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Safety and Tolerability Study of Recombinant L-IFN Adenovirus Injection in Patients With Recurrent Glioblastoma (YSCH-01)

Primary Purpose

Recurring Glioblastoma

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
Recombinant L-IFN adenovirus injection
Sponsored by
Binhai Hospital of Fujian Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurring Glioblastoma

Eligibility Criteria

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

Inclusion Criteria: 1.Voluntarily sign the informed consent and follow the requirements of the protocol; 2.18 years old ≤ age ≤75 years old, male or female; 3. Expected survival time ≥12 weeks; 4.KPS score ≥50 before treatment; 5. Patients with pathologically and/or cytologically confirmed glioblastoma; After conventional radiation and/or systemic therapy, the disease recurred. PETCT/MRI of the head within 14 days before screening confirmed at least one enhancement lesion ≥1 cm in length. 6. The patient has recovered from the toxic effects of the last treatment before the first dose (CTCAE≤1, except for special conditions such as "alopecia" and "pigmentation"), and the corresponding AE is judged by the investigator to be not a safety risk; 7. Organ and bone marrow function levels must meet the following requirements: Bone marrow: Absolute neutrophil count (ANC) ≥1.5×10^9/L, platelet count ≥100×10^9/L, hemoglobin ≥90 g/L, and no platelet or red blood cell transfusion within 14 days before the first dose; No blood transfusion or biological response regulators (such as granulocyte stimulating growth factor, erythrocyte growth factor, interleukin-11, etc.) within 14 days before the first dose; Liver function: No history of cirrhosis (Child-Pugh class B, C decompensated cirrhosis) Patients without liver metastasis were required to have serum total bilirubin (TBIL) ≤1.5× upper limit of normal (ULN), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5×ULN. Patients with liver metastasis required TBIL ≤1.5×ULN, ALT and AST≤5×ULN; Renal function: serum creatinine ≤1.5×ULN or creatinine clearance ≥50 ml/ minute (Cockcorft-Gault formula) Qualitative urine protein ≤1+; If urinary protein qualitative ≥2+,24-hour urinary protein quantitative test is required. The investigators determined the enrollment according to the examination results. Coagulation: prothrombin time (PT) ≤1.5 times ULN An international normalized ratio (INR) of 1.5×ULN or less and an activated partial thromboplastin time (APTT) of 1.5×ULN or less (except for those receiving therapeutic anticoagulants); 8. Female participants of childbearing age must have taken a serum pregnancy test with a negative result within 3 days before starting study medication and be willing to use a medically approved, highly effective contraceptive (e.g., IUD, contraceptive pill, or condom) during the study and for 5 months after last administration of study medication; For male subjects whose partner was a woman of childbearing age, consent was given to use an effective method of contraception for the duration of the study and for 5 months after the last study dose. Exclusion Criteria: Previous or current history of other types of malignant tumors, except for the following: radical cutaneous basal cell carcinoma, superficial bladder cancer, cutaneous squamous cell carcinoma, or cervical cancer in situ; second primary cancer that has been cured with no recurrence within 5 years; Known allergy to the study drug or any of its excipients, or a history of unexplained severe allergic reaction; Any contraindications to gadolinium contrast-enhanced MRI, such as personal use of a pacemaker, infusion pump, or allergy to MRI contrast media; Any contraindications to implantation of Ommaya reservoir; Received any of the following treatments or medications before the first study treatment: major surgery or major trauma within 4 weeks before the first study drug. (Major surgery is defined as any invasive procedure that involves extensive resection or that requires opening of mesothelial cell barriers (e.g., pleural space, peritoneum, meninges). However, biopsies needed for diagnosis were permitted. Severe trauma is a wound, ulcer or fracture that does not heal; administration of live attenuated vaccine within 4 weeks before or planned for the duration of the first study drug; medium (adult) drug treatment with anti-tumor indications within 2 weeks before