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HEPLISAV-B Hepatitis B Vaccine in Chronic Lymphocytic Leukemia (CLL) and CLL Treated With Bruton's-Tyrosine Kinase Inhibitor (BTK-I)

Response to the HEPLISAV-B Hepatitis B Vaccine in Treatment Naive Chronic Lymphocytic Leukemia (CLL) and CLL Treated With Bruton's -Tyrosine Kinase Inhibitor (BTK-I)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03685708
Enrollment
78
Registered
2018-09-26
Start date
2018-12-07
Completion date
2020-12-16
Last updated
2022-02-08

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

Conditions

Hepatitis, Safety and Tolerability

Keywords

Ibrutinib, Acalabrutinib, Immunology

Brief summary

Background: People with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) tend to get infections more easily. This is because their immune systems are weakened. Hepatitis B is a virus that can be transmitted when body fluids from an infected person enter the body of an uninfected person. This virus can be dangerous for people with leukemia and lymphoma. HEPLISAV-B is a new hepatitis B vaccine. Researchers want to see if it can protect people with CLL/SLL from getting hepatitis B. Objective: To learn how HEPLISAV-B works in people who have CLL or SLL. Eligibility: Adults 18 years and older with CLL (or SLL). They must be getting no treatment for their CLL, or getting ibrutinib or acalabrutinib for it. Design: This study lasts 6 months from the date of first vaccination. Participants may be screened with: Physical exam Blood tests Pregnancy test Visit 1 Participants will get blood drawn and the study vaccine. It will be given as an injection. If they get any symptoms within 7 days of the vaccine, they will write them in a diary. Visit 2 After 3 months, participants will come back to the NIH to get another blood draw and the second vaccine dose. Visit 3 Participants will return 3 months after the second vaccine dose was given. They will have blood drawn.

Detailed description

This study aims to determine the HEPLISAV-B hepatitis B vaccine efficacy in chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) lymphocytic patients that are treatment naive or receiving Bruton s-tyrosine kinase inhibitor (BTK-I) therapy. (Note: Since CLL and SLL are considered the same disease, CLL/SLL will be referred to as CLL hereafter, unless otherwise specified). Key Eligibility Criteria: 1. Diagnosis of CLL 2. Cohort 1: Treatment naive CLL or SLL patients 3. Cohort 2: Subjects must be receiving ibrutinib monotherapy for at least 6 months prior to administration of the first vaccine dose 4. Cohort 3: Subjects must be receiving acalabrutinib monotherapy for at least 6 months prior to administration of the first vaccine dose 5. No known active or past hepatitis B infection 6. No history of prior hepatitis B virus vaccination (approved or investigational) 7. Age greater greater than or equal to 18 years. 8. ECOG performance status of 0-1 Design: Patients with CLL will enroll on the study for the purpose of determining the HEPLISAV-B vaccine efficacy in patients who are treatment naive ore receiving BTK-I therapy. A series of 2 doses of HEPLISAV-B will be given on a 0- and 3- month schedule by intramuscular injection. Subjects will be followed at regular intervals and receive serologic response assessment following completion of the HEPLISAV-B vaccine series (6 months after the first vaccine administration). Study Objectives: Primary Objective: a) Determine the rate of hepatitis B seroprotective titer achievement (anti-HBs greater than or equal to 10mIU/mL) following completion of the HEPLISAV-B 2-dose vaccine series (6 months after the first vaccine administration) in the following populations: * CLL patients who are treatment naive (n=54) * CLL patients receiving treatment with ibrutinib (n=27) * CLL patients receiving treatment with acalabrutinib (n=27) Secondary Objective: a) Determine the safety and tolerability of the HEPLISAV-B vaccine among CLL patients who are treatment naive or receiving BTK-Is (ibrutinib or acalabrutinib).

Interventions

BIOLOGICALHEPLISAV-B

HEPLISAV-B (Hepatitis B Vaccine \[Recombinant \], adjuvanted) vaccine - A series of 2 doses (0.5 ml each) will be given on a 0- and 3- month schedule via intramuscular injection.

