Vaccine booster for COVID-19 in patients with chronic lymphocytic leukemia

Randomized Observer-Blinded Phase 2 Trial of COVID-19 Booster With GEO-CM04S1 or mRNA Vaccine in Patients With Chronic Lymphocytic Leukemia

This study is testing a new COVID-19 booster vaccine to see if it works better than the standard vaccine for people with chronic lymphocytic leukemia.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: City of Hope Medical Center (Academic / other)
• Drugs / interventions: chimeric antigen receptor, prednisone
• Locations: 1 site (Duarte, California)
• Trial ID: NCT05672355 on ClinicalTrials.gov

What this trial studies

This phase II trial evaluates the effectiveness of the GEO-CM04S1 vaccine compared to the standard of care vaccine in preventing COVID-19 infections among patients with chronic lymphocytic leukemia (CLL). The GEO-CM04S1 vaccine utilizes a modified vaccinia virus (MVA) backbone designed to enhance immune responses, particularly in individuals with compromised immune systems. The study will assess T cell-based immune responses, safety, and the durability of immunity over a 12-month period. Participants will receive either the new vaccine or the standard vaccine and will be monitored for COVID-19 infection rates and immune response metrics.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18 and older with a confirmed diagnosis of chronic lymphocytic leukemia who have received prior COVID-19 vaccinations.

Not a fit: Patients who have not been vaccinated against COVID-19 or those with severe comorbidities may not benefit from this study.

Why it matters

Potential benefit: If successful, this vaccine could significantly improve COVID-19 protection for patients with chronic lymphocytic leukemia.

How similar studies have performed: Other studies have shown promise in using modified viral vectors for vaccine development, suggesting potential success for this approach.

Eligibility criteria

Inclusion Criteria:

* Documented informed consent of the participant and/or legally authorized representative
* Age: \>= 18 years
* Eastern Cooperative Oncology Group (ECOG) =\< 1
* Histologically confirmed diagnosis of CLL according to World Health Organization (WHO) classification
* Prior COVID-19 Vaccination (2 or more Pfizer or Moderna) with last injection \>= 3 months prior
* Fully recovered from the acute toxic effects (except alopecia) to =\< Grade 1 to prior anti-cancer therapy
* White Blood Cells (WBC) \>= 1,000/mm\^3 (To be performed within 14 days prior to Day 1 of protocol therapy)
* Platelets \>= 50,000/mm\^3 (To be performed within 14 days prior to Day 1 of protocol therapy)
* Total bilirubin =\< 1.5 X upper limit of normal (ULN) (unless has Gilbert's disease) (To be performed within 14 days prior to Day 1 of protocol therapy)
* Aspartate aminotransferase (AST) =\< 2.5 x ULN (To be performed within 14 days prior to Day 1 of protocol therapy)
* Alanine transaminase (ALT) =\< 2.5 x ULN (To be performed within 14 days prior to Day 1 of protocol therapy)
* Creatinine clearance \<1.5 ULN (To be performed within 14 days prior to Day 1 of protocol therapy)
* Women of childbearing potential (WOCBP): negative urine or serum pregnancy test (To be performed within 14 days prior to Day 1 of protocol therapy)

  * If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
* Agreement by females and males of childbearing potential to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 6 weeks after the last vaccine injection

  * Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for \> 1 year (women only)

Exclusion Criteria:

* Known current SARS CoV-2 infection
* Prior Evusheld or other anti-SARS CoV-2 prophylaxis \< 2 weeks prior
* Prior hematopoietic cell transplantation (HCT) or chimeric antigen receptor (CAR) T cell therapy within the previous year
* Systemic corticosteroids required for chronic conditions at doses \> 0.5mg/kg/day prednisone equivalent within 7 days of enrollment
* Intensive cytotoxic therapies, T-cell depleting therapies, within 30 days of enrollment; however, patients with stable disease on maintenance therapies are allowed (See ConMeds for lists of acceptable and contraindicated therapies)
* Participants who have had a live vaccine =\< 30 days prior to administration of any dose of study vaccine or subjects who are =\< 2 weeks within administration of inactivated vaccines (e.g., influenza vaccine). Flu shots are allowed \> 2 weeks before a study vaccine injection and \> 2 weeks post study vaccine injection
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to study agent (e.g., egg allergies)
* Active infection not controlled on appropriate therapy
* History of adverse event with a prior smallpox vaccination
* History of pericarditis or myocarditis
* Any MVA vaccine or poxvirus vaccine in the last 12 months
* Females only: Pregnant or breastfeeding
* Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures
* Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)

Where this trial is running

Duarte, California

• City of Hope Medical Center — Duarte, California, United States (Recruiting)

Study contacts

• Principal investigator: Alexey V Danilov — City of Hope Medical Center

Conditions Chronic Lymphocytic Leukemia; COVID-19 Infection