A Phase 2 interventional study of Laboratory Biomarker Analysis and Placebo Administration in Stage I Prostate Adenocarcinoma AJCC v7 and Stage II Prostate Adenocarcinoma AJCC v7, sponsored by National Cancer Institute (NCI). Completed at 7 sites in United States. Open to male participants. Per ClinicalTrials.gov, last updated 2023-07-19.
Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Prevention
This randomized phase II trial studies how well PROSTVAC (prostate-specific antigen [PSA]-TRICOM) works in preventing disease progression in patients with prostate cancer undergoing active surveillance. Vaccines made from a person's tumor cells may help the body build an effective immune response to kill tumor cells that express PSA.
PRIMARY OBJECTIVES:
I. To determine the effect of rilimogene-galvacirepvec (PROSTVAC) on the change (from pre to post-intervention) in CD8+ positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
II. To determine the effect of PROSTVAC on the change in CD4+ positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
SECONDARY OBJECTIVES:
I. To assess the effect of PROSTVAC on PD-L1 positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
II. To assess the correlation between the change in CD8+ and the change in PSA. III. To assess the effect of PROSTVAC on CD8+, CD4+, and PD-L1 positive cells in the benign portion of the prostate biopsies.
IV. To assess the effect of PROSTVAC on the change in PSA. V. To assess the effect of PROSTVAC on tumor grade (Gleason score). VI. To assess the effect of PROSTVAC on tumor extent (percent of positive random biopsy cores).
VII. To compare the proportion of men on the two study arms with no cancer on post-intervention biopsy.
VIII. To assess the effect of PROSTVAC on the size of the dominant lesion on magnetic resonance imaging (MRI) (largest histopathologically confirmed lesion) in the subgroup of patients with MRIs pre and postintervention.
IX. To assess the effect of PROSTVAC on circulating 15-Mer PSA-specific, MUC-1 and Brachyury-specific T cells.
X. To assess the effect of PROSTVAC on soluble antibodies to tumor-associated antigens.
XI. To assess the immunologic effects of PROSTVAC in prostate tissue using multiplex immunofluorescence.
XII. To assess the safety and feasibility of PROSTVAC in the active surveillance population.
XIII. To assess the effect of PROSTVAC on lower urinary tract symptoms (LUTS) in the active surveillance population.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive rilimogene-galvacirepvec subcutaneously (SC) at baseline and on days 14, 28, 56, 84, 112, and 140.
ARM II: Patients receive placebo SC at baseline and on days 14, 28, 56, 84, 112, and 140.
After completion of study treatment, patients are followed up for 30 days and then at 6 months.
6,370 studies on the registry are indexed under Prostatic Neoplasms; 1,400 are open to participants now.
This study's enrollment of 154 is above the median of 58 across 4,822 interventional studies indexed under Prostatic Neoplasms.
Browse Prostatic Neoplasms studies →National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.
Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.
Counted across the registry records on this site, refreshed daily.
Biopsy-proven (consisting of >= 10 tissue cores) adenocarcinoma of the prostate with cancer present in at least one biopsy core, either random or targeted, in the most recent biopsy
Exclusion Criteria:
Prior or concurrent eczema or other eczemoid skin disorders or active skin condition (acute, chronic, or exfoliative) that disrupts the epidermis; persons with psoriasis are not excluded except in cases of:
Patients receive rilimogene-galvacirepvec SC at baseline and on days 14, 28, 56, 84, 112, and 140.
Other: Laboratory Biomarker Analysis · Biological: Rilimogene Galvacirepvec
Patients receive placebo SC at baseline and on days 14, 28, 56, 84, 112, and 140.
