Phase 2 Trial of a Novel Peptide Vaccine (PEP-CMV) Targeting CMV Antigen for Newly Diagnosed Pediatric High-grade Glioma and Diffuse Intrinsic Pontine Glioma and Recurrent Medulloblastoma
Nationwide Children's Hospital
Summary
This study will address the question of whether targeting CMV antigens with PEP-CMV can serve as a novel immunotherapeutic approach in pediatric patients with newly-diagnosed high-grade glioma (HGG) or diffuse intrinsic pontine glioma (DIPG) as well as recurrent medulloblastoma (MB). PEP-CMV is a vaccine mixture of a peptide referred to as Component A. Component A is a synthetic long peptide (SLP) of 26 amino acid residues from human pp65. The SLPs encode multiple potential class I, class II, and antibody epitopes across several haplotypes. Component A will be administered as a stable water:oil emulsion in Montanide ISA 51. Funding Source - FDA OOPD
Description
This phase II clinical trial will have 3 strata in order to assess the efficacy of a highly immunogenic CMV-directed peptide vaccines in children with (1) recurrent medulloblastoma (rMB), (2) newly-diagnosed high-grade gliomas (HGG) and (3) newly-diagnosed diffuse intrinsic pontine glioma (DIPG). Each stratum will run independently with a different endpoint and statistical design. Within each stratum, the populations that may be used for analysis are defined as: * Safety Analysis: Patients who receive at least 1 dose of the treatment will be used for safety analyses. * Efficacy Analysis: Pat…
Eligibility
- Age range
- 3–39 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria for patients with recurrent /progressive medulloblastoma (stratum I) 1. Age: Patients must be ≥3 and ≤39 years of age at the time of study enrollment 2. Diagnosis: Patients must have a diagnosis of medulloblastoma that is recurrent, progressive or refractory. All patients must have histological verification of a medulloblastoma, at original diagnosis or relapse. • Patients must have measurable disease defined as a lesion that can be measured in two perpendicular diameters on MRI. 3. Metastatic Disease: Patients with M+ disease are eligible. 4. Performance Status: Ka…
Interventions
- BiologicalPEP-CMV
The PEP-CMV vaccine will be administered as follows: 250 µg/m2 (up to a maximum of 500 µg) of Component A mixed with Montanide ISA-51 (1:1 volume ratio) intradermally administered half in the RIGHT groin and half in the LEFT groin.
- DrugTemozolomide
Patients will receive one course of temozolomide 200 mg/m2/day x 5 days on Days 1-5 of cycle 1
- BiologicalTetanus Diphtheria Vaccine
Patients will receive a tetanus (Td) booster (Td 5 flocculation units, Lf) at the time of enrollment. Immunotherapy begins with a Td pre-conditioning vaccine (Td 1 Lf, in 0.4 mL of saline) delivered i.d. at the RIGHT groin site of the vaccine injection 6-24 hours prior to the first vaccine on day 21.
Locations (12)
- Children's Hospital ColoradoAurora, Colorado
- Children's National Medical CenterWashington D.C., District of Columbia
- Nicklaus Children's HospitalMiami, Florida
- Ann & Robert H. Lurie Children's Hospital of ChicagoChicago, Illinois
- Dana-Farber Cancer InstituteBoston, Massachusetts
- St. Louis Children's HospitalSt Louis, Missouri