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出境医 / 临床实验 / A Study to Determine if New Types of Malaria Vaccines Are Safe, Effective and Lead to Immunity in Kenyan Adults

A Study to Determine if New Types of Malaria Vaccines Are Safe, Effective and Lead to Immunity in Kenyan Adults

Study Description
Brief Summary:
This is a phase IIb clinical trial in malaria-exposed individuals to assess the immunogenicity, safety and efficacy of the two vaccines in the context of controlled human malaria infection, P. falciparum sporozoite challenge (PfSPZ Challenge).

Condition or disease Intervention/treatment Phase
Malaria,Falciparum Biological: R21/Matrix-M Biological: ChAd63/MVA ME-TRAP Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge Phase 2

Detailed Description:

A total of 64 participants will be enrolled for challenge and divided into four groups as follows:

  • 20 participants to receive R21/Matrix M (R21/MM) with intradermal PfSPZ Challenge;
  • 20 participants to receive viral-vectored ME-TRAP with intradermal PfSPZ Challenge;
  • 10 participants to receive R21/MM with direct venous inoculation PfSPZ Challenge; and
  • 14 participants comprising of the control group with intradermal PfSPZ Challenge.

Blood tests and clinical assessments will be conducted to screen out participants with health conditions that may impact participation in the study.

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 64 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Safety, Immunogenicity, and Efficacy of R21/Matrix-M and ChAd63/MVA-ME-TRAP in the Context of Controlled Human Malaria Infection: A Phase IIb Trial in Kenyan Adults
Estimated Study Start Date : April 2021
Estimated Primary Completion Date : January 2023
Estimated Study Completion Date : January 2023
Arms and Interventions
Arm Intervention/treatment
Experimental: Group 1
Group 1 adults (n=20) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.
Biological: R21/Matrix-M
R21: Protein particle malaria vaccine candidate in Matrix-M: Saponin based vaccine adjuvant.

Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
PfSPZ Challenge: cryopreserved Plasmodium falciparum sporozoites.

Experimental: Group 2
Group 2 adults (n=20) will be receiving 5x10^10 vp ChAd63 ME-TRAP and 2x10^8 pfu MVA ME-TRAP vaccines, 8 weeks apart, and then a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge, 4 weeks later.
Biological: ChAd63/MVA ME-TRAP
ChAd63, chimpanzee adenovirus serotype 63; ME-TRAP, multiple epitope string fused to the thrombospondin-related adhesion protein; MVA, modified vaccinia Ankara.

Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
PfSPZ Challenge: cryopreserved Plasmodium falciparum sporozoites.

Experimental: Group 3
Group 3 adults (n=10) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intravenously (DVI) by inoculation of 3,200 PfSPZ Challenge.
Biological: R21/Matrix-M
R21: Protein particle malaria vaccine candidate in Matrix-M: Saponin based vaccine adjuvant.

Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
PfSPZ Challenge: cryopreserved Plasmodium falciparum sporozoites.

Experimental: Group 4
Group 4 adults (n=14) will be the control group receiving no vaccine, only a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.
Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
PfSPZ Challenge: cryopreserved Plasmodium falciparum sporozoites.

Outcome Measures
Primary Outcome Measures :
  1. Occurrence of solicited local and systemic reactogenicity signs and symptoms, and unsolicited adverse events [ Time Frame: Solicited AEs are collected for 7 days post vaccination and unsolicited AEs for 28 days post vaccination ]
    Assessing the safety and reactogenicity of adjuvanted R21/MM and heterologous prime- boost regime of ChAd63-MVA ME-TRAP in healthy adult volunteers

  2. Occurrence of P. falciparum parasitemia assessed by PCR, and parasite density dynamics assessed by PCR, against malaria sporozoite challenge [ Time Frame: up to 3 months after malaria sporozoite challenge ]
    To assess the safety of intradermal sporozoite infection dose in semi-immune healthy adult volunteers

  3. Occurrence of P. falciparum parasitemia, assessed by qPCR [ Time Frame: from vaccination day up to 90 days after malaria sporozoite challenge ]
    To assess the efficacy of adjuvanted R21 and heterologous prime- boost regime of ChAd63-MVA ME-TRAP against malaria sporozoite challenge, in healthy adult volunteers


Secondary Outcome Measures :
  1. To measure cellular immunogenicity assessed by ELISPOT [ Time Frame: from vaccination day up to 90 days after malaria sporozoite challenge ]
    Assessing cellular immunogenicity by ELISPOT to enumerate IFN-ƴ producing T cells

  2. To measure humoral immunogenicity assessed by ELISA [ Time Frame: from vaccination day up to 90 days after malaria sporozoite challenge ]
    Assessing humoral immunogenicity by ELISA to quantify antibodies to the vaccine components CS, NANP, TRAP and HBsAb.

