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Clinical Study of VG161 in Combination With Nivolumab in Subjects With Advanced Pancreatic Cancer

Primary Purpose

Advanced Pancreatic Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Recombinant Human IL12/15-PDL1B Oncolytic HSV-1 Injection (Vero Cell)) in combination with Nivolumab
Sponsored by
Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Pancreatic Cancer focused on measuring Solid Tumor

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subjects must give informed consent to this study before the trial and voluntarily sign a written informed consent form
  • Age 18 to 75 years (inclusive), male or female
  • According to the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer, patients with histologically or cytologically confirmed advanced primary pancreatic ductal adenocarcinoma, acinar cell carcinoma or adenosquamous carcinoma, accompanied by metastasis (TxNxM1), who have failed standard treatment, or have no effective treatment at this stage
  • The presence of at least one intratumoral injection lesion with the longest diameter (the longest diameter of lymph nodes) greater than or equal to 1.5 cm that is required by the dose volume of the acceptable current dose group, including superficial lesions or deep lesions that can be injected under B ultrasound/CT guidance (such as liver metastases, etc.)
  • Herpes simplex virus type I (HSV-1) antibody test results (HSV-1IgG or HSV-1IgM) are positive
  • ECOG performance score 0-1
  • The expected survival time is more than 3 months
  • Adequate organ function: 1) blood routine (No blood transfusion or colony-stimulating factor treatment Within 14 days): ANC ≥ 1.5 × 10^9/L, PLT ≥ 75 × 10^9/L, Hb ≥ 90 g/L, lymphocyte count ≥ 1.5 × 10^9/L (for lymphocyte count 1.0 × 10^9/L to 1.5 × 10^9/L, the investigator judges whether it is necessary); 2) liver function: TBIL ≤ 1.5 × ULN, ALT ≤ 3 × ULN, AST ≤ 3 × ULN (patients with liver metastases can receive ALT ≤ 5 × ULN, AST ≤ 5 × ULN); 3) Child-Pugh score: A-B; 4) renal function: Cr ≤ 1.5 × ULN, and creatinine clearance ≥ 45ml/min (calculated according to CockftGault formula); 5) coagulation function: activated partial thromboplastin time (APTT) ≤ 1.5 × ULN, international normalized ratio (INR) ≤ 1.5 × ULN
  • Eligible patients of childbearing potential (male and female) must agree to use a reliable method of contraception (hormonal or barrier method or abstinence) during the trial and for at least 90 days after medication; female patients of childbearing age must have a negative blood pregnancy test 7 days before inclusion

Exclusion Criteria:

  • Received chemotherapy, radiotherapy, biological therapy, endocrine therapy, targeted therapy, immunotherapy (including PD-1/PD-L1 inhibitors) and other anti-tumor drug therapy 4 weeks before the first use of the study drug, oral fluoropyrimidines and small molecule targeted drugs are 2 weeks before the first use of the study drug or within 5 half-lives of the drug (whichever is longer)
  • Received other unmarketed clinical trial treatment 4 times before the first use of the study drug
  • Major organ surgery (excluding needle biopsy) or significant trauma 4 times before the first use of study drugs; 4. Patients who have received systemic corticosteroids (prednisone > 10 mg/day or equivalent doses of the same class of drugs) or other immunosuppressive agents within 14 days before the first use of study drugs; except for the following conditions: the use of topical, ocular, intra-articular, intranasal and inhaled corticosteroids; short-term use of corticosteroids for prophylaxis (such as prevention of contrast agent allergy)
  • Have received vaccination 4 times before the first use of the study drug
  • The adverse reactions of previous anti-tumor treatment have not recovered to CTCAE 5.0 grade evaluation ≤ 1 (except alopecia and other toxicities that are judged by the investigator to have no safety risk)
  • Patients with central nervous system or spinal cord malignant tumors or metastases, which are not suitable for enrollment as judged by the investigator
  • Accompanied by spinal cord compression, which is not suitable for the investigator's judgment
  • In the period of herpes simplex virus recurrence and infection, and there are corresponding clinical manifestations, such as oral herpes labialis, herpetic keratitis, herpetic dermatitis, genital herpes and so on. 10.Other active uncontrolled infection
  • History of immunodeficiency, including a positive HIV antibody test
  • Patients with active hepatitis B or active hepatitis C. (Patients with hepatitis B virus carriers, stable hepatitis B after drug treatment [HBV-DNA negative] and cured hepatitis C [HCV RNA test negative]) were excluded. 13.History of severe cardiovascular disease: 1) arrhythmia requiring clinical intervention; 2) QTc interval > 480 ms; 3) acute coronary syndrome, congestive heart failure, stroke or other grade III and above cardiovascular events within 6 months; 4) New York Heart Association (NYHA) functional classification ≥ II or LVEF < 40%; 5) uncontrolled hypertension (judged by the investigator)
  • Patients with active or previous autoimmune diseases that may relapse (such as interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism, including but not limited to these diseases or syndromes); patients with clinically stable autoimmune thyroiditis, autoimmune-mediated hypothyroidism treated with stable doses of thyroid replacement hormone, type I diabetes mellitus treated with stable doses of insulin, vitiligo or recovered childhood asthma/allergy, who do not require any intervention in adulthood
  • Had received immunotherapy and experienced an irAE grade ≥ 3
  • Known alcohol or drug dependence
  • Patients with mental disorders or poor compliance
  • Women who are pregnant or breastfeeding
  • The subject has other serious systemic diseases or other reasons that make the subject unsuitable for this clinical study in the opinion of the investigator

