QUILT-3.051: NANT Ovarian Cancer Vaccine: Combination Immunotherapy in Subjects With Epithelial Ovarian Cancer Who Have Progressed on or After Standard-of-care (SoC) Therapy
Primary Purpose
Ovarian Cancer
Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Avelumab
Bevacizumab
Capecitabine
Cyclophosphamide
5-fluorouracil
Fulvestrant
Leucovorin
Paclitaxel
omega-3 acid ethyl esters
Oxaliplatin
Stereotactic Body Radiation Therapy
ALT-803
ETBX-021
ETBX-051
ETBX-061
GI-4000
GI-6301
haNK®
Sponsored by
About this trial
This is an interventional treatment trial for Ovarian Cancer
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years.
- Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
- Histologically-confirmed epithelial ovarian cancer that has progressed on or after SoC therapy. Germ cell, stromal, and borderline ovarian tumors are not allowed.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
- Have at least 1 measurable lesion of ≥ 1.5 cm.
- Must have a tumor biopsy specimen following the conclusion of the most recent anticancer treatment. If a historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period.
- Must be willing to provide blood samples and, if considered safe by the Investigator, a tumor biopsy specimen at 8 weeks after the start of treatment.
- Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
- Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment.
Exclusion Criteria:
- History of persistent grade 2 or higher (CTCAE Version 4.03) hematologic toxicity resulting from previous therapy.
- Within 5 years prior to first dose of study treatment, any evidence of other active malignancies or brain metastasis except for controlled basal cell carcinoma; prior history of in situ cancer (eg, breast, melanoma, and cervical); and bulky (≥ 1.5 cm) disease with metastasis in the central hilar area of the chest and involving the pulmonary vasculature.
- Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
- Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma).
- History of organ transplant requiring immunosuppression.
- History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
- Requires whole blood transfusion to meet eligibility criteria.
Inadequate organ function, evidenced by the following laboratory results:
- White blood cell (WBC) count < 3,000 cells/mm3
- Absolute neutrophil count < 1,500 cells/mm3.
- Platelet count < 100,000 cells/mm3.
- Hemoglobin < 9 g/dL.
- Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
- Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
- Alkaline phosphatase (ALP) levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
- Serum creatinine > 2.0 mg/dL or 177 μmol/L.
- International normalized ratio (INR), activated partial thromboplastin time (aPTT), or partial thromboplastin time (PTT) >1.5 × ULN (unless on therapeutic anti-coagulation).
- Uncontrolled hypertension (systolic > 150 mm Hg and/or diastolic > 100 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication.
- Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.
- Positive results of screening test for human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV).
- Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
- Known hypersensitivity to any component of the study medication(s).
- Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
- Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.
- Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.
- Participation in an investigational drug study or history of receiving any investigational treatment within 14 days prior to screening for this study.
- Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
- Concurrent participation in any interventional clinical trial.
- Pregnant and nursing women.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
NANT Ovarian Cancer Vaccine
Arm Description
avelumab, bevacizumab, capecitabine, cyclophosphamide, 5-fluorouracil, fulvestrant, leucovorin, paclitaxel, omega-3-acid ethyl esters, oxaliplatin, stereotactic body radiation therapy, ALT-803, ETBX-021, ETBX-051, ETBX-061, GI-4000, GI-6301, and hank®.
Outcomes
Primary Outcome Measures
Incidence of treatment-emergent adverse events (AEs) and serious AE (SAEs), graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03.
Phase 1b primary endpoint
Objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
Phase 2 primary endpoint
ORR by Immune-related response criteria (irRC )
Phase 2 primary endpoint
Secondary Outcome Measures
ORR by RECIST Version 1.1
Phase 1b secondary endpoint
ORR by irRC
Phase 1b secondary endpoint
Progression-free survival (PFS) by RECIST Version 1.1
Phase 1b and 2 secondary endpoint
PFS by irRC
Phase 1b and 2 secondary endpoint
Overall survival (OS): time from the date of first treatment to the date of death (any cause)
Phase 1b and 2 secondary endpoint
Duration of response (DR): time from the date of first response (partial response (PR) or complete response (CR)) to the date of disease progression or death (any cause) whichever occurs first
Phase 1b and 2 secondary endpoint
Disease control rate (DCR): confirmed complete response, partial response, or stable disease lasting for at least 2 months
Phase 1b and 2 secondary endpoint
Quality of life (QoL) by patient-reported outcome using the Functional Assessment of Cancer Therapy-Ovarian Cancer (FACT-O) questionnaire
Phase 1b and 2 secondary endpoint
Incidence of treatment-emergent AEs and SAEs, graded using the NCI CTCAE Version 4.03
Phase 2 secondary endpoint
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03197584
Brief Title
QUILT-3.051: NANT Ovarian Cancer Vaccine: Combination Immunotherapy in Subjects With Epithelial Ovarian Cancer Who Have Progressed on or After Standard-of-care (SoC) Therapy
Official Title
NANT Ovarian Cancer Vaccine: Combination Immunotherapy in Subjects With Epithelial Ovarian Cancer Who Have Progressed on or After Standard-of-care (SoC) Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
October 2017
Overall Recruitment Status
Withdrawn
Why Stopped
Trial not initiated
Study Start Date
December 2017 (Anticipated)
Primary Completion Date
February 2019 (Anticipated)
Study Completion Date
April 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ImmunityBio, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a phase 1b/2 study to evaluate the safety and efficacy of metronomic combination therapy in subjects with epithelial ovarian cancer who have progressed on or after SoC therapy.
