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NMRC-M3V-Ad-PfCA Vaccine - Clinical Trial 1
This study is currently recruiting participants.
Verified by Walter Reed Army Institute of Research (WRAIR), May 2009
First Received: October 24, 2006   Last Updated: May 5, 2009   History of Changes
Sponsors and Collaborators: U.S. Army Office of the Surgeon General
United States Agency for International Development (USAID)
Congressionally Directed Medical Research Programs (CDMRP)
Military Infectious Diseases Research Program (MIDRP)
Information provided by: Walter Reed Army Institute of Research (WRAIR)
ClinicalTrials.gov Identifier: NCT00392015
  Purpose

The purpose of this study is to determine whether a new investigational malaria vaccine is safe, well tolerated and effective against experimental exposure to malaria when given to healthy people with no previous exposure to malaria. The vaccine consists of a modified form of a relatively common virus, adenovirus, that has been rendered incapable of replicating itself and modified to deliver the malaria gene of interest to the body's cells allowing the cell to manufacture the protein encoded by the gene and present it to the body's immune system in a more natural and presumably effective way.


Condition Intervention Phase
Plasmodium Falciparum
Biological: NMRC-M3V-Ad-PfCA
Biological: NMRC-MV-Ad-PfC, NMRC-MV-Ad-PfA
Phase I
Phase II

MedlinePlus related topics: Malaria
Drug Information available for: Malaria Vaccines
U.S. FDA Resources
Study Type: Interventional
Study Design: Prevention, Randomized, Open Label, Dose Comparison, Factorial Assignment, Safety/Efficacy Study
Official Title: A Two Part Clinical Trial Assessing the Safety, Tolerability, Immunogenicity and Protective Efficacy of NMRC-M3V-Ad-PfCA, a Multivalent, Adenovirus-Vectored Plasmodium Falciparum Malaria Vaccine, in Healthy, Malaria-Naïve Adults

Further study details as provided by Walter Reed Army Institute of Research (WRAIR):

Primary Outcome Measures:
  • Part A Dose-escalation: Assess the safety and tolerability of NMRC-M3V-Ad-PfCA, in a dose-escalation design, in healthy, malaria-naïve adults. [ Designated as safety issue: Yes ]
  • Part B Regimen-comparison: Assess the safety and tolerability of the two components individually (NMRC-MV-Ad-PfC, NMRC-MV-Ad-PfA) and when combined (NMRC-M3V-Ad-PfCA). [ Designated as safety issue: Yes ]
  • Part B Regimen Comparison: Assess the protective efficacy against sporozoite challenge (Pf, 3D7 strain) of the two components individually (NMRC-MV-Ad-PfC, NMRC-MV-Ad-PfA) and when combined (NMRC-M3V-Ad-PfCA). [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Part A Dose-escalation: Assess the immunogenicity of NMRC-M3V-Ad-PfCA in healthy, malaria- naïve adults. [ Designated as safety issue: No ]
  • Part B Regimen-comparison: Assess immunogenicity of the two components individually (NMRC-MV-Ad-PfC, NMRC-MV-Ad-PfA) and when combined. (NMRC-M3V-Ad-PfCA) [ Designated as safety issue: No ]
  • Part B Regimen-comparison: Compare immunogenicity and protective efficacy of one vs. two doses of NMRC-M3V-Ad-PfCA. [ Designated as safety issue: No ]
  • Part B Regimen-comparison: Compare immunogenicity and protective efficacy of two doses of NMRC-M3V-Ad-PfCA administered at short (ten days) vs long (16 weeks) intervals. [ Designated as safety issue: Yes ]

Estimated Enrollment: 70
Study Start Date: October 2006
Arms Assigned Interventions
Dose-escalation: Experimental Biological: NMRC-M3V-Ad-PfCA
Malaria Vaccine
Regimen-comparison: Experimental Biological: NMRC-MV-Ad-PfC, NMRC-MV-Ad-PfA
Malaria Vaccines

Detailed Description:

The vaccine, called NMRC-M3V-Ad-PfCA (key: NMRC + Multi-antigen Multi-stage, Malaria Vaccine + Adenovectored + P. falciparum CSP & AMA1 antigens), is a combination of two recombinant adenovirus-derived constructs (adenovectors), one expressing the pre-erythrocytic stage antigen circumsporozoite protein (CSP) and the other expressing the erythrocytic stage antigen Apical Membrane Antigen 1 (AMA1), both from the 3D7 strain of P. falciparum. The vector is an attenuated, replication-deficient adenovirus derived from wildtype serotype 5 adenovirus through the deletion of several genes. The vaccine is formulated in a buffered saline solution (Final Formulation Buffer = FFB).

