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Response to the SHINGRIX Varicella Zoster Virus (VZV) Vaccine in Chronic Lymphocytic Leukemia (CLL) and CLL Treated With Bruton's Tyrosine Kinase Inhibitor (BTK-I)

Response to the SHINGRIX Varicella Zoster Virus (VZV) Vaccine in Chronic Lymphocytic Leukemia (CLL) Patients That Are Treatment Naive or Receiving Bruton s-Tyrosine Kinase Inhibitor (BTK-I) Therapy

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03702231
Enrollment
116
Registered
2018-10-11
Start date
2018-12-07
Completion date
2023-07-12
Last updated
2023-08-04

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

Conditions

Chronic Lymphocytic Leukemia (CLL), Compare SHINGRIX Vaccine Response Rates, Safety and Tolerability, Small Lymphocytic Lymphoma (SLL)

Keywords

Ibrutinib, Acalabrutinib, Shingles, Herpes

Brief summary

Background: People who have cancer tend to get sick more often. This is in part because of the cancer treatments they get. Because of this, they may get shingles. Scientists had thought people with chronic lymphocytic leukemia (CLL) should not get the shingles vaccine. Now there is a new shingles vaccine that is not live and cannot cause shingles. The new shingles vaccine may protect people with weak immune systems from getting shingles. This is currently shown to be safe to give people 50 years and older to prevent shingles. Researchers want to test how safe the vaccine is and how it works in people with CLL. Objective: To learn how a new shingles vaccine works in people who have chronic lymphocytic leukemia or small lymphocytic lymphoma (SLL). Eligibility: Adults ages 18 years and older with CLL or SLL who are not being treated for CLL or who are getting certain treatments. Design: Participants will be screened with a chart review or through another protocol. Visit 1 At visit 1, participants may have a pregnancy test, blood test, or physical exam. Pregnant participants cannot be in the study. Eligible participants will get the shingles vaccine as an injection. Participants will receive a diary and write down any symptoms they have for 7 days after the vaccines. Visit 2 Visit 2 will be 3 months later. Participants will have blood taken and get another dose of the vaccine. Participants will receive a diary and write down any symptoms they have for 7 days after the vaccines. Visit 3 Visit 3 will be 3 months after visit 2. Participants will have blood taken. Participants may be able to get an additional vaccine the same day as the shingles vaccine.

Detailed description

This study aims to determine the efficacy of the SHINGRIX varicella zoster virus (VZV) vaccine in chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) patients that are treatment naive or receiving Bruton s-tyrosine kinase inhibitor (BTK-I). (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: * Diagnosis of CLL or SLL * Cohort 1: Treatment naive CLL or SLL patients * Cohort 2: Subjects must be receiving ibrutinib for at least 6 months prior to administration of the first vaccine dose * Cohort 3: Subjects must be receiving acalabrutinib 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 Design: Patients with CLL will enroll on the study for the purpose of determining the SHINGRIX vaccine efficacy in patients who are treatment naive or receiving BTK-I therapy. A series of 2 doses of SHINGRIX will be given at 0- and 3- month schedule by intramuscular injection. Subjects will be followed for 6 months and receive assessment of serologic response 6 months after the first vaccine dose administration. Study Objectives: Primary Objective: a)Determine the serologic response against VZV after completing the SHINGRIX (RZV) 2- dose vaccine series in the following populations: * CLL patients that 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 SHINGRIX vaccine among CLL patients who are treatment naive or receiving BTK-Is (ibrutinib or acalabrutinib).

Interventions

A series of 2 doses of SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted) will be given on a 0- and 3-month schedule by intramuscular injection.

Sponsors

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

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
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 * Cohort 1:Treatment naive CLL/SLL patients * Cohort 2: Subjects must be receiving treatment ibrutinib for at least 6 months prior to administration of the first vaccine dose * Cohort 3: Subjects must be receiving acalabrutinib for at least 6 months prior to administration of the first vaccine dose * No active, symptomatic VZV or herpes zoster infection within 12 months prior to vaccination * No exposure to the live VZV vaccine (ZOSTAVAX) within 12 months prior to vaccination * No prior exposure to the SHINGRIX vaccine * Age greater than or equal to 18 years. * ECOG performance status of 0-2 * Able to comprehend the investigational nature of the protocol and provide informed consent

Exclusion criteria

* Female patients who are currently in pregnancy * 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 * Severe allergic reaction to any component of SHINGRIX. * Received intravenous immunoglobulin (IVIG) within 3 months prior to vaccination. * Concomitant use of immunosuppressive agents (e.g. steroids, radio therapy, chemotherapy) * Hereditary or acquired immunodeficiency syndrome unrelated to chronic lymphocytic leukemia * Non-English speaking individuals will be excluded from the study

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Varicella Zoster Virus (VZV) Seroprotective Titer6 months after the first vaccine administrationDetermine the rate of varicella zoster virus (VZV) seroprotective titer achievement in participants following completion of the SHINGRIX 2-dose vaccine series in Chronic Lymphocytic Leukemia (CLL) patients that are treatment naive or receiving therapy with a Bruton Tyrosine Kinase (BTK) Inhibitor (Ibrutinib or Acalabrutinib). The response criteria for achieving serologic response against VZV following the SHINGRIX vaccine are based on a validated luciferase immunoprecipitation assay detecting VZV antiglycoprotein E antibody. The primary endpoint is serologic response defined as ≥ four-fold rises in VZV anti-gE blood. IgG titer achievement after completing the SHINGRIX (RZV) 2-dose vaccine series.

