Mutant CALR-peptide Based Vaccine in Patients With Mutated CALR Myeloproliferative Neoplasm

Inclusion Criteria:

• Subjects must be ≥18 years of age at the time of signing the informed consent form.

• Confirmed diagnosis of chronic phase MPN:

• Previously treated or relapsed/refectory high risk ET

• Low to intermediate 1 risk (DIPSS 0-1) PMF or ET-MF

• Verified mutation in CALR exon 9

• PS ≤ 2

• Adequate organ function:

• Absolute neutrophil count ≥ 1000/mm3,

• Platelet count ≥ 50,000/mm3,

• Creatinine ≤ 2.5 mg/dL,

• Total bilirubin ≤ 2 mg/dL, (except in patients with Gilbert Syndrome who canhave total bilirubin < 3.0 mg/dL)

• Transaminases < 3 times above the upper limits of the institutional normal.

• Females of childbearing potential (FCBP) must have a negative serum or urinepregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior tostarting study medication and must either commit to continued abstinence fromheterosexual intercourse or begin TWO acceptable methods of birth control, onehighly effective method and one additional effective method AT THE SAME TIME, atleast 4 weeks prior to first dose of vaccine. FCBP must also agree to ongoingpregnancy testing. Men must agree to use a condom during sexual contact with afemale of childbearing potential even if they have had a successful vasectomy.

• Ability to understand and the willingness to sign a written informed consent.

• Ability to adhere to the study visit schedule and all protocol requirements.

• Subjects receiving cytoreductive therapy with hydroxyurea must be on a stable dosefor at least 8 weeks prior to week 1.

Exclusion Criteria:

• Other invasive malignancy in the past 3 years except non-melanoma skin cancer,localized cured prostate cancer and early stage breast cancer on HRT.

• Active autoimmune disease.

• Uncontrolled serious infection.

• Known immunodeficiency.

• Pregnant and breastfeeding women.

• Not willing to use contraception.

• Current use of immunosuppressive medications including steroids.

• Current JAK inhibitor use.

• Current use of IFN (use of anagrelide is permitted).

• Treatment with other experimental drugs within 30 days of week 1.

• Treatment with any MPN directed therapy unless otherwise noted within 5 half-livesof week 1.

• Any significant psychiatric/medical condition per investigators judgment.