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QUILT-3.038: Active Immunotherapy CEA Vaccine in Patients With Malignancies Expressing CEA

A Phase I/II Study of Active Immunotherapy With Ad5 [E1-,E2b-]-CEA(6D) Vaccine in Patients With Advanced or Metastatic Malignancies Expressing CEA

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01147965
Enrollment
43
Registered
2010-06-22
Start date
2010-07-16
Completion date
2017-05-31
Last updated
2025-11-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer, Colorectal Cancer, Lung Cancer, Prostate Cancer

Keywords

Colon Cancer, Lung Cancer, Breast Cancer, CEA, Prostate Cancer

Brief summary

The purpose of this study is to find out what effects (good and bad) that a cancer vaccine has on you and your cancer. The cancer vaccine is called Ad5 \[E1-, E2b-\]-CEA(6D)or ETBX-011 and is made by Etubics. This vaccine is based on a virus called an adenovirus but it has been changed to express the protein CEA that is found on some cancer cells. Therefore, the vaccine can tell the immune system to attack cancer cells which make CEA. The investigators are trying to determine whether giving this virus is safe and whether this causes a strong immune system attack on the cancer. ETBX-011 is an investigational drug.

Detailed description

This is a phase I/II study with the primary purpose to determine the safety of immunization with Ad5 \[E1-, E2B-\]-CEA(6D), in patients with advanced or metastatic CEA-expressing malignancies. The secondary objectives are to evaluate CEA-specific immune responses to the immunizations and to obtain preliminary data on clinical response rate. The study population consists of patients with a histologically confirmed diagnosis of metastatic malignancy that is CEA positive who were previously treated with standard therapy known to have a possible survival benefit or refused such therapy. The study will determine the safety of three dosage levels of Ad5 \[E1-, E2B-\]-CEA(6D) vaccine (phase I component), and the maximally tolerated dose of Ad5 \[E1-, E2B-\]-CEA(6D) vaccine (phase II component). The study drug is Ad5 \[E1-, E2B-\]-CEA(6D) given by subcutaneous (SQ) injection every 3 weeks for 3 immunizations. We will evaluate safety in each cohort at least 3 weeks after the last patient in the previous cohort has received their first injection. A dosing scheme will be considered safe if \<33% of patients treated at a dosage level experience DLT (e.g., 0 of 3, ≤1 of 6, ≤3 of 12 or ≤5 of 18 patients). We are currently enrolling up to 10 additional patients (Cohort 6) to evaluate safety, immunogenicity, and efficacy at the highest dose of vaccine.

Interventions

BIOLOGICALAd5 CEA Vaccine

Ad5 \[E1-, E2b-\]-CEA(6D) Vector Vaccine

Sponsors

NantCell, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
21 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

