Personalized dendritic cell vaccine for recurrent high-grade gliomas

Phase I Clinical Trial of Personalized Dendritic Cell Injection ZSNeo-DC1.1 in the Treatment of Recurrent or Progressive High-grade Glioma

This study is testing a personalized vaccine made from patients' own immune cells to see if it can help adults with recurring high-grade brain tumors fight their cancer better after standard treatments.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 12 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Beijing Tiantan Hospital (Academic / other)
• Drugs / interventions: prednisone
• Locations: 1 site (Beijing, Beijing Municipality)
• Trial ID: NCT06253234 on ClinicalTrials.gov

What this trial studies

This phase I clinical trial evaluates the safety and preliminary efficacy of ZSNeo-DC1.1, a personalized dendritic cell injection, in adult patients with recurrent or progressive WHO grade III-IV gliomas following standard treatment. The trial involves administering autologous dendritic cell vaccines loaded with tumor neoantigen peptides through intrahippocampal injections after surgical reoperation. A total of 15 subjects will receive three injections, with safety and tolerability assessed during the study. The primary focus is to observe the activation of anti-tumor immune responses and monitor any dose-limiting toxicities.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 to 75 with histologically confirmed recurrent or progressive WHO grade III-IV gliomas post-standard treatment.

Not a fit: Patients who are not experiencing recurrence or progression of their gliomas or those with significant comorbidities may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a novel immunotherapy option for patients with recurrent high-grade gliomas, potentially improving their outcomes.

How similar studies have performed: While this approach is innovative, similar studies using dendritic cell vaccines have shown promise in other cancers, indicating potential for success in this context.

Eligibility criteria

Inclusion Criteria:

* Participants must meet all the following criteria to be eligible:

  1. Age from 18 to 75 years (including 18 and 75 years old).
  2. Subjects with histologically or cytologically confirmed WHO grade III-IV gliomas experiencing recurrence or progression after standard treatment.
  3. Bridging therapy is allowed during the preparatory period after sample collection, with discontinuation at least 7 days or 5 drug half-lives (whichever is longer) before the initial treatment.
  4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 2.
  5. Laboratory test results defining satisfactory hematological and organ function:

     Platelets (PLT) ≥ 90 × 10\^9/L; Absolute Neutrophil Count (ANC) ≥ 1.5 × 10\^9/L; Haemoglobin (HGB) ≥ 90 g/L; Serum Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) ≤ 2.5× ULN; Total Bilirubin (TBIL) ≤ 2.5 × ULN; Albumin (ALB) ≥ 3 g/dl; Creatinine clearance rate (CrCl) ≥ 45 mL/minute or Serum Creatinine ≤ 1.5 ×ULN; International Normalized Ratio (INR), Activated Partial Thromboplastin Time (APTT) ≤ 1.5 × ULN; Lipase ≤ 1.5 × ULN; Amylase ≤ 1.5 × ULN; Alkaline Phosphatase (ALP) ≤ 2.5 × ULN.
  6. Adequate tumor and blood samples for NGS gene sequencing can be obtained through tumor reduction surgery or biopsy. Peripheral blood mononuclear cell function is normal.
  7. Relief of any acute, clinically significant treatment-related toxicities (excluding alopecia) to ≤ Grade 1 before the first treatment.
  8. Heart function: Stable hemodynamics, LVEF ≥ 50%.
  9. Adequate venous access for PBMC collection, with no contraindications.
  10. Non-surgically sterilized reproductive-age subjects must use contraception during the study and have a negative pregnancy test.
  11. Expected survival period \> 3 months.
  12. Voluntary participation, signed informed consent.
  13. Based on health and lab assessments, the investigator sees favorable risk-benefit for the subject in the clinical trial.
  14. Subjects must consistently comply, actively participate in follow-up visits, and undergo regular testing and evaluation at the research center throughout the trial.

Exclusion Criteria:

* Subjects meeting any of the following criteria are ineligible:

  1. Recent participation in other drug trials, concurrent anti-tumor therapy (excluding allowed bridging therapy) within 4 weeks before initial treatment, had blood transfusions, EPO, G-CSF, or GM-CSF in the 14 days before peripheral blood mononuclear cell collection, or received live virus vaccinations within 28 days before the first treatment.
  2. Subjects who had camptothecin sustained-release agent implantation surgery within 6 months before the initial treatment.
  3. Active autoimmune diseases, prolonged use of immunosuppressive therapy, or known egg allergy.
  4. Positive for HIV or syphilis antibodies, or active hepatitis B or C.
  5. Recent systemic immunosuppressive treatment within 30 days before the initial treatment.

     Note: Short-term, systemic immunosuppressive treatment may be considered in consultation with the investigator and sponsor approval. The washout period and its duration before the initial treatment will be decided in consultation with the sponsor for these patients.

     Allowed: Inhaled glucocorticoids for COPD, salt corticosteroids (e.g., fludrocortisone) for orthostatic hypotension, and low-dose glucocorticoid supplements (≤10 mg/day prednisone or equivalent) for adrenal insufficiency.
  6. Exclusion: Severe vaccine allergy history, use of attenuated live vaccines within 28 days before initial treatment, or anticipated need within 6 months after the last dose of the investigational drug.
  7. Uncontrolled systemic diseases, including cardiovascular diseases, organ failure, diabetes, and poorly controlled hypertension.
  8. Unmanageable mental illness or significant medical history that may increase risks or interfere with results.
  9. Thrombotic events within the first 6 months before initial treatment, unless anticoagulation can be discontinued during the screening period.
  10. Irreversible electrolyte imbalances.
  11. Severe infection in the first month before initial treatment, poorly controlled infection, or requiring antibiotic treatment within the past week (excluding prophylactic use).
  12. Pregnant or lactating subjects.
  13. Factors judged by the investigator that may necessitate premature study termination, such as non-compliance, other severe diseases requiring concurrent treatment, severe laboratory abnormalities, or family/social factors affecting subject safety or data/sample collection.

Where this trial is running

Beijing, Beijing Municipality

• Beijing Tiantan Hospital, Capital Medical University — Beijing, Beijing Municipality, China (Recruiting)

Study contacts

• Study coordinator: Yang Zhang, Dr

Conditions WHO Grade III Gliomas; WHO Grade IV Gliomas