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A Clinical Evaluation of the Aliya™ System in Late Stage Cancer (INCITE LS)

Primary Purpose

Cancer of Lung, Kidney or Liver

Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Pulsed electric field treatment using the Aliya system
Sponsored by
Galvanize Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer of Lung, Kidney or Liver

Eligibility Criteria

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

Inclusion Criteria:

  • Patient is eligible for inclusion if diagnosed and currently under physician care for one of the following advanced stage or metastatic conditions:

    • Stage IV non-small cell lung cancer
    • Stage IV hepatocellular carcinoma
    • Stage IV renal cell carcinoma
  • Patient is currently receiving PD-1/PD-L1 axis immunotherapy as their most recent line of therapy, either alone or in combination with standard of care systemic therapy for their malignancy.
  • Patient has exhibited at least 6 months of response to PD-1/PD-L1 axis immunotherapy regimen (defined as complete response (CR), partial response (PR), or stable disease (SD) in their index tumors per RECIST 1.1) prior to progression.
  • Patient has radiologically documented or confirmed progressive disease (per RECIST 1.1) defined as a total of ≤ 5 new areas of growth on existing tumors and/or new tumors.
  • New tumors must be ≤ 2cm in longest diameter. New areas of growth on existing tumors must be ≤ 2cm in longest diameter. Tumors and new areas of growth must be deemed suitable by the investigator for complete treatment with PEF. Pathologic lymph nodes must be ≥ 15mm in shortest axis.
  • In the judgement of the investigator, the patient is able to remain on PD-1/PD-L1 axis immunotherapy for at least 3 months after PEF treatment.
  • New tumors and areas of growth on existing tumors are amenable to core or forceps biopsy in order to confirm disease progression.
  • Patient must be willing to undergo tumor biopsy at PEF treatment delivery.
  • Patient refuses surgery and/or stereotactic body radiotherapy (SBRT).
  • Life expectancy ≥ 12 weeks.
  • ECOG performance status 0-1

Exclusion Criteria:

  • Patient has implanted lung devices or electronic devices.
  • Patient is receiving bevacizumab concurrently with their PD-1/PD-L1 axis immunotherapy.
  • Patient has received any prior systemic therapy (systemic chemotherapy, immunotherapy or investigational drug) in another study within 21 days prior to study enrollment.
  • Patient is scheduled to receive any concurrent chemotherapy, immunotherapy, biologic or hormonal therapy for off-label cancer treatment while on this study.
  • Patient has unresolved adverse reaction to immunotherapy that requires dose modification.
  • Patient has received any radiation therapy within 6 weeks prior to study enrollment.
  • Patient has leptomeningeal disease or active brain metastases that are not clinically controlled and asymptomatic for at least 14 days following treatment and prior to study enrollment or has residual neurological dysfunction and has not been off corticosteroids for at least seven days prior to study enrollment.
  • Patient has an active autoimmune disease that has required systemic treatment in past two years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed
  • Patient has received systemic treatment with corticosteroids (> 10 mg daily prednisone or equivalent) or other immunosuppressive medications within seven days prior to study enrollment. Inhaled or topical steroids, and adrenal replacement doses ≤ 10 mg daily prednisone or equivalent are permitted in the absence of active autoimmune disease.
  • Patient has any history of primary immunodeficiency.
  • Patient has any history of organ transplant that requires use of immunosuppressives.
  • Patient has clinical signs or symptoms of active tuberculosis infection.
  • Patient has history of (non-infectious) pneumonitis that required steroids or current pneumonitis/interstitial lung disease.
  • Patient has documented evidence of acute hepatitis or has an active or uncontrolled infection.
  • Patient has undergone major surgery within 28 days prior to study enrollment or has planned for other major surgery to be performed while enrolled in the clinical trial.
  • Patient is unable or unwilling to complete all required screening and/or follow-up assessments.
  • Patient is currently enrolled in another interventional clinical trial or is receiving treatment with an investigational medication or medical device that conflicts with the study protocol.
  • Patient for whom the investigator considers that the PEF treatment is not in the patient's best interest.
  • Patient has active alcohol or drug addiction or any other condition that, in the investigator's opinion, would interfere with their ability to comply with the study requirements.
  • Patient has any concurrent condition that, in the investigator's opinion, would jeopardize the safety of the patient or compliance with the protocol

