breakthroughs and big questions: aids vaccine research in 2014 · 2014-05-19 · studies planned to...
TRANSCRIPT
![Page 1: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/1.jpg)
Breakthroughs and Big Questions: AIDS vaccine research in 2014
Mary A. MarovichDirector, Vaccine Research Program
Division of AIDSNIAID/NIH
May 19, 2014
1
![Page 2: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/2.jpg)
Future of HIV-1 vaccines is bright
Major breakthroughs in last 5 years converge:
• First Efficacy signal - RV144• New technology - viral targets, Env structure • Human broadly neutralizing Abs - protect NHP• CD8 T cells - protect NHP, clear infection
2
![Page 3: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/3.jpg)
HIV Vaccine Research and Development“breakthroughs”
•RV144 Efficacy Signal– 1st HIV vaccine study shows acquisition effect – Correlates work ongoing– Studies planned to extend/substantiate results
•Broad neutralizing Abs (bNabs)– Hundreds of new bNabs identified– 4 viral targets (MPER, CD4bs, glycan V3, V1V2)– Produced by human immune repertoire
•T cell immunogens– CMV-SIV vectored vaccine ½ animals cleared infection– Other viral vectors some animals protected
3
![Page 4: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/4.jpg)
How long does it take to make a vaccine?
Disease Years to develop vaccine
Typhoid 105
Haemophilusinfluenzae B
92
Pertussis 89
Polio 30
Measles 42
Hepatitis B 15
HIV 30 and countingSource: Modified from H. Markel, NEJM 2005 4
![Page 5: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/5.jpg)
Do they work?
“How Vaccines Have Changed Our World in One Graphic” www.forbes.comFeb. 19, 2013(using data from JAMA 2010)
5
![Page 6: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/6.jpg)
Most effective vaccines induce Abs to key viral surface protein(s)
Hemagglutinin (HA)e.g., H1, H3
gp120 HBsAg
Influenza AHIV-1 Hepatitis B
6
![Page 7: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/7.jpg)
C
HIV Vaccine Research and Development“breakthroughs”
•RV144 Efficacy Signal– 1st HIV vaccine study shows acquisition effect – Correlates work ongoing– Studies planned to extend/substantiate results
•Broad neutralizing Abs (bNabs)– Hundreds of new bNabs identified– 4 viral targets (MPER, CD4bs, glycan V3, V1V2)– Produced by human immune repertoire
•T cell immunogens– CMV-SIV vectored vaccine ½ animals cleared infection– Other viral vectors some animals protected
7
![Page 8: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/8.jpg)
RV144 – First link to Clinical Efficacy
Waning durability Ab?
Prob
abilit
y of
HIV
-1 In
fect
ion
(%)
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
YEARS0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5
.38
.15
.64
.41
.84
.58
.96
.68
PlaceboVaccine
Placebo
Vaccine
8
![Page 9: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/9.jpg)
RV144 Antibody CorrelatesAntibodies to variable loop regions (V1V2)
V2 IgG Abs correlate with decreased infection risk*9
![Page 10: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/10.jpg)
Pox-Protein Public Private Partnership (P5)
• Goal: Substantiate and extend the RV144 result in high incidence populations
• Partnership: BMGF, NIAID/DAIDS, Novartis, Sanofi-Pasteur and USMHRP with critical linkages to:
-Medical Research Council of RSA-GlaxoSmithKline (provide ASO1B)
• Implementers: HIV Vaccine Trials Network
10
![Page 11: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/11.jpg)
Clade B Domestic ProgramQ1 2014 – Q1 2020
CTMQ1
2014 –Q3
2014
Phase IIbQ2 2014 – Q3 2015
Phase IIb LicensureQ1 2015 – Q1 2020
Ad/MVA/ProteinQ1 2013 – Q2 2018
CTMQ1 2013 – Q2 2014
