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Clinical Trial to Assess the Safety and Efficacy of AloCELYVIR With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) in Combination With Radiotherapy or Medulloblastoma in Monotherapy (AloCELYVIR)

Primary Purpose

Diffuse Intrinsic Pontine Glioma, Medulloblastoma, Childhood, Recurrent

Status
Recruiting
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
AloCELYVIR
Sponsored by
Hospital Infantil Universitario Niño Jesús, Madrid, Spain
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Intrinsic Pontine Glioma focused on measuring Icovir-5, Mesenchymal stem cells, Medulloblastoma, Diffuse Intrinsic Pontine Glioma

Eligibility Criteria

1 Year - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA COMMON TO THE TWO COHORTS

  1. Patients aged 1 to 21 years.
  2. Written informed consent signed by the patients legal representative and, if applicable, the minor (informed consent in patients 12 years of age or older).
  3. Measurable or evaluable disease according to RANO criteria.
  4. Appropriate functional status, organic function (renal, hepatic) and hematological values:

    • Lanksy and karnofsky functional status ≥50%. Patients who use a wheelchair due of tumor-associated paralysis will be considered as outpatients for functional status evaluation.
    • Haematology function:

      • Platelet count ≥75.000/µL (without support for 3 days)
      • Absolute neutrophil count (ANC) ≥500/ µL (without growth factor for 3 days)
      • Hemoglobin ≥ 8 g/dL (Transfusion allowed)
    • Liver and renal function

      • Glomerular filtration rate (GFR) (estimated by Schwartz ) >60 mL/min/1.73 m2
      • Total bilirubin ≤ 1.5 × the upper limit of normal (ULN)
      • Transaminases (GOT and GPT) ≤3 × the upper limit of normal (ULN). ≤ 5 times ULN for patients with hepatic metastasis.
  5. Patient able to comply with treatment and schedule of visits and assessments
  6. Life expectancy of ≥8 weeks.
  7. Appropriate contraceptive methods for sexually active males and females of childbearing age
  8. Negative pregnancy test in blood or urine for females of childbearing age

INCLUSION CRITERIA COMMON TO THE COHORT A

  1. Patient with new DIPG diagnosis (clinical, radiological, or histological in case a biopsy was performed before being included in the study).
  2. Not having received previous treatment with radiotherapy or chemotherapy.
  3. Patient able to receive radiotherapy

INCLUSION CRITERIA COMMON TO THE COHORT B

  1. Patient diagnosed with relapsed and/or refractory medulloblastoma. Patients must have received at least surgery, radiation therapy and chemotherapy as part of standard treatment and have failed these treatments before they can participate in this study.
  2. To be recovered to ≤ G1 from the toxic effects according to CTCAE derived from the previous treatments, excluding ototoxicity, alopecia and peripheral neurotoxicity.

EXCLUSION CRITERIA COMMON TO THE TWO COHORTS

  1. Previous treatment with CELYVIR or AloCELYVIR.
  2. Known active bacterial, viral, fungal or parasitic infection not controlled
  3. Known active Hepatitis B or C virus or VIH infection.
  4. If patients are treated with corticosteroids, they should be clinically stable and on stable or tapering doses of steroids for at least one week.
  5. To be receiving another anti-cancer treatment not foreseen in this protocol or to anticipate receiving it during the patient's participation in the same concomitant with the experimental treatment.
  6. Clinically significant or uncontrolled serious active and past systemic diseases that may pose an added risk to the patient

EXCLUSION CRITERIA COMMON TO THE COHORT A

  1. Spontaneous massive intratumoral bleeding. Patients with postoperative bleeding (in case of biopsy or surgery) may be included in the study provided that the bleeding is controlled. The same rule applies for other postoperative complications (infection, loss of cerebrospinal fluid, absence of wound closure, subdural collection ...)
  2. Patients who have previously received radiotherapy to the brain stem for another malignancy

EXCLUSION CRITERIA COMMON TO THE COHORT B

1. Washout period respect to previous treatments:

  • At least two weeks since the last dose of chemotherapy. For patients receiving low-dose metronomic oral chemotherapy, this period is at least one week.
  • At least four weeks since the autologous hematopoietic stem cell transplant
  • At least two weeks since the last focal radiotherapy or six weeks in case of cranio-spinal radiotherapy.
  • At least 2 weeks or 5 half-lifes (whichever occurs first) since the last dose of a biological or investigational treatment.

Sites / Locations

  • Hospital Infantil Universitario Niño JesúsRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AloCELYVIR

Arm Description

Patients will received weekly infusion of AloCELYVIR during 8 weeks.

Outcomes

Primary Outcome Measures

Dose-Limiting Toxicities rate (DLTs)
Proportion of patients who has experienced a DLT

Secondary Outcome Measures

Objective response rate
Percentage of patients that achieve complete response or partial response according to RECIST 1.1 criteria
Feasibility of the combination/monotherapy
Rate of patients meeting selection criteria who can receive at least one dose of AloCELYVIR
Incidence of treatment-Emergent Adverse Event
Rate of related-AEs
Progression-free survival (PFS)
Time from the date of first dose of study treatment to the date of progression or death (from ant cause).
Overall Survival (OS)
Time from the date of first dose of study treatment to the date of death
Antiadenoviral humoral immune response in patients
Anti-Adenovirus serotype 5 antibody titers
Antiadenoviral tumoral immune response in patients
Number of CD8 antiadenovirus T-lymphocytes
Replication kinetics of Icovir-5
Quantification of circulating adenoviral particles

Full Information

First Posted
February 8, 2021
Last Updated
September 11, 2023
Sponsor
Hospital Infantil Universitario Niño Jesús, Madrid, Spain
Collaborators
Apices Soluciones S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT04758533
Brief Title
Clinical Trial to Assess the Safety and Efficacy of AloCELYVIR With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) in Combination With Radiotherapy or Medulloblastoma in Monotherapy
Acronym
AloCELYVIR
Official Title
Phase IB Clinical Trial to Assess the Safety, Tolerability, and Preliminary Efficacy of AloCELYVIR (Mesenchymal Allogenic Cells + ICOVIR-5) in Children, Adolescent and Young Adults With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) in Combination With Radiotherapy or Medulloblastoma in Relapse/Progression in Monotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 19, 2021 (Actual)
Primary Completion Date
April 2025 (Anticipated)
Study Completion Date
April 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hospital Infantil Universitario Niño Jesús, Madrid, Spain
Collaborators
Apices Soluciones S.L.

4. Oversight

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

5. Study Description

Brief Summary
The aim of this study is to assess the safety and efficacy of AloCELYVIR, which consist in bone marrow-derived allogenic mesenchymal stem cells infected with an oncolytic Adenovirus, ICOVIR-5. It has recently been proven that this type of cells are able of transporting oncolytic substances to tumor targets that are difficult to reach, such as medulloblastomas and gliomas, youth cancers located in the cranial cavity that have a poor prognosis and a fatal outcome. In addition, to exerting an anti-tumor action, this virus has the ability to stimulate the immune response, making the therapy even more effective. Thus, the diffuse intrinsic pontine glioma and the medulloblastoma in relapse/progression have been chosen to study the potential of this new advanced therapy through a weekly infusion for 8 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Intrinsic Pontine Glioma, Medulloblastoma, Childhood, Recurrent
Keywords
Icovir-5, Mesenchymal stem cells, Medulloblastoma, Diffuse Intrinsic Pontine Glioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Open, non-randomized, single-center Phase I clinical trial.
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
AloCELYVIR
Arm Type
Experimental
Arm Description
Patients will received weekly infusion of AloCELYVIR during 8 weeks.
Intervention Type
Biological
Intervention Name(s)
AloCELYVIR
Intervention Description
Mesenchymal allogenic cells + ICOVIR-5: 500.000 cells/kg
Primary Outcome Measure Information:
Title
Dose-Limiting Toxicities rate (DLTs)
Description
Proportion of patients who has experienced a DLT
Time Frame
1 Month
Secondary Outcome Measure Information:
Title
Objective response rate
Description
Percentage of patients that achieve complete response or partial response according to RECIST 1.1 criteria
Time Frame
24 Months
Title
Feasibility of the combination/monotherapy
Description
Rate of patients meeting selection criteria who can receive at least one dose of AloCELYVIR
Time Frame
1 Month
Title
Incidence of treatment-Emergent Adverse Event
Description
Rate of related-AEs
Time Frame
2,5 Months
Title
Progression-free survival (PFS)
Description
Time from the date of first dose of study treatment to the date of progression or death (from ant cause).
Time Frame
24 Months
Title
Overall Survival (OS)
Description
Time from the date of first dose of study treatment to the date of death
Time Frame
24 Months
Title
Antiadenoviral humoral immune response in patients
Description
Anti-Adenovirus serotype 5 antibody titers
Time Frame
2,5 Months
Title
Antiadenoviral tumoral immune response in patients
Description
Number of CD8 antiadenovirus T-lymphocytes
Time Frame
2,5 Months
Title
Replication kinetics of Icovir-5
Description
Quantification of circulating adenoviral particles
Time Frame
2,5 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA COMMON TO THE TWO COHORTS Patients aged 1 to 21 years. Written informed consent signed by the patients legal representative and, if applicable, the minor (informed consent in patients 12 years of age or older). Measurable or evaluable disease according to RANO criteria. Appropriate functional status, organic function (renal, hepatic) and hematological values: Lanksy and karnofsky functional status ≥50%. Patients who use a wheelchair due of tumor-associated paralysis will be considered as outpatients for functional status evaluation. Haematology function: Platelet count ≥75.000/µL (without support for 3 days) Absolute neutrophil count (ANC) ≥500/ µL (without growth factor for 3 days) Hemoglobin ≥ 8 g/dL (Transfusion allowed) Liver and renal function Glomerular filtration rate (GFR) (estimated by Schwartz ) >60 mL/min/1.73 m2 Total bilirubin ≤ 1.5 × the upper limit of normal (ULN) Transaminases (GOT and GPT) ≤3 × the upper limit of normal (ULN). ≤ 5 times ULN for patients with hepatic metastasis. Patient able to comply with treatment and schedule of visits and assessments Life expectancy of ≥8 weeks. Appropriate contraceptive methods for sexually active males and females of childbearing age Negative pregnancy test in blood or urine for females of childbearing age INCLUSION CRITERIA COMMON TO THE COHORT A Patient with new DIPG diagnosis (clinical, radiological, or histological in case a biopsy was performed before being included in the study). Not having received previous treatment with radiotherapy or chemotherapy. Patient able to receive radiotherapy INCLUSION CRITERIA COMMON TO THE COHORT B Patient diagnosed with relapsed and/or refractory medulloblastoma. Patients must have received at least surgery, radiation therapy and chemotherapy as part of standard treatment and have failed these treatments before they can participate in this study. To be recovered to ≤ G1 from the toxic effects according to CTCAE derived from the previous treatments, excluding ototoxicity, alopecia and peripheral neurotoxicity. EXCLUSION CRITERIA COMMON TO THE TWO COHORTS Previous treatment with CELYVIR or AloCELYVIR. Known active bacterial, viral, fungal or parasitic infection not controlled Known active Hepatitis B or C virus or VIH infection. If patients are treated with corticosteroids, they should be clinically stable and on stable or tapering doses of steroids for at least one week. To be receiving another anti-cancer treatment not foreseen in this protocol or to anticipate receiving it during the patient's participation in the same concomitant with the experimental treatment. Clinically significant or uncontrolled serious active and past systemic diseases that may pose an added risk to the patient EXCLUSION CRITERIA COMMON TO THE COHORT A Spontaneous massive intratumoral bleeding. Patients with postoperative bleeding (in case of biopsy or surgery) may be included in the study provided that the bleeding is controlled. The same rule applies for other postoperative complications (infection, loss of cerebrospinal fluid, absence of wound closure, subdural collection ...) Patients who have previously received radiotherapy to the brain stem for another malignancy EXCLUSION CRITERIA COMMON TO THE COHORT B 1. Washout period respect to previous treatments: At least two weeks since the last dose of chemotherapy. For patients receiving low-dose metronomic oral chemotherapy, this period is at least one week. At least four weeks since the autologous hematopoietic stem cell transplant At least two weeks since the last focal radiotherapy or six weeks in case of cranio-spinal radiotherapy. At least 2 weeks or 5 half-lifes (whichever occurs first) since the last dose of a biological or investigational treatment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Álvaro Lassaletta Atienza, MD
Phone
+34 91 5035938
Email
alvaro.lassaletta@salud.madrid.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Álvaro Lassaletta Atienza, MD
Organizational Affiliation
Hospital Infantil Universitario Niño Jesús
Official's Role
Study Chair
Facility Information:
Facility Name
Hospital Infantil Universitario Niño Jesús
City
Madrid
ZIP/Postal Code
28009
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Álvaro Lassaletta Atienza, MD
Email
alvaro.lassaletta@salud.madrid.org
First Name & Middle Initial & Last Name & Degree
Álvaro Lassaletta Atienza, MD

12. IPD Sharing Statement

Learn more about this trial

Clinical Trial to Assess the Safety and Efficacy of AloCELYVIR With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) in Combination With Radiotherapy or Medulloblastoma in Monotherapy

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