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Phase 1 Trial of Interleukin 12 Gene Therapy for Metastatic Pancreatic Cancer

Primary Purpose

Metastatic Pancreatic Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ad5-yCD/mutTKSR39rep-hIL12
Sponsored by
Henry Ford Health System
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically proven (biopsy or cytology) metastatic pancreatic adenocarcinoma.
  • Age ≥ 18 years.
  • No prior treatment (surgery, chemotherapy, radiotherapy, or biological therapy) for the study cancer.
  • Zubrod performance score of 0 - 2 within 30 days of registration.
  • Subjects must have adequate baseline organ function, as assessed by the following laboratory values, within 30 days before initiating the study therapy:

    • Adequate renal function with serum creatinine ≤ 1.8 mg/dL or creatinine clearance ≥ 50 mL/min/m2.
    • Absolute neutrophil count > 1,000/μL.
    • Hemoglobin > 8.0 g/dL.
    • Platelet count > 100,000/μL.
    • Bilirubin < 2.0 mg/dL.
    • SGOT and SGPT < 3.0 times upper limit of normal (ULN). Subjects with liver metastases may have SGOT/SGPT < 5.0 times ULN.
  • Women of childbearing potential and male participants must agree to use a medically effective means of birth control throughout and for 60 days beyond the treatment phase of the study.
  • Subjects on oral warfarin anticoagulation therapy may be included in this study, but must have close monitoring of their coagulation parameters as altered parameters and/or bleeding have been reported in patients taking Xeloda® and such agents concomitantly. Subjects on other forms of anti-coagulation therapies may need close clinical monitoring for signs or symptoms of bleeding.
  • The subject must possess the ability to give informed consent and express a willingness to meet all of the expected requirements of the protocol for the duration of the study.

Exclusion Criteria:

  • Pregnant and lactating women.
  • Clinical or laboratory evidence of pancreatitis, based on discretion of treating physician.
  • Serious non-malignant disease (e.g., congestive heart failure or uncontrolled infections), which, in the opinion of the investigator would compromise study objectives.
  • Major surgery planned within 3 months of registration other than diagnostic procedures such as laparoscopy or endoscopic ultrasound and stenting or PEG/PEJ placement.
  • Islet cell tumor, benign cyst, peri-ampullary carcinoma or any non-adenocarcinomas.
  • Acute infection. Acute infection is defined by any viral, bacterial, or fungal infection that has required specific therapy within 72 hours of initiation of the study therapy (defined as day 1).
  • Previous history of liver disease including hepatitis.
  • Positive serologic test for Hepatitis B or C at baseline.
  • Immunosuppressive therapy including systemic corticosteroids. Use of inhaled and topical corticosteroids is permitted.
  • Impaired immunity or susceptibility to serious viral infections.
  • Allergy to any product used on the protocol.
  • Serious medical or psychiatric illness or concomitant medication, which, in the judgment of the investigator, might interfere with the subject's ability to respond to or tolerate the treatment or complete the trial.

Sites / Locations

  • Henry Ford Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Investigational Arm

Arm Description

Patients will receive a single intratumoral injection of the oncolytic Ad5-yCD/mutTKSR39rep-hIL12 adenovirus at one of three dose levels. Two days later, subjects will be administered (orally) 7 days of 5-fluorocytosine (5-FC) prodrug therapy. Fourteen days after completion of the 5-FC prodrug therapy course, subjects will be administered chemotherapy at the discretion of the treating physician. On an optional basis, subjects will be administered [18F]-FHBG, a HSV-1 TK substrate, and will undergo PET imaging to quantify the intensity, persistence, and biodistribution of HSV-1 TK gene expression in the pancreas.

Outcomes

Primary Outcome Measures

Toxicity of the gene therapy
grade 1 - 5 CTCAE adverse events

Secondary Outcome Measures

>= grade 3 adverse events
grade 3 - 5 CTCAE adverse events
PET imaging
HSV-1 TK gene expression via [18F]-FHBG administration and PET imaging

Full Information

First Posted
September 11, 2017
Last Updated
February 15, 2022
Sponsor
Henry Ford Health System
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1. Study Identification

Unique Protocol Identification Number
NCT03281382
Brief Title
Phase 1 Trial of Interleukin 12 Gene Therapy for Metastatic Pancreatic Cancer
Official Title
PHASE 1 TRIAL OF ONCOLYTIC ADENOVIRUS-MEDIATED CYTOTOXIC AND IL-12 GENE THERAPY IN COMBINATION WITH CHEMOTHERAPY FOR THE TREATMENT OF METASTATIC PANCREATIC CANCER
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
July 1, 2017 (Actual)
Primary Completion Date
May 28, 2019 (Actual)
Study Completion Date
May 28, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Henry Ford Health System

