbearing potential and male participants must be willing to practice adequate contraception throughout the study and for at least 24 weeks after the last dose of study drug. To be assessed prior to initiation of adjuvant TMZ: * Must have completed RT (targeted total dose of 59.4-60.0 Gy over ≤ 7 weeks) and concomitant TMZ (targeted dose of 75mg/m2/d for ≤ 49 days) therapy without significant toxicity that persisted over 4 weeks. * History \& physical with neurologic examination prior to initiation of adjuvant TMZ. * For patients receiving steroids, daily dose must be ≤ 4 mg. * CBC with differential with adequate bone marrow function. * Adequate renal function. * Adequate hepatic function. Abbreviated Exclusion Criteria: To be verified in order to randomize subject: * Prior invasive malignancy unless disease free for ≥ 3 years. * Metastases detected below the tentorium or beyond the cranial vault and leptomeningeal involvement. * Recurrent or multifocal malignant gliomas. * HIV, Hepatitis B, or Hepatitis C seropositive. * Known active infection or immunosuppressive disease. * Prior chemotherapy or radiosensitizers (including Gliadel wafers) for cancers of the head and neck region. * Prior radiotherapy to the head or neck, resulting in overlap of radiation fields. * Severe, active co-morbidity. * Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception for the entire study period. * Pregnant or lactating women. * Prior allergic reaction to temozolomide, GM-CSF or Td. * Prior history of brachial neuritis or Guillain-Barré syndrome. * Patients treated on any other therapeutic clinical protocols within 30 days prior to study entry. To be assessed prior to initiation of adjuvant TMZ: * Did not start radiation therapy and temozolomide within 7 weeks of surgery. * Progression of disease as defined by modified RANO criteria. * More than 45 days after completion of radiation therapy and temozolomide
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.3 intervention groups are designated in this study
33.333% chance of being blinded to the placebo group
Treatment Groups
Group I
ExperimentalGroup II
PlaceboGroup III
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 3 locations
Orlando Health
Orlando, United StatesDuke University Medical Center
Durham, United States