1. Histologically confirmed diagnosis of malignancy expressing CEA. Because this is a safety and immunogenicity study, patients are NOT required to have measurable or evaluable disease by Response Evaluation Criteria in Solid Tumors (RECIST). 2. For all tumor types other than colorectal, the tumor must express CEA as defined by immunohistochemical staining (at least 50% of the tumor with at least moderate intensity of staining) or a tumor known to be universally CEA positive (i.e. colon and rectal cancer). If colorectal cancer then, pathologic or clinical confirmation of adenocarcinoma is required. 3. Patients must have received treatment with standard therapy known to have a possible overall survival benefit. For the following common cancers, the following eligibility criteria apply: * Colorectal cancer: Must have received and progressed through at least one line of palliative chemotherapy consisting of one of the following regimens: * Palliative chemotherapy for metastatic colorectal cancer with 5 fluorouracil (or capecitabine) and oxaliplatin. * Palliative chemotherapy for metastatic colorectal cancer with 5 fluorouracil (or capecitabine) and irinotecan. * Palliative chemotherapy regimen for metastatic colorectal cancer that includes bevacizumab. * Colorectal cancer patients currently receiving palliative single-agent bevacizumab or cetuximab will be eligible for this trial and may continue these therapies concomitant with study treatment (if they have been on these single agent therapies for at least 3 months). * Breast cancer: Must have received and progressed through at least one line of chemotherapy for metastatic breast cancer consisting of one of the following regimens: * Palliative anthracycline- or taxane-based chemotherapy * Patients with tumors that over express HER2 (IHC 3+ or FISH+) must have received and progressed through at least one line of palliative therapy that combines trastuzumab with chemotherapy. * Breast cancer patients currently receiving palliative endocrine therapy or single-agent trastuzumab will be eligible for this trial and may continue these therapies concomitant with study treatment (if they have been on these single agent therapies for at least 3 months). * Patients who have been treated or offered the options of treatment with Bevacizumab (option clearly stated in the consent form). * Patients who have been treated or offered the options of treatment with Lapatinib (option clearly stated in the consent form). * Lung cancer: Must have received and progressed through chemotherapy for metastatic disease consisting of one of the following regimens: * Palliative platinum-based (cisplatin or carboplatin) chemotherapy if the patient has not received chemotherapy previously. * Palliative taxane-based (docetaxel or paclitaxel) or vinorelbine chemotherapy if the patient has received chemotherapy previously. * Lung cancer patients currently receiving palliative single-agent erlotinib or gefitinib will be eligible for this trial and may continue these therapies concomitant with study treatment (if they have been on these single agent therapies for at least 3 months). * Pancreatic cancer: Must have received and progressed through chemotherapy including gemcitabine. \- Pancreatic cancer patients currently receiving palliative single-agent erlotinib will be eligible for this trial and may continue this therapy concomitant with study treatment (if they have been on this single agent therapy for at least 3 months). * For other malignancies, if a first line therapy with survival or palliative benefit exists, it should have been administered and there should have been progressive disease. * Patients who have received and progressed through first-line palliative chemotherapy must be advised regarding second-line therapy before being enrolled on this investigational study. 4. Karnofsky performance score of 70% or higher 5. Estimated life expectancy \> 3 months 6. Age ≥ 21 years, but \< 75 7. Adequate hematologic function, with WBC ≥ 3000/microliter, hemoglobin ≥ 9 g/dL (it is acceptable to have had prior transfusion), platelets ≥ 75,000/microliter; PT-INR \<1.5, PTT \<1.5X ULN 8. Adequate renal and hepatic function, with serum creatinine \< 1.5 mg/dL, bilirubin \< 1.5 mg/dL (except for Gilbert's syndrome which will allow bilirubin ≤ 2.0 mg/dL), ALT and AST ≤ 2.5 x upper limit of normal. 9. Patients who have received prior CEA-targeted immunotherapy are eligible for this trial, if this treatment was discontinued at least 3 months prior to enrollment. 10. Patients who are taking medications that do not have a known history of immunosuppression are eligible for this trial. 11. Ability to understand and provide signed informed consent that fulfills Institutional Review Board's guidelines. 12. Ability to return to the clinical site for adequate follow-up, as required by this protocol.

