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INO-5401 and INO-9012 Delivered by Electroporation (EP) in Combination With Cemiplimab (REGN2810) in Newly-Diagnosed Glioblastoma (GBM)

Primary Purpose

Glioblastoma

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
INO-5401
INO-9012
Cemiplimab
Radiation Therapy
Temozolomide
Sponsored by
Inovio Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma focused on measuring Glioblastoma, immunotherapy, DNA therapy, checkpoint inhibitor

Eligibility Criteria

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

Inclusion Criteria:

  • Newly-diagnosed brain cancer with histopathological diagnosis of GBM;
  • Karnofsky Performance Status (KPS) rating of >/=70 at baseline;
  • Receive dexamethasone equivalent dose </=2 mg per day, stable or decreased for >/= three days prior to Day 0;
  • Recovery from the effects of prior GBM surgery as defined by the Investigator;
  • Electrocardiogram (ECG) with no clinically significant findings as assessed by the Investigator;
  • Adequate organ function as demonstrated by hematological, renal, hepatic laboratory assessments;
  • Agree that during the trial, men will not father a child, and women cannot be or become pregnant. Participants must be of non-child bearing potential or agree to use one highly effective or combined contraceptive methods that result in a failure rate of <1% per year during the treatment period and at least through week 12 after last dose;
  • Ability to tolerate magnetic resonance imaging (MRI).

Exclusion Criteria:

  • Presence of greater than 1 cm x 1 cm residual tumor enhancement on postoperative MRI;
  • Multifocal disease or leptomeningeal disease (LM) disease on post-operative MRI;
  • Not scheduled to start radiation within 42 days of surgical resection of tumor;
  • Dexamethasone equivalent dose >2 mg per day;
  • Prior treatment with an agent that blocks the PD-1/PD-Ligand 1 pathway;
  • Receipt of previous approved or investigative immune modulatory agent within 28 days of receiving the first dose of treatment;
  • Prior treatment with idelalisib;
  • Past, current or planned treatment with tumor treatment fields; oncolytic viral treatment; or prior exposure to an investigational agent or device within 28 days of receiving the first dose of treatment;
  • Allergy or hypersensitivity to cemiplimab or to any of its excipients;
  • History of documented allergic reactions or acute hypersensitivity reaction attributed to antibody treatments;
  • Ongoing or recent (within 5 years) evidence of autoimmune disease that required treatment with systemic immunosuppressive treatments;
  • Diagnosis of immunodeficiency or treatment with systemic immunosuppressive therapy within 28 days prior to the first dose of trial treatment, other than dexamethasone for the underlying disease under investigation, as noted in the inclusion criteria;
  • History of clinically significant, medically unstable disease which, in the judgment of the investigator, would jeopardize the safety of the subject, interfere with trial assessments or endpoint evaluation, or otherwise impact the validity of the trial results.

Sites / Locations

  • City of Hope
  • Stanford University, School of Medicine
  • University of California, San Francisco
  • University of Miami - Sylvester Comprehensive Cancer Center
  • Moffitt Cancer Center
  • Emory University School of Medicine
  • Dana-Farber Cancer Institute
  • Henry Ford Health System
  • Rutgers University - Cancer Institute of New Jersey
  • New York University Langone Medical Center; Perlmutter Cancer Center
  • Icahn School of Medicine at Mount Sinai
  • Columbia University Medical Center The Neurological Institute of New York
  • New York-Presbyterian Hospital/Weill Cornell Medical Center
  • University of North Carolina School of Medicine
  • Stephenson Cancer Center
  • Oregon Health & Science University
  • University of Pennsylvania Health System: Penn Medicine
  • UPMC Cancer Center Neuro-Oncology; UPMC Cancer Pavilion
  • Texas Oncology
  • Baylor College of Medicine
  • Huntsman Cancer Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort A: Unmethylated MGMT Promoter

Cohort B: Methylated MGMT Promoter

Arm Description

Cohort A will include participants with a glioblastoma tumor with an unmethylated MGMT promoter. Participants will receive INO-5401 and INO-9012 and cemiplimab as well as radiation and temozolomide (TMZ; only during radiation therapy), if clinically indicated.

Cohort B will include participants with a glioblastoma tumor with a methylated MGMT promoter or with indeterminate MGMT status. Participants will receive INO-5401 and INO-9012 and cemiplimab as well as radiation and temozolomide (TMZ), if clinically indicated. Participants will continue to receive TMZ following radiation therapy, for up to six additional cycles, if clinically indicated.

