Salvage Ovarian FANG™ Vaccine + Bevacizumab
Primary Purpose
Stage III Ovarian Cancer, Stage IV Ovarian Cancer
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Vigil™ Vaccine
Bevacizumab
Sponsored by
About this trial
This is an interventional treatment trial for Stage III Ovarian Cancer focused on measuring Papillary Serous Ovarian Cancer, Endometrioid Ovarian Cancer, Epithelial Ovarian Cancer
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed papillary serous or endometrioid ovarian cancer.
- Previous randomization to Gradalis, Inc. protocol CL-PTL 105; observation arm (Group B) or patients with vaccine prepared for CLPTL 105 but not otherwise qualifying.
- Recurrent cisplatinum resistant/refractory disease (defined as the appearance of any measurable or evaluable lesion or as asymptomatic CA-125 levels greater than 100 u/mL at two consecutive measurements with no intervening therapy.
- Successful manufacturing of 4 vials of Vigil™ vaccine.
- Recovered from all clinically relevant toxicities related to prior therapies.
- ECOG PS 0-2 prior to Vigil™ vaccine administration.
Normal organ and marrow function as defined below:
- Absolute granulocyte count ≥1,500/mm3
- Absolute lymphocyte count ≥ 200/mm3
- Platelets ≥100,000/mm3
- Total bilirubin ≤1.5 x ULN
- AST(SGOT)/ALT(SGPT)/alkaline phosphatase ≤2.5 x ULN
- Creatinine <1.5 mg/dL
- INR < 1.5
- Baseline blood pressure must be under 140/90
- Urine protein-to-creatinine ratio < 1.0 mg/dL.
- Patients must be off all "statin" drugs for ≥ 2 weeks prior to initiation of therapy.
- Ability to understand and the willingness to sign a written informed protocol specific consent.
Exclusion Criteria:
- Surgery involving general anesthesia, chemotherapy, radiotherapy, steroid therapy, or immunotherapy within 4 weeks prior to vaccination. Chemotherapy within 3 weeks prior to vaccination. Steroid therapy within 1 week prior to vaccination.
- Major surgery within 6 weeks or minor surgery within 2 weeks of receiving bevacizumab.
- Patient must not have received any other investigational agents within 4 weeks prior to study entry.
- Patients who require parenteral hydration of nutrition and have evidence of partial bowel obstruction or perforation.
- Patients with history of brain metastases.
- Patients with compromised pulmonary disease.
- Short term (<30 days) concurrent systemic steroids ≤ 0.25 mg/kg prednisone per day (maximum 7.5 mg/day) and bronchodilators (inhaled steroids) are permitted; other steroid regimens and/or immunosuppressives are excluded.
- Prior splenectomy.
- Prior malignancy (excluding nonmelanoma carcinomas of the skin and carcinoma in situ cervix) unless in remission for ≥ 2 years.
- Kaposi's Sarcoma.
- Patients with active bleeding or pathologic conditions that carry high risk of bleeding such as a known bleeding disorder, coagulopathy, or tumor involving major blood vessels.
- History of Stroke/Transient Ischemic Attack
- Use of bleeding diathesis
- Use of anti-coagulants
Patients with clinically significant cardiovascular disease including any of the following:
- Significant cardiac conduction abnormalities (e.g., PR interval > 0.24 sec or second or third degree AV block.
- Uncontrolled hypertension, defined as systolic blood pressure (BP) > 150 mm Hg or diastolic BP > 90 mm Hg.
- Myocardial infarction, cardiac arrhythmia, or unstable angina within the past 6 months.
- New York Heart Association grade II or greater congestive heart failure.
- Serious cardiac arrhythmia requiring medication.
- Grade II or greater peripheral vascular disease except episodes of ischemia < 24 hours induration that are managed non-surgically and without permanent deficit
- History of cerebrovascular accident within the past 6 months.
- No significant traumatic injury within the past 28 days.
- Uncontrolled infection or psychiatric illness/social situations that would limit compliance with study requirements.
- Patients with known HIV.
- Patients with chronic Hepatitis B and C infection.
- Patients with uncontrolled autoimmune diseases.
Sites / Locations
- Mary Crowley Cancer Research Centers
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Vigil™ Vaccine
Arm Description
Patients will receive 1.0 x 10e7 cells via intradermal injection one day each cycle for a maximum of 12 doses as long as sufficient material is available and subject is clinically stable. Additionally, patients will receive bevacizumab 10 mg/kg intravenously (prior to Vigil™ administration) every 2 weeks (4 weeks=1 cycle).