Phase IQ2 2014 - Q2 2015
Phase IIa/bQ1 2015 – Q2 2018
P5 Research TrackQ1 2012 – Q2 2020
CTM Phase IQ1 2012 – Q2 2014
CTM Phase IIQ1 2012 – Q1 2015
Phase I/IIbQ4 2014 - Q1 2016
Go/No-GoJanuary 2016
Products
Partners , Geography, and Networks
RSA
Thailand
ALVAC-HIV (vCP2438)• HIV-1 Clade C (ZM96) gp120 env• HIV-1 Clade B (LAI) gag, pro and gp41 tm anchor
sequencegp120 Env proteins
• 1086• TV1
MF59 Adjuvant
CTMQ1
2014 –Q3
2014
Phase IIbQ2 2014 – Q3 2015
CTMQ1 2013 – Q2 2014
Phase IQ2 2014 - Q2 2015
Partners, Geography, & Network
RSA, Mozam., +
Pox-Protein Public-Private Partnership (P5)
Licensure Track Correlates/Discovery Track
ProductsDNA-HIV-PT123
• HIV-1 Clade CNYVAC-HIV-PT1/PT4
• HIV-1 Clade C (ZM96) gp120 envgp120 Env proteins
• 1086• TV1
MF59, ASO1B Adjuvants
![Page 12: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/12.jpg)
C
HIV Vaccine Research and Development“breakthroughs”
•RV144 Efficacy Signal– 1st HIV vaccine study shows acquisition effect – Correlates work ongoing– Studies planned to extend/substantiate results
•Broad neutralizing Abs (bNabs)– Hundreds of new bNabs identified– 4 viral targets (MPER, CD4bs, glycan V3, V1V2)– Produced by human immune repertoire
•T cell immunogens– CMV-SIV vectored vaccine ½ animals cleared infection– Other viral vectors some animals protected
12
![Page 13: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/13.jpg)
Sites of vulnerability = targets of BNabs
13
![Page 14: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/14.jpg)
14
![Page 15: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/15.jpg)
Envimmunogen
Engage Germ Line and Drive Ab Maturation
Immune-based
15
![Page 16: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/16.jpg)
Recent study in AIDS 2014 showed exciting news:
•Modestly neutralizing Abs may be more common than we think•There is a spectrum of responses•Most sera shows some level of cross-neutralization•Approx. 50% of sera neutralize 50% of viruses•Titers of neutralization (potency) were correlated with breadth•Many sera had breadth ~ to several of less potent bNAbs
Neutralizing antibody hurdle
•Good news for vaccine induced antibodies
Hraber et al, AIDS 2014, 28:163-169
![Page 17: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/17.jpg)
C
HIV Vaccine Research and Development“breakthroughs”
•RV144 Efficacy Signal– 1st HIV vaccine study shows acquisition effect – Correlates work ongoing– Studies planned to extend/substantiate results
•Broad neutralizing Abs (bNabs)– Hundreds of new bNabs identified– 4 viral targets (MPER, CD4bs, glycan V3, V1V2)– Produced by human immune repertoire
•T cell immunogens– CMV-SIV vectored vaccine ½ animals cleared infection– Other viral vectors some animals protected
17
![Page 18: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/18.jpg)
![Page 19: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/19.jpg)
RhCMV- SIV Vector controls SIV challenge
Non-Controllers
Controllers*
RhCMV/SIV vector-vaccinated
n=9
n=7
Control
RhCMV/Tb vector-vaccinated
Picker, et al 2012
Key finding: 50% animals ‘cleared’ infection; Effector Memory
19
![Page 20: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/20.jpg)
Vaccine Induced Antibodies: Major Questions to Address Going Forward
1. Antibody Durability
2. Quality of IgG and IgA Binding
3. Mucosal Antibodies
4. Neutralization
![Page 21: Breakthroughs and Big Questions: AIDS vaccine research in 2014 · 2014-05-19 · Studies planned to extend/substantiate results ... Q1 2014 – Q1 2020. CTM. Q1 20 ... P5 Research](https://reader034.vdocuments.net/reader034/viewer/2022050102/5f416c8f77ffaa1c6f20ce9e/html5/thumbnails/21.jpg)
Thank you