Outcomes

Primary Outcome Measures

Percentage of Participants with Adverse Events (AEs)

Secondary Outcome Measures

Overall survival at 18 months (OS18)
Change from Baseline in Interferon-gamma Secreting T Lymphocytes in Peripheral Blood Mononuclear Cells (PBMCs)
Change from Baseline in T-Cell Phenotypes in PBMCs
Change from Baseline in T Cell Receptor (TCR) Subtypes in PBMCs
Change from Baseline in Antigen-Specific Humoral Response

Full Information

First Posted
April 2, 2018
Last Updated
May 16, 2023
Sponsor
Inovio Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03491683
Brief Title
INO-5401 and INO-9012 Delivered by Electroporation (EP) in Combination With Cemiplimab (REGN2810) in Newly-Diagnosed Glioblastoma (GBM)
Official Title
An Open-Label, Multi-Center Trial of INO-5401 and INO-9012 Delivered by Electroporation (EP) in Combination With REGN2810 in Subjects With Newly-Diagnosed Glioblastoma (GBM)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 31, 2018 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Inovio Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
Phase 1/2 trial to evaluate safety, immunogenicity and preliminary efficacy of INO-5401 and INO-9012 in combination with cemiplimab (REGN2810), with radiation and chemotherapy, in subjects with newly-diagnosed glioblastoma (GBM).
Detailed Description
This is a phase 1/2, open-label, multi-center trial to evaluate safety, immunogenicity and preliminary efficacy of INO-5401 and INO-9012 in combination with cemiplimab in subjects with newly-diagnosed glioblastoma (GBM). INO-5401 and INO-9012 will be delivered by intramuscular (IM) injection followed by electroporation (EP) in combination with cemiplimab and chemoradiation and radiation. There will be 2 cohorts in this trial. Cohort A will be participants with a tumor with an unmethylated O6-methylguanine-deoxyribonucleic acid (DNA) methyltransferase (MGMT) promoter. Cohort B will be participants with a tumor with a MGMT methylated promoter or who have indeterminate MGMT status. Both cohorts will receive INO-5401 and INO-9012 and cemiplimab at the same doses and on the same dosing schedule, and both cohorts will receive radiation and temozolomide (TMZ), if clinically indicated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma
Keywords
Glioblastoma, immunotherapy, DNA therapy, checkpoint inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
52 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort A: Unmethylated MGMT Promoter
Arm Type
Experimental
Arm Description
Cohort A will include participants with a glioblastoma tumor with an unmethylated MGMT promoter. Participants will receive INO-5401 and INO-9012 and cemiplimab as well as radiation and temozolomide (TMZ; only during radiation therapy), if clinically indicated.
Arm Title
Cohort B: Methylated MGMT Promoter
Arm Type
Experimental
Arm Description
Cohort B will include participants with a glioblastoma tumor with a methylated MGMT promoter or with indeterminate MGMT status. Participants will receive INO-5401 and INO-9012 and cemiplimab as well as radiation and temozolomide (TMZ), if clinically indicated. Participants will continue to receive TMZ following radiation therapy, for up to six additional cycles, if clinically indicated.
Intervention Type
Biological
Intervention Name(s)
INO-5401
Intervention Description
INO-5401 is a combination of 3 separate DNA plasmids targeting Wilms tumor gene-1 (WT1) antigen, prostate-specific membrane antigen (PSMA) and human telomerase reverse transcriptase (hTERT) genes. Starting on Day 0 three milligrams (mg) of each plasmid will be delivered IM followed by EP using the CELLECTRA® 2000 EP device every three weeks for four doses, and then every 9 weeks until disease progression as defined by immunotherapy Response Assessment in Neuro-Oncology (iRANO), unacceptable toxicity, withdrawal of consent, or death.
Intervention Type
Biological
Intervention Name(s)
INO-9012
Intervention Description
INO-9012 is a DNA plasmid for expression of human interleukin-12 (IL-12). Starting on Day 0 one mg plasmid will be delivered IM followed by EP using the CELLECTRA® 2000 EP device every three weeks for four doses, and then every 9 weeks until disease progression as defined by iRANO, unacceptable toxicity, withdrawal of consent, or death.
Intervention Type
Biological
Intervention Name(s)
Cemiplimab
Other Intervention Name(s)
REGN2810
Intervention Description
Cemiplimab is an antibody to programmed death-1 (PD-1) protein. Starting on Day 0 cemiplimab will be administered intravenously (IV) every three weeks at a dose of 350 mg per dose in the absence of dose holding, until disease progression as defined by iRANO, unacceptable toxicity, withdrawal of consent, or death.
Intervention Type
Radiation
Intervention Name(s)
Radiation Therapy
Intervention Description
Radiation therapy (RT) will begin no later than 42 days after surgical intervention, and should start approximately 2 weeks after Day 0. RT will be given for three weeks.
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Intervention Description
Temozolomide (TMZ) will be given daily during radiation therapy (RT) at a dose of 75 milligrams per square meter (mg/m^2).
Primary Outcome Measure Information:
Title
Percentage of Participants with Adverse Events (AEs)
Time Frame