Outcomes
Primary Outcome Measures
Time to Progression
Time to progression (TTP) following bevacizumab integrated with Vigil vaccine in patients failing standard of care in study CL-PTL 105 or in those not otherwise qualifying after vaccine production. This will be measured from the treatment start date (date of first dose) to either the date the patient is first recorded as having disease recurrence (even if the patient went off treatment because of toxicity), or the date of death if the patient dies due to any causes before progression.
Response Rate
Response will be evaluated using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline.
Secondary Outcome Measures
Number of Alive Subjects
Survival status of patients after treatment was determined by following these patients up to 24 months.
Enzyme-Linked ImmunoSorbent Spot (ELISPOT)
To determine if subjects will have a positive (defined as >10 ELISPOTS from baseline) immune response to Vigil. Blood was collected to compare ELISPOT results from baseline until 30 days after last dose.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01551745
Brief Title
Salvage Ovarian FANG™ Vaccine + Bevacizumab
Official Title
Phase II Trial of Adjuvant Bi-shRNAfurin and GMCSF Augmented Autologous Tumor Cell Vaccine (FANG™) Integrated With Bevacizumab for Patients With Recurrent/Refractory Ovarian Cancer Participating in Study CL-PTL 105
Study Type
Interventional
2. Study Status
Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
March 2012 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gradalis, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a Phase II study of Vigil™ autologous tumor cell vaccine integrated with bevacizumab. All patients will have had Vigil™ prepared and stored from initial primary surgical debulking. Patients meeting eligibility criteria will receive Vigil™ 1.0 x 10e7 cells/intradermal injection once every 4 weeks and bevacizumab 10 mg/kg intravenously every 2 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage III Ovarian Cancer, Stage IV Ovarian Cancer
Keywords
Papillary Serous Ovarian Cancer, Endometrioid Ovarian Cancer, Epithelial Ovarian Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
5 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Vigil™ Vaccine
Arm Type
Experimental
Arm Description
Patients will receive 1.0 x 10e7 cells via intradermal injection one day each cycle for a maximum of 12 doses as long as sufficient material is available and subject is clinically stable. Additionally, patients will receive bevacizumab 10 mg/kg intravenously (prior to Vigil™ administration) every 2 weeks (4 weeks=1 cycle).
Intervention Type
Biological
Intervention Name(s)
Vigil™ Vaccine
Other Intervention Name(s)
bi-shRNA furin and GMCSF Augmented Autologous Tumor Cell Vaccine, formerly known as FANG™
Intervention Description
Patients meeting eligibility criteria will receive Autologous Vigil™ vaccine will be supplied by Gradalis,Inc. Patients will receive 1.0 x 10e7 cells via intradermal injection one day each cycle for a maximum of 12 doses as long as sufficient material is available and subject is clinically stable. Additionally, patients will receive bevacizumab 10 mg/kg intravenously (prior to Vigil™ administration) every 2 weeks (4 weeks=1 cycle).
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Other Intervention Name(s)
VEGF
Intervention Description
Patients meeting eligibility criteria will receive bevacizumab 10 mg/kg intravenously every 2 weeks.
Primary Outcome Measure Information:
Title
Time to Progression
Description
Time to progression (TTP) following bevacizumab integrated with Vigil vaccine in patients failing standard of care in study CL-PTL 105 or in those not otherwise qualifying after vaccine production. This will be measured from the treatment start date (date of first dose) to either the date the patient is first recorded as having disease recurrence (even if the patient went off treatment because of toxicity), or the date of death if the patient dies due to any causes before progression.
Time Frame
24 months
Title
Response Rate
Description
Response will be evaluated using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline.
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Number of Alive Subjects
Description
Survival status of patients after treatment was determined by following these patients up to 24 months.
Time Frame
24 months
Title
Enzyme-Linked ImmunoSorbent Spot (ELISPOT)
Description
To determine if subjects will have a positive (defined as >10 ELISPOTS from baseline) immune response to Vigil. Blood was collected to compare ELISPOT results from baseline until 30 days after last dose.
Time Frame
Baseline, End of Treatment (30 days after last dose) up to 12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically confirmed papillary serous or endometrioid ovarian cancer.
