Dose starting at 4 mg daily (for patients randomized to the Dexamethasone arm).

Dose starting at 25 mg/day (a calculation of equipotent steroid equivalencies will be used).

Brain Metastases, Adult

The study intervention is defined as treatment with either prednisone or dexamethasone as palliative therapy for the control of neurological symptoms; patients with symptomatic brain metastases with a requirement for glucocorticoid therapy will be treated with an available, standard-of-care immune checkpoint inhibitor regimen.

Glucocorticoid therapy

Cross Cancer Institute

Accelerated Checkpoint Therapy for Any Steroid Dependent Patient With Brain Metastases

An Interventional, Randomized Phase II Study Investigating the Efficacy of Immune Checkpoint Inhibitors While Corticosteroid Therapy is Required for Patients With Symptomatic Brain Metastases.

Objective response rate will be determined utilizing RECIST 1.1 criteria. Baseline staging diagnostic imaging (CT and/or MRI studies) will be performed in advance of beginning treatment and repeated 6 weeks following treatment initiation and at 12 week intervals thereafter.

Defined as the time interval between first radiographic documentation of intracranial metastatic disease and initiation of systemic immunotherapy.

Secondary study outcomes include progression-free and overall survival (PFS, OS). PFS is defined as the time between the date of treatment initiation and the date of disease progression (determined utilizing RECIST 1.1 criteria) or death (whatever the cause), whichever occurs first. For participants who remain alive and whose disease has not progressed, PFS will be censored on the date of last visit/contact with disease assessments. PFS will be based on the disease assessment or date of death provided by the investigator. OS is defined as the time between the date of treatment initiation and the date of death (whatever the cause). For participants who remain alive OS will be censored on the date of last visit/contact with disease assessments. OS will be based on the date of death provided by the investigator.

An analysis of patient-reported quality of life will be conducted utilizing the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the EORTC Brain Cancer Module (EORTC QLQ-BN20) questionnaires). Quality of life questionnaires will be administered to participants following enrolment to study but prior to initiation of immunotherapy. Follow-up questionnaires will be administered as part of the standard of care immunotherapy pre-treatment starting 6 weeks from Cycle 1 and every 6 weeks thereafter until end of treatment. Quality of life questionnaires should be administered prior to investigator assessment at each indicated time-point.

The Common Terminology Criteria for Adverse Events (CTCAE, version 4.03) will be used to categorize treatment related and non-treatment related adverse events.

AHS Cancer Control Alberta

Open label, two cohort, permuted block randomization phase II study.

IMA950 mixed with Poly-ICLC administered subcutaneously

Pembrolizumab 200mg q3w IV and IMA950 mixed with Poly- ICLC administered subcutaneously

Glioblastoma Multiforme

Glioblastoma, Adult

Glioma of Brain

Glioblastoma Multiforme of Brain

IMA950/Poly-ICLC

IMA950 mixed with Poly-ICLC administered subcutaneously in combination with pembrolizumab

IMA950/Poly-ICLC and pembrolizumab

University Hospitals of Geneva

Pembrolizumab in Association With the IMA950/Poly-ICLC for Relapsing Glioblastoma

Pembrolizumab in Association With the Multipeptide Vaccine IMA950 Adjuvanted With Poly-ICLC for Relapsing Glioblastoma: a Randomized Phase I/ II Trial

To assess tolerability and safety of IMA950 adjuvanted with Poly-ICLC when given together with pembrolizumab, using CTCAE v.4.03

To estimate 6, 9 and 12-month progression-free survival (PFS) using gadolinium-enhanced MRI and clinical assessment according to revised iRANO criteria

To estimate OS, defined as the time between the date of study entry and the date of death due to any cause. Subjects who have not died at the time of last known follow-up will be censored

Quality of life patient-reported outcomes (EORTC QLQ-C30 questionnaire)

To assess synergy/immunogenicity of IMA950 plus Poly-ICLC when given together with Pembrolizumab using Tumor Infiltrating Lymphocyte (TIL) density assessment

To assess synergy/immunogenicity of IMA950 plus Poly-ICLC when given together with Pembrolizumab by assessing vaccine-induced peripheral immune responses by flow cytometry or IHC as surrogate markers

Pierre-Yves Dietrich

Principal Investigator

University Hospital, Geneva

(n=74): adjuvanted FLU-v on Day 0, saline (0.5mL) on Day 21

(n=37): saline solution (0.5ml) on Day 0 and Day 21

(n=37): Adjuvanted placebo on Day 0, saline (0.5mL) on Day 21

FLU-v on Day 0 and Day 21
FLU-v: Subcutaneous injection in the upper arm with 500 ug of FLU-v as 0.5ml suspension in 0.01M HCl and 0.01M NaOH

2x Non-adjuvanted FLU-v

adjuvanted FLU-v on Day 0, saline (0.5mL) on Day 21
adjuvanted FLU-v: Subcutaneous injection in the upper arm with 500ug of FLU-v emulsified in 0.25ml of Montanide ISA-51 adjuvant (Seppic, France) and 0.25ml of water for injection
Saline: Subcutaneous injection in the upper arm with 0.5ml of saline

1x Adjuvanted FLU-v

saline solution (0.5ml) on Day 0 and Day 21
Saline: Subcutaneous injection in the upper arm with 0.5ml of saline

Non-adjuvanted Placebo

Adjuvanted placebo on Day 0, saline (0.5mL) on Day 21
Saline: Subcutaneous injection in the upper arm with 0.5ml of saline
Adjuvanted placebo: Subcutaneous injection in the upper arm with an emulsion made with 0.25ml of Montanide ISA-51 adjuvant (Seppic, France) and 0.25ml of water for injection

Adjuvanted Placebo

Total

Sex: Female, Male

Race/Ethnicity, Customized

Subjects were asked whether they had received previous influenza vaccinations and whether it was within 2 years or more from joining the trial.

previous influenza vaccination

Serum samples were collected at screening (summer-autumn 2016) and later analysed for pre-existing neutralising antibodies against the main influenza strains that circulated in the Netherlands during the influenza season of 2016-2017 (B/Phuket/3073/2013, B/Brisbane/60/2008, A/Hong Kong/5738/2014 (H3N2) and A/Michigan/45/15 (H1N1)). The number of subjects with a HA titer for A strains ≥ 40 and with HA ≥ 80 for B strains was recorded in each group.