the first study drug treatment; antineoplastic therapy (including chemotherapy, radiotherapy, immunotherapy, targeted therapy, biological therapy or tumor embolization) within 4 weeks before the first dose; For oral fluorouracil and endocrine therapy, drug withdrawal ≤2 weeks; In the case of nitrosourea, mitomycin or monoclonal antibody, drug withdrawal ≤6 weeks. If washout time is insufficient due to schedule or PK characteristics of the drug, it needs to be discussed with the partner; Patients with symptoms, disseminated to viscera, and risk of life-threatening complications in a short period of time, patients with pleural effusion, peritoneal effusion, and pericardial effusion who underwent puncture and drainage within three weeks before the first administration; Subjects with active or preexisting autoimmune diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, autoimmune thyroid disease, multiple sclerosis, vasculitis, glomerulonephritis, etc.) or those at high risk (e.g., organ transplant recipients requiring immunosuppressive therapy). However, subjects with the following conditions were allowed: patients with type I diabetes who are stable on fixed doses of insulin; autoimmune hypothyroidism with hormone replacement therapy only; skin conditions requiring no systemic treatment (e.g. eczema, rashes covering less than 10% of the body surface, psoriasis without eye symptoms, etc.); patients who have resolved childhood asthma/allergy without intervention in adulthood; Cardiovascular disease within 6 months before screening meets any of the following criteria: congestive heart failure with New York Heart Association (NYHA) class Ⅱ or above; Left ventricular ejection fraction (LVEF) < 50%; severe arrhythmias requiring medical treatment; QTcF (Fridericia's formula) > 450 msec in a man or > 470 msec in a woman, or the presence of risk factors for torsdes pointes, such as hypokalemia, a family history of long QT syndrome, or a family history of arrhythmias (e.g., the Wolff-White syndrome), as judged by the investigator to be clinically significant; a history of myocardial infarction or severe/unstable angina within 6 months before treatment; a history of thromboembolic events of grade ≥3 within the past 2 years or receiving thrombolytic or anticoagulant therapy due to a high risk of thrombosis; Patients with sudden lung disease, interstitial lung disease or pneumonia, pulmonary fibrosis, acute lung disease, etc. which could not be controlled after treatment, except for local interstitial pneumonia induced by radiotherapy; Uncontrolled systemic diseases, such as diabetes (fasting blood glucose ≥13.3mM), hypertension (systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg), etc.; Have a history of human immunodeficiency virus infection or other acquired or congenital immunodeficiency diseases, or have a history of organ transplantation or stem cell transplantation; Except for those who do not require immunosuppressive therapy, such as corneal transplantation; Evidence of active infection: Hepatitis B (HBsAg positive, HBV-DNA≥500IU/ml and abnormal liver function); Hepatitis C (HCV-Ab positive, HCV-RNA higher than the detection limit of analytical method and abnormal liver function); Systemic use of anti-infective agents for ≥7 days within 4 weeks before the first dose or unexplained fever > 38.5°C during screening/before the first dose (according to the investigator's judgment, fever caused by cancer could be enrolled); Patients with active pulmonary tuberculosis infection detected by medical history or CT examination, or with a history of active pulmonary tuberculosis infection within 1 year before enrollment, or with a history of active pulmonary tuberculosis infection more than 1 year before enrollment but without regular treatment; A definite history of a previous neurological or mental disorder or a known history of psychotropic substance abuse, alcohol abuse or drug use; Received any investigational drug within 4 weeks before the first dose or was enrolled in another clinical study (except if the patient was enrolled in an observational, noninterventional clinical study or was in the follow-up period of an interventional clinical study; or more than 5 half-lives of the last study medication); Women who are pregnant or lactating, or who have a positive baseline pregnancy test; Patients deemed by the investigator to be ineligible for inclusion in the study.