Previous randomization to Gradalis, Inc. protocol CL-PTL 105; observation arm (Group B) or patients with vaccine prepared for CLPTL 105 but not otherwise qualifying.
Recurrent cisplatinum resistant/refractory disease (defined as the appearance of any measurable or evaluable lesion or as asymptomatic CA-125 levels greater than 100 u/mL at two consecutive measurements with no intervening therapy.
Successful manufacturing of 4 vials of Vigil™ vaccine.
Recovered from all clinically relevant toxicities related to prior therapies.
ECOG PS 0-2 prior to Vigil™ vaccine administration.
Normal organ and marrow function as defined below:
Absolute granulocyte count ≥1,500/mm3
Absolute lymphocyte count ≥ 200/mm3
Platelets ≥100,000/mm3
Total bilirubin ≤1.5 x ULN
AST(SGOT)/ALT(SGPT)/alkaline phosphatase ≤2.5 x ULN
Creatinine <1.5 mg/dL
INR < 1.5
Baseline blood pressure must be under 140/90
Urine protein-to-creatinine ratio < 1.0 mg/dL.
Patients must be off all "statin" drugs for ≥ 2 weeks prior to initiation of therapy.
Ability to understand and the willingness to sign a written informed protocol specific consent.
Exclusion Criteria:
Surgery involving general anesthesia, chemotherapy, radiotherapy, steroid therapy, or immunotherapy within 4 weeks prior to vaccination. Chemotherapy within 3 weeks prior to vaccination. Steroid therapy within 1 week prior to vaccination.
Major surgery within 6 weeks or minor surgery within 2 weeks of receiving bevacizumab.
Patient must not have received any other investigational agents within 4 weeks prior to study entry.
Patients who require parenteral hydration of nutrition and have evidence of partial bowel obstruction or perforation.
Patients with history of brain metastases.
Patients with compromised pulmonary disease.
Short term (<30 days) concurrent systemic steroids ≤ 0.25 mg/kg prednisone per day (maximum 7.5 mg/day) and bronchodilators (inhaled steroids) are permitted; other steroid regimens and/or immunosuppressives are excluded.
Prior splenectomy.
Prior malignancy (excluding nonmelanoma carcinomas of the skin and carcinoma in situ cervix) unless in remission for ≥ 2 years.
Kaposi's Sarcoma.
Patients with active bleeding or pathologic conditions that carry high risk of bleeding such as a known bleeding disorder, coagulopathy, or tumor involving major blood vessels.
History of Stroke/Transient Ischemic Attack
Use of bleeding diathesis
Use of anti-coagulants
Patients with clinically significant cardiovascular disease including any of the following:
Significant cardiac conduction abnormalities (e.g., PR interval > 0.24 sec or second or third degree AV block.
Uncontrolled hypertension, defined as systolic blood pressure (BP) > 150 mm Hg or diastolic BP > 90 mm Hg.
Myocardial infarction, cardiac arrhythmia, or unstable angina within the past 6 months.
New York Heart Association grade II or greater congestive heart failure.
Serious cardiac arrhythmia requiring medication.
Grade II or greater peripheral vascular disease except episodes of ischemia < 24 hours induration that are managed non-surgically and without permanent deficit
History of cerebrovascular accident within the past 6 months.
No significant traumatic injury within the past 28 days.
Uncontrolled infection or psychiatric illness/social situations that would limit compliance with study requirements.
Patients with known HIV.
Patients with chronic Hepatitis B and C infection.
Patients with uncontrolled autoimmune diseases.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Minal Barve, MD
Organizational Affiliation
Mary Crowley Cancer Research Centers
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mary Crowley Cancer Research Centers
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
22186789
Citation
Senzer N, Barve M, Kuhn J, Melnyk A, Beitsch P, Lazar M, Lifshitz S, Magee M, Oh J, Mill SW, Bedell C, Higgs C, Kumar P, Yu Y, Norvell F, Phalon C, Taquet N, Rao DD, Wang Z, Jay CM, Pappen BO, Wallraven G, Brunicardi FC, Shanahan DM, Maples PB, Nemunaitis J. Phase I trial of "bi-shRNAi(furin)/GMCSF DNA/autologous tumor cell" vaccine (FANG) in advanced cancer. Mol Ther. 2012 Mar;20(3):679-86. doi: 10.1038/mt.2011.269. Epub 2011 Dec 20.
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Salvage Ovarian FANG™ Vaccine + Bevacizumab
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