Neoadjuvant PD-1 Antibody Alone or Combined With DC Vaccines for Recurrent Glioblastoma

  • STATUS
    Recruiting
  • End date
    May 1, 2024
  • participants needed
    40
  • sponsor
    Huashan Hospital
Updated on 25 August 2021

Summary

Glioblastoma multiforme (GBM) are the most prevalent malignant tumor in central nervous system. At recurrence, no clear standard-of-care therapy is agreed for recurrent GBM (rGBM) and median overall survival is estimated to rarely exceed 6-9 months with effective therapies. Neoadjuvant therapy with anti-PD-1 monoclonal antibodies were confirmed to be helpful to extend survival in rGBM. Vaccine, dendritic cells (DCs) pulsed with glioblastoma stem-like cell (GSC) antigens (GSC-DCV), could extend survival for GBM patients in our previous clinical study (PMID: 30159779). The purpose of this study is to evaluate the safety and efficiency of using the neoadjuvant therapy with PD-1 antibody (Carilizumab) plus DC vaccine (GSC-DCV) in patients with recurrent glioblastoma.

Description

This is a phase II randomized controlled clinical study. The purpose of this research is to study the safety and efficacy of Camrelizumab alone or combined with GSC-DCV vaccines in treating patients with recurrent glioblastomas. The participants will be randomly assigned into two group. Patients in group A will receive neoadjuvant Camrelizumab (PD-1 antibody), followed by surgical resection, DC vaccines and further PD-1 inhibitor treatment until toxicity or progression. Patients in group B will receive neoadjuvant Camrelizumab (PD-1 antibody), followed by surgical resection, placebo and further PD-1 inhibitor treatment until toxicity or progression. Furthermore, to evaluate the associations between exploratory biomarkers, clinical outcomes, and adverse events based on the next generation sequencing.

Details
Condition Recurrent Glioblastoma
Treatment Camrelizumab plus GSC-DCV, Camrelizumab plus Placebo
Clinical Study IdentifierNCT04888611
SponsorHuashan Hospital
Last Modified on25 August 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Age from 18 to 70 years
Eastern Cooperative Oncology Group (ECOG) performance status of 0,1 or 2
Estimated life expectancy > 3 months
Pathological diagnosis or molecular diagnosis was confirmed to be brain glioblastoma multiforme before
Previous first-line therapy with radiotherapy and chemotherapy, first or second relapse with unequivocal evidence of tumor progression
Patients with maximum safe resection of the tumor (95%) confirmed with contrast MR within 72 hours after surgery
No high-dose systemic corticosteroids (defined as >10 mg day-1 of prednisone or bio-equivalent for at least seven consecutive days before administration)
No antibiotics for at least three consecutive days before administration
Adequate organ function defined by
Adequate bone marrow reserve: absolute neutrophil (segmented and bands) count
(ANC) 1.010^9/L, platelets 10010^9/L; hemoglobin 8 g/dL. Hepatic: bilirubin
upper limit of normal (ULN), aspartate transaminase (AST) and alanine
transaminase (ALT) < 2.5upper limit of normal (ULN). Renal: Normal serum
Creatinine for age (below) or creatinine clearance >60 ml/min/1.73 m2
Electrocardiogram: normal
\. Written informed consent
\. Patient should have good follow-up compliance

Exclusion Criteria

Pregnant or breast-feeding patients
Patients with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements
Patients with history of immune system abnormalities such as hyperimmunity (e.g., autoimmune diseases) and hypoimmunity (e.g., myelodysplastic disorders, marrow failures, AIDS, ongoing pregnancy, transplant immuno-suppression), or medication of cortisol
Patients with any conditions that could potentially alter immune function (e.g., AIDS, multiple sclerosis, diabetes, renal failure)
Any previous investigational medication within 30 days before first administration of Camrelizumab
History of allergy to study drug components or of severe hypersensitivity reactions to any monoclonal antibodies
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