Sponsors

National Heart, Lung, and Blood Institute (NHLBI)
Lead SponsorNIH

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No

Inclusion criteria

* INCLUSION CRITERIA: * Diagnosis of CLL/SLL which is made according to the updated criteria of the NCI Working Group. * No known active or past hepatitis B infection * No history of prior hepatitis B virus vaccination (approved or investigational) * History of negative hepatitis B viral titers (negative HBsAg, HBsAb and HBcAb) * Cohort 1: Treatment naive CLL patients * Cohort 2: Subjects must be receiving ibrutinib monotherapy for at least 6 months prior to administration of the first vaccine dose * Cohort 3: Subjects must be receiving acalabrutinib monotherapy for at least 6 months prior to administration of the first vaccine dose * Age greater than or equal to 18 years. * ECOG performance status of 0-1 * Able to comprehend the investigational nature of the protocol and provide informed consent.

Exclusion criteria

* Female patients who are currently pregnant. * Any uncontrolled active systemic infection * Any life-threatening illness, medical condition, or organ system dysfunction that, in the investigator s opinion, could compromise the subject s safety or put the study outcomes at undue risk * History of severe allergic reaction to any component of HEPLISAV-B, including yeast * Receive intravenous or subcutaneous immunoglobulin (IVIG) within 3 months prior to vaccination * Concomitant use of immunosuppressive agents (e.g. steroids, radiotherapy, chemotherapy) * Hereditary or acquired immunodeficiency syndrome unrelated to CLL * Non-English speaking individuals will be excluded from the study

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With HEPLISAV-B Seroprotective Titer (Anti-HBs 10mIU/mL)6 months after the first vaccine administrationDetermine the rate of hepatitis B seroprotective titer achievement (anti-HBs 10mIU/mL) following completion of the HEPLISAV-B 2-dose vaccine series (6 months after the first vaccine administration) among chronic lymphocytic leukemia (CLL) patients who are treatment naïve or receiving Bruton Tyrosine Kinase (BTK) inhibitors (Ibrutinib or Acalabrutinib).

Secondary

MeasureTime frameDescription
Number of Participants That Experienced Serious Adverse Events Following HEPLISAV-B Vaccine Among CLL Patients6 months after the first vaccine administrationDetermine the safety of the HEPLISAV-B vaccine among chronic lymphocytic leukemia (CLL) patients who are treatment naïve or receiving Bruton Tyrosine Kinase (BTK) inhibitors (Ibrutinib or Acalabrutinib).
Number of Participants That Did Not Complete Study Due to Intolerance of the HEPLISAV-B Vaccine Among CLL Patients.6 months after the first vaccine administrationDetermine the tolerability of the HEPLISAV-B vaccine among chronic lymphocytic leukemia (CLL) patients who are treatment naïve or receiving Bruton Tyrosine Kinase (BTK) inhibitors (Ibrutinib or Acalabrutinib).

Countries

United States

Participant flow

Recruitment details

A total of 78 participants were assessed for eligibility and consented. 76 participants met eligibility criteria.

Participants by arm

ArmCount
Chronic Lymphocytic Leukemia Patients Receiving Treatment With Acalabrutinib
Acalabrutinib monotherapy for at least 6 months prior to administration of the first vaccine dose in patients with Chronic Lymphocytic Leukemia (CLL) or small lymphocytic lymphoma (SLL). Patients will receive HEPLISAV-B (Hepatitis B Vaccine \[Recombinant \], adjuvanted) vaccine - A series of 2 doses (0.5 ml each) will be given on a 0- and 3- month schedule via intramuscular injection.
14
Chronic Lymphocytic Leukemia Patients Receiving Treatment With Ibrutinib
Ibrutinib monotherapy for at least 6 months prior to administration of the first vaccine dose in patients with Chronic Lymphocytic Leukemia (CLL) or small lymphocytic lymphoma (SLL). Patients will receive HEPLISAV-B (Hepatitis B Vaccine \[Recombinant \], adjuvanted) vaccine - A series of 2 doses (0.5 ml each) will be given on a 0- and 3- month schedule via intramuscular injection.
18
Chronic Lymphocytic Leukemia Patients That Are Treatment Naïve
Treatment naïve Chronic Lymphocytic Leukemia (CLL) or small lymphocytic lymphoma (SLL) patients will receive HEPLISAV-B (Hepatitis B Vaccine \[Recombinant \], adjuvanted) vaccine - A series of 2 doses (0.5 ml each) will be given on a 0- and 3- month schedule via intramuscular injection.
46
Total78