Other: Laboratory Biomarker Analysis · Other: Placebo Administration
Correlative studies
Given SC
Given SC
Also known as: PROSTVAC, Prostvac-V, Recombinant Vaccinia-PSA(L155)-TRICOM Vaccine, Recombinant Vaccinia-PSA(L155)/TRICOM, Recombinant Vaccinia-PSA(L155)/TRICOM Vaccine, rVaccinia-Prostate-Specific Antigen/TRICOM Vaccine, rVaccinia-PSA(L155)-TRICOM Vaccine
Change in CD8+ Positive Cells in the Stroma Adjacent to Tumor and Within the Malignant Portion of the Prostate Biopsies
change (from pre to post-intervention) in CD8+ positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
Time frame: Baseline to up to 14 days after the last dose
Change in CD4+ Positive Cells in the Stroma Adjacent to Tumor and Within the Malignant Portion of the Prostate Biopsies
change (from pre to post-intervention) in CD4+ positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
Time frame: Baseline to up to 14 days after the last dose
Change in PD-L1 Positive Cells in the Stroma Adjacent to Tumor and Within the Malignant Portion of the Prostate Biopsies
Change (from pre to post-intervention) in PD-L1 positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies
Time frame: Baseline to 6 months post-intervention
Change in Prostate-specific Antigen (PSA)
Change (from baseline to 6 months post-intervention) in prostate-specific antigen (PSA)
Time frame: Baseline to 6 months post-intervention
Change in CD8+ Positive Cells in the Benign Portion of the Prostate Biopsies
Change (from pre to post-intervention) in CD8+ positive cells in the benign portion of the prostate biopsies
Time frame: Baseline to up to 14 days after the last dose
Change in CD4+ Positive Cells in the Benign Portion of the Prostate Biopsies
Change (from pre to post-intervention) in CD4+ positive cells in the benign portion of the prostate biopsies
Time frame: Baseline to up to 14 days after the last dose
Change in PD-L1 Positive Cells in the Benign Portion of the Prostate Biopsies
Change (from pre to post-intervention) in PD-L1 positive cells in the benign portion of the prostate biopsies
Time frame: Baseline to up to 14 days after the last dose
Tumor Grade Progression
Assessed by the proportion of men with an increase in Gleason score to \>= 4+3 from baseline to post-intervention biopsy. The Gleason score is determined by adding the two most common grades. The Gleason score usually ranges from 6 to 10. Higher numbers indicate a faster growing cancer that is more likely to spread.
Time frame: Baseline to up to 14 days after the last dose
Change in Tumor Extent
Assessed by change (from pre to post-intervention) in percent positive random cores
Time frame: Baseline to up to 14 days after the last dose
Proportion of Men With no Cancer in the Post-intervention Biopsy
Assessed by the proportion of patients with no cancer on the post-intervention biopsy
Time frame: Up to 14 days after the last dose
Size of Dominant MRI Lesion
The size of dominant MRI lesion.
Time frame: Up to 14 days after the last dose
Change in Circulating 15-Mer PSA-specific T Cells
Change (from pre to post-intervention) in circulating 15-Mer PSA-specific T cells
Time frame: Baseline to up to 14 days after the last dose
Change in Soluble Antibodies to Tumor-associated Antigens
Change (from pre to post-intervention) in soluble antibodies to tumor-associated antigens
Time frame: Baseline to up to 14 days after the last dose
Immunologic Effects on the Target Organ Using Multiplex Immunofluorescence
Time frame: Up to 14 days after the last dose
Change in International Prostate Symptom Score
Change (from baseline to 6 months post-intervention) in International Prostate Symptom Score (IPSS). The IPSS score ranges from 0-35. Higher scores mean a worse symptom.
Time frame: Baseline to up to 6 months post-intervention
| Milestone | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Started | 106 | 48 |
| Completed | 103 | 47 |
| Not completed | 3 | 1 |
change (from pre to post-intervention) in CD8+ positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
| number of positive cells per mm^2 | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in CD8+ Positive Cells in the Stroma Adjacent to Tumor and Within the Malignant Portion of the Prostate Biopsies | 12.2 ± 151.4 | -6.9 ± 154 |
change (from pre to post-intervention) in CD4+ positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies.
| number of positive cells per mm^2 | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in CD4+ Positive Cells in the Stroma Adjacent to Tumor and Within the Malignant Portion of the Prostate Biopsies | 4.6 ± 166.7 | 5.8 ± 261.1 |
Change (from pre to post-intervention) in PD-L1 positive cells in the stroma adjacent to tumor and within the malignant portion of the prostate biopsies
No measurements were reported for this outcome.