Exclusion criteria

1. Patients with concurrent cytotoxic chemotherapy or radiation therapy should be excluded. There are no exclusions based on the number of prior chemotherapy, biologic, hormonal, or experimental regimens. Except for the permitted concomitant therapies (bevacizumab, cetuximab, trastuzumab, erlotinib, gefitinib, or hormonal therapy which patients must have been on for at least 3 months at the time of enrollment if they intend to continue them with the vaccine), there must be at least 3 months between any prior CEA-targeted immunotherapy and study treatment and at least 4 weeks between any other prior therapy (including radiotherapy) and study treatment. Patients must have recovered to grade 1 acute toxicities from prior treatment. 2. Patients with a history of or current brain metastases will not be permitted. 3. Patients with a history of autoimmune disease, such as but not restricted to, inflammatory bowel disease, systemic lupus erythematosus, ankylosing spondylitis, scleroderma, or multiple sclerosis. Autoimmune related thyroid disease and vitiligo are permitted. 4. Patients with serious intercurrent chronic or acute illness, such as cardiac disease (NYHA class III or IV), hepatic disease, or other illness considered by the Principal Investigator as unwarranted high risk for investigational drug treatment. 5. Patients with a medical or psychological impediment to probable compliance with the protocol should be excluded. 6. Concurrent (or within the last 5 years) second malignancy other than non melanoma skin cancer, cervical carcinoma in situ, controlled superficial bladder cancer, or other carcinoma in situ that has been treated. 7. Presence of an active acute or chronic infection including: a urinary tract infection, HIV (as determined by ELISA and confirmed by Western Blot). Patients with HIV are excluded based on immunosuppression, which may render them unable to respond to the vaccine; patients with chronic hepatitis are excluded because of concern that hepatitis could be exacerbated by the injections. 8. Patients on steroid therapy (or other immunosuppressives, such as azathioprine or cyclosporin A) are excluded on the basis of potential immune suppression. Patients must have had 6 weeks of discontinuation of any steroid therapy (except that used as pre-medication for chemotherapy or contrast-enhanced studies) prior to enrollment. 9. Pregnant and nursing women should be excluded from the protocol since this research may have unknown and harmful effects on an unborn child or on young children. If the patient is sexually active, the patient must agree to use a medically acceptable form of birth control while receiving treatment and for a period of 4 months following the last vaccination therapy. It is not known whether the treatment used in this study could affect the sperm and could potentially harm a child that may be fathered while on this study. 10. Patients with acute or chronic skin disorders that will interfere with injection into the skin of the extremities or subsequent assessment of potential skin reactions will be excluded. 11. Patients will be allowed warfarin 1mg po qd other than for port prophylaxis. 12. Patients with metastatic disease which is determined to be resectable will be excluded.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Dose Limiting ToxicitiesEvery 3 weeks for 9 weeks and every 3 months for 1 yearThe primary objective of this protocol is to determine the safety of immunization with Ad5 \[E1-, E2b-\]-CEA(6D) in patients with advanced or metastatic CEA-expressing malignancies. A dosing scheme will be considered safe if \<33% of patients treated at a dosage level experience DLT (e.g., 0 of 3, ≤1 of 6, ≤3 of 12 or ≤5 of 18 patients).
Number of Participants With Adverse Eventsfrom the time of first dose to the 30 days past last dose of study drug, up to 330 days

Secondary

MeasureTime frameDescription
Clinical Response Ratefrom first dose up to a year follow upClinical response was assessed for participants that achieve a clinical response of complete response (CR) or partial response (PR), according to RECISIT criteria (v1.0 for Cohorts 1-5 and v1.1 for Cohort 6). CR is defined as disappearance of all target lesions. PR is defined as \>=30% decrease in the sum of the longest diameter of target lesions.
Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline (Week 0) up to Week 9Cell mediated immune response was characterized using ELISpot assays performed on Peripheral Blood Mononuclear Cells to determine the number of IFN-gamma secreting cells.
CEA Antibody (ng/mL) by VisitBaseline (Week 0) to Week 9Summary of CEA Antibody (ng/mL) by Visit

Countries

United States

Participant flow

Pre-assignment details

Endpoints were tabulated as planned for the 43 patients by cohorts.

Participants by arm

ArmCount
Cohort 1
1x10\^9 VP (0.5 mL)
3
Cohort 2
1x10\^10 VP (0.5 mL)
4
Cohort 3
1x10\^11 VP (0.5 mL)
7
Cohort 4
(Phase II Cohort at MTD): Ad5 \[E1-, E2b-\]-CEA(6D) at a dose of 1 x 10\^11 particles
14
Cohort 5
5x10\^11 VP (2.5 mL)
6
Cohort 6
5x10\^11 VP (1.0 mL)
9
Total43

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Overall StudyAdministration Of Alternative Therapy000001
Overall StudyDeath001102
Overall StudyOther000310
Overall StudyProgressive Disease335955
Overall StudyWithdrawal by Subject001100

Baseline characteristics

CharacteristicCohort 1TotalCohort 6Cohort 5Cohort 4Cohort 3Cohort 2
Age, Continuous61.0 years
STANDARD_DEVIATION 7.21
58.8 years
STANDARD_DEVIATION 8.56
62.1 years
STANDARD_DEVIATION 7.46
55.5 years
STANDARD_DEVIATION 11.86
61.7 years
STANDARD_DEVIATION 8.31
54.0 years
STANDARD_DEVIATION 4.8
52.8 years
STANDARD_DEVIATION 7.8
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants2 Participants0 Participants0 Participants2 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants1 Participants0 Participants0 Participants1 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
3 Participants40 Participants9 Participants6 Participants11 Participants7 Participants4 Participants
Sex: Female, Male
Female
1 Participants20 Participants7 Participants3 Participants5 Participants3 Participants1 Participants
Sex: Female, Male
Male
2 Participants23 Participants2 Participants3 Participants9 Participants4 Participants3 Participants
Subjects with advanced or metastatic malignancies expressing CEA3 Participants43 Participants9 Participants6 Participants14 Participants7 Participants4 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
3 / 33 / 46 / 78 / 144 / 67 / 9
other
Total, other adverse events
2 / 33 / 46 / 710 / 146 / 69 / 9
serious
Total, serious adverse events
0 / 31 / 42 / 71 / 141 / 62 / 9

Outcome results

Primary

Number of Participants With Adverse Events

Time frame: from the time of first dose to the 30 days past last dose of study drug, up to 330 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Cohort 1Number of Participants With Adverse Events2 Participants
Cohort 2Number of Participants With Adverse Events3 Participants
Cohort 3Number of Participants With Adverse Events6 Participants
Cohort 4Number of Participants With Adverse Events10 Participants
Cohort 5Number of Participants With Adverse Events6 Participants
Cohort 6Number of Participants With Adverse Events9 Participants
Primary

Number of Participants With Dose Limiting Toxicities

The primary objective of this protocol is to determine the safety of immunization with Ad5 \[E1-, E2b-\]-CEA(6D) in patients with advanced or metastatic CEA-expressing malignancies. A dosing scheme will be considered safe if \<33% of patients treated at a dosage level experience DLT (e.g., 0 of 3, ≤1 of 6, ≤3 of 12 or ≤5 of 18 patients).

Time frame: Every 3 weeks for 9 weeks and every 3 months for 1 year

Population: Safety population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Cohort 1Number of Participants With Dose Limiting Toxicities0 Participants
Cohort 2Number of Participants With Dose Limiting Toxicities0 Participants
Cohort 3Number of Participants With Dose Limiting Toxicities0 Participants
Cohort 4Number of Participants With Dose Limiting Toxicities0 Participants
Cohort 5Number of Participants With Dose Limiting Toxicities0 Participants
Cohort 6Number of Participants With Dose Limiting Toxicities0 Participants
Secondary

CEA Antibody (ng/mL) by Visit

Summary of CEA Antibody (ng/mL) by Visit

Time frame: Baseline (Week 0) to Week 9

Population: Safety Population

ArmMeasureGroupValue (MEAN)Dispersion
Cohort 1CEA Antibody (ng/mL) by VisitBaseline0.0470 ng/mLStandard Deviation 0.02291
Cohort 1CEA Antibody (ng/mL) by VisitWeek 90.0760 ng/mLStandard Deviation 0.11953
Cohort 2CEA Antibody (ng/mL) by VisitBaseline0.0310 ng/mLStandard Deviation 0.004
Cohort 2CEA Antibody (ng/mL) by VisitWeek 90.0307 ng/mLStandard Deviation 0.01106
Cohort 3CEA Antibody (ng/mL) by VisitBaseline0.0690 ng/mLStandard Deviation 0.09319
Cohort 3CEA Antibody (ng/mL) by VisitWeek 90.1157 ng/mLStandard Deviation 0.10571
Cohort 4CEA Antibody (ng/mL) by VisitBaseline0.0709 ng/mLStandard Deviation 0.09117
Cohort 4CEA Antibody (ng/mL) by VisitWeek 90.0439 ng/mLStandard Deviation 0.05536
Cohort 5CEA Antibody (ng/mL) by VisitBaseline0.3193 ng/mLStandard Deviation 0.21676
Cohort 5CEA Antibody (ng/mL) by VisitWeek 90.3665 ng/mLStandard Deviation 0.19723
Cohort 6CEA Antibody (ng/mL) by VisitBaseline0 ng/mLStandard Deviation 0
Cohort 6CEA Antibody (ng/mL) by VisitWeek 90 ng/mLStandard Deviation 0
Secondary

Clinical Response Rate

Clinical response was assessed for participants that achieve a clinical response of complete response (CR) or partial response (PR), according to RECISIT criteria (v1.0 for Cohorts 1-5 and v1.1 for Cohort 6). CR is defined as disappearance of all target lesions. PR is defined as \>=30% decrease in the sum of the longest diameter of target lesions.

Time frame: from first dose up to a year follow up

Population: Safety Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Cohort 1Clinical Response Rate0 Participants
Cohort 2Clinical Response Rate0 Participants
Cohort 3Clinical Response Rate0 Participants
Cohort 4Clinical Response Rate0 Participants
Cohort 5Clinical Response Rate0 Participants
Cohort 6Clinical Response Rate0 Participants
Secondary

Immune Response Against CEA - IFN-gamma Secreting Cells by Visit

Cell mediated immune response was characterized using ELISpot assays performed on Peripheral Blood Mononuclear Cells to determine the number of IFN-gamma secreting cells.

Time frame: Baseline (Week 0) up to Week 9

ArmMeasureGroupValue (MEAN)Dispersion
Cohort 1Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 36.7 Spot-forming cells per 1,000,000 PBMCStandard Deviation 5.77
Cohort 1Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 90.0 Spot-forming cells per 1,000,000 PBMCStandard Deviation 0
Cohort 1Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline1.0 Spot-forming cells per 1,000,000 PBMCStandard Deviation 1.73
Cohort 1Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 616.0 Spot-forming cells per 1,000,000 PBMCStandard Deviation 23.52
Cohort 2Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 326.3 Spot-forming cells per 1,000,000 PBMCStandard Deviation 43.04
Cohort 2Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 61.7 Spot-forming cells per 1,000,000 PBMCStandard Deviation 2.89
Cohort 2Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 913.3 Spot-forming cells per 1,000,000 PBMCStandard Deviation 23.09
Cohort 2Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline8.5 Spot-forming cells per 1,000,000 PBMCStandard Deviation 7.59
Cohort 3Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline183.8 Spot-forming cells per 1,000,000 PBMCStandard Deviation 448.83
Cohort 3Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 3270.4 Spot-forming cells per 1,000,000 PBMCStandard Deviation 585.78
Cohort 3Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 6242.7 Spot-forming cells per 1,000,000 PBMCStandard Deviation 449.4
Cohort 3Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 959.0 Spot-forming cells per 1,000,000 PBMCStandard Deviation 98.77
Cohort 4Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 3100.2 Spot-forming cells per 1,000,000 PBMCStandard Deviation 154.91
Cohort 4Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline32.8 Spot-forming cells per 1,000,000 PBMCStandard Deviation 68.42
Cohort 4Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 678.7 Spot-forming cells per 1,000,000 PBMCStandard Deviation 110.54
Cohort 4Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 9188.4 Spot-forming cells per 1,000,000 PBMCStandard Deviation 364.15
Cohort 5Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 982.4 Spot-forming cells per 1,000,000 PBMCStandard Deviation 93.84
Cohort 5Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 3181.3 Spot-forming cells per 1,000,000 PBMCStandard Deviation 226.02
Cohort 5Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline19.2 Spot-forming cells per 1,000,000 PBMCStandard Deviation 32.88
Cohort 5Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 6214.4 Spot-forming cells per 1,000,000 PBMCStandard Deviation 191.11
Cohort 6Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 627.6 Spot-forming cells per 1,000,000 PBMCStandard Deviation 64.34
Cohort 6Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 910.3 Spot-forming cells per 1,000,000 PBMCStandard Deviation 13.29
Cohort 6Immune Response Against CEA - IFN-gamma Secreting Cells by VisitWeek 39.0 Spot-forming cells per 1,000,000 PBMCStandard Deviation 18.73
Cohort 6Immune Response Against CEA - IFN-gamma Secreting Cells by VisitBaseline29.5 Spot-forming cells per 1,000,000 PBMCStandard Deviation 44.96

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026