Mutant-CALR Peptide Vaccine for the Treatment of Patients with CALR Mutation Positive Myeloproliferative Neoplasms

Inclusion Criteria

• Subjects must be >= 18 years of age at the time of signing the informed consent form
• Confirmed diagnosis of chronic phase MPN: * High risk ET and meeting one of the below: ** Previously treated relapsed/refectory OR ** Intolerant for treatment per the investigator * Low to intermediate risk (Dynamic International Prognostic Scoring System [DIPSS] 0-1) primary myelofibrosis (PMF) or ET-MF
• Verified mutation in CALR exon 9
• Performance status (PS) =< 2
• Absolute neutrophil count >= 1000/mm^3
• Platelet count >= 50,000/mm^3
• Creatinine =< 2.5 mg/dL
• Total bilirubin =< 2 mg/dL, (except in patients with Gilbert Syndrome who can have total bilirubin < 3.0 mg/dL)
• Transaminases <= 3 times above the upper limits of the institutional normal
• International normalized ratio (INR) < 2 if off of anticoagulation. Patients on anticoagulation therapy with an INR > 2 may be enrolled at the discretion of the investigator if they have not had any episodes of severe hemorrhage within the last 6 months
• Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10-14 days prior to starting study medication and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 4 weeks prior to first dose of vaccine. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a condom during sexual contact with a female of child bearing potential even if they have had a successful vasectomy
• Ability to understand and the willingness to sign a written informed consent
• Ability to adhere to the study visit schedule and all protocol requirements
• Subjects receiving cytoreductive therapy with hydroxyurea must be on a stable dose for at least 8 weeks prior to week 1

Exclusion Criteria

• Other invasive malignancy in the past 3 years except non-melanoma skin cancer, localized cured prostate cancer and early stage breast cancer on hormone replacement therapy (HRT)
• Active autoimmune disease
• Uncontrolled serious infection
• Known immunodeficiency
• Pregnant and breastfeeding women
• Not willing to use contraception
• Current use of immunosuppressive medications including steroids
• Current Janus kinase (JAK) inhibitor use
• Current use of interferon (IFN) (use of anagrelide is permitted)
• Treatment with other experimental drugs within 30 days of week 1
• Treatment with any MPN directed therapy unless otherwise noted within 5 half-lives of week 1
• Any significant psychiatric/medical condition per investigators judgment