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A Study of Ad-RTS-hIL-12 With Veledimex in Subjects With Glioblastoma or Malignant Glioma

Primary Purpose

Glioblastoma Multiforme, Anaplastic Oligoastrocytoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ad-RTS-hIL-12
veledimex
Sponsored by
Alaunos Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma Multiforme

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female subjects ≥ 18 and ≤ 75 years of age
  2. Provision of written informed consent for tumor resection, stereotactic surgery, tumor biopsy, samples collection and treatment with investigational products prior to undergoing any study procedures
  3. Histologically confirmed supratentorial glioblastoma or other WHO grade III or IV malignant glioma from archival tissue.
  4. Evidence of tumor recurrence/progression by MRI (RANO criteria) post standard initial therapy.
  5. Previous standard of care anti-tumor treatment including surgery and/or biopsy and chemoradiation. The washout periods from prior therapies are intended as follows:

    1. Nitrosoureas: 6 weeks
    2. Other cytotoxic agents: 4 weeks
    3. Anti-angiogenic agents including bevacizumab: 4 weeks
    4. Targeted agents including small-molecule tyrosine kinase inhibitors: 2 weeks
    5. Experimental immunotherapies: 3 months
    6. Vaccine based therapy: 3 months
  6. Able to undergo standard MRI scans with contrast agent
  7. Karnofsky Performance Status ≥ 70
  8. Adequate bone marrow reserves and liver and kidney function, as assessed by the following laboratory requirements:

    1. Hemoglobin ≥ 9 g/L
    2. Lymphocytes > 500/ mm3
    3. Absolute Neutrophil Count ≥ 1500/ mm3
    4. Platelets ≥ 100,000/ mm3
    5. Serum creatinine ≤ 1.5 x ULN
    6. AST (SGOT) and ALT (SGPT) ≤ 2.5 x ULN. For subjects with documented liver metastases, ALT and AST ≤ 5 × ULN
    7. Total bilirubin < 1.5 x ULN
    8. International Normalized Ratio (INR) and activated Partial Thromboplastin Time [PTT] within normal institutional limits
  9. Male and female subjects must agree to use a highly reliable method of birth control (expected failure rate less than 5% per year) from the screening visit through 28 days after the last dose of study drug. Women of childbearing potential must have a negative pregnancy test at screening.

Exclusion Criteria:

  1. Radiotherapy within 4 weeks or less prior to starting first veledimex dose
  2. Subjects with clinically significant increased intracranial pressure or uncontrolled seizures.
  3. Known immunosuppressive disease, autoimmune conditions, and /or chronic viral infections
  4. Use of systemic antibacterials, antifungals or antivirals for the treatment of acute clinically significant infection within 2 weeks of first veledimex dose. Concomitant therapy for chronic infections is not allowed. Subjects must be afebrile prior to Ad-RTS-hIL-12 injection; only prophylactic antibiotic use is permitted perioperatively.
  5. Use of enzyme-inducing anti-epileptic drugs (EIAED) within 7 days prior to the first dose of study drug.
  6. Other concurrent clinically active malignant disease, requiring treatment, with the exception of non-melanoma cancers of the skin or carcinoma in-situ of the cervix or non-metastatic prostate cancer.
  7. Nursing or pregnant females
  8. Prior exposure to veledimex
  9. Use of medications that induce, inhibit or are substrates of CYP450 3A4 within 7 days prior to the first veledimex dosing
  10. Presence of any contra-indication for a neurosurgical procedure
  11. Unstable or clinically significant concurrent medical condition that would, in the opinion of the investigator or medical monitor, jeopardize the safety of a subject and/or their compliance with the protocol.

Sites / Locations

  • Cedars-Sinai
  • University of California - San Francisco
  • Northwestern
  • University of Chicago
  • Brigham & Women's
  • MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ad-RTS-hIL-12+veledimex

Arm Description

varying doses of intratumoral Ad-RTS-hIL-12 (INXN-2001) and oral veledimex (activator ligand).

Outcomes

Primary Outcome Measures

Safety and tolerability of varying doses of intratumoral Ad-RTS-hIL-12 and oral veledimex doses in subjects with recurrent or progressive glioblastoma or Grade III malignant glioma
Evaluation will be based on the incidence, intensity, and type of Adverse Events (AEs). Clinically significant changes in the subjects' physical examinations, vital signs, and ECG evaluations, and clinical manifestations relevant to abnormal laboratory values will be captured as AEs.