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase 1 trial will investigate the toxicity of combining interleukin 12 gene therapy with standard chemotherapy in metastatic pancreatic cancer.
Detailed Description
This protocol proposes a phase 1 trial combining oncolytic adenovirus-mediated cytotoxic and IL-12 gene therapy with chemotherapy in metastatic pancreatic cancer. Nine subjects (3 cohorts, 3 subjects/cohort) with metastatic pancreatic cancer will receive a single intratumoral injection of the oncolytic Ad5-yCD/mutTKSR39rep-hIL12 adenovirus at one of three dose levels (cohort 1- 1 x 1011 vp, cohort 2- 3 x 1011 vp, cohort 3- 1 x 1012 vp). Depending on the location of the target lesion, the adenovirus will be injected either through the stomach or duodenal wall using endoscopic ultrasound (EUS) guidance. Two days later, subjects will be administered (orally) 7 days of 5-fluorocytosine (5-FC) prodrug therapy. Fourteen days after completion of the 5-FC prodrug therapy course, subjects will be administered chemotherapy at the discretion of the treating physician. On an optional basis, subjects will be administered [18F]-FHBG, a HSV-1 TK substrate, and will undergo PET imaging to quantify the intensity, persistence, and biodistribution of HSV-1 TK gene expression in the pancreas. The primary endpoint is toxicity at day 21. A secondary endpoint is rates of ≥ grade 3 CTCAE adverse events. Exploratory endpoints include 1) intensity, persistence, and biodistribution of HSV-1 TK gene expression, and 2) association of immunological measurements (i.e., cytokine levels, NK cytolytic activity) with toxicity and clinical outcome.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Pancreatic Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Investigational Arm
Arm Type
Experimental
Arm Description
Patients will receive a single intratumoral injection of the oncolytic Ad5-yCD/mutTKSR39rep-hIL12 adenovirus at one of three dose levels. Two days later, subjects will be administered (orally) 7 days of 5-fluorocytosine (5-FC) prodrug therapy. Fourteen days after completion of the 5-FC prodrug therapy course, subjects will be administered chemotherapy at the discretion of the treating physician. On an optional basis, subjects will be administered [18F]-FHBG, a HSV-1 TK substrate, and will undergo PET imaging to quantify the intensity, persistence, and biodistribution of HSV-1 TK gene expression in the pancreas.
Intervention Type
Biological
Intervention Name(s)
Ad5-yCD/mutTKSR39rep-hIL12
Intervention Description
Oncolytic adenovirus expressing two suicide genes and human IL-12
Primary Outcome Measure Information:
Title
Toxicity of the gene therapy
Description
grade 1 - 5 CTCAE adverse events
Time Frame
21 days
Secondary Outcome Measure Information:
Title
>= grade 3 adverse events
Description
grade 3 - 5 CTCAE adverse events
Time Frame
21 days
Title
PET imaging
Description
HSV-1 TK gene expression via [18F]-FHBG administration and PET imaging
Time Frame
14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically proven (biopsy or cytology) metastatic pancreatic adenocarcinoma. Age ≥ 18 years. No prior treatment (surgery, chemotherapy, radiotherapy, or biological therapy) for the study cancer. Zubrod performance score of 0 - 2 within 30 days of registration. Subjects must have adequate baseline organ function, as assessed by the following laboratory values, within 30 days before initiating the study therapy: Adequate renal function with serum creatinine ≤ 1.8 mg/dL or creatinine clearance ≥ 50 mL/min/m2. Absolute neutrophil count > 1,000/μL. Hemoglobin > 8.0 g/dL. Platelet count > 100,000/μL. Bilirubin < 2.0 mg/dL. SGOT and SGPT < 3.0 times upper limit of normal (ULN). Subjects with liver metastases may have SGOT/SGPT < 5.0 times ULN. Women of childbearing potential and male participants must agree to use a medically effective means of birth control throughout and for 60 days beyond the treatment phase of the study. Subjects on oral warfarin anticoagulation therapy may be included in this study, but must have close monitoring of their coagulation parameters as altered parameters and/or bleeding have been reported in patients taking Xeloda® and such agents concomitantly. Subjects on other forms of anti-coagulation therapies may need close clinical monitoring for signs or symptoms of bleeding. The subject must possess the ability to give informed consent and express a willingness to meet all of the expected requirements of the protocol for the duration of the study. Exclusion Criteria: Pregnant and lactating women. Clinical or laboratory evidence of pancreatitis, based on discretion of treating physician. Serious non-malignant disease (e.g., congestive heart failure or uncontrolled infections), which, in the opinion of the investigator would compromise study objectives. Major surgery planned within 3 months of registration other than diagnostic procedures such as laparoscopy or endoscopic ultrasound and stenting or PEG/PEJ placement. Islet cell tumor, benign cyst, peri-ampullary carcinoma or any non-adenocarcinomas. Acute infection. Acute infection is defined by any viral, bacterial, or fungal infection that has required specific therapy within 72 hours of initiation of the study therapy (defined as day 1). Previous history of liver disease including hepatitis. Positive serologic test for Hepatitis B or C at baseline. Immunosuppressive therapy including systemic corticosteroids. Use of inhaled and topical corticosteroids is permitted. Impaired immunity or susceptibility to serious viral infections. Allergy to any product used on the protocol. Serious medical or psychiatric illness or concomitant medication, which, in the judgment of the investigator, might interfere with the subject's ability to respond to or tolerate the treatment or complete the trial.
Facility Information:
Facility Name
Henry Ford Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase 1 Trial of Interleukin 12 Gene Therapy for Metastatic Pancreatic Cancer

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