This is a Phase 1/2a, randomized, open-label, dose-escalating trial of the NMRC-M3V-Ad-PfCA vaccine administered intramuscularly to healthy, malaria-naïve adult volunteers. All volunteers will be seronegative (< 1:500, by a luciferase-based neutralizing antibody assay; VRC, Bethesda) for adenovirus serotype 5. In the first part of the study (dose-escalation phase, Part A), 1 x 1010 particle units (pu) per construct or 2 x 1010 pu total will be administered to six volunteers as a single dose to assess safety, and 4 weeks later, 5 x 1010 pu per construct or 1 x 1011 pu total dose (five-fold dose escalation) will be administered to six additional volunteers. In the second part of the study (regimen-comparison phase, Part B), three regimens for administration will be compared: one dose, two doses administered ten days apart, and two doses administered 16 weeks apart. Separate groups will receive one dose of the individual components of the vaccine (NMRC-MV-Ad-PfC and NMRC-MV-Ad-PfA). Following immunization, volunteers participating in the regimen-comparison phase as well as several non-immunized control volunteers (serving as infectivity controls) will be challenged with P.

falciparum sporozoites in order to assess vaccine efficacy against non-immunized controls challenged at the same time. The proposed design of the regimen-comparison phase will provide information to direct selection of an appropriate dosing regimen for subsequent studies, and will also indicate whether the two constituent antigens, when co-formulated, act synergistically, independently, or interfere with each other in the induction of antigen-specific immune responses and protective immunity.

  Eligibility

Ages Eligible for Study:   18 Years to 50 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Between the ages of 18-50 (inclusive)
  • Negative results of HIV ELISA, HbSAg, anti-HCV antibody, and no other clinically significant abnormal laboratory results from screening.
  • Adenovirus serotype 5 titer <1:500.
  • Able to provide written informed consent.
  • Complete an Assessment of Understanding and verbalize an understanding of any questions answered incorrectly.
  • In good general health without clinically significant medical history or physical exam abnormalities at screening.
  • Willing to continue immunogenicity and clinical follow-ups for one year and telephone or mail (electronic/U.S. Postal) contact as long term safety monitoring provision for an additional four years (totaling five years of participation; immunized volunteers only).
  • Male and female participants being immunized and female participants being challenged agree to use effective means of birth control (an FDA approved contraceptive, abstinence) between screening and 60 days following last clinical study visit or able to provide evidence of no reproductive capability.

Exclusion Criteria:

  • Plan to participate (or have participated in the last 30 days) in any other research study including an investigational drug or device during active clinical trials and follow-up.
  • History of malaria infection, travel to a malaria endemic region within 2 years prior to first immunization, history of long term residence (> 5 years) in area known to have significant transmission of P. falciparum, or receipt of a candidate malaria vaccine containing either the CSP or AMA1 antigens..
  • Significant cardiovascular, hepatic, renal, hematologic, or immunologic abnormality either by history or laboratory examination. Includes bleeding or seizure disorders.
  • Determined, using a non-invasive cardiac risk assessment tool, to have a cardiovascular risk profile that might place them at increased risk if they should develop malaria as a result of the study. (Part B only) Volunteers determined to have a greater than 10% 5 year risk for a cardiovascular event based on the cardiac assessment tool outlined by Gaziano et al, 2008 will be excluded from participation.
  • A positive result on HIV testing at screening.
  • A positive result on Hepatitis B or C testing at screening.
  • An Adenovirus serotype 5 titer > 1:500 (Part A only)
  • Splenectomy.
  • Use of immunosuppressive drugs (excluding nasal steroids or topical steroids) within thirty days of first scheduled immunization (Trial Day 0)/challenge.
  • Volunteers who have received immunizations (live or killed) within thirty days of first scheduled immunization (Trial Day 0)/challenge.
  • Volunteers who require immunizations for travel or other purposes during the immunization phase of the trial.
  • Volunteers receiving blood products within 120 days of immunization/challenge.
  • Serious Adverse Reaction to other vaccines (such as hives, anaphylaxis, respiratory difficulty, angioedema or abdominal pain [excluding abdominal pain caused by oral vaccines such as oral typhoid vaccine]).
  • Any other finding which would increase the risk of having an adverse outcome during treatment should the volunteer develop malaria as a result of the study.

