A Study to Evaluate the Safety of Intuvax Administered Intra-tumorally in Patients With Gastrointestinal Stromal Tumors (GIST)
Primary Purpose
Gastrointestinal Stromal Tumor
Status
Completed
Phase
Phase 1
Locations
Sweden
Study Type
Interventional
Intervention
Intuvax (ilixadencel)
Sponsored by
About this trial
This is an interventional treatment trial for Gastrointestinal Stromal Tumor focused on measuring GIST
Eligibility Criteria
Inclusion Criteria:
- Be informed of the nature of the study and have provided written informed consent.
- At least 18 years of age.
- Diagnosis of GIST (according to modified NIH criteria, 2011) where curative excision is no longer an option, i.e. confirmed unresectable or metastatic GIST, and that has progressed on second, third or fourth line tyrosine kinase inhibitor (TKI) treatment.
- Radiologically measurable tumor(s), i.e at least 3 cm in longest uni-dimensional diameter as measured by CT
- Clinical and/or CT verified disease progression despite ongoing second, third or fourth line treatment with a TKI
- Female who has been post-menopausal for more than one (1) year or female of childbearing potential using a highly efficient method of contraception (i.e. a method with less than 1% failure rate [e.g. sterilization, hormone implants, hormone injections, some intrauterine devices, or vasectomized partner with combined use of condom and/or birth control pills]) during study participation. Female of childbearing potential must have a negative blood pregnancy test at Screening, and if randomized to vaccination a negative blood or urine pregnancy test within one (1) day before each dose of Intuvax, or Male agreeing to use condoms during the study participation or male having a female partner who is using a highly efficient method of contraception as described above during the partner's study participation.
Exclusion Criteria:
- Performance status > ECOG 2
- Known major reaction/adverse event in connection with previously made vaccination (e.g. asthma, anaphylaxia or other serious reaction)
- Known major reaction/adverse event in connection with previous transfusions of blood products
- Active autoimmune disease requiring treatment with systemic immunosuppressive agents, e.g. inflammatory bowel disease, multiple sclerosis, sarcoidosis, psoriasis, autoimmune hemolytic anemia, rheumatoid arthritis, SLE, vasculitis, Sjögren's syndrome, scleroderma, autoimmune hepatitis, and other rheumatological diseases.
- Tested positive for HIV
- Active virus disease (HBV and HCV).
- Ongoing infection that requires treatment with parenteral antibiotics or antiviral medication
- Corticosteroid treatment per os exceeding 10mg/day within 7 days prior to the first injection of Intuvax. Inhaled, intranasal and local steroids accepted.
Inadequate laboratory parameters, i.e.:
- B-Leukocyte count < 3.0 x109/L
- B-Platelet count < 75 x109/L
- B-Hemoglobin < 100 g/L
- P-Prothrombincomplex (PK) >1.4
- P-APT time outside normal limit
- Previous organ transplantation
- Pregnant or lactating women
- Life expectancy less than 3 months.
- Investigational treatment (within 28 days) prior to the first injection of Intuvax
- Known blood dyscrasia (bleeding complication)
- Prior history of invasive cancer within 5 years before screening, except for adequately treated in situ carcinomas or non melanoma skin cancer
- History of alcohol or substance abuse
- patient will not be available for follow up assessments
- Any other reason that, in the opinion of the investigator, contraindicates that the patient participates in the study.
Sites / Locations
- Department of Breast and Endocrine Surgery, Section of Endocrine and Sarcoma Surgery, Karolinska University Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Intuvax (ilixadencel)
Arm Description
Intuvax (ilixadencel) will be administered 2 or 3 times. First injection Day 1 (pat 1-12), second injection 14 days after the first vaccination (pat 1-12), third injection 28 days after the second vaccination (only pat 7-12). Max 10 000 000 allogeneic dendritic cells/ml per injection.
Outcomes
Primary Outcome Measures
Changes in vital signs (heart rate, blood pressure, body temperature)
Changes in lab parameters (hematology and biochemistry) during the study versus baseline
Adverse events according to CTCAE v 4.03
Secondary Outcome Measures
Tumor response by determining changes (PD, SD, PR, CR) in tumor diameter according to mRECIST
Criteria based on the diameter of the contrast-enhanced portions of the tumor
Tumor response by determining changes (PD, SD, PR, CR) in tumor diameter according to RECIST 1.1.