Sites / Locations

  • the First Affiliated Hospital, School of Medicine, Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single Arm

Arm Description

Intratumoral injection of VG161 - 1.5*10^8 on D1 + Nivolumab on D8, D22 Intratumoral injection of VG161 - 1.0*10^8 on D1, D2 + Nivolumab on D8, D22 Intratumoral injection of VG161 - 1.0*10^8 on D1, D2, D3 + Nivolumab on D8, D22

Outcomes

Primary Outcome Measures

MTD
MTD (Maximum tolerable dose)
Occurrence and numbers of DLT (phase 1)
Occurence of DLT (Dose Limiting Toxicity) and numbers of DLT
Occurence and frequence of AE and SAE (phase 1)
Occurence and frequence of Adverse Event (AE) and Serious Adverse Event (SAE) (NCI CTCAE 5.0)
DCR (phase 2)
Evaluate Disease Control Rate by RECIST 1.1
RP2D (phase 1)
RP2D (Recommended dose for phase II)

Secondary Outcome Measures

DCR (phase 1)
Evaluate Disease Control Rate by RECIST 1.1
ORR
Evaluate Objective Response Rate by RECIST 1.1
PFS
Evaluate Progression Free Survival by RECIST 1.1
PD-1
PD-1 level in peripheral blood T cells
Single cell sequencing
Single-cell sequencing of tumor biopsy samples
Occurence and frequence of AE and SAE (phase 2)
Occurence and frequence of Adverse Event (AE) and Serious Adverse Event (SAE) (NCI CTCAE 5.0)
CD3+
Concentration of CD3+
CD4+
Concentration of CD4+
CD8+
Concentration of CD8+
CD4+/CD8+
Concentration of CD4+/CD8+
NK
Concentration of NK
CD19+
Concentration of CD19+
CD56+
Concentration of CD56+
IL-6
Cytokine levels of IL-6
TNF-a
Cytokine levels of TNF-a
IFN-γ
Cytokine levels of IFN-γ
CA19-9
Tumor markers of CA19-9
CA125
Tumor markers of CA125
CEA
Tumor markers of CEA

Full Information

First Posted
November 23, 2021
Last Updated
March 8, 2022
Sponsor
Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT05162118
Brief Title
Clinical Study of VG161 in Combination With Nivolumab in Subjects With Advanced Pancreatic Cancer
Official Title
Clinical Trial to Evaluate the Safety, Tolerability and Preliminary Efficacy of VG161 in Combination With Nivolumab in Patients With Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 8, 2022 (Anticipated)
Primary Completion Date
March 22, 2025 (Anticipated)
Study Completion Date
December 22, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang University

4. Oversight

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

5. Study Description

Brief Summary
VG161 is a recombinant human-IL12/15/PDL1B oncolytic HSV-1 Injectable. This is a multicenter, open, single-arm design clinical trial coducted in HSV-seropositive subjects with advanced pancreatic cancer to determine the safety, tolerability and preliminary efficacy of VG161 combined with PD-1 inhibitor (Nivolumab Injection).
Detailed Description
A multicenter, open, single-arm design of clinical trial of VG161 in combined with PD-1 inhibitor (Nivolumab) in the treatment of patients with advanced pancreatic cancer with metastasis. The standard 3 + 3 design was used in the dose-finding study to explore the safety of the combination treatment, determine the recommended safe dose (RP2D) of the combination treatment in the second phase of efficacy study. The first cycle was observed until Day 28, i.e., DLT observation period. In the efficacy investigation trial, Simon two-segment design was used to continue to investigate the preliminary efficacy of the combination at a safe dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Pancreatic Cancer
Keywords
Solid Tumor