Detailed Description
Treatment will be administered in two phases, an induction and a maintenance phase. Subjects will continue induction treatment for up to 1 year or until they experience progressive disease (PD) or unacceptable toxicity (not correctable with dose reduction), withdraw consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. Those who have a complete response (CR) in the induction phase will enter the maintenance phase of the study. Subjects may remain in the maintenance phase of the study for up to 1 year. Treatment will continue in the maintenance phase until the subject experiences PD or unacceptable toxicity (not correctable with dose reduction), withdraws consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. The maximum time on study treatment, including both the induction and maintenance phases, is 2 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
NANT Ovarian Cancer Vaccine
Arm Type
Experimental
Arm Description
avelumab, bevacizumab, capecitabine, cyclophosphamide, 5-fluorouracil, fulvestrant, leucovorin, paclitaxel, omega-3-acid ethyl esters, oxaliplatin, stereotactic body radiation therapy, ALT-803, ETBX-021, ETBX-051, ETBX-061, GI-4000, GI-6301, and hank®.
Intervention Type
Biological
Intervention Name(s)
Avelumab
Intervention Description
Fully human anti-PD-L1 IgG1 lambda monoclonal antibody
Intervention Type
Biological
Intervention Name(s)
Bevacizumab
Intervention Description
Recombinant human anti-VEGF IgG1 monoclonal antibody
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
5'-deoxy-5-fluoro-N-[(pentyloxy) carbonyl]-cytidine
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate
Intervention Type
Drug
Intervention Name(s)
5-fluorouracil
Intervention Description
5-fluoro-2,4 (1H,3H)-pyrimidinedione
Intervention Type
Drug
Intervention Name(s)
Fulvestrant
Intervention Description
7-alpha-[9-(4,4,5,5,5-pentafluoropentylsulphinyl) nonyl]estra-1,3,5-(10)- triene-3,17-beta-diol
Intervention Type
Drug
Intervention Name(s)
Leucovorin
Intervention Description
Calcium N-[p-[[[(6RS)-2-amino-5-formyl-5,6,7,8-tetrahydro-4-hydroxy-6-pteridinyl]methyl]amino]benzoyl]-L-glutamate (1:1)
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Intervention Description
5β,20-Epoxy-1,2α,4,7β,10β,13α-hexahydroxytax-11-en-9-one 4,10-diacetate 2-benzoate 13-ester with (2R,3S)-N-benzoyl-3-phenylisoserine
Intervention Type
Drug
Intervention Name(s)
omega-3 acid ethyl esters
Intervention Description
omega-3 acid ethyl esters
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
cis-[(1 R,2 R)-1,2-cyclohexanediamine-N,N'] [oxalato(2-)- O,O'] platinum
Intervention Type
Radiation
Intervention Name(s)
Stereotactic Body Radiation Therapy
Intervention Description
Stereotactic Body Radiation Therapy (SBRT)
Intervention Type
Biological
Intervention Name(s)
ALT-803
Intervention Description
Recombinant human super agonist IL-15 complex
Intervention Type
Biological
Intervention Name(s)
ETBX-021
Intervention Description
Ad5 [E1-, E2b-]-HER2 vaccine
Intervention Type
Biological
Intervention Name(s)
ETBX-051
Intervention Description
Ad5 [E1-, E2b-]-Brachyury vaccine
Intervention Type
Biological
Intervention Name(s)
ETBX-061
Intervention Description
Ad5 [E1-, E2b-]-MUC1 vaccine
Intervention Type
Biological
Intervention Name(s)
GI-4000
Intervention Description
Heat-killed S. cerevisiae yeast expressing the mutated RAS oncoproteins
Intervention Type
Biological
Intervention Name(s)
GI-6301
Intervention Description
Heat-killed S. cerevisiae yeast expressing the human Brachyury (hBrachyury) oncoprotein
Intervention Type
Biological
Intervention Name(s)
haNK®
Intervention Description
NK-92 [CD16.158V, ER IL-2]
Primary Outcome Measure Information:
Title
Incidence of treatment-emergent adverse events (AEs) and serious AE (SAEs), graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03.