Criteria based on the maximal tumor diameter
Tumor response by determining changes (PD, SD, PR, CR) in tumor diameter according to Choi criteria
Criteria based on unidimensional tumor size and tumor density on contrast-enhanced CT images.
Progression free survival according to mRECIST
Criteria based on the diameter of the contrast-enhanced portions of the tumor
Progression free survival according to RECIST 1.1
Criteria based on the maximal tumor diameter
Progression free survival according to Choi criteria
Criteria based on unidimensional tumor size and tumor density on contrast-enhanced CT images.
Changes in WHO-ECOG score
Levels of autoimmunization parameters
Screening of autoantibodies against nuclear antigens (ANA), including the nuclear antigens SSA, SSB, Sm, RNP, Scl-70, Centromeres and Jo-1
Levels of alloimmunization parameters
Screening of alloantibodies against HLA-A, B, C (MHC-class I) and HLA-DR (MHC-class II) antigens
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02686944
Brief Title
A Study to Evaluate the Safety of Intuvax Administered Intra-tumorally in Patients With Gastrointestinal Stromal Tumors
Acronym
GIST
Official Title
A Phase I Open-label Study Evaluating Safety and Efficacy of Intratumorally Administered Intuvax in Patients With Progressing Gastrointestinal Stromal Tumors (GIST) During Ongoing Second, Third or Fourth Line Treatment With Tyrosine Kinase Inhibition Therapy. A Prospective Single Armed, Open Label Phase I Safety and Efficacy Study
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
June 1, 2016 (Actual)
Primary Completion Date
May 10, 2019 (Actual)
Study Completion Date
May 10, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mendus
4. Oversight
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The study is a prospective single armed, open label phase I study. Patients with advanced or metastatic GIST and tumor progression despite ongoing treatment with second, third or fourth line TKI treatment, and with at least one measureable tumor lesion, will be eligible for the study. A maximum of 12 patients will be included in this study. The patients will continue with TKI treatment until the 3 months follow up visit. If further tumor progression TKI will be withdrawn but if stable disease or objective response the patient will continue with TKI until progress. The investigational product Intuvax will be injected into a tumor lesion at two or three treatment occasions; day 1, 14 days (±3 days) after the first vaccination, and 28 days (±3 days) after the second vaccination (patient 7-12 only). Intuvax will be injected in a viable part of the tumor, using ultrasound-guided or CT technique for correct administration.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Stromal Tumor
Keywords
GIST
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Masking Description
Open Label
Allocation
N/A
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Intuvax (ilixadencel)
Arm Type
Experimental
Arm Description
Intuvax (ilixadencel) will be administered 2 or 3 times. First injection Day 1 (pat 1-12), second injection 14 days after the first vaccination (pat 1-12), third injection 28 days after the second vaccination (only pat 7-12).
Max 10 000 000 allogeneic dendritic cells/ml per injection.
Intervention Type
Biological
Intervention Name(s)
Intuvax (ilixadencel)
Other Intervention Name(s)
ilixadencel
Intervention Description
Therapeutic vaccine: allogeneic, proinflammatory dendritic cells, suspension for intratumoral injection
Primary Outcome Measure Information:
Title
Changes in vital signs (heart rate, blood pressure, body temperature)
Time Frame
Up to 12 months after vaccination 1
Title
Changes in lab parameters (hematology and biochemistry) during the study versus baseline
Time Frame
Up to 12 months after vaccination 1
Title
Adverse events according to CTCAE v 4.03
Time Frame
Up to 12 months after vaccination 1
Secondary Outcome Measure Information:
Title
Tumor response by determining changes (PD, SD, PR, CR) in tumor diameter according to mRECIST
Description
Criteria based on the diameter of the contrast-enhanced portions of the tumor
Time Frame
Every 3 months up to 12 months after vaccination 1
Title
Tumor response by determining changes (PD, SD, PR, CR) in tumor diameter according to RECIST 1.1.
Description
Criteria based on the maximal tumor diameter
Time Frame
Every 3 months up to 12 months after vaccination 1
Title
Tumor response by determining changes (PD, SD, PR, CR) in tumor diameter according to Choi criteria
Description
Criteria based on unidimensional tumor size and tumor density on contrast-enhanced CT images.