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
51 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single Arm
Arm Type
Experimental
Arm Description
Intratumoral injection of VG161 - 1.5*10^8 on D1 + Nivolumab on D8, D22 Intratumoral injection of VG161 - 1.0*10^8 on D1, D2 + Nivolumab on D8, D22 Intratumoral injection of VG161 - 1.0*10^8 on D1, D2, D3 + Nivolumab on D8, D22
Intervention Type
Drug
Intervention Name(s)
Recombinant Human IL12/15-PDL1B Oncolytic HSV-1 Injection (Vero Cell)) in combination with Nivolumab
Other Intervention Name(s)
VG161 + Nivolumab
Intervention Description
Intratumoral injection of VG161 on day 1 only or day 1 through 3, in combination of Nivolumab intravenous injection only, Once every 2 weeks, 3 mg/kg each time.
Primary Outcome Measure Information:
Title
MTD
Description
MTD (Maximum tolerable dose)
Time Frame
1 month
Title
Occurrence and numbers of DLT (phase 1)
Description
Occurence of DLT (Dose Limiting Toxicity) and numbers of DLT
Time Frame
1 month
Title
Occurence and frequence of AE and SAE (phase 1)
Description
Occurence and frequence of Adverse Event (AE) and Serious Adverse Event (SAE) (NCI CTCAE 5.0)
Time Frame
24 month
Title
DCR (phase 2)
Description
Evaluate Disease Control Rate by RECIST 1.1
Time Frame
24 month
Title
RP2D (phase 1)
Description
RP2D (Recommended dose for phase II)
Time Frame
1 month
Secondary Outcome Measure Information:
Title
DCR (phase 1)
Description
Evaluate Disease Control Rate by RECIST 1.1
Time Frame
24 month
Title
ORR
Description
Evaluate Objective Response Rate by RECIST 1.1
Time Frame
24 month
Title
PFS
Description
Evaluate Progression Free Survival by RECIST 1.1
Time Frame
24 month
Title
PD-1
Description
PD-1 level in peripheral blood T cells
Time Frame
24 month
Title
Single cell sequencing
Description
Single-cell sequencing of tumor biopsy samples
Time Frame
24 month
Title
Occurence and frequence of AE and SAE (phase 2)
Description
Occurence and frequence of Adverse Event (AE) and Serious Adverse Event (SAE) (NCI CTCAE 5.0)
Time Frame
24 month
Title
CD3+
Description
Concentration of CD3+
Time Frame
24 month
Title
CD4+
Description
Concentration of CD4+
Time Frame
24 month
Title
CD8+
Description
Concentration of CD8+
Time Frame
24 month
Title
CD4+/CD8+
Description
Concentration of CD4+/CD8+
Time Frame
24 month
Title
NK
Description
Concentration of NK
Time Frame
24 month
Title
CD19+
Description
Concentration of CD19+
Time Frame
24 month
Title
CD56+
Description
Concentration of CD56+
Time Frame
24 month
Title
IL-6
Description
Cytokine levels of IL-6
Time Frame
24 month
Title
TNF-a
Description
Cytokine levels of TNF-a
Time Frame
24 month
Title
IFN-γ
Description
Cytokine levels of IFN-γ
Time Frame
24 month
Title
CA19-9
Description
Tumor markers of CA19-9
Time Frame
24 month
Title
CA125
Description
Tumor markers of CA125
Time Frame
24 month
Title
CEA
Description
Tumor markers of CEA
Time Frame
24 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must give informed consent to this study before the trial and voluntarily sign a written informed consent form Age 18 to 75 years (inclusive), male or female According to the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer, patients with histologically or cytologically confirmed advanced primary pancreatic ductal adenocarcinoma, acinar cell carcinoma or adenosquamous carcinoma, accompanied by metastasis (TxNxM1), who have failed standard treatment, or have no effective treatment at this stage The presence of at least one intratumoral injection lesion with the longest diameter (the longest diameter of lymph nodes) greater than or equal to 1.5 cm that is required by the dose volume of the acceptable current dose group, including superficial lesions or deep lesions that can be injected under B ultrasound/CT guidance (such as liver metastases, etc.) Herpes simplex virus type I (HSV-1) antibody test results (HSV-1IgG or HSV-1IgM) are positive ECOG performance score 0-1 The expected survival time is more than 3 months Adequate organ function: 1) blood routine (No blood transfusion or colony-stimulating factor treatment Within 14 days): ANC ≥ 1.5 × 10^9/L, PLT ≥ 75 × 10^9/L, Hb ≥ 90 g/L, lymphocyte count ≥ 1.5 × 10^9/L (for lymphocyte count 1.0 × 10^9/L to 1.5 × 10^9/L, the investigator judges whether it is necessary); 2) liver function: TBIL ≤ 1.5 × ULN, ALT ≤ 3 × ULN, AST ≤ 3 × ULN (patients with liver metastases can receive ALT ≤ 5 × ULN, AST ≤ 5 × ULN); 3) Child-Pugh score: A-B; 4) renal function: Cr ≤ 1.5 × ULN, and creatinine clearance ≥ 45ml/min (calculated according to CockftGault formula); 5) coagulation function: activated partial thromboplastin time (APTT) ≤ 1.5 × ULN, international normalized ratio (INR) ≤ 1.5 × ULN Eligible patients of childbearing potential (male and female) must agree to use a reliable method of contraception (hormonal or barrier method or abstinence) during the trial and for at least 90 days after medication; female patients of childbearing age must have a negative blood pregnancy test 7 days before inclusion Exclusion Criteria: Received chemotherapy, radiotherapy, biological therapy, endocrine therapy, targeted therapy, immunotherapy (including PD-1/PD-L1 inhibitors) and other anti-tumor drug therapy 4 weeks before the first use of the study drug, oral fluoropyrimidines and small molecule targeted drugs are 2 weeks before the first use of the study drug or within 5 half-lives of the drug (whichever is longer) Received other unmarketed clinical trial treatment 4 times before the first use of the study drug Major organ surgery (excluding needle biopsy) or significant trauma 4 times before the first use of study drugs; 4. Patients who have received systemic corticosteroids (prednisone > 10 mg/day or equivalent doses of the same class of drugs) or other immunosuppressive agents within 14 days before the first use of study drugs; except for the following conditions: the use of topical, ocular, intra-articular, intranasal and inhaled corticosteroids; short-term use of corticosteroids for prophylaxis (such as prevention of contrast agent allergy) Have received vaccination 4 times before the first use of the study drug The adverse reactions of previous anti-tumor treatment have not recovered to CTCAE 5.0 grade evaluation ≤ 1 (except alopecia and other toxicities that are judged by the investigator to have no safety risk) Patients with central nervous system or spinal cord malignant tumors or metastases, which are not suitable for enrollment as judged by the investigator Accompanied by spinal cord compression, which is not suitable for the investigator's judgment In the period of herpes simplex virus recurrence and infection, and there are corresponding clinical manifestations, such as oral herpes labialis, herpetic keratitis, herpetic dermatitis, genital herpes and so on. 10.Other active uncontrolled infection History of immunodeficiency, including a positive HIV antibody test Patients with active hepatitis B or active hepatitis C. (Patients with hepatitis B virus carriers, stable hepatitis B after drug treatment [HBV-DNA negative] and cured hepatitis C [HCV RNA test negative]) were excluded. 13.History of severe cardiovascular disease: 1) arrhythmia requiring clinical intervention; 2) QTc interval > 480 ms; 3) acute coronary syndrome, congestive heart failure, stroke or other grade III and above cardiovascular events within 6 months; 4) New York Heart Association (NYHA) functional classification ≥ II or LVEF < 40%; 5) uncontrolled hypertension (judged by the investigator) Patients with active or previous autoimmune diseases that may relapse (such as interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism, including but not limited to these diseases or syndromes); patients with clinically stable autoimmune thyroiditis, autoimmune-mediated hypothyroidism treated with stable doses of thyroid replacement hormone, type I diabetes mellitus treated with stable doses of insulin, vitiligo or recovered childhood asthma/allergy, who do not require any intervention in adulthood Had received immunotherapy and experienced an irAE grade ≥ 3 Known alcohol or drug dependence Patients with mental disorders or poor compliance Women who are pregnant or breastfeeding The subject has other serious systemic diseases or other reasons that make the subject unsuitable for this clinical study in the opinion of the investigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tingbo Liang, Doctor
Phone
13967159109
Email
liangtingbo@zju.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Yinan Shen, Doctor
Phone
13486180288
Email
fysyn@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tingbo Liang, Doctor
Organizational Affiliation
The First Affiliated Hospital Zhengjiang University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
the First Affiliated Hospital, School of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
TingBo Liang, MD, PHD
Phone
086-571-87236688
Email
liangtingbo@zju.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

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Clinical Study of VG161 in Combination With Nivolumab in Subjects With Advanced Pancreatic Cancer

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