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyCOVID 19 Pandemic116
Overall StudyDisease Progression001
Overall StudyScreen Fail011
Overall StudyWithdrawal by Subject001

Baseline characteristics

CharacteristicChronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibChronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibChronic Lymphocytic Leukemia Patients That Are Treatment NaïveTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
5 Participants12 Participants24 Participants41 Participants
Age, Categorical
Between 18 and 65 years
9 Participants6 Participants22 Participants37 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants1 Participants2 Participants3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
14 Participants17 Participants43 Participants74 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
Black or African American
1 Participants0 Participants2 Participants3 Participants
Race (NIH/OMB)
More than one race
1 Participants1 Participants1 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
12 Participants17 Participants42 Participants71 Participants
Sex: Female, Male
Female
3 Participants6 Participants20 Participants29 Participants
Sex: Female, Male
Male
11 Participants12 Participants26 Participants49 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 140 / 180 / 46
other
Total, other adverse events
12 / 1417 / 1840 / 46
serious
Total, serious adverse events
0 / 140 / 181 / 46

Outcome results

Primary

Number of Participants With HEPLISAV-B Seroprotective Titer (Anti-HBs 10mIU/mL)

Determine the rate of hepatitis B seroprotective titer achievement (anti-HBs 10mIU/mL) following completion of the HEPLISAV-B 2-dose vaccine series (6 months after the first vaccine administration) among chronic lymphocytic leukemia (CLL) patients who are treatment naïve or receiving Bruton Tyrosine Kinase (BTK) inhibitors (Ibrutinib or Acalabrutinib).

Time frame: 6 months after the first vaccine administration

Population: All participants that completed the 2 doses vaccine series and blood draws. 8 participants could not complete laboratory assessments due to COVID pandemic.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Chronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibNumber of Participants With HEPLISAV-B Seroprotective Titer (Anti-HBs 10mIU/mL)0 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibNumber of Participants With HEPLISAV-B Seroprotective Titer (Anti-HBs 10mIU/mL)1 Participants
Chronic Lymphocytic Leukemia Patients That Are Treatment NaïveNumber of Participants With HEPLISAV-B Seroprotective Titer (Anti-HBs 10mIU/mL)9 Participants
Secondary

Number of Participants That Did Not Complete Study Due to Intolerance of the HEPLISAV-B Vaccine Among CLL Patients.

Determine the tolerability of the HEPLISAV-B vaccine among chronic lymphocytic leukemia (CLL) patients who are treatment naïve or receiving Bruton Tyrosine Kinase (BTK) inhibitors (Ibrutinib or Acalabrutinib).

Time frame: 6 months after the first vaccine administration

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Chronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibNumber of Participants That Did Not Complete Study Due to Intolerance of the HEPLISAV-B Vaccine Among CLL Patients.0 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibNumber of Participants That Did Not Complete Study Due to Intolerance of the HEPLISAV-B Vaccine Among CLL Patients.0 Participants
Chronic Lymphocytic Leukemia Patients That Are Treatment NaïveNumber of Participants That Did Not Complete Study Due to Intolerance of the HEPLISAV-B Vaccine Among CLL Patients.0 Participants
Secondary

Number of Participants That Experienced Serious Adverse Events Following HEPLISAV-B Vaccine Among CLL Patients

Determine the safety of the HEPLISAV-B vaccine among chronic lymphocytic leukemia (CLL) patients who are treatment naïve or receiving Bruton Tyrosine Kinase (BTK) inhibitors (Ibrutinib or Acalabrutinib).

Time frame: 6 months after the first vaccine administration

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Chronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibNumber of Participants That Experienced Serious Adverse Events Following HEPLISAV-B Vaccine Among CLL Patients0 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibNumber of Participants That Experienced Serious Adverse Events Following HEPLISAV-B Vaccine Among CLL Patients0 Participants
Chronic Lymphocytic Leukemia Patients That Are Treatment NaïveNumber of Participants That Experienced Serious Adverse Events Following HEPLISAV-B Vaccine Among CLL Patients1 Participants

Source: ClinicalTrials.gov · Data processed: Feb 17, 2026