NEOadjuvant Dendritic Cell Vaccination for Ovarian Cancer

NCT05773859RecruitingPHASE1, PHASE2INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Radboud University Medical Center

Enrollment

10

Start Date

2023-03-17

Completion Date

2026-03-01

Study Type

INTERVENTIONAL

Official Title

Induction of Neo-Antigen Specific Cytotoxic T Cells by Autologous Tumor Lysate-loaded Specialized Cross-Presenting Dendritic Cells in Epithelial Ovarian Cancer Patients Treated With Neoadjuvant Chemotherapy, the NEODOC Study

Interventions

XP-DC vaccinations

Conditions

Epithelial Ovarian CancerOvarian Carcinoma

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion criteria

* Women over 18 years old with histologically confirmed primary epithelial ovarian cancer.
* Not amenable by primary debulking surgery and in need of neoadjuvant chemotherapy and interval debulking
* High-grade or low grade serous histology
* FIGO stage IIIb, IIIc, IVa or IVb if only lymph nodes ≤ 1cm above the diaphragm or in the groins
* Extensive abdominal spread of tumor
* WHO/ECOG performance status 0-1
* Neutrophils \>1.5x 109/L, platelets \>100x 109/L, hemoglobin \>5,6 mmol/L (9.0 g/dl), estimated glomerular filtration rate \> 45 ml/min/1.73m2 , AST/ALT \<3 x ULN, serum bilirubin \<1.5 x ULN (exception: Gilbert's syndrome is permitted)
* Expected adequacy of follow-up
* Postmenopausal or evidence of non-childbearing status or for women of childbearing potential: negative urine or serum pregnancy test, within 28 days of study treatment and confirmed prior to treatment on day 1. Postmenopausal is defined as:

  * Amenorrhoeic for 1 year or more following cessation of exogenous hormonal treatments;
  * or surgical sterilisation (bilateral oophorectomy or hysterectomy).
* Informed consent

Exclusion criteria

* Recurrent ovarian cancer
* Histologies other than high grade serous ovarian cancer such as, but not restricted to, endometrioid, mucinous, clear cell or carcinosarcoma
* Unable and/or unwilling to undergo standard chemotherapy and interval debulking surgery
* FIGO stage I-IIb, IIIa or IVb with liver, spleen or lung metastases or lymph nodes above the diaphragm or in the groins \> 1 cm
* History of any second malignancy, with the exception of adequately treated basal cell carcinoma, cervical cancer \> 5 years ago or early stage breast cancer \>10 years ago.
* Any serious clinical condition that may interfere with the safe administration of DC vaccinations
* Heart failure (NYHA class III/IV)
* Any uncontrolled co-morbidity, e.g. psychiatric or social conditions interfering which participation
* Unable to undergo a tumor biopsy
* Pregnancy or insufficient anti-conception if reproduction is still possible
* Active infection of Hepatitis B, C, HIV and syphilis
* Serious other active infections
* Known allergy to shell fish
* Auto immune disease (exception: vitiligo is permitted)
* History of organ allografts
* Chronic treatment with systemic immunosuppressive drugs (i.e. more than 10 mg prednisolone equivalent)

Outcome Measures

Primary Outcomes

Number of patients with an immunological response to XP-DC vaccination

Immunologically responding patients are defined as: T cells isolated from vaccine challenged sites (DTH biopsies) that can be expanded and 1) express T cell receptors specific for the vaccine and 2) show effector functions measured by IFN-gamma secretion or cytolytic activity against tumor antigen expressing target cells. Immunologically non-responding patients are defined as: No T cells, or T cells isolated from DTH biopsies that cannot be expanded, or T cells that can be expanded but do not recognize tumor antigens, or can recognize tumor antigens but do not display T effector functions i.e. lysis of tumor cell targets or release of IFN-α.

Time frame: At DTH skin test after the second vaccination (approximately study week 10)

Secondary Outcomes

Safety as assessed by incidence of treatment-related adverse events

Toxicity will be assessed according to CTCAE version 4.03.

Time frame: Throughout the treatment phase until 1 year of follow-up

Feasibility of tumor lysate-loaded XP-DC vaccinations in patients with advanced EOC

Feasibility assessment will be based on reporting of: * the number of patients from whom a successful apheresis product can be obtained * the number of patients from whom (both quantitatively and qualitatively) sufficient tumor lysate can be obtained * the number of patients for whom a DC product can be manufactured that meets the prespecified criteria * the number of patients that has received the planned number of vaccinations.

Time frame: Throughout the treatment phase until the last planned vaccination (approximately study week 23)

Recurrence free survival (RFS) after 12 months

Percentage of patients alive without recurrence of disease after 12 months

Time frame: 1 year

Number of patients with complete pathological response

The number of patients with a complete pathological response

Time frame: At time of debulking surgery (approximately study week 11)

Locations

Radboud University Medical Center, Nijmegen, Netherlands

Linked Papers

2025-11-09

NEOadjuvant Dendritic cell therapy added to first line standard of care in advanced epithelial Ovarian Cancer (NEODOC): protocol of a first-in-human, exploratory, single-centre phase I/II trial in the Netherlands

Introduction The currently available immunotherapies have failed to meet expectations in inducing durable responses in patients with advanced epithelial ovarian cancer (EOC). The low number of somatic missense mutations in EOC necessitates highly potent neoantigen-directed approaches. To this end, we have developed a novel dendritic cell (DC) product that consists of a specialised cross-presenting subset of DC, conventional DC type 1 (cDC1). Methods and analysis We will conduct the NEODOC study, an investigator-initiated first-in-human phase I/II trial. This study will assess the immunogenicity, safety and feasibility of a cDC1-based, autologous tumour lysate-loaded, DC product. 10 patients with previously untreated advanced EOC (stage IIIb-c, IVa or stage IVb if only supradiaphragmatic or inguinal lymph nodes &lt;1 cm) requiring neoadjuvant chemotherapy will receive DC therapy alongside standard-of-care carboplatin/paclitaxel chemotherapy and interval cytoreductive surgery. The primary endpoint is immune response, and the secondary endpoints are the safety and feasibility of the treatment as well as clinical efficacy. Ethics and dissemination Ethical approval for this trial was granted by the Netherlands Central Committee on Research Involving Human Subjects. The results will be disseminated through publications in international, open-access scientific journals and presentations at scientific conferences. Trial registration number NCT05773859 ; EUCT number 2024-512353-24-01.