  3. Parasite density dynamics assessed by qPCR [ Time Frame: up to 3 months after malaria sporozoite challenge ]
    To assess any differences in efficacy estimates with ID versus DVI challenge in individuals receiving R21/MM


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 adults aged 18 to 45 years
  • Able and willing (in the Investigator's opinion) to comply with all study requirements
  • Non-pregnant, non-lactating adult female or adult male
  • Agreement to refrain from blood donation during the study
  • Use of effective method of contraception for the duration of study for female participants. For those with no contraception, they will be referred for contraception at the relevant health facility. For female participants, we will ask them to attend with their family planning records for verification. Effective contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly, in accordance with the product label. Examples of these include: combined oral contraceptives; injectable progestogen; implants of etenogestrel or levonorgestrel; intrauterine device or intrauterine system; male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository); and male condom combined with a female diaphragm, either with or without a vaginal spermicide (foam, gel, film, cream, or suppository)
  • Provide written informed consent
  • Plan to remain resident in the study area for 1 year following first dose of vaccination

Exclusion Criteria:

  • Clinically significant congenital abnormalities as judged by the study clinicians
  • 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).
  • Sickle cell disease
  • Any history of anaphylaxis in relation to vaccination
  • Clinically significant laboratory abnormality as judged by the study clinician
  • Blood transfusion within one month of enrolment
  • Haemoglobin less than 11.3 g/dl for men and less than 10g/dl for in women, where judged to be clinically significant in the opinion of the investigator.
  • Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate
  • Participation in another research study involving receipt of an investigational product in the 30 days preceding enrolment, or planned use during the study period
  • Seropositive for hepatitis B surface antigen (HBsAg) or hepatitis C (HCV IgG)
  • Use of systemic antibiotics with known antimalarial activity within 30 days of administration of PfSPZ Challenge (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin)
  • Women only; pregnancy, or an intention to become pregnant a day before challenge i.e. at C-1
  • Any significant disease, disorder or situation which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial
  • Confirmed parasite positive by PCR a day before challenge i.e. at C-1.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Rachel Roberts +44 (0)1865 611418 vaccinetrials@ndm.ox.ac.uk

Sponsors and Collaborators
University of Oxford
Kenya Medical Research Institute
European and Developing Countries Clinical Trials Partnership (EDCTP)
Tracking Information
First Submitted Date  ICMJE May 7, 2019
First Posted Date  ICMJE May 13, 2019
Last Update Posted Date February 4, 2021
Estimated Study Start Date  ICMJE April 2021
Estimated Primary Completion Date January 2023   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 10, 2019)
  • Occurrence of solicited local and systemic reactogenicity signs and symptoms, and unsolicited adverse events [ Time Frame: Solicited AEs are collected for 7 days post vaccination and unsolicited AEs for 28 days post vaccination ]
    Assessing the safety and reactogenicity of adjuvanted R21/MM and heterologous prime- boost regime of ChAd63-MVA ME-TRAP in healthy adult volunteers
  • Occurrence of P. falciparum parasitemia assessed by PCR, and parasite density dynamics assessed by PCR, against malaria sporozoite challenge [ Time Frame: up to 3 months after malaria sporozoite challenge ]
    To assess the safety of intradermal sporozoite infection dose in semi-immune healthy adult volunteers
  • Occurrence of P. falciparum parasitemia, assessed by qPCR [ Time Frame: from vaccination day up to 90 days after malaria sporozoite challenge ]
    To assess the efficacy of adjuvanted R21 and heterologous prime- boost regime of ChAd63-MVA ME-TRAP against malaria sporozoite challenge, in healthy adult volunteers
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: May 10, 2019)
  • To measure cellular immunogenicity assessed by ELISPOT [ Time Frame: from vaccination day up to 90 days after malaria sporozoite challenge ]
    Assessing cellular immunogenicity by ELISPOT to enumerate IFN-ƴ producing T cells
  • To measure humoral immunogenicity assessed by ELISA [ Time Frame: from vaccination day up to 90 days after malaria sporozoite challenge ]
    Assessing humoral immunogenicity by ELISA to quantify antibodies to the vaccine components CS, NANP, TRAP and HBsAb.
  • Parasite density dynamics assessed by qPCR [ Time Frame: up to 3 months after malaria sporozoite challenge ]
    To assess any differences in efficacy estimates with ID versus DVI challenge in individuals receiving R21/MM
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 A Study to Determine if New Types of Malaria Vaccines Are Safe, Effective and Lead to Immunity in Kenyan Adults
Official Title  ICMJE Safety, Immunogenicity, and Efficacy of R21/Matrix-M and ChAd63/MVA-ME-TRAP in the Context of Controlled Human Malaria Infection: A Phase IIb Trial in Kenyan Adults
Brief Summary This is a phase IIb clinical trial in malaria-exposed individuals to assess the immunogenicity, safety and efficacy of the two vaccines in the context of controlled human malaria infection, P. falciparum sporozoite challenge (PfSPZ Challenge).
Detailed Description

A total of 64 participants will be enrolled for challenge and divided into four groups as follows:

  • 20 participants to receive R21/Matrix M (R21/MM) with intradermal PfSPZ Challenge;
  • 20 participants to receive viral-vectored ME-TRAP with intradermal PfSPZ Challenge;
  • 10 participants to receive R21/MM with direct venous inoculation PfSPZ Challenge; and
  • 14 participants comprising of the control group with intradermal PfSPZ Challenge.

