Combination Immunotherapy for Ovarian Cancer

Amit Oza, MD profile photo
Overseen ByAmit Oza, MD
Age: 18+
Sex: Female
Trial Phase: Phase 2
Sponsor: University Health Network, Toronto
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new combination of treatments to combat advanced ovarian, fallopian tube, or primary peritoneal cancer. The treatments include a vaccine called DPX-Survivac, which trains the immune system to attack cancer cells, a drug called pembrolizumab that aids the immune system in targeting cancer, and a chemotherapy drug called cyclophosphamide. This study suits individuals whose cancer has returned after initial treatment and who have experienced disease progression. Participants must have specific types of these cancers and be willing to provide tumor samples for research. As a Phase 2 trial, this research focuses on measuring the treatment's effectiveness in an initial, smaller group of people.

Do I have to stop taking my current medications for the trial?

The trial does not specify if you need to stop taking your current medications, but you cannot be on any investigational drugs or immunosuppressive therapy within 7 days before starting the trial treatment.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Previous studies have shown that pembrolizumab, when combined with other treatments, is well-tolerated by patients with ovarian cancer. This drug, already approved for certain skin and lung cancers, has a strong safety record.

Cyclophosphamide, another treatment in this study, is also well-tolerated. Past research has demonstrated its effectiveness and safety when used with other drugs for various types of cancer.

The DPX-Survivac vaccine has been tested in ovarian cancer patients and found to be well-tolerated. It aids the immune system in fighting cancer cells.

Together, these treatments have shown promising safety results in other studies. Although this current trial is still in the early stages, available evidence suggests these treatments are generally well-tolerated.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about the combination of cyclophosphamide, DPX-Survivac, and pembrolizumab for ovarian cancer because it offers a novel approach compared to standard treatments like surgery and chemotherapy. Unlike traditional therapies, this combination leverages immunotherapy to stimulate the body's immune system to recognize and attack cancer cells more effectively. DPX-Survivac is particularly unique as it targets the survivin protein, which is often overexpressed in cancer cells and helps them survive. Pembrolizumab, known as a checkpoint inhibitor, works by unleashing the immune system to fight cancer cells, adding an extra layer of defense. This combination could potentially lead to more targeted and durable responses in patients, especially those with platinum-sensitive or resistant types of ovarian cancer.

What evidence suggests that this trial's treatments could be effective for ovarian cancer?

This trial will evaluate the combination of pembrolizumab, DPX-Survivac, and cyclophosphamide for treating ovarian cancer. Studies have shown that pembrolizumab, when combined with other drugs, helps patients with recurrent ovarian cancer live longer without disease progression. DPX-Survivac, an experimental vaccine, has proven safe and beneficial for these patients. Cyclophosphamide, a chemotherapy drug, has been effective when used regularly for recurrent ovarian cancer. These treatments aim to strengthen the immune system to fight cancer cells, and early research shows promising results. Participants in this trial will receive these treatments in different cohorts based on their specific cancer characteristics.34678

Who Is on the Research Team?

Dr. Amit Oza | Bras DDP

Amit Oza, MD

Principal Investigator

Princess Margaret Cancer Centre

Are You a Good Fit for This Trial?

This trial is for patients with advanced ovarian, fallopian tube, or primary peritoneal cancer who've had disease progression after platinum-based chemotherapy. They must have measurable disease and a good performance status (ECOG <=1), be willing to provide tumor tissue samples, and have a life expectancy over 16 weeks. Those with immunodeficiency, recent immunosuppressive therapy, autoimmune diseases requiring treatment in the last two years (except vitiligo or diabetes), active TB, CNS metastases, or allergies to the drugs are excluded.

Inclusion Criteria

My cancer is in the ovary, peritoneum, or fallopian tube and confirmed by a lab test.
I had platinum-based chemotherapy after surgery and my cancer has come back.
I agree to provide tumor samples before and during treatment.
See 6 more

Exclusion Criteria

I have an autoimmune disease but it's not diabetes or vitiligo.
I am not allergic to Pembrolizumab, DPX-Survivac, Cyclophosphamide, or their ingredients.
I have previously been treated with specific immune therapies or a DPX-Survivac vaccine.
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

4 weeks
1 visit (in-person)

Dose Escalation

Participants receive one of two dose levels of study drugs to determine the best dose level for further testing

8 weeks
8 visits (in-person)

Dose Expansion

Additional participants are enrolled to further test the safety, tolerability, and efficacy of the study drugs at the determined dose level

24 weeks
8 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

52 weeks
Every 12 weeks for the first year, then every 24 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Cyclophosphamide
  • DPX-Survivac
  • Pembrolizumab
Trial Overview The study tests if pembrolizumab (a drug that helps the immune system fight cancer cells by blocking PD-1 protein) combined with DPX-Survivac vaccine (which may teach the immune system to kill cancer cells) and low-dose cyclophosphamide (a chemotherapy drug) can effectively treat these cancers. It's a phase 2 trial focusing on anti-tumor activity.
How Is the Trial Designed?
4Treatment groups
Experimental Treatment
Group I: Dose Expansion - Cohort CExperimental Treatment3 Interventions
Group II: Dose Expansion - Cohort BExperimental Treatment3 Interventions
Group III: Dose Expansion - Cohort AExperimental Treatment3 Interventions
Group IV: Dose EscalationExperimental Treatment3 Interventions

Cyclophosphamide is already approved in United States, European Union, Canada, Japan for the following indications:

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Approved in United States as Cytoxan for:
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Approved in European Union as Endoxan for:
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Approved in Canada as Neosar for:
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Approved in Japan as Endoxan for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University Health Network, Toronto

Lead Sponsor

Trials
1,555
Recruited
526,000+

Merck Sharp & Dohme LLC

Industry Sponsor

Trials
4,096
Recruited
5,232,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

ImmunoVaccine Technologies, Inc. (IMV Inc.)

Industry Sponsor

Trials
11
Recruited
580+

Citations

Effectiveness and toxicity of metronomic oral ...Effectiveness and toxicity of metronomic oral cyclophosphamide for recurrent or platinum-refractory ovarian cancer: A meta-analysis - PMC.
Cyclophosphamide With or Without Celecoxib in Treating ...To assess the response rates in patients with recurrent or persistent epithelial ovarian, fallopian tube or primary peritoneal cancer who are treated with oral ...
Oral cyclophosphamide plus bevacizumab in recurrent ...Conclusions: Bevacizumab in combination with oral cyclophosphamide was well tolerated and active, with a response rate of 40% in patients with ...
Continuous oral cyclophosphamide as salvage or ...Continuous oral cyclophosphamide can be used as an alternative salvage therapy in recurrent ovarian cancer with an acceptable response rate and toxicity.
Efficacy and Safety of Pembrolizumab in Combination With ...The combination of pembrolizumab with bevacizumab and oral cyclophosphamide was well tolerated and demonstrated clinical benefit in 95.0% and durable treatment ...
Study Details | NCT00538031 | Cyclophosphamide With or ...PURPOSE: This randomized phase II trial is studying how well giving cyclophosphamide together with celecoxib works compared to cyclophosphamide alone in ...
7.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/33211063/
Efficacy and Safety of Pembrolizumab in Combination With ...The combination of pembrolizumab with bevacizumab and oral cyclophosphamide was well tolerated and demonstrated clinical benefit in 95.0% and durable treatment ...
Randomized Trial of Oral Cyclophosphamide and Veliparib in ...... cyclophosphamide, an oral, well-tolerated treatment, in patients with HGSOC, primary peritoneal and fallopian tube cancers, and BRCA-mutant ovarian cancer.
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