Sites / Locations

  • Binhai Hospital of Fujian Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Recombinant L-IFN adenovirus injection and Ommaya reservoir

Arm Description

Recombinant L-IFN adenovirus injection was locally injected through the Ommaya reservoir.A single injection dose of 5.0×10^10 VP (total dose per injection) was administered during the treatment period.

Outcomes

Primary Outcome Measures

Dose Limiting Toxicities (DLT)
To define the maximum tolerated dose (MTD) of intratumoral administration of Recombinant L-IFN adenovirus injection in humans with malignant tumors
Safety and tolerability assessed by Adverse Events (AEs)
An AE is any untoward medical occurrence in a subject administered an investigational product (IP), and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of IP whether or not considered related to the IP

Secondary Outcome Measures

Overall survival (OS)
Months alive following treatment as measured during periodic study visits
Presence of neutralizing antibodies of antidrug antibodies (ADAs) development
To evaluate the immunogenicity of Recombinant L-IFN adenovirus injection given as single agent post injection
Quality of life (QOL)
To measure quality of life (QOL) baseline assessment and any changes over time,EORTC QLQ-C30 scale was used for assessment,except for items 29 and 30, all items in QLQ-C30 scale are reverse items (the higher the value, the worse the quality of life).

Full Information

First Posted
June 11, 2023
Last Updated
June 27, 2023
Sponsor
Binhai Hospital of Fujian Medical University
Collaborators
Shanghai Yuansong Biotechnology Co., LTD
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1. Study Identification

Unique Protocol Identification Number
NCT05914935
Brief Title
Safety and Tolerability Study of Recombinant L-IFN Adenovirus Injection in Patients With Recurrent Glioblastoma
Acronym
YSCH-01
Official Title
Safety、Tolerability、Pharmacokinetics and Initial Efficacy of Recombinant L-IFN Adenovirus Injection in the Treatment of Recurrent Glioblastoma:an Open-label, Single-arm, Single-center, Multi-dose Investigator-initiated Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 27, 2023 (Actual)
Primary Completion Date
June 12, 2024 (Anticipated)
Study Completion Date
December 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Binhai Hospital of Fujian Medical University
Collaborators
Shanghai Yuansong Biotechnology Co., LTD

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
The target subjects were patients with histologically or cytologically confirmed recurrent glioblastoma.Six subjects were expected to be enrolled,the number of subjects will be adjusted according to the course and outcome of the trial.The aim of this study was to evaluate the safety and tolerability of recombinant L-IFN adenovirus injection in the treatment of patients with recurrent glioblastoma, and to determine the registered clinical recommended dose and dosing regimen.
Detailed Description
The IIT clinical study of recombinant L-IFN adenovirus injection is planned to adopt an open-label, non-randomized, dose exploratory study design. The trial was divided into screening, treatment and maintenance periods.The Ommaya reservoir was surgically implanted, and multiple intracapsular injections were administered.The overall survival (OS), progression-free survival (PFS) and disease control rate (DCR) were used to evaluate the efficacy of recombinant adenovirus L-IFN injection in the treatment of recurrent glioblastoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurring Glioblastoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Recombinant L-IFN adenovirus injection and Ommaya reservoir
Arm Type
Experimental
Arm Description
Recombinant L-IFN adenovirus injection was locally injected through the Ommaya reservoir.A single injection dose of 5.0×10^10 VP (total dose per injection) was administered during the treatment period.
Intervention Type
Drug
Intervention Name(s)
Recombinant L-IFN adenovirus injection
Other Intervention Name(s)
YSCH-01, Oncolytic adenovirus
Intervention Description
The Ommaya reservoir was surgically implanted, and multiple intracapsular injections were given medicine. On the second day after Ommaya reservoir implantation, CT examination confirmed that the implantation was successful, and the experimental drug injection was started.
Primary Outcome Measure Information:
Title
Dose Limiting Toxicities (DLT)
Description
To define the maximum tolerated dose (MTD) of intratumoral administration of Recombinant L-IFN adenovirus injection in humans with malignant tumors
Time Frame
Up to 28 days
Title
Safety and tolerability assessed by Adverse Events (AEs)
Description
An AE is any untoward medical occurrence in a subject administered an investigational product (IP), and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of IP whether or not considered related to the IP
Time Frame
Up to 6 months
Secondary Outcome Measure Information:
Title
Overall survival (OS)
Description
Months alive following treatment as measured during periodic study visits
Time Frame
3.5 years
Title
Presence of neutralizing antibodies of antidrug antibodies (ADAs) development
Description
To evaluate the immunogenicity of Recombinant L-IFN adenovirus injection given as single agent post injection
Time Frame
Up to 6 months
Title
Quality of life (QOL)
Description
To measure quality of life (QOL) baseline assessment and any changes over time,EORTC QLQ-C30 scale was used for assessment,except for items 29 and 30, all items in QLQ-C30 scale are reverse items (the higher the value, the worse the quality of life).
Time Frame
18 months

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: 1.Voluntarily sign the informed consent and follow the requirements of the protocol; 2.18 years old ≤ age ≤75 years old, male or female; 3. Expected survival time ≥12 weeks; 4.KPS score ≥50 before treatment; 5. Patients with pathologically and/or cytologically confirmed glioblastoma; After conventional radiation and/or systemic therapy, the disease recurred. PETCT/MRI of the head within 14 days before screening confirmed at least one enhancement lesion ≥1 cm in length. 6. The patient has recovered from the toxic effects of the last treatment before the first dose (CTCAE≤1, except for special conditions such as "alopecia" and "pigmentation"), and the corresponding AE is judged by the investigator to be not a safety risk; 7. Organ and bone marrow function levels must meet the following requirements: Bone marrow: Absolute neutrophil count (ANC) ≥1.5×10^9/L, platelet count ≥100×10^9/L, hemoglobin ≥90 g/L, and no platelet or red blood cell transfusion within 14 days before the first dose; No blood transfusion or biological response regulators (such as granulocyte stimulating growth factor, erythrocyte growth factor, interleukin-11, etc.) within 14 days before the first dose; Liver function: No history of cirrhosis (Child-Pugh class B, C decompensated cirrhosis) Patients without liver metastasis were required to have serum total bilirubin (TBIL) ≤1.5× upper limit of normal (ULN), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5×ULN. Patients with liver metastasis required TBIL ≤1.5×ULN, ALT and AST≤5×ULN; Renal function: serum creatinine ≤1.5×ULN or creatinine clearance ≥50 ml/ minute (Cockcorft-Gault formula) Qualitative urine protein ≤1+; If urinary protein qualitative ≥2+,24-hour urinary protein quantitative test is required. The investigators determined the enrollment according to the examination results. Coagulation: prothrombin time (PT) ≤1.5 times ULN An international normalized ratio (INR) of 1.5×ULN or less and an activated partial thromboplastin time (APTT) of 1.5×ULN or less (except for those receiving therapeutic anticoagulants); 8. Female participants of childbearing age must have taken a serum pregnancy test with a negative result within 3 days before starting study medication and be willing to use a medically approved, highly effective contraceptive (e.g., IUD, contraceptive pill, or condom) during the study and for 5 months after last administration of study medication; For male subjects whose partner was a woman of childbearing age, consent was given to use an effective method of contraception for the duration of the study and for 5 months after the last study dose. Exclusion Criteria: Previous or current history of other types of malignant tumors, except for the following: radical cutaneous basal cell carcinoma, superficial bladder cancer, cutaneous squamous cell carcinoma, or cervical cancer in situ; second primary cancer that has been cured with no recurrence within 5 years; Known allergy to the study drug or any of its excipients, or a history of unexplained severe allergic reaction; Any contraindications to gadolinium contrast-enhanced MRI, such as personal use of a pacemaker, infusion pump, or allergy to MRI contrast media; Any contraindications to implantation of Ommaya reservoir; Received any of the following treatments or medications before the first study treatment: major surgery or major trauma within 4 weeks before the first study drug. (Major surgery is defined as any invasive procedure that involves extensive resection or that requires opening of mesothelial cell barriers (e.g., pleural space, peritoneum, meninges). However, biopsies needed for diagnosis were permitted. Severe trauma is a wound, ulcer or fracture that does not heal; administration of live attenuated vaccine within 4 weeks before or planned for the duration of the first study drug; medium (adult) drug treatment with anti-tumor indications within 2 weeks before the first study drug treatment; antineoplastic therapy (including chemotherapy, radiotherapy, immunotherapy, targeted therapy, biological therapy or tumor embolization) within 4 weeks before the first dose; For oral fluorouracil and endocrine therapy, drug withdrawal ≤2 weeks; In the case of nitrosourea, mitomycin or monoclonal antibody, drug withdrawal ≤6 weeks. If washout time is insufficient due to schedule or PK characteristics of the drug, it needs to be discussed with the partner; Patients with symptoms, disseminated to viscera, and risk of life-threatening complications