From Day 0 to 30 days after the last dose of study treatment (non-serious AEs) and to 6 months after the last dose of study treatment (immune-related AEs, AEs of special interest and serious AEs) up to approximately 24 months
Secondary Outcome Measure Information:
Title
Overall survival at 18 months (OS18)
Time Frame
At Month 18
Title
Change from Baseline in Interferon-gamma Secreting T Lymphocytes in Peripheral Blood Mononuclear Cells (PBMCs)
Time Frame
From Day 0 to last dose of study treatment up to approximately 18 months
Title
Change from Baseline in T-Cell Phenotypes in PBMCs
Time Frame
From Day 0 to last dose of study treatment up to approximately 18 months
Title
Change from Baseline in T Cell Receptor (TCR) Subtypes in PBMCs
Time Frame
From Day 0 to last dose of study treatment up to approximately 18 months
Title
Change from Baseline in Antigen-Specific Humoral Response
Time Frame
From Day 0 to last dose of study treatment up to approximately 18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Newly-diagnosed brain cancer with histopathological diagnosis of GBM; Karnofsky Performance Status (KPS) rating of >/=70 at baseline; Receive dexamethasone equivalent dose </=2 mg per day, stable or decreased for >/= three days prior to Day 0; Recovery from the effects of prior GBM surgery as defined by the Investigator; Electrocardiogram (ECG) with no clinically significant findings as assessed by the Investigator; Adequate organ function as demonstrated by hematological, renal, hepatic laboratory assessments; Agree that during the trial, men will not father a child, and women cannot be or become pregnant. Participants must be of non-child bearing potential or agree to use one highly effective or combined contraceptive methods that result in a failure rate of <1% per year during the treatment period and at least through week 12 after last dose; Ability to tolerate magnetic resonance imaging (MRI). Exclusion Criteria: Presence of greater than 1 cm x 1 cm residual tumor enhancement on postoperative MRI; Multifocal disease or leptomeningeal disease (LM) disease on post-operative MRI; Not scheduled to start radiation within 42 days of surgical resection of tumor; Dexamethasone equivalent dose >2 mg per day; Prior treatment with an agent that blocks the PD-1/PD-Ligand 1 pathway; Receipt of previous approved or investigative immune modulatory agent within 28 days of receiving the first dose of treatment; Prior treatment with idelalisib; Past, current or planned treatment with tumor treatment fields; oncolytic viral treatment; or prior exposure to an investigational agent or device within 28 days of receiving the first dose of treatment; Allergy or hypersensitivity to cemiplimab or to any of its excipients; History of documented allergic reactions or acute hypersensitivity reaction attributed to antibody treatments; Ongoing or recent (within 5 years) evidence of autoimmune disease that required treatment with systemic immunosuppressive treatments; Diagnosis of immunodeficiency or treatment with systemic immunosuppressive therapy within 28 days prior to the first dose of trial treatment, other than dexamethasone for the underlying disease under investigation, as noted in the inclusion criteria; History of clinically significant, medically unstable disease which, in the judgment of the investigator, would jeopardize the safety of the subject, interfere with trial assessments or endpoint evaluation, or otherwise impact the validity of the trial results.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Skolnik, MD
Organizational Affiliation
Inovio Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Stanford University, School of Medicine
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
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
University of Miami - Sylvester Comprehensive Cancer Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Emory University School of Medicine
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Henry Ford Health System
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Rutgers University - Cancer Institute of New Jersey
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Facility Name
New York University Langone Medical Center; Perlmutter Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Columbia University Medical Center The Neurological Institute of New York
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
New York-Presbyterian Hospital/Weill Cornell Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
University of North Carolina School of Medicine
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Stephenson Cancer Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pennsylvania Health System: Penn Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
UPMC Cancer Center Neuro-Oncology; UPMC Cancer Pavilion
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Texas Oncology
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Huntsman Cancer Institute
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84112
Country
United States

12. IPD Sharing Statement

Learn more about this trial

INO-5401 and INO-9012 Delivered by Electroporation (EP) in Combination With Cemiplimab (REGN2810) in Newly-Diagnosed Glioblastoma (GBM)

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