Vaccine to prevent cocaine effects in dependent individuals

Phase I Randomized, Double-blind, Placebo Control Study for an Anti-cocaine Vaccine

This study is testing a new vaccine that aims to help people with cocaine dependence by blocking the drug's effects on the brain.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 150 (estimated)
• Ages: 21 Years to 69 Years
• Sex: All
• Sponsor: Weill Medical College of Cornell University (Academic / other)
• Locations: 1 site (New York, New York)
• Trial ID: NCT02455479 on ClinicalTrials.gov

What this trial studies

This Phase I clinical trial evaluates the safety and preliminary efficacy of the dAd5GNE vaccine, designed to create immunity against cocaine by preventing it from reaching the brain. The vaccine works by stimulating the immune system to produce antibodies that bind to cocaine molecules, thereby blocking their effects. Participants will receive either the vaccine or a placebo over a 32-week period while concurrently engaging in behavioral therapy. The study aims to assess how well this vaccine can help individuals diagnosed with cocaine dependence.

Who should consider this trial

Good fit: Ideal candidates are adults aged 21 to 69 who have been diagnosed with a cocaine use disorder according to DSM-V-TR criteria.

Not a fit: Patients who do not have a cocaine use disorder or are outside the age range of 21 to 69 may not benefit from this study.

Why it matters

Potential benefit: If successful, this vaccine could provide a novel treatment option for individuals struggling with cocaine dependence.

How similar studies have performed: While this approach is innovative, similar vaccine strategies for substance dependence have shown promise in pre-clinical studies, but this specific vaccine is novel and untested in humans.

Eligibility criteria

Accrual will be random, with no bias as to gender or racial/ethnic group. Because the accrual process will be random, it is possible that there may be differences in the proportion of males and females, and racial/ethnic groups among the study individuals. All subjects will be concurrently participating in behavioral therapy programs run by Dr. Beeder's clinical team. Each case will be reviewed with the Eligibility Committee, comprised of three investigators other than the PI, to determine eligibility. The Principal Investigator will not participate in this process.

All subjects must fulfill all inclusion criteria and none of the exclusion criteria in order to participate in this study.

Inclusion Criteria:

1. All subjects should be able to provide informed consent.
2. Must provide HIV informed consent.
3. Males and females, 21- 69 years of age.
4. Individuals that have been diagnosed with a cocaine use disorder according to DSM-V-TR criteria, with documented evidence of cocaine use within the past 60 days and have previously used an average of 1 to 10 grams of powdered and/or crack cocaine (via insufflation or smoking only) per week. Any prior 1 to 4 month period of cocaine abstinence in the past year will be excluded when calculating average cocaine use to evaluate study eligibility.

6\. Fertile males and females must agree to use adequate forms of contraception for the duration of the entire study.

7\. Body weight \> 45 kg.

Exclusion Criteria:

1. Individuals not deemed in good overall health by the investigator.
2. Diagnosed history of severe psychotic disorders.
3. Abnormal EKG at screening with changes consistent with cardiac disease.
4. History of significant cardiovascular disease, hypertension, prior myocardial infarction and/or cerebrovascular event.
5. Individuals who are currently on beta-blockers.
6. Physical signs or laboratory values suggestive of systemic disorders.
7. History of attempted suicide, as assessed by Columbia-Suicide Severity Rating Scale (C-SSRS) and/or committed homicide.
8. History of diagnosed obsessive compulsive disorder (OCD).
9. Known allergy to soy.
10. Individuals who are currently taking alprazolam (Xanax) or ziprasidone (Geodon).
11. Evidence of active infection of any types, including COVID-19, or positive for human immunodeficiency virus (HIV).
12. Historical or current use of immunomodulators or immunosuppressants \<5 years prior to screening.
13. Receipt of blood within 3 months of screening.
14. Females who are pregnant or nursing.
15. Concurrent participation in any other FDA approved Investigational New Drug.
16. Abnormal liver function (transaminases greater than 2x the upper limit of normal values)
17. eGFR \<30 mL/min/1.73 m2
18. Severe substance use disorder based on DSM-V-TR criteria (excluding cocaine, nicotine, caffeine, alcohol, marijuana and opiates prescribed for medication assisted therapy or pain treatment) currently not in remission according to one of the following criteria:

    * Early Full Remission: This specifier is used if none of the criteria for Dependence or Abuse have been met for at least 1 month, but less than 12 months OR
    * Early Partial Remission: This specifier is used if only one or more (but not all) of the criteria for Dependence or Abuse has/have been met for at least 1 month, but less than 12 months. OR
    * Sustained Full Remission: This specifier is used if none of the criteria for Dependence or Abuse have been met at any time during a period of 12 months or longer OR
    * Sustained Partial Remission: This specifier is used if only one or more (but not all) of the criteria for Dependence or Abuse has/have been met for a period of 12 months or longer OR
    * On Agonist Therapy: This specifier is used if the individual is on a prescribed agonist medication, and none of the criteria for Dependence or Abuse has been met for that class of medication for at least the past month (except tolerance to, or withdrawal from, the agonist). This category also applies to those being treated for Dependence using a partial agonist or an agonist/antagonist OR
    * Substance Use Related Disorder (mild) up to two disorders: Patients that are assessed to have mild substance-use-related disorders according to the DSM-V criteria will be allowed to participate in the study as long as the number of the disorder-resulting substances does not exceed two (with the exception of the nicotine, caffeine, alcohol, marijuana and opiates prescribed for medication assisted therapy or pain treatment).
19. History of any seizure disorder.
20. Individuals with history of Guillain-Barré Syndrome.
21. Diagnosis of \>2 Substance Use Related Disorders (mild) based on DSM-V- TR criteria (excluding nicotine, caffeine, alcohol, marijuana and opiates prescribed for medication assisted therapy or pain treatment
22. On a prescribed agonist medication, with criteria for dependence or abuse for that class ofmedication for at least the past month (except tolerance to, or withdrawal from, the agonist

Where this trial is running

New York, New York

• WCMC Department of Genetic Medicine — New York, New York, United States (Recruiting)

Study contacts

• Principal investigator: Ronald G Crystal, MD — Weill Medical College of Cornell University
• Study coordinator: Sandra Hyde

Conditions Cocaine Dependence; cocaine vaccine; cocaine dependence; Cocaine