Sites / Locations

  • Prince of Wales Hospital
  • Radboud University Medical Center
  • Hospital Universitario de Salamanca

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Aliya PEF treatment

Arm Description

Outcomes

Primary Outcome Measures

Device and Procedure serious adverse event rate
The rate of system-related and procedure-related serious adverse events (SAEs)
Radiologic local control
Frequency with which local control of the tumor is attained using Pulsed Electric Field (PEF)-treated tumor(s)

Secondary Outcome Measures

Immunologic response: lymphocytes
Changes from baseline in lymphocytes (CD3+, CD4+, CD8+, Treg, NK, Neutrophils; all analyzed as cells per mL)
Immunologic response: cytokines
Changes from baseline in serum levels of cytokines (IL-2, IL-6, IL-10, IL-12; all analyzed as concentration in pg / mL) from blood samples
Immunologic response: PD-L1
Changes in PD-L1 percentage from biopsy samples

Full Information

First Posted
February 22, 2021
Last Updated
March 13, 2023
Sponsor
Galvanize Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04773275
Brief Title
A Clinical Evaluation of the Aliya™ System in Late Stage Cancer
Acronym
INCITE LS
Official Title
INCITE LS: A Clinical Evaluation of the Aliya™ System in Late Stage Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 9, 2022 (Actual)
Primary Completion Date
June 2023 (Anticipated)
Study Completion Date
August 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Galvanize Therapeutics, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
A prospective, single-arm, non-randomized, multi-center, open-label study following patients to 1 year. The study is designed to evaluate the safety and clinical utility of Pulsed Electric Field (PEF) treatment of advanced stage or metastatic cancer following progression on immunotherapy.
Detailed Description
This study is designed to evaluate the safety and clinical utility of Pulsed Electric Field (PEF) treatment of advanced stage or metastatic cancer following progression on immunotherapy. The study will enroll adult patients with confirmed 8th ed. Stage IV non-small cell lung cancer (NSCLC), Stage IV renal cell carcinoma (RCC), or Stage IV hepatocellular carcinoma (HCC), who have experienced a response to checkpoint inhibitor (CPI) therapy (complete response (CR), partial response (PR), or stable disease (SD) as per RECIST 1.1) for a minimum of 6 months, and have documented radiologic progression (progressive disease (PD) as defined by RECIST 1.1) in up to five sites (non-central nervous system). PEF treatment delivery is to be performed in conjunction with the clinically appropriate approach to collect standard of care biopsy samples to confirm disease progression. The PI has the discretion to approach via endoluminal or percutaneous method if the target(s) is/are amenable. PEF treatment will be delivered to accessible new areas of growth on existing tumors or new tumors. Treatment may be delivered via either an endoluminal (bronchoscopic) or percutaneous approach at the discretion of the clinical investigator utilizing two available device configurations: Endoluminal: Galvanize Aliya System with compatible commercially available TBNA Needle and RF probe electrode Percutaneous: Galvanize Aliya System with compatible commercially available RF needle and RF probe electrode The study will enroll and treat up to 30 adult patients at up to 5 clinical sites.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer of Lung, Kidney or Liver