Blood tests and clinical assessments will be conducted to screen out participants with health conditions that may impact participation in the study.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Malaria,Falciparum
Intervention  ICMJE
  • Biological: R21/Matrix-M
    R21: Protein particle malaria vaccine candidate in Matrix-M: Saponin based vaccine adjuvant.
  • Biological: ChAd63/MVA ME-TRAP
    ChAd63, chimpanzee adenovirus serotype 63; ME-TRAP, multiple epitope string fused to the thrombospondin-related adhesion protein; MVA, modified vaccinia Ankara.
  • Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
    PfSPZ Challenge: cryopreserved Plasmodium falciparum sporozoites.
Study Arms  ICMJE
  • Experimental: Group 1
    Group 1 adults (n=20) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.
    Interventions:
    • Biological: R21/Matrix-M
    • Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
  • Experimental: Group 2
    Group 2 adults (n=20) will be receiving 5x10^10 vp ChAd63 ME-TRAP and 2x10^8 pfu MVA ME-TRAP vaccines, 8 weeks apart, and then a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge, 4 weeks later.
    Interventions:
    • Biological: ChAd63/MVA ME-TRAP
    • Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
  • Experimental: Group 3
    Group 3 adults (n=10) will be receiving, 4 weeks apart, three doses of 10µg R21 /50µg Matrix M vaccine, and a CHMI intravenously (DVI) by inoculation of 3,200 PfSPZ Challenge.
    Interventions:
    • Biological: R21/Matrix-M
    • Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
  • Experimental: Group 4
    Group 4 adults (n=14) will be the control group receiving no vaccine, only a CHMI intradermally (ID) by inoculation of 22,500 PfSPZ Challenge.
    Intervention: Biological: intradermal injection (ID) or direct venous injection (DVI) of PfSPZ Challenge
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 Not yet recruiting
Estimated Enrollment  ICMJE
 (submitted: May 10, 2019)
64
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE January 2023
Estimated Primary Completion Date January 2023   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Healthy adults aged 18 to 45 years
  • Able and willing (in the Investigator's opinion) to comply with all study requirements
  • Non-pregnant, non-lactating adult female or adult male
  • Agreement to refrain from blood donation during the study
  • Use of effective method of contraception for the duration of study for female participants. For those with no contraception, they will be referred for contraception at the relevant health facility. For female participants, we will ask them to attend with their family planning records for verification. Effective contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly, in accordance with the product label. Examples of these include: combined oral contraceptives; injectable progestogen; implants of etenogestrel or levonorgestrel; intrauterine device or intrauterine system; male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository); and male condom combined with a female diaphragm, either with or without a vaginal spermicide (foam, gel, film, cream, or suppository)
  • Provide written informed consent
  • Plan to remain resident in the study area for 1 year following first dose of vaccination

Exclusion Criteria:

  • Clinically significant congenital abnormalities as judged by the study clinicians
  • 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).
  • Sickle cell disease
  • Any history of anaphylaxis in relation to vaccination
  • Clinically significant laboratory abnormality as judged by the study clinician
  • Blood transfusion within one month of enrolment
  • Haemoglobin less than 11.3 g/dl for men and less than 10g/dl for in women, where judged to be clinically significant in the opinion of the investigator.
  • Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate
  • Participation in another research study involving receipt of an investigational product in the 30 days preceding enrolment, or planned use during the study period
  • Seropositive for hepatitis B surface antigen (HBsAg) or hepatitis C (HCV IgG)
  • Use of systemic antibiotics with known antimalarial activity within 30 days of administration of PfSPZ Challenge (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin)
  • Women only; pregnancy, or an intention to become pregnant a day before challenge i.e. at C-1
  • Any significant disease, disorder or situation which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial
  • Confirmed parasite positive by PCR a day before challenge i.e. at C-1.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 45 Years   (Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE
Contact: Rachel Roberts +44 (0)1865 611418 vaccinetrials@ndm.ox.ac.uk
Listed Location Countries  ICMJE Not Provided
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03947190
Other Study ID Numbers  ICMJE VAC074
Has Data Monitoring Committee Not Provided
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
  • Kenya Medical Research Institute
  • European and Developing Countries Clinical Trials Partnership (EDCTP)
Investigators  ICMJE Not Provided
PRS Account University of Oxford
Verification Date February 2021

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