Secondary Outcome Measures

Veledimex maximum tolerated dose (MTD) when given with varying doses of intratumoral Ad-RTS-hIL-12
Veledimex pharmacokinetic profile and veledimex concentration ratio between the brain tumor and the blood
Veledimex PK parameters to be determined will include, but are not limited to, the maximum plasma concentration (Cmax), time to maximum plasma concentration (Tmax), half-life (t1/2), area-under-the-concentration versus time curve (AUC), volume of distribution (Vd), and clearance (CL). Where possible, descriptive statistics of the PK parameters will be provided; individual subject veledimex concentrations, actual sampling times, and PK parameters will be listed.
Cellular and humoral immune responses elicited by Ad-RTS-hIL-12 and veledimex
Tumor Objective Response Rate (ORR)
Progression-free survival (PFS)
Overall survival (OS)

Full Information

First Posted
December 16, 2013
Last Updated
September 21, 2021
Sponsor
Alaunos Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02026271
Brief Title
A Study of Ad-RTS-hIL-12 With Veledimex in Subjects With Glioblastoma or Malignant Glioma
Official Title
A Phase I Study of Ad-RTS-hIL-12, an Inducible Adenoviral Vector Engineered to Express hIL-12 in the Presence of the Activator Ligand Veledimex in Subjects With Recurrent or Progressive Glioblastoma or Grade III Malignant Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
August 2019 (Actual)
Study Completion Date
August 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alaunos Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study involves an investigational product: Ad-RTS-hIL-12 given with veledimex for production of human IL-12. IL-12 is a protein that can improve the body's natural response to disease by enhancing the ability of the immune system to kill tumor cells and may interfere with blood flow to the tumor. The main purpose of this study is to evaluate the safety and tolerability of a single tumor injection of Ad-RTS-hIL-12 given with oral veledimex.
Detailed Description
Eligible patients will be stratified to one of two groups, according to clinical indication for tumor resection. Patients who are scheduled for a standard of care craniotomy and tumor resection will receive one dose of veledimex before the resection procedure. Ad-RTS-hIL-12 will be administered by free-hand injection. Patients will continue on oral veledimex for 14 days. Patients not scheduled for tumor resection will receive Ad-RTS-hIL-12 by stereotactic injection and then will continue on oral veledimex for 14 days. The study is divided into three periods: the screening period, the treatment period and the follow-up period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma Multiforme, Anaplastic Oligoastrocytoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ad-RTS-hIL-12+veledimex
Arm Type
Experimental
Arm Description
varying doses of intratumoral Ad-RTS-hIL-12 (INXN-2001) and oral veledimex (activator ligand).
Intervention Type
Biological
Intervention Name(s)
Ad-RTS-hIL-12
Other Intervention Name(s)
INXN-2001
Intervention Description
2.0 x 10^11 viral particles (vp) per injection or 1.0 x 10^12 viral particles (vp) per injection one intratumoral injection of Ad-RTS-hIL-12
Intervention Type
Drug
Intervention Name(s)
veledimex
Other Intervention Name(s)
INXN-1001, Activator Ligand
Intervention Description
4 doses (20mg/day, 40mg/day, 80mg/day, and 120mg/day) 14 oral daily doses of veledimex 1 Expansion cohort at a single dose level at or below MTD
Primary Outcome Measure Information:
Title
Safety and tolerability of varying doses of intratumoral Ad-RTS-hIL-12 and oral veledimex doses in subjects with recurrent or progressive glioblastoma or Grade III malignant glioma
Description
Evaluation will be based on the incidence, intensity, and type of Adverse Events (AEs). Clinically significant changes in the subjects' physical examinations, vital signs, and ECG evaluations, and clinical manifestations relevant to abnormal laboratory values will be captured as AEs.
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Veledimex maximum tolerated dose (MTD) when given with varying doses of intratumoral Ad-RTS-hIL-12
Time Frame
3 years
Title
Veledimex pharmacokinetic profile and veledimex concentration ratio between the brain tumor and the blood
Description
Veledimex PK parameters to be determined will include, but are not limited to, the maximum plasma concentration (Cmax), time to maximum plasma concentration (Tmax), half-life (t1/2), area-under-the-concentration versus time curve (AUC), volume of distribution (Vd), and clearance (CL). Where possible, descriptive statistics of the PK parameters will be provided; individual subject veledimex concentrations, actual sampling times, and PK parameters will be listed.
