Cytomegalovirus (CMV) Vaccine in Orthotopic Liver Transplant Candidates

Purpose

This is a multi-center clinical trial in Cytomegalovirus (CMV) seronegative prospective liver transplant recipients to determine the efficacy of two doses of Cytomegalovirus-Modified Vaccinia Ankara (CMV-MVA) Triplex CMV vaccine pre-transplant. The primary objective is to assess the effect of pre-transplant (Tx) Triplex vaccination on duration of CMV antiviral therapy (AVT) within the first 100 days post-Tx in CMV seropositive donor (D+) and seronegative (R-) (D+R-) liver transplant recipients (LTxRs). A protocol-mandated preemptive therapy (PET) will be used for CMV disease prevention in D+R- LTxRs.

Condition

  • Liver Transplant

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Subject must be able to understand and provide informed consent 2. Negative for Cytomegalovirus (CMV) IgG antibody as assessed in a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory within 12 months of enrollment, and no history of prior positive CMV serology (IgG antibody) 3. Negative human immunodeficiency virus (HIV) testing and no clinical suspicion of HIV infection 4. Planned for a first living donor liver transplant or listed/anticipated to be listed for a first deceased donor liver transplant. 5. Anticipated to receive a liver transplant within 1-12 months 6. For individuals of reproductive potential, a negative serum or urine pregnancy test within 72 hours prior to enrollment. NOTE: Individuals of reproductive potential are defined as individuals who have reached menarche and who have not been post-menopausal for at least 12 consecutive months with follicle-stimulating hormone (FSH) >=40 IU/mL or 24 consecutive months if an FSH is not available, i.e., who have had menses within the preceding 24 months, and have not undergone a sterilization procedure (e.g., hysterectomy, bilateral oophorectomy, or salpingectomy) 7. Participants who are able to impregnate or become pregnant (i.e., of reproductive potential) and are participating in sexual activity that could lead to pregnancy must agree to practice contraception/birth control (hormonal or barrier method) or agree to not participate in a conception process (e.g., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization) for at least 1 month following the last vaccine/placebo dose. For acceptable contraception methods that are more than 80 percent effective, see Food and Drug Administration (FDA) Office of Women's Health (http://www.fda.gov/birthcontrol) 8. The most recent platelet count is >= 20,000 cells/mm^3 within 3 months prior to enrollment and in the opinion of the investigator, has not decreased < 20,000 cells/mm^3 at time of study IP administration. Eligibility criteria required: Dose 2: 1. Most recent platelet count >= 20,000 cells/mm^3 within 3 months prior to enrollment and in the opinion of the investigator, has not decreased < 20,000 cells/mm^3 since last result 2. For women of reproductive potential as defined previously, a negative serum or urine pregnancy test (performed within 72 hours)

Exclusion Criteria

  1. Women who are breastfeeding or planning to breastfeed 2. Prior Cytomegalovirus (CMV) vaccination 3. Receipt of immunoglobulin or CMV-specific immunoglobulin within the last 3 months (this includes coronavirus disease (COVID) convalescent plasma) 4. Currently enrolled in another interventional study that, in the investigator's opinion, could affect the evaluation of safety and/or vaccine effect outcomes 5. Prior (ever) receipt of a stem cell transplant (Peripheral blood stem cell (PBSC), marrow, cord blood, etc.) 6. Receipt of immunosuppression: - Within the last 3 months prior to randomization: - Systemic Chemotherapy or immunotherapy for cancer in the last 3 months (localized therapy for hepatocellular carcinoma [HCC] such as chemoembolization, Y-90 are not considered "systemic chemotherapy" and are not excluded) - Systemic immunosuppressive agents (e.g., cyclophosphamide, methotrexate, mycophenolate, azathioprine, calcineurin inhibitors, mTOR inhibitors, TNF-alpha inhibitors) and/or combination immunosuppressive drugs for any autoimmune or other conditions in the last 3 months except corticosteroids as below - Within the last 28 days prior to randomization: averaged daily corticosteroid therapy dose ≥20 mg of prednisone equivalent - Within the last 6 months prior to randomization: receipt of T- or Bcell depleting agents (e.g. ATG, Alemtuzumab, Rituximab) 7. Transplant status 1A or in the opinion of the investigator is likely to receive a transplant within the next month 8. At the time of randomization, either listed for, or, in the opinion of the investigator, likely to receive any non-liver organ transplant 9. Receipt of a clinical vaccine < 14 days before or planned to receive a clinical vaccine <14 days after the study agent 10. Known allergy to any component of the study agent 11. Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study Exclusion criteria required: Dose 2: 1. Anaphylaxis or other severe reaction (Grade 4) considered definitely or probably attributable to dose 1 2. Receipt of liver transplant prior to dose 2 3. The participant must not have any severe acute illness or other factor, that, in the opinion of the investigator, requires postponement of dose 2 because of safety concerns. The participant can be re-evaluated for eligibility throughout the window of eligibility for the dose 2, once the illness or other factor has improved or resolved 4. Receipt of a clinical vaccine < 14 days before or planned to receive a clinical vaccine <14 days after the study agent