HAI titer at screening

To compare the number of subjects that showed at least a two-fold increase on day 42 and day 180 following vaccination in the number of CD4+T-cells secreting TH1 cytokines in all groups.

Percentage of CD4+ TH1 Cytokine Responders

Responders were defined as subjects having at least a two-fold increase in the amount of IFNg secreted on day 42 and day 180 compared the amount secreted on day 0. IFNg was measured by ELISA

Percentage of Responders on Day 42 and Day 180 for IFNgamma Secretion by PBMCs

To evaluate the solicited AEs in all subjects

Solicited AEs

To evaluate the level of TH2 cytokines (IL-4) from baseline in all groups 42 and 180 days following FLU-v vaccination.

Th2 Cytokine Responses (IL-4)

To evaluate the humoral immune responses specific to FLU-v from baseline in all groups 42 and 180 days following FLU-v vaccination. Specific FLU-v IgG antibodies were measured by ELISA. The geometric mean for each treatment group was provided.

Antibody Responses to FLU-v

To evaluate unsolicited AEs and SAEs in all subjects

Unsolicited AEs and SAEs

To evaluate the change from baseline in cellular immune responses based on additional CMI assays such as ELISPOT (Enzyme-Linked ImmunoSpot) in all groups at 42 and 180 days following FLU-v vaccination

Immune Responses Measured by IFNgamma/Granzyme B ELISPOT

During the influenza season (Dec 2016 to March 2017), fully vaccinated subjects will contact the trial center immediately if they feel unwell for 24h, with a sudden onset of flu-like symptoms. The medical staff will arrange for a nasopharyngeal swab to be performed if the subject has at least one respiratory (cough, sore throat, shortness of breath, runny nose, stuffy nose, sneezing and earache) and one systemic symptom (fever, malaise, headache and myalgia (muscle and joint pain). Swabs should be taken from the reported subjects within 3 days from the trial center being contacted or within 4 days of the onset of symptoms, whatever time is shorter.

Percentage of Participants Who Tested Positive for Influenza Strains

Subjects recorded daily influenza symptoms from December 2016 up to March 2017. Subjects with a sudden onset of at least one respiratory and one systemic symptom were swabbed. If the results were positive for influenza then the symptoms were included in the analysis. The duration of symptoms was recorded as the number of symptomatic days during the influenza episode. Fever (≥38oC), malaise, headache, myalgia (muscle and joint pain), cough, sore throat, shortness of breath, runny nose, stuffy nose, sneezing and earache were scored on a severity scale of 0 to 3 (0: no symptom, 1: mild, 2: moderate, 3: severe). The daily severity score was the sum of the severity score for all symptoms listed above on a single day. The total score was the sum of all daily scores during the influenza episode. The peak score was the highest daily score during the influenza episode. The average score was the total score divided by the number of days the influenza episode lasted.

Severity of Symptoms in RT-PCR Influenza-confirmed Subjects.

Subjects recorded daily influenza symptoms from December 2016 up to March 2017. Subjects with a sudden onset of at least one respiratory and one systemic symptom were swabbed. If the results were positive for influenza then the symptoms were included in the analysis. The duration of symptoms was recorded as the number of symptomatic days during the influenza episode. The following symptoms were recorded: fever (≥38oC), malaise, headache, myalgia (muscle and joint pain), cough, sore throat, shortness of breath, runny nose, stuffy nose, sneezing and earache.

Duration of Influenza Symptoms in RT-PCR Confirmed Infected Subjects.

Overall Study

Dr Olga Pleguezuelos, Chief Scientific Officer

Influenza

Subcutaneous injection in the upper arm with 500 ug of FLU-v as 0.5ml suspension in 0.01M HCl and 0.01M NaOH

FLU-v

Subcutaneous injection in the upper arm with 500ug of FLU-v emulsified in 0.25ml of Montanide ISA-51 adjuvant (Seppic, France) and 0.25ml of water for injection

adjuvanted FLU-v

Subcutaneous injection in the upper arm with 0.5ml of saline

Saline

Subcutaneous injection in the upper arm with an emulsion made with 0.25ml of Montanide ISA-51 adjuvant (Seppic, France) and 0.25ml of water for injection

Adjuvanted placebo

Website for the Consortium Universal Influenza Vaccine Secure

Isala

A Randomised, Double-blind, Placebo-controlled Phase IIb Trial to Test FLU-v Vaccine

A Randomised, Double-blind, Placebo-controlled, Single-centre Phase IIb Trial as Part of the EU-funded UNISEC Project to Assess the Immunogenicity and Safety of Different Formulations and Dosing Regimens of FLU-v Vaccine in Healthy Adults

melanoma/peavalu

Accelerated Checkpoint Therapy for Any Steroid Dependent Patient With Brain Metastases

Pembrolizumab in Association With the IMA950/Poly-ICLC for Relapsing Glioblastoma

A Randomised, Double-blind, Placebo-controlled Phase IIb Trial to Test FLU-v Vaccine

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