Secondary

MeasureTime frameDescription
Number of Participants That Experienced Serious Adverse Events Following the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.6 months after the first vaccine administrationDetermine the safety and tolerability of the SHINGRIX vaccine among Chronic Lymphocytic Leukemia (CLL) patients who are treatment naïve or receiving a Brutons-tyrosine kinase inhibitor (BTK-I) (Ibrutinib or Acalabrutinib).
Number of Participants That Did Not Complete Study Due to Intolerance of the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.6 months after the first vaccine administrationDetermine the tolerability of the SHINGRIX vaccine among Chronic Lymphocytic Leukemia (CLL) patients who are treatment naïve or receiving a Brutons-tyrosine kinase inhibitor (BTK-I) (Ibrutinib or Acalabrutinib).

Countries

United States

Participant flow

Participants by arm

ArmCount
Chronic Lymphocytic Leukemia Patients That Are Treatment Naive
Chronic Lymphocytic Leukemia Patients That Are Treatment Naive will be followed for 6 months and receive assessment of serologic response 6- months following the first SHINGRIX vaccine dose. Zoster Vaccine Recombinant, Adjuvanted: A series of 2 doses of SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted) will be given on a 0- and 3-month schedule by intramuscular injection.
58
Chronic Lymphocytic Leukemia Patients Receiving Treatment With Ibrutinib
Chronic Lymphocytic Leukemia Patients Receiving Treatment With Ibrutinib will be followed for 6 months and receive assessment of serologic response 6- months following the first SHINGRIX vaccine dose. Zoster Vaccine Recombinant, Adjuvanted: A series of 2 doses of SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted) will be given on a 0- and 3-month schedule by intramuscular injection.
30
Chronic Lymphocytic Leukemia Patients Receiving Treatment With Acalabrutinib
Chronic Lymphocytic Leukemia Patients Receiving Treatment With Acalabrutinib will be followed for 6 months and receive assessment of serologic response 6- months following the first SHINGRIX vaccine dose. Zoster Vaccine Recombinant, Adjuvanted: A series of 2 doses of SHINGRIX (Zoster Vaccine Recombinant, Adjuvanted) will be given on a 0- and 3-month schedule by intramuscular injection.
28
Total116

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyChange in CLL Treatment001
Overall StudyCOVID Pandemic141
Overall StudyNon-compliance001
Overall StudyProtocol Violation001
Overall StudyWithdrawal by Subject100

Baseline characteristics

CharacteristicChronic Lymphocytic Leukemia Patients That Are Treatment NaiveChronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibChronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
33 Participants23 Participants12 Participants68 Participants
Age, Categorical
Between 18 and 65 years
25 Participants7 Participants16 Participants48 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants1 Participants1 Participants4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
55 Participants29 Participants26 Participants110 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants0 Participants1 Participants2 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
2 Participants2 Participants2 Participants6 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
55 Participants27 Participants25 Participants107 Participants
Region of Enrollment
United States
59 participants29 participants28 participants116 participants
Sex: Female, Male
Female
26 Participants15 Participants8 Participants49 Participants
Sex: Female, Male
Male
32 Participants15 Participants20 Participants67 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 580 / 300 / 28
other
Total, other adverse events
58 / 5829 / 3027 / 28
serious
Total, serious adverse events
1 / 580 / 300 / 28

Outcome results

Primary

Number of Participants With Varicella Zoster Virus (VZV) Seroprotective Titer

Determine the rate of varicella zoster virus (VZV) seroprotective titer achievement in participants following completion of the SHINGRIX 2-dose vaccine series in Chronic Lymphocytic Leukemia (CLL) patients that are treatment naive or receiving therapy with a Bruton Tyrosine Kinase (BTK) Inhibitor (Ibrutinib or Acalabrutinib). The response criteria for achieving serologic response against VZV following the SHINGRIX vaccine are based on a validated luciferase immunoprecipitation assay detecting VZV antiglycoprotein E antibody. The primary endpoint is serologic response defined as ≥ four-fold rises in VZV anti-gE blood. IgG titer achievement after completing the SHINGRIX (RZV) 2-dose vaccine series.

Time frame: 6 months after the first vaccine administration

Population: 116 patients enrolled in study and 106 patients were analyzed. 10 patients did not complete study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Chronic Lymphocytic Leukemia Patients That Are Treatment NaiveNumber of Participants With Varicella Zoster Virus (VZV) Seroprotective Titer43 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibNumber of Participants With Varicella Zoster Virus (VZV) Seroprotective Titer11 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibNumber of Participants With Varicella Zoster Virus (VZV) Seroprotective Titer9 Participants
Secondary

Number of Participants That Did Not Complete Study Due to Intolerance of the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.

Determine the tolerability of the SHINGRIX vaccine among Chronic Lymphocytic Leukemia (CLL) patients who are treatment naïve or receiving a Brutons-tyrosine kinase inhibitor (BTK-I) (Ibrutinib or Acalabrutinib).

Time frame: 6 months after the first vaccine administration

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

Number of Participants That Experienced Serious Adverse Events Following the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.

Determine the safety and tolerability of the SHINGRIX vaccine among Chronic Lymphocytic Leukemia (CLL) patients who are treatment naïve or receiving a Brutons-tyrosine kinase inhibitor (BTK-I) (Ibrutinib or Acalabrutinib).

Time frame: 6 months after the first vaccine administration

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Chronic Lymphocytic Leukemia Patients That Are Treatment NaiveNumber of Participants That Experienced Serious Adverse Events Following the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.1 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With IbrutinibNumber of Participants That Experienced Serious Adverse Events Following the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.0 Participants
Chronic Lymphocytic Leukemia Patients Receiving Treatment With AcalabrutinibNumber of Participants That Experienced Serious Adverse Events Following the SHINGRIX Vaccine Among Chronic Lymphocytic Leukemia Patients.0 Participants

Source: ClinicalTrials.gov · Data processed: Feb 20, 2026