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Single cohort consecutive case series
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Aliya PEF treatment
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
Pulsed electric field treatment using the Aliya system
Intervention Description
Patients will undergo pulsed electric field (PEF) treatment of up to 5 tumors (new or progressing) measuring ≤ 2cm in longest diameter.
Primary Outcome Measure Information:
Title
Device and Procedure serious adverse event rate
Description
The rate of system-related and procedure-related serious adverse events (SAEs)
Time Frame
30 days
Title
Radiologic local control
Description
Frequency with which local control of the tumor is attained using Pulsed Electric Field (PEF)-treated tumor(s)
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Immunologic response: lymphocytes
Description
Changes from baseline in lymphocytes (CD3+, CD4+, CD8+, Treg, NK, Neutrophils; all analyzed as cells per mL)
Time Frame
all time points up to 1 year
Title
Immunologic response: cytokines
Description
Changes from baseline in serum levels of cytokines (IL-2, IL-6, IL-10, IL-12; all analyzed as concentration in pg / mL) from blood samples
Time Frame
all time points up to 1 year
Title
Immunologic response: PD-L1
Description
Changes in PD-L1 percentage from biopsy samples
Time Frame
all time points up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is eligible for inclusion if diagnosed and currently under physician care for one of the following advanced stage or metastatic conditions: Stage IV non-small cell lung cancer Stage IV hepatocellular carcinoma Stage IV renal cell carcinoma Patient is currently receiving PD-1/PD-L1 axis immunotherapy as their most recent line of therapy, either alone or in combination with standard of care systemic therapy for their malignancy. Patient has exhibited at least 6 months of response to PD-1/PD-L1 axis immunotherapy regimen (defined as complete response (CR), partial response (PR), or stable disease (SD) in their index tumors per RECIST 1.1) prior to progression. Patient has radiologically documented or confirmed progressive disease (per RECIST 1.1) defined as a total of ≤ 5 new areas of growth on existing tumors and/or new tumors. New tumors must be ≤ 2cm in longest diameter. New areas of growth on existing tumors must be ≤ 2cm in longest diameter. Tumors and new areas of growth must be deemed suitable by the investigator for complete treatment with PEF. Pathologic lymph nodes must be ≥ 15mm in shortest axis. In the judgement of the investigator, the patient is able to remain on PD-1/PD-L1 axis immunotherapy for at least 3 months after PEF treatment. New tumors and areas of growth on existing tumors are amenable to core or forceps biopsy in order to confirm disease progression. Patient must be willing to undergo tumor biopsy at PEF treatment delivery. Patient refuses surgery and/or stereotactic body radiotherapy (SBRT). Life expectancy ≥ 12 weeks. ECOG performance status 0-1 Exclusion Criteria: Patient has implanted lung devices or electronic devices. Patient is receiving bevacizumab concurrently with their PD-1/PD-L1 axis immunotherapy. Patient has received any prior systemic therapy (systemic chemotherapy, immunotherapy or investigational drug) in another study within 21 days prior to study enrollment. Patient is scheduled to receive any concurrent chemotherapy, immunotherapy, biologic or hormonal therapy for off-label cancer treatment while on this study. Patient has unresolved adverse reaction to immunotherapy that requires dose modification. Patient has received any radiation therapy within 6 weeks prior to study enrollment. Patient has leptomeningeal disease or active brain metastases that are not clinically controlled and asymptomatic for at least 14 days following treatment and prior to study enrollment or has residual neurological dysfunction and has not been off corticosteroids for at least seven days prior to study enrollment. Patient has an active autoimmune disease that has required systemic treatment in past two years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed Patient has received systemic treatment with corticosteroids (> 10 mg daily prednisone or equivalent) or other immunosuppressive medications within seven days prior to study enrollment. Inhaled or topical steroids, and adrenal replacement doses ≤ 10 mg daily prednisone or equivalent are permitted in the absence of active autoimmune disease. Patient has any history of primary immunodeficiency. Patient has any history of organ transplant that requires use of immunosuppressives. Patient has clinical signs or symptoms of active tuberculosis infection. Patient has history of (non-infectious) pneumonitis that required steroids or current pneumonitis/interstitial lung disease. Patient has documented evidence of acute hepatitis or has an active or uncontrolled infection. Patient has undergone major surgery within 28 days prior to study enrollment or has planned for other major surgery to be performed while enrolled in the clinical trial. Patient is unable or unwilling to complete all required screening and/or follow-up assessments. Patient is currently enrolled in another interventional clinical trial or is receiving treatment with an investigational medication or medical device that conflicts with the study protocol. Patient for whom the investigator considers that the PEF treatment is not in the patient's best interest. Patient has active alcohol or drug addiction or any other condition that, in the investigator's opinion, would interfere with their ability to comply with the study requirements. Patient has any concurrent condition that, in the investigator's opinion, would jeopardize the safety of the patient or compliance with the protocol
Facility Information:
Facility Name
Prince of Wales Hospital
City
Sha Tin
Country
Hong Kong
Facility Name
Radboud University Medical Center
City
Nijmegen
ZIP/Postal Code
6500HB
Country
Netherlands
Facility Name
Hospital Universitario de Salamanca
City
Salamanca
ZIP/Postal Code
37007
Country
Spain

12. IPD Sharing Statement

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A Clinical Evaluation of the Aliya™ System in Late Stage Cancer

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