Description
Phase 1b primary endpoint
Time Frame
1 year
Title
Objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
Description
Phase 2 primary endpoint
Time Frame
1 year
Title
ORR by Immune-related response criteria (irRC )
Description
Phase 2 primary endpoint
Time Frame
1 year
Secondary Outcome Measure Information:
Title
ORR by RECIST Version 1.1
Description
Phase 1b secondary endpoint
Time Frame
1 year
Title
ORR by irRC
Description
Phase 1b secondary endpoint
Time Frame
1 year
Title
Progression-free survival (PFS) by RECIST Version 1.1
Description
Phase 1b and 2 secondary endpoint
Time Frame
2 years
Title
PFS by irRC
Description
Phase 1b and 2 secondary endpoint
Time Frame
2 years
Title
Overall survival (OS): time from the date of first treatment to the date of death (any cause)
Description
Phase 1b and 2 secondary endpoint
Time Frame
2 years
Title
Duration of response (DR): time from the date of first response (partial response (PR) or complete response (CR)) to the date of disease progression or death (any cause) whichever occurs first
Description
Phase 1b and 2 secondary endpoint
Time Frame
2 years
Title
Disease control rate (DCR): confirmed complete response, partial response, or stable disease lasting for at least 2 months
Description
Phase 1b and 2 secondary endpoint
Time Frame
2 years
Title
Quality of life (QoL) by patient-reported outcome using the Functional Assessment of Cancer Therapy-Ovarian Cancer (FACT-O) questionnaire
Description
Phase 1b and 2 secondary endpoint
Time Frame
2 years
Title
Incidence of treatment-emergent AEs and SAEs, graded using the NCI CTCAE Version 4.03
Description
Phase 2 secondary endpoint
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18 years.
Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
Histologically-confirmed epithelial ovarian cancer that has progressed on or after SoC therapy. Germ cell, stromal, and borderline ovarian tumors are not allowed.
Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
Have at least 1 measurable lesion of ≥ 1.5 cm.
Must have a tumor biopsy specimen following the conclusion of the most recent anticancer treatment. If a historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period.
Must be willing to provide blood samples and, if considered safe by the Investigator, a tumor biopsy specimen at 8 weeks after the start of treatment.
Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment.
Exclusion Criteria:
History of persistent grade 2 or higher (CTCAE Version 4.03) hematologic toxicity resulting from previous therapy.
Within 5 years prior to first dose of study treatment, any evidence of other active malignancies or brain metastasis except for controlled basal cell carcinoma; prior history of in situ cancer (eg, breast, melanoma, and cervical); and bulky (≥ 1.5 cm) disease with metastasis in the central hilar area of the chest and involving the pulmonary vasculature.
Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma).
History of organ transplant requiring immunosuppression.
History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
Requires whole blood transfusion to meet eligibility criteria.
Inadequate organ function, evidenced by the following laboratory results:
White blood cell (WBC) count < 3,000 cells/mm3
Absolute neutrophil count < 1,500 cells/mm3.
Platelet count < 100,000 cells/mm3.
Hemoglobin < 9 g/dL.
Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
Alkaline phosphatase (ALP) levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
Serum creatinine > 2.0 mg/dL or 177 μmol/L.
International normalized ratio (INR), activated partial thromboplastin time (aPTT), or partial thromboplastin time (PTT) >1.5 × ULN (unless on therapeutic anti-coagulation).
Uncontrolled hypertension (systolic > 150 mm Hg and/or diastolic > 100 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication.
Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.
Positive results of screening test for human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV).
Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
Known hypersensitivity to any component of the study medication(s).
Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.
Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.
Participation in an investigational drug study or history of receiving any investigational treatment within 14 days prior to screening for this study.
Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
Concurrent participation in any interventional clinical trial.
Pregnant and nursing women.
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
QUILT-3.051: NANT Ovarian Cancer Vaccine: Combination Immunotherapy in Subjects With Epithelial Ovarian Cancer Who Have Progressed on or After Standard-of-care (SoC) Therapy
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