Time Frame
Every 3 months up to 12 months after vaccination 1
Title
Progression free survival according to mRECIST
Description
Criteria based on the diameter of the contrast-enhanced portions of the tumor
Time Frame
Up to 12 months after vaccination 1
Title
Progression free survival according to RECIST 1.1
Description
Criteria based on the maximal tumor diameter
Time Frame
Up to 12 months after vaccination 1
Title
Progression free survival according to Choi criteria
Description
Criteria based on unidimensional tumor size and tumor density on contrast-enhanced CT images.
Time Frame
Up to 12 months after vaccination 1
Title
Changes in WHO-ECOG score
Time Frame
Up to 12 months after vaccination 1
Title
Levels of autoimmunization parameters
Description
Screening of autoantibodies against nuclear antigens (ANA), including the nuclear antigens SSA, SSB, Sm, RNP, Scl-70, Centromeres and Jo-1
Time Frame
Up to 3 months after vaccination 1
Title
Levels of alloimmunization parameters
Description
Screening of alloantibodies against HLA-A, B, C (MHC-class I) and HLA-DR (MHC-class II) antigens
Time Frame
Up to 3 months after vaccination 1
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Be informed of the nature of the study and have provided written informed consent.
At least 18 years of age.
Diagnosis of GIST (according to modified NIH criteria, 2011) where curative excision is no longer an option, i.e. confirmed unresectable or metastatic GIST, and that has progressed on second, third or fourth line tyrosine kinase inhibitor (TKI) treatment.
Radiologically measurable tumor(s), i.e at least 3 cm in longest uni-dimensional diameter as measured by CT
Clinical and/or CT verified disease progression despite ongoing second, third or fourth line treatment with a TKI
Female who has been post-menopausal for more than one (1) year or female of childbearing potential using a highly efficient method of contraception (i.e. a method with less than 1% failure rate [e.g. sterilization, hormone implants, hormone injections, some intrauterine devices, or vasectomized partner with combined use of condom and/or birth control pills]) during study participation. Female of childbearing potential must have a negative blood pregnancy test at Screening, and if randomized to vaccination a negative blood or urine pregnancy test within one (1) day before each dose of Intuvax, or Male agreeing to use condoms during the study participation or male having a female partner who is using a highly efficient method of contraception as described above during the partner's study participation.
Exclusion Criteria:
Performance status > ECOG 2
Known major reaction/adverse event in connection with previously made vaccination (e.g. asthma, anaphylaxia or other serious reaction)
Known major reaction/adverse event in connection with previous transfusions of blood products
Active autoimmune disease requiring treatment with systemic immunosuppressive agents, e.g. inflammatory bowel disease, multiple sclerosis, sarcoidosis, psoriasis, autoimmune hemolytic anemia, rheumatoid arthritis, SLE, vasculitis, Sjögren's syndrome, scleroderma, autoimmune hepatitis, and other rheumatological diseases.
Tested positive for HIV
Active virus disease (HBV and HCV).
Ongoing infection that requires treatment with parenteral antibiotics or antiviral medication
Corticosteroid treatment per os exceeding 10mg/day within 7 days prior to the first injection of Intuvax. Inhaled, intranasal and local steroids accepted.
Inadequate laboratory parameters, i.e.:
B-Leukocyte count < 3.0 x109/L
B-Platelet count < 75 x109/L
B-Hemoglobin < 100 g/L
P-Prothrombincomplex (PK) >1.4
P-APT time outside normal limit
Previous organ transplantation
Pregnant or lactating women
Life expectancy less than 3 months.
Investigational treatment (within 28 days) prior to the first injection of Intuvax
Known blood dyscrasia (bleeding complication)
Prior history of invasive cancer within 5 years before screening, except for adequately treated in situ carcinomas or non melanoma skin cancer
History of alcohol or substance abuse
patient will not be available for follow up assessments
Any other reason that, in the opinion of the investigator, contraindicates that the patient participates in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Mendus
Official's Role
Study Director
Facility Information:
Facility Name
Department of Breast and Endocrine Surgery, Section of Endocrine and Sarcoma Surgery, Karolinska University Hospital
City
Stockholm
ZIP/Postal Code
SE-171 76
Country
Sweden
12. IPD Sharing Statement
Plan to Share IPD
No
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A Study to Evaluate the Safety of Intuvax Administered Intra-tumorally in Patients With Gastrointestinal Stromal Tumors
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