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A Phase 1 Study of Intravesical VAX014 for Instillation in Subjects With Non-Muscle Invasive Bladder Cancer

Primary Purpose

Urothelial Carcinoma of the Urinary Bladder

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
VAX014
Sponsored by
Vaxiion Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urothelial Carcinoma of the Urinary Bladder focused on measuring Non-Muscle Invasive Bladder Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed, informed consent
  2. Age 18 or more years
  3. Pathologically confirmed low-grade Ta urothelial carcinoma (UC) of the urinary bladder
  4. NMIBC with one solitary measurable tumor at the start of study, measuring ≥ 5 mm and ≤ 15 mm in greatest diameter (up to 4 additional low-grade Ta lesions, each measuring no more than 15 mm may be removed at screening provided a single lesion remains)
  5. Treatment-naïve or failed one previous regimen of intravesical therapy (BCG or chemotherapy)
  6. If recurrent disease, then more than 6 months from prior resection, more than 3 months from completion of last intravesical therapy with BCG, and more than 6 weeks from completion of last therapeutic intravesical therapy with chemotherapy
  7. If previously treated, recovered from prior treatment-related toxicity to ≤ Grade 1
  8. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 116
  9. Absolute neutrophil count (ANC) ≥ 1,500/mm3
  10. Platelet count ≥ 100,000/mm3
  11. Total bilirubin ≤ 1.5 x upper limit of normal (ULN), or ≤ 3 x ULN in subjects with Gilberts disease
  12. Serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 30 mL/min
  13. Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) ≤ 2.5 x ULN
  14. Willingness to participate in collection of pharmacokinetic samples
  15. Women of childbearing potential must have a negative serum pregnancy test.
  16. All subjects of childbearing potential must be willing to use effective contraception while on treatment and for 3 months after the last dose of VAX014

Exclusion Criteria:

  1. Additional papillary disease at screening (in addition to the solitary low-grade Ta lesion detailed in the inclusion criteria) that

    1. Consist of 6 or more lesions
    2. Consists of any lesion with a maximal diameter of greater than 15 mm
  2. Confirmed or suspected perforated bladder
  3. History of difficult catheterization that in the opinion of the investigator will prevent administration of VAX014
  4. Presence or history of any high-grade urothelial cancer (including CIS) or high-grade urine cytology
  5. Intravesical chemo-or biological therapy within 6 months of first administration of VAX014
  6. UC of the ureters or urethra
  7. History of interstitial cystitis
  8. History of radiation to the pelvis
  9. History of vesicoureteral reflux or an indwelling urinary stent
  10. Other known active cancer(s) likely to require treatment or interfere with study objectives over the next two (2) years
  11. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy
  12. Known HIV, Hepatitis B, or Hepatitis C infection
  13. Significant cardiovascular risk (e.g., coronary stenting within 8 weeks, myocardial infarction within 6 months)
  14. Major surgery other than diagnostic surgery within 4 weeks of first administration of VAX014
  15. Pregnant or currently breast-feeding
  16. Psychiatric illness/social situations that would interfere with compliance with study requirements
  17. Presence of any sessile appearing tumor suspected of being invasive or high-grade

Sites / Locations

  • The Urology Center of Colorado
  • University of Iowa Hospital and Clinics
  • New Jersey Urology, LLC.
  • Carolina Urologic Research Center
  • Baylor College of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

VAX014

Arm Description

Intravesical VAX014 (dose: 3.33x10^10 - 9.0x10^11 recombinant bacterial minicells (rBMCs)), given once per week for Weeks 1-6

Outcomes

Primary Outcome Measures

Maximum tolerated dose (MTD) of VAX014
The MTD will be defined as the dose level at which at most one of six patients experiences a dose limiting toxicity (DLT) after 28 days of treatment have occurred, with the next higher dose having at least 2/3 or 2/6 patients experiencing a DLT
Incidence of Treatment-Emergence Adverse Events (Safety and Tolerability)
Toxicities will be assessed in each subject by tracking the occurrence of graded Adverse Events (AEs). AEs will be graded according to the National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) v5.0

Secondary Outcome Measures

Recommended Phase 2 Dose (RP2D) of intravesical VAX014
The RP2D will be determined following the determination of the MTD and an overall assessment of safety as determined by the Safety Committee
Peak Plasma Concentration (Cmax)
The peak plasma concentration (Cmax) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Trough Plasma Concentration (Cmin)
The trough plasma concentration (Cmin) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time to Peak Plasma Concentration (Tmax)
The time to peak plasma concentration (Tmax) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Volume and Distribution (Vd)
The volume and distribution (Vd) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Half Life (t[1/2])
The half life (t[1/2]) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Area Under Curve (AUC)
The area under the plasma concentration versus time curve (AUC) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Clearance (Cl)
The clearance (Cl) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Overall Response Rate
Response rate will be evaluated for low-grade Ta lesions. Lesions will be assessed with cystoscopy and change in tumor size will be recorded.
Anti-Drug Antibodies (Immunogenicity)
The presence or absence of anti-drug antibodies (ADA) in serum will be assessed by assay.

Full Information

First Posted
February 21, 2019
Last Updated
March 1, 2023
Sponsor
Vaxiion Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT03854721
Brief Title
A Phase 1 Study of Intravesical VAX014 for Instillation in Subjects With Non-Muscle Invasive Bladder Cancer
Official Title
Phase I Safety and Tolerability of Intravesical VAX014 for Instillation in Subjects With Non-Muscle Invasive Bladder Cancer (NMIBC)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
May 10, 2019 (Actual)
Primary Completion Date
March 1, 2023 (Actual)
Study Completion Date
March 1, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vaxiion Therapeutics

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this research study is to evaluate the safety, tolerability and activity of VAX014 for Instillation (VAX014) in patients with low-grade Non-Muscle Invasