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出境医 / 临床实验 / VAC071: A Study to Assess Efficacy of the ChAd63/MVA PvDBP Vaccines

VAC071: A Study to Assess Efficacy of the ChAd63/MVA PvDBP Vaccines

Study Description
Brief Summary:

This is an open label, Phase IIa, controlled human malaria infection (CHMI) study aimed to assess whether the new vivax malaria vaccines ChAd63 PvDBP and MVA PvDBP can protect against malaria infection.

The participants will receive one or two doses of ChAd63 PvDBP followed by one dose of MVA PvDBP 8 weeks later.

Approximately 4 weeks after the second vacccination, the volunteers will be challenged (deliberately infected) with malaria by intravenous injection blood-stage


Condition or disease Intervention/treatment Phase
Malaria, Vivax Biological: ChAd63 PvDBP and MVA PvDBP Phase 2

Detailed Description:

Volunteers will be recruited and vaccinated at the CCVTM, Oxford.

There will be two groups vaccinated in the trial, with an optional third group included if fewer than 6 volunteers complete group 2. Up to 19 volunteers will be included in total. These will be compared to a matched number of infectivity controls, receiving no vaccination, who will be recruited as part of a separate study (VAC069 - NCT03797989).

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 19 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: A Phase IIa Challenge Study to Assess Efficacy of the Plasmodium Vivax Malaria Vaccine Candidates ChAd63 PvDBP and MVA PvDBP in Healthy Adults Living in the UK
Actual Study Start Date : July 18, 2019
Estimated Primary Completion Date : February 2022
Estimated Study Completion Date : February 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: Group 1
3 volunteers receiving 5 x 10^10 vp ChAd63 PvDBP and 2 x 10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen, followed by blood-stage CHMI 2-4 weeks later.
Biological: ChAd63 PvDBP and MVA PvDBP
one dose of 5 x 10^10 vp ChAd63 PvDBP and one dose of 2 x 10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen.

Experimental: Group 2
Up to 10 volunteers receiving one dose of 5 x 10^10 vp ChAd63 PvDBP, 12-18 months later receiving a second dose of 5 x 10^10 vp ChAd63 PvDBP and 8 weeks later 2 x 10^8 pfu MVA PvDBP, followed by blood-stage CHMI 2-4 weeks later.
Biological: ChAd63 PvDBP and MVA PvDBP
one dose of 5 x 10^10 vp ChAd63 PvDBP and one dose of 2 x 10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen.

Experimental: Group 3

If fewer than 6 volunteers complete the study in Group 2, then new volunteers will be recruited into Group 3, to make up a total of 6 volunteers between Groups 2 and 3 who complete all vaccinations and CHMI.

Volunteers in Group 3 will receive 5 x 10^10 vp ChAd63 PvDBP and 2 x10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen, followed by blood-stage CHMI 2-4 weeks later.

Biological: ChAd63 PvDBP and MVA PvDBP
one dose of 5 x 10^10 vp ChAd63 PvDBP and one dose of 2 x 10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen.

Outcome Measures
Primary Outcome Measures :
  1. Efficacy of the ChAd63 and MVA PvDBP vaccines, administered in a heterologous prime-boost regimen, assessed by a reduced parasite multiplication rate in vaccinated subjects [ Time Frame: 3 months ]
    Quantitative PCR-derived parasite multiplication rate (PMR) will be the primary efficacy endpoint and a comparison of the endpoint between Groups 1 and 2 (pooled data) and malaria-naïve controls partaking in simultaneous CHMI, under identical conditions, will constitute the primary analysis for efficacy.


Secondary Outcome Measures :
  1. Safety of the ChAd63 and MVA PvDBP vaccines andidates, administered in a heterologous prime-boost regimen in a CHMI study in healthy volunteers [ Time Frame: for approximately 1 year following priming with ChAd63 PvDBP ]
    The specific endpoints for safety and reactogenicity will be actively and passively collected data on adverse events.

  2. The humoral immunogenicity ChAd63 and MVA PvDBP vaccine candidates, administered in a heterologous prime-boost regimen [ Time Frame: 3 months ]
    Antibody responses to the P. vivax Duffy-binding protein (PvDBP) - total IgG, isotypes and avidity

  3. The cellular immunogenicity ChAd63 and MVA PvDBP vaccine candidates, administered in a heterologous prime-boost regimen [ Time Frame: 3 months ]
    T cell responses to PvDBP by ex-vivo ELISpot and flow cytometry assays and in vitro functional PvDBP_RII inhibitory binding assays.

  4. Immunological readouts for association with a reduced parasite multiplication rate [ Time Frame: 3 months ]
    Statistical correlation between anti-PvDBP antibody responses induced by the ChAd63 and MVA PvDBP vaccines and PMR.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Healthy adult aged 18 to 45 years.
  • Red blood cells positive for the Duffy antigen/chemokine receptor (DARC).
  • Normal serum levels of Glucose-6-phosphate dehydrogenase (G6PD).
  • Able and willing (in the Investigator's opinion) to comply with all study requirements.
  • Willing to allow the Investigators to discuss the volunteer's medical history with their General Practitioner.
  • Women only: Must practice continuous effective contraception* for the duration of the study
  • Agreement to permanently refrain from blood donation
  • Written informed consent to participate in the trial.
  • Reachable (24/7) by mobile phone during the period between CHMI and completion of all antimalarial treatment.
  • Willing to take a curative anti-malarial regimen following CHMI.
  • Willing to reside in Oxford for the duration of the study, until antimalarials have been completed.
  • Answer all questions on the informed consent quiz correctly.

    • Female volunteers are required to use an effective form of contraception during the course of the study as malaria challenge could pose a serious risk to both maternal health and the unborn foetus.

Exclusion Criteria:

  • History of clinical malaria (any species).
  • Travel to a clearly malaria endemic locality during the study period or within the preceding six months.
  • Current or planned treatment with long-acting immune-modifying drugs at any time during the study period (e.g. infliximab).
  • Chronic use of antibiotics with antimalarial effects (e.g. tetracyclines for dermatologic patients, trimethoprim-sulfamethoxazole for recurrent urinary tract infections, etc.).
  • Weight less than 50kg, as measured at the screening visit.
  • Receipt of immunoglobulins within the three months prior to planned administration of the vaccine candidate.
  • Receipt of blood products (e.g., blood transfusion) at any time in the past.
  • Peripheral venous access unlikely to allow twice daily blood testing (as determined by the Investigator).
  • Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period.
  • Receipt of any vaccine in the 30 days preceding enrolment, or planned receipt of any other vaccine within 30 days preceding or following each study vaccination, with the exception of licensed COVID-19 vaccines, which should not be received within 14 days before or 7 days after any study vaccination.
  • Planned receipt of a COVID-19 vaccine between 2 weeks before the day of CHMI until completion of antimalarial treatment
  • Concurrent involvement in another clinical trial or planned involvement during the study period.
  • Prior receipt of an investigational vaccine likely to impact on interpretation of the trial data or the P. vivax parasite as assessed by the Investigator.
  • History of sickle cell anaemia, sickle cell trait, thalassaemia or thalassaemia trait or any haematological condition that could affect susceptibility to malaria infection.
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
  • History of allergic disease or reactions likely to be exacerbated by any component of the vaccine e.g. egg products, Kathon, aminoglycosides.
  • History of allergic disease or reactions likely to be exacerbated by malaria infection.
  • History of clinically significant contact dermatitis.
  • Any history of anaphylaxis in reaction to vaccinations.
  • Pregnancy, lactation or intention to become pregnant during the study.
  • Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone.
  • Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone.
  • Any clinical condition known to prolong the QT interval.
  • History of cardiac arrhythmia, including clinically relevant bradycardia.
  • Disturbances of electrolyte balance, e.g. hypokalaemia or hypomagnesaemia.
  • Family history of congenital QT prolongation or sudden death.
  • Contraindications to the use of both of the proposed anti-malarial medications; Riamet Malarone.
  • History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ).
  • History of serious psychiatric condition that may affect participation in the study.
  • Any other serious chronic illness requiring hospital specialist supervision.
  • Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 25 standard UK units every week.
  • Suspected or known injecting drug abuse in the 5 years preceding enrolment.
  • Hepatitis B surface antigen (HBsAg) detected in serum.
  • Seropositive for hepatitis C virus (antibodies to HCV) at screening or (unless has taken part in a prior hepatitis C vaccine study with confirmed negative HCV antibodies prior to participation in that study, and negative HCV RNA PCR at screening for this study).
  • Positive family history in both 1st AND 2nd degree relatives < 50 years old for cardiac disease.
  • Volunteers unable to be closely followed for social, geographic or psychological reasons.
  • Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. In the event of abnormal test results, confirmatory repeat tests will be requested. Procedures for identifying laboratory values meeting exclusion criteria are shown in SOP VC027.
  • Any other significant disease, disorder, or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data.
  • Inability of the study team to contact the volunteer's GP to confirm medical history and safety to participate.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Volunteer Recruitment Co-ordinator 01865 611424 vaccinetrials@ndm.ox.ac.uk
Contact: Volunteer Recruitment Co-ordinator vaccinetrials@ndm.ox.ac.uk

Locations
Layout table for location information
United Kingdom
Centre for Clinical Vaccinology & Tropical Medicine Recruiting
Oxford, Oxfordshire, United Kingdom, OX3 7LE
Contact: Angela M Minassian    01865 611425    angela.minassian@ndm.ox.ac.uk   
Contact: Fay L Nugent    01865 611412    fay.nugent@ndm.ox.ac.uk   
Sponsors and Collaborators
University of Oxford
Investigators
Layout table for investigator information
Principal Investigator: Angela M Minassian, MBBS MA DPhil MRCP FRCPath University of Oxford
Tracking Information
First Submitted Date  ICMJE July 3, 2019
First Posted Date  ICMJE July 5, 2019
Last Update Posted Date May 26, 2021
Actual Study Start Date  ICMJE July 18, 2019
Estimated Primary Completion Date February 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 3, 2019)
Efficacy of the ChAd63 and MVA PvDBP vaccines, administered in a heterologous prime-boost regimen, assessed by a reduced parasite multiplication rate in vaccinated subjects [ Time Frame: 3 months ]
Quantitative PCR-derived parasite multiplication rate (PMR) will be the primary efficacy endpoint and a comparison of the endpoint between Groups 1 and 2 (pooled data) and malaria-naïve controls partaking in simultaneous CHMI, under identical conditions, will constitute the primary analysis for efficacy.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: July 3, 2019)
  • Safety of the ChAd63 and MVA PvDBP vaccines andidates, administered in a heterologous prime-boost regimen in a CHMI study in healthy volunteers [ Time Frame: for approximately 1 year following priming with ChAd63 PvDBP ]
    The specific endpoints for safety and reactogenicity will be actively and passively collected data on adverse events.
  • The humoral immunogenicity ChAd63 and MVA PvDBP vaccine candidates, administered in a heterologous prime-boost regimen [ Time Frame: 3 months ]
    Antibody responses to the P. vivax Duffy-binding protein (PvDBP) - total IgG, isotypes and avidity
  • The cellular immunogenicity ChAd63 and MVA PvDBP vaccine candidates, administered in a heterologous prime-boost regimen [ Time Frame: 3 months ]
    T cell responses to PvDBP by ex-vivo ELISpot and flow cytometry assays and in vitro functional PvDBP_RII inhibitory binding assays.
  • Immunological readouts for association with a reduced parasite multiplication rate [ Time Frame: 3 months ]
    Statistical correlation between anti-PvDBP antibody responses induced by the ChAd63 and MVA PvDBP vaccines and PMR.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE VAC071: A Study to Assess Efficacy of the ChAd63/MVA PvDBP Vaccines
Official Title  ICMJE A Phase IIa Challenge Study to Assess Efficacy of the Plasmodium Vivax Malaria Vaccine Candidates ChAd63 PvDBP and MVA PvDBP in Healthy Adults Living in the UK
Brief Summary

This is an open label, Phase IIa, controlled human malaria infection (CHMI) study aimed to assess whether the new vivax malaria vaccines ChAd63 PvDBP and MVA PvDBP can protect against malaria infection.

The participants will receive one or two doses of ChAd63 PvDBP followed by one dose of MVA PvDBP 8 weeks later.

Approximately 4 weeks after the second vacccination, the volunteers will be challenged (deliberately infected) with malaria by intravenous injection blood-stage

Detailed Description

Volunteers will be recruited and vaccinated at the CCVTM, Oxford.

There will be two groups vaccinated in the trial, with an optional third group included if fewer than 6 volunteers complete group 2. Up to 19 volunteers will be included in total. These will be compared to a matched number of infectivity controls, receiving no vaccination, who will be recruited as part of a separate study (VAC069 - NCT03797989).

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Condition  ICMJE Malaria, Vivax
Intervention  ICMJE Biological: ChAd63 PvDBP and MVA PvDBP
one dose of 5 x 10^10 vp ChAd63 PvDBP and one dose of 2 x 10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen.
Study Arms  ICMJE
  • Experimental: Group 1
    3 volunteers receiving 5 x 10^10 vp ChAd63 PvDBP and 2 x 10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen, followed by blood-stage CHMI 2-4 weeks later.
    Intervention: Biological: ChAd63 PvDBP and MVA PvDBP
  • Experimental: Group 2
    Up to 10 volunteers receiving one dose of 5 x 10^10 vp ChAd63 PvDBP, 12-18 months later receiving a second dose of 5 x 10^10 vp ChAd63 PvDBP and 8 weeks later 2 x 10^8 pfu MVA PvDBP, followed by blood-stage CHMI 2-4 weeks later.
    Intervention: Biological: ChAd63 PvDBP and MVA PvDBP
  • Experimental: Group 3

    If fewer than 6 volunteers complete the study in Group 2, then new volunteers will be recruited into Group 3, to make up a total of 6 volunteers between Groups 2 and 3 who complete all vaccinations and CHMI.

    Volunteers in Group 3 will receive 5 x 10^10 vp ChAd63 PvDBP and 2 x10^8 pfu MVA PvDBP 8 weeks later, in a heterologous prime-boost regimen, followed by blood-stage CHMI 2-4 weeks later.

    Intervention: Biological: ChAd63 PvDBP and MVA PvDBP
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: February 19, 2021)
19
Original Estimated Enrollment  ICMJE
 (submitted: July 3, 2019)
15
Estimated Study Completion Date  ICMJE February 2022
Estimated Primary Completion Date February 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Healthy adult aged 18 to 45 years.
  • Red blood cells positive for the Duffy antigen/chemokine receptor (DARC).
  • Normal serum levels of Glucose-6-phosphate dehydrogenase (G6PD).
  • Able and willing (in the Investigator's opinion) to comply with all study requirements.
  • Willing to allow the Investigators to discuss the volunteer's medical history with their General Practitioner.
  • Women only: Must practice continuous effective contraception* for the duration of the study
  • Agreement to permanently refrain from blood donation
  • Written informed consent to participate in the trial.
  • Reachable (24/7) by mobile phone during the period between CHMI and completion of all antimalarial treatment.
  • Willing to take a curative anti-malarial regimen following CHMI.
  • Willing to reside in Oxford for the duration of the study, until antimalarials have been completed.
  • Answer all questions on the informed consent quiz correctly.

    • Female volunteers are required to use an effective form of contraception during the course of the study as malaria challenge could pose a serious risk to both maternal health and the unborn foetus.

Exclusion Criteria:

  • History of clinical malaria (any species).
  • Travel to a clearly malaria endemic locality during the study period or within the preceding six months.
  • Current or planned treatment with long-acting immune-modifying drugs at any time during the study period (e.g. infliximab).
  • Chronic use of antibiotics with antimalarial effects (e.g. tetracyclines for dermatologic patients, trimethoprim-sulfamethoxazole for recurrent urinary tract infections, etc.).
  • Weight less than 50kg, as measured at the screening visit.
  • Receipt of immunoglobulins within the three months prior to planned administration of the vaccine candidate.
  • Receipt of blood products (e.g., blood transfusion) at any time in the past.
  • Peripheral venous access unlikely to allow twice daily blood testing (as determined by the Investigator).
  • Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period.
  • Receipt of any vaccine in the 30 days preceding enrolment, or planned receipt of any other vaccine within 30 days preceding or following each study vaccination, with the exception of licensed COVID-19 vaccines, which should not be received within 14 days before or 7 days after any study vaccination.
  • Planned receipt of a COVID-19 vaccine between 2 weeks before the day of CHMI until completion of antimalarial treatment
  • Concurrent involvement in another clinical trial or planned involvement during the study period.
  • Prior receipt of an investigational vaccine likely to impact on interpretation of the trial data or the P. vivax parasite as assessed by the Investigator.
  • History of sickle cell anaemia, sickle cell trait, thalassaemia or thalassaemia trait or any haematological condition that could affect susceptibility to malaria infection.
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
  • History of allergic disease or reactions likely to be exacerbated by any component of the vaccine e.g. egg products, Kathon, aminoglycosides.
  • History of allergic disease or reactions likely to be exacerbated by malaria infection.
  • History of clinically significant contact dermatitis.
  • Any history of anaphylaxis in reaction to vaccinations.
  • Pregnancy, lactation or intention to become pregnant during the study.
  • Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone.
  • Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone.
  • Any clinical condition known to prolong the QT interval.
  • History of cardiac arrhythmia, including clinically relevant bradycardia.
  • Disturbances of electrolyte balance, e.g. hypokalaemia or hypomagnesaemia.
  • Family history of congenital QT prolongation or sudden death.
  • Contraindications to the use of both of the proposed anti-malarial medications; Riamet Malarone.
  • History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ).
  • History of serious psychiatric condition that may affect participation in the study.
  • Any other serious chronic illness requiring hospital specialist supervision.
  • Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 25 standard UK units every week.
  • Suspected or known injecting drug abuse in the 5 years preceding enrolment.
  • Hepatitis B surface antigen (HBsAg) detected in serum.
  • Seropositive for hepatitis C virus (antibodies to HCV) at screening or (unless has taken part in a prior hepatitis C vaccine study with confirmed negative HCV antibodies prior to participation in that study, and negative HCV RNA PCR at screening for this study).
  • Positive family history in both 1st AND 2nd degree relatives < 50 years old for cardiac disease.
  • Volunteers unable to be closely followed for social, geographic or psychological reasons.
  • Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. In the event of abnormal test results, confirmatory repeat tests will be requested. Procedures for identifying laboratory values meeting exclusion criteria are shown in SOP VC027.
  • Any other significant disease, disorder, or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data.
  • Inability of the study team to contact the volunteer's GP to confirm medical history and safety to participate.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 45 Years   (Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE
Contact: Volunteer Recruitment Co-ordinator 01865 611424 vaccinetrials@ndm.ox.ac.uk
Contact: Volunteer Recruitment Co-ordinator vaccinetrials@ndm.ox.ac.uk
Listed Location Countries  ICMJE United Kingdom
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04009096
Other Study ID Numbers  ICMJE VAC071
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party University of Oxford
Study Sponsor  ICMJE University of Oxford
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Angela M Minassian, MBBS MA DPhil MRCP FRCPath University of Oxford
PRS Account University of Oxford
Verification Date May 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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