A Phase I Study To Evaluate The Antitumor Activity And Safety Of DUKE-002-VRP(HUHER2-ECD+TM), An Alphaviral Vector Encoding The HER2 Extracellular Domain And Transmembrane Region, In Patient With Locally Advanced Or Metastatic Human Epidermal Growth Factor Receptor 2-Positive (HER2+) Cancers Including Breast Cancer
Metastatic breast cancer continues to account for more than 400,000 deaths yearly with HER2
positive breast cancers representing approximately one third of cases. Despite the efficacy
of trastuzumab in HER2 overexpressing breast cancer, progression of metastatic disease is
inevitable. Lapatinib, when combined with capecitabine, improves time to progression in
those with trastuzumab resistant disease, but lapatinib resistance also develops in the
majority of these patients. HER2 overexpression is also reported in lung, gastric, ovarian,
and pancreatic cancers, all of which are also in need of improved treatment options. Because
HER2 continues to be expressed in patients with refractory disease, using an
immune-targeting approach against HER2 remains a promising strategy. A number of clinical
trials have confirmed the ability of vaccines to activate T cell and antibody responses
against HER2. We propose using a propagation-defective, single-cycle, RNA replicon vector
system that expresses HER2 as an antigen-specific cancer vaccine in a Phase I clinical trial
in patients with advanced or metastatic malignancies expressing HER2. The vaccine was
prepared from an attenuated strain of an alphavirus in which 3 of the 7 viral genes were
removed and replaced with a HER2 gene to create a self-amplifying RNA (replicon) that
expresses large amounts of HER2. The HER2 gene used includes the extracellular domain (ECD)
and transmembrane (TM) regions of HER2 but not the ICD region. The HER2 ECDTM replicon is
packaged into virus-like replicon particles (VRP) by providing the alphavirus structural
proteins from separate RNA molecules. When VRP are used for immunization, the VRP infect
individual cells and the replicon expresses HER2 which then induces an immune response.
The primary objective of the study is to evaluate the safety of immunization with HER2 ECDTM
VRP in patients with advanced or metastatic HER2-expressing malignancies. The study will
also monitor immune responses to HER2. Preliminary data on tumor response rate will also be
collected.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label
Safety
The primary objective of the study is to evaluate the safety of immunization with HER2 ECDTM VRP in patients with advanced or metastatic HER2-expressing malignancies
3 months
Yes
Michael Morse, MD
Principal Investigator
Duke University
United States: Food and Drug Administration
Pro00034612
NCT01526473
September 2012
September 2015
Name | Location |
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Duke University Medical Center | Durham, North Carolina 27710 |