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Double (Participant, Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Vaccine Arm 		Participants in this arm will receive two doses of Cytomegalovirus-Modified Vaccinia Ankara (CMV-MVA) Triplex CMV vaccine
  • Drug: CMV-MVA Triplex
    The dosage used will be 5.0 x 10^8 pfu, administered under sterile conditions intramuscularly. The CMV-MVA Triplex vaccine lots range in titre from 5.0 to 9.0 x 10^8 pfu/mL in a supplied volume of 1.0 mL
Placebo Comparator
Placebo Arm 		Participants will receive two doses of matching placebo of the Cytomegalovirus-Modified Vaccinia Ankara (CMV-MVA) Triplex CMV vaccine
  • Drug: Placebo for CMV-MVA Triplex
    Arm 2 participants receive two doses of matching placebo CMV-MVA Triplex

Recruiting Locations

University of California, San Diego School of Medicine
La Jolla 5363943, California 5332921 92093
Contact:
Saima Aslam, MD
619-543-6146
saslam@health.ucsd.edu

Stanford University
Redwood City 5386834, California 5332921 94063-3126
Contact:
Dora Yuk-Wai Ho, MD, PhD
650-736-2442
jsbach@stanford.edu

University of California, San Francisco
San Francisco 5391959, California 5332921 94143-0000
Contact:
Monica Fung, MD, MPH
415-353-1275
monica.fung@ucsf.edu

University of Miami, Jackson Memorial Hospital
Miami 4164138, Florida 4155751 33136-1003
Contact:
Yoichiro Natori, MD, MPH
Please email
yxn138@med.miami.edu

Emory University Hospital
Atlanta 4180439, Georgia 4197000 30322-0000
Contact:
Aneesh Mehta, MD
Please email
aneesh.mehta@emory.edu

Northwestern University, Feinberg School of Medicine
Chicago 4887398, Illinois 4896861 60611-0000
Contact:
Michael Angarone, DO
312-695-6601
m-angarone@northwestern.edu

Johns Hopkins University School of Medicine
Baltimore 4347778, Maryland 4361885 21205-0000
Contact:
Robin Avery, MD
410-614-6702
ravery4@jhmi.edu

University of Michigan Medical Center
Ann Arbor 4984247, Michigan 5001836 48109-1274
Contact:
Kevin Gregg, MD
734-232-1486
kvngregg@med.umich.edu

Mayo Clinic, Rochester - College of Medicine and Science
Rochester 5043473, Minnesota 5037779 55905-0001
Contact:
Raymund Razonable, MD
507-255-7761
Razonable.Raymund@mayo.edu

University of Nebraska Medical Center
Omaha 5074472, Nebraska 5073708 68198-7835
Contact:
Sias Scherger, MD
402-559-8650
sscherger@unmc.edu

Duke University School of Medicine
Durham 4464368, North Carolina 4482348 27710-1000
Contact:
Matthew Kappus, MD
919-385-5487
matthew.kappus@duke.edu

Oregon Health & Sciences University
Portland 5746545, Oregon 5744337 97239-3098
Contact:
Lynne Strasfeld, MD
503-494-7735
strasfel@ohsu.edu

University of Pennsylvania School of Medicine
Philadelphia 4560349, Pennsylvania 6254927 19104-5127
Contact:
Emily Blumberg, MD
Please email
eblumber@pennmedicine.upenn.edu

University of Pittsburgh Medical Center
Pittsburgh 5206379, Pennsylvania 6254927 15213-0000
Contact:
Fernanda Silveira, MD, MS
412-648-6512
silvfd@upmc.edu

Vanderbilt University School of Medicine
Nashville 4644585, Tennessee 4662168 37232-0011
Contact:
Suzanne Sharpton, MD
Please email
suzanne.sharpton@vumc.org

University of Texas Southwestern Medical Center
Dallas 4684888, Texas 4736286 75390-0000
Contact:
Ricardo La Hoz, MD
205-306-5037
ricardo.lahoz@utsouthwestern.edu

University of Washington Medical Center: Transplantation
Seattle 5809844, Washington 5815135 98195
Contact:
Cindy P. Fisher, MD
206-598-9149
celaine@uw.edu

More Details

NCT ID
NCT06075745
Status
Recruiting
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

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ResearchMatch is funded in part by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program, led by the NIH’s National Center for Advancing Translational Sciences (NCATS), grants UL1TR000445 and 1U54RR032646-01, and grant U24TR001579 from NCATS and the National Library of Medicine. The content of this website is solely the responsibility of ResearchMatch and Vanderbilt University and does not necessarily represent the official views of the NIH, NCATS, or NLM.

Vanderbilt University Medical Center