Change (from baseline to 6 months post-intervention) in prostate-specific antigen (PSA)
| ng/ml | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in Prostate-specific Antigen (PSA) | 0.26 ± 2.36 | -0.66 ± 3.49 |
Change (from pre to post-intervention) in CD8+ positive cells in the benign portion of the prostate biopsies
| number of positive cells per mm^2 | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in CD8+ Positive Cells in the Benign Portion of the Prostate Biopsies | 7.22 ± 202.94 | 45.25 ± 198.25 |
Change (from pre to post-intervention) in CD4+ positive cells in the benign portion of the prostate biopsies
| number of positive cells per mm^2 | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in CD4+ Positive Cells in the Benign Portion of the Prostate Biopsies | 73.41 ± 287.74 | -19.75 ± 206.59 |
Change (from pre to post-intervention) in PD-L1 positive cells in the benign portion of the prostate biopsies
No measurements were reported for this outcome.
Assessed by the proportion of men with an increase in Gleason score to \>= 4+3 from baseline to post-intervention biopsy. The Gleason score is determined by adding the two most common grades. The Gleason score usually ranges from 6 to 10. Higher numbers indicate a faster growing cancer that is more likely to spread.
| Participants | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Tumor Grade Progression | 8 | 6 |
Assessed by change (from pre to post-intervention) in percent positive random cores
| percentage of total cores | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in Tumor Extent | -1.7 ± 16.1 | 1.6 ± 15.2 |
Assessed by the proportion of patients with no cancer on the post-intervention biopsy
| Participants | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Proportion of Men With no Cancer in the Post-intervention Biopsy | 25 | 8 |
The size of dominant MRI lesion.
No measurements were reported for this outcome.
Change (from pre to post-intervention) in circulating 15-Mer PSA-specific T cells
No measurements were reported for this outcome.
Change (from pre to post-intervention) in soluble antibodies to tumor-associated antigens
No measurements were reported for this outcome.
No measurements were reported for this outcome.
Change (from baseline to 6 months post-intervention) in International Prostate Symptom Score (IPSS). The IPSS score ranges from 0-35. Higher scores mean a worse symptom.
| score on a scale | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Change in International Prostate Symptom Score | -0.12 ± 4.67 | 0.87 ± 3.57 |
Collected over 30 days after the last study dose was given. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Arm I (Rilimogene-galvacirepvec) | 1/106 (0.9%) | 1/106 (0.9%) | 103/106 (97.2%) |
| Arm II (Placebo) | 0/48 (0%) | 0/48 (0%) | 48/48 (100%) |
| Event | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| FallInjury, poisoning and procedural complications | 1/106 | 0/48 |
| Event | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) |
|---|---|---|
| Injection site reactionGeneral disorders | 95/106 | 45/48 |
| Flu like syndromesHepatobiliary disorders | 63/106 | 30/48 |
| FatigueGeneral disorders | 43/106 | 14/48 |
| HeadacheNervous system disorders | 23/106 | 9/48 |
| FeverGeneral disorders | 17/106 | 6/48 |
| DiarrheaGastrointestinal disorders | 10/106 | 6/48 |
| Upper respiratory infectionInfections and infestations | 10/106 | 4/48 |
| DizzinessNervous system disorders | 10/106 | 0/48 |
| NauseaGastrointestinal disorders | 9/106 | 2/48 |
| White blood cell decreasedInvestigations | 1/106 | 4/48 |
| Age, Continuous(years) | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) | Total |
|---|---|---|---|
| Mean | 65 ± 7 | 64 ± 8 | 64 ± 8 |
| Sex: Female, Male(Participants) | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) | Total |
|---|---|---|---|
| Female | 0 | 0 | 0 |
| Male | 106 | 48 | 154 |
| Ethnicity (NIH/OMB)(Participants) | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) | Total |
|---|---|---|---|
| Hispanic or Latino | 4 | 1 | 5 |
| Not Hispanic or Latino | 98 | 45 | 143 |
| Unknown or Not Reported | 4 | 2 | 6 |
| Race (NIH/OMB)(Participants) | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 3 | 0 | 3 |
| Native Hawaiian or Other Pacific Islander | 1 | 0 | 1 |
| Black or African American | 7 | 5 | 12 |
| White | 91 | 43 | 134 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 4 | 0 | 4 |
| Region of Enrollment(participants) | Arm I (Rilimogene-galvacirepvec) | Arm II (Placebo) | Total |
|---|---|---|---|
| United States | 106 | 48 | 154 |
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