Additional Criteria for Females:

Pregnant or breast-feeding females or those planning to become pregnant within the next year.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00392015

Contacts
Contact: Jose Mendoza-Silveiras, MD 301-295-0224 jose.mendoza1@med.navy.mil

Locations
United States, Maryland
Naval Medical Research Center (NMRC) Clinical Trials Center Recruiting
Bethesda, Maryland, United States, 20889-5607
Contact: Jose Mendoza-Silveiras, MD     301-295-0224     jose.mendoza1@med.navy.mil    
Contact: Maria Sharina T Reyes, MD     301-295-0875     reyesm@med.navy.mil    
Sub-Investigator: Judith Epstein, MD            
Sub-Investigator: Thomas L Richie, MD, PhD            
Sub-Investigator: Martha Sedegah, PhD            
Sub-Investigator: Ilin Chuang, MD, MPH            
Sponsors and Collaborators
U.S. Army Office of the Surgeon General
United States Agency for International Development (USAID)
Congressionally Directed Medical Research Programs (CDMRP)
Military Infectious Diseases Research Program (MIDRP)
Investigators
Principal Investigator: Cindy Tamminga, MD, MPH Naval Medical Research Center
  More Information

Additional Information:
Publications:
Li S, Locke E, Bruder J, Clarke D, Doolan DL, Havenga MJ, Hill AV, Liljestrom P, Monath TP, Naim HY, Ockenhouse C, Tang DC, Van Kampen KR, Viret JF, Zavala F, Dubovsky F. Viral vectors for malaria vaccine development. Vaccine. 2006 Aug 1 Ophorst OJ, Radosevic K, Havenga MJ, Pau MG, Holterman L, Berkhout B, Goudsmit J, Tsuji M. Immunogenicity and protection of a recombinant human adenovirus serotype 35-based malaria vaccine against Plasmodium yoelii in mice. Infect Immun. 2006 Jan;74(1):313-20. Bruna-Romero O, Rocha CD, Tsuji M, Gazzinelli RT. Enhanced protective immunity against malaria by vaccination with a recombinant adenovirus encoding the circumsporozoite protein of Plasmodium lacking the GPI-anchoring motif. Vaccine. 2004 Sep 9;22(27-28):3575-84. Gilbert SC, Schneider J, Hannan CM, Hu JT, Plebanski M, Sinden R, Hill AV. Enhanced CD8 T cell immunogenicity and protective efficacy in a mouse malaria model using a recombinant adenoviral vaccine in heterologous prime-boost immunisation regimes. Vaccine. 2002 Jan 15;20(7-8):1039-45. Rodrigues EG, Zavala F, Nussenzweig RS, Wilson JM, Tsuji M. Efficient induction of protective anti-malaria immunity by recombinant adenovirus. Vaccine. 1998 Nov;16(19):1812-7.

Responsible Party: Division of Regulated Activities and Compliance ( Robert E. Miller )
Study ID Numbers: NMRC.2006.0001, HSRRB A-13453
Study First Received: October 24, 2006
Last Updated: May 5, 2009
ClinicalTrials.gov Identifier: NCT00392015     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Walter Reed Army Institute of Research (WRAIR):
Malaria Vaccine
Adenovirus
Plasmodium falciparum

Study placed in the following topic categories:
Protozoan Infections
Adenoviridae Infections
Parasitic Diseases
Malaria
Healthy
Malaria, Falciparum

Additional relevant MeSH terms:
Protozoan Infections
Coccidiosis
Parasitic Diseases
Malaria
Malaria, Falciparum

ClinicalTrials.gov processed this record on May 07, 2009