Time Frame
3 years
Title
Cellular and humoral immune responses elicited by Ad-RTS-hIL-12 and veledimex
Time Frame
3 years
Title
Tumor Objective Response Rate (ORR)
Time Frame
3 years
Title
Progression-free survival (PFS)
Time Frame
3 years
Title
Overall survival (OS)
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects ≥ 18 and ≤ 75 years of age Provision of written informed consent for tumor resection, stereotactic surgery, tumor biopsy, samples collection and treatment with investigational products prior to undergoing any study procedures Histologically confirmed supratentorial glioblastoma or other WHO grade III or IV malignant glioma from archival tissue. Evidence of tumor recurrence/progression by MRI (RANO criteria) post standard initial therapy. Previous standard of care anti-tumor treatment including surgery and/or biopsy and chemoradiation. The washout periods from prior therapies are intended as follows: Nitrosoureas: 6 weeks Other cytotoxic agents: 4 weeks Anti-angiogenic agents including bevacizumab: 4 weeks Targeted agents including small-molecule tyrosine kinase inhibitors: 2 weeks Experimental immunotherapies: 3 months Vaccine based therapy: 3 months Able to undergo standard MRI scans with contrast agent Karnofsky Performance Status ≥ 70 Adequate bone marrow reserves and liver and kidney function, as assessed by the following laboratory requirements: Hemoglobin ≥ 9 g/L Lymphocytes > 500/ mm3 Absolute Neutrophil Count ≥ 1500/ mm3 Platelets ≥ 100,000/ mm3 Serum creatinine ≤ 1.5 x ULN AST (SGOT) and ALT (SGPT) ≤ 2.5 x ULN. For subjects with documented liver metastases, ALT and AST ≤ 5 × ULN Total bilirubin < 1.5 x ULN International Normalized Ratio (INR) and activated Partial Thromboplastin Time [PTT] within normal institutional limits Male and female subjects must agree to use a highly reliable method of birth control (expected failure rate less than 5% per year) from the screening visit through 28 days after the last dose of study drug. Women of childbearing potential must have a negative pregnancy test at screening. Exclusion Criteria: Radiotherapy within 4 weeks or less prior to starting first veledimex dose Subjects with clinically significant increased intracranial pressure or uncontrolled seizures. Known immunosuppressive disease, autoimmune conditions, and /or chronic viral infections Use of systemic antibacterials, antifungals or antivirals for the treatment of acute clinically significant infection within 2 weeks of first veledimex dose. Concomitant therapy for chronic infections is not allowed. Subjects must be afebrile prior to Ad-RTS-hIL-12 injection; only prophylactic antibiotic use is permitted perioperatively. Use of enzyme-inducing anti-epileptic drugs (EIAED) within 7 days prior to the first dose of study drug. Other concurrent clinically active malignant disease, requiring treatment, with the exception of non-melanoma cancers of the skin or carcinoma in-situ of the cervix or non-metastatic prostate cancer. Nursing or pregnant females Prior exposure to veledimex Use of medications that induce, inhibit or are substrates of CYP450 3A4 within 7 days prior to the first veledimex dosing Presence of any contra-indication for a neurosurgical procedure Unstable or clinically significant concurrent medical condition that would, in the opinion of the investigator or medical monitor, jeopardize the safety of a subject and/or their compliance with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arnold Gelb, MD
Organizational Affiliation
Ziopharm Oncology
Official's Role
Study Director
Facility Information:
Facility Name
Cedars-Sinai
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
University of California - San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Northwestern
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Brigham & Women's
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
31413142
Citation
Chiocca EA, Yu JS, Lukas RV, Solomon IH, Ligon KL, Nakashima H, Triggs DA, Reardon DA, Wen P, Stopa BM, Naik A, Rudnick J, Hu JL, Kumthekar P, Yamini B, Buck JY, Demars N, Barrett JA, Gelb AB, Zhou J, Lebel F, Cooper LJN. Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: Results of a phase 1 trial. Sci Transl Med. 2019 Aug 14;11(505):eaaw5680. doi: 10.1126/scitranslmed.aaw5680.
Results Reference
derived

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A Study of Ad-RTS-hIL-12 With Veledimex in Subjects With Glioblastoma or Malignant Glioma

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