in a short period of time, patients with pleural effusion, peritoneal effusion, and pericardial effusion who underwent puncture and drainage within three weeks before the first administration; Subjects with active or preexisting autoimmune diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, autoimmune thyroid disease, multiple sclerosis, vasculitis, glomerulonephritis, etc.) or those at high risk (e.g., organ transplant recipients requiring immunosuppressive therapy). However, subjects with the following conditions were allowed: patients with type I diabetes who are stable on fixed doses of insulin; autoimmune hypothyroidism with hormone replacement therapy only; skin conditions requiring no systemic treatment (e.g. eczema, rashes covering less than 10% of the body surface, psoriasis without eye symptoms, etc.); patients who have resolved childhood asthma/allergy without intervention in adulthood; Cardiovascular disease within 6 months before screening meets any of the following criteria: congestive heart failure with New York Heart Association (NYHA) class Ⅱ or above; Left ventricular ejection fraction (LVEF) < 50%; severe arrhythmias requiring medical treatment; QTcF (Fridericia's formula) > 450 msec in a man or > 470 msec in a woman, or the presence of risk factors for torsdes pointes, such as hypokalemia, a family history of long QT syndrome, or a family history of arrhythmias (e.g., the Wolff-White syndrome), as judged by the investigator to be clinically significant; a history of myocardial infarction or severe/unstable angina within 6 months before treatment; a history of thromboembolic events of grade ≥3 within the past 2 years or receiving thrombolytic or anticoagulant therapy due to a high risk of thrombosis; Patients with sudden lung disease, interstitial lung disease or pneumonia, pulmonary fibrosis, acute lung disease, etc. which could not be controlled after treatment, except for local interstitial pneumonia induced by radiotherapy; Uncontrolled systemic diseases, such as diabetes (fasting blood glucose ≥13.3mM), hypertension (systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg), etc.; Have a history of human immunodeficiency virus infection or other acquired or congenital immunodeficiency diseases, or have a history of organ transplantation or stem cell transplantation; Except for those who do not require immunosuppressive therapy, such as corneal transplantation; Evidence of active infection: Hepatitis B (HBsAg positive, HBV-DNA≥500IU/ml and abnormal liver function); Hepatitis C (HCV-Ab positive, HCV-RNA higher than the detection limit of analytical method and abnormal liver function); Systemic use of anti-infective agents for ≥7 days within 4 weeks before the first dose or unexplained fever > 38.5°C during screening/before the first dose (according to the investigator's judgment, fever caused by cancer could be enrolled); Patients with active pulmonary tuberculosis infection detected by medical history or CT examination, or with a history of active pulmonary tuberculosis infection within 1 year before enrollment, or with a history of active pulmonary tuberculosis infection more than 1 year before enrollment but without regular treatment; A definite history of a previous neurological or mental disorder or a known history of psychotropic substance abuse, alcohol abuse or drug use; Received any investigational drug within 4 weeks before the first dose or was enrolled in another clinical study (except if the patient was enrolled in an observational, noninterventional clinical study or was in the follow-up period of an interventional clinical study; or more than 5 half-lives of the last study medication); Women who are pregnant or lactating, or who have a positive baseline pregnancy test; Patients deemed by the investigator to be ineligible for inclusion in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dezhi Kang, PhD
Phone
13960920021
Email
kirby98@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dezhi Kang, PhD
Organizational Affiliation
First Affiliated Hospital of Fujian Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Binhai Hospital of Fujian Medical University
City
Fujian
State/Province
Fujian
ZIP/Postal Code
350005
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dezhi Kang, PhD
Phone
13859099988
Email
kirby98@126.com

12. IPD Sharing Statement

Learn more about this trial

Safety and Tolerability Study of Recombinant L-IFN Adenovirus Injection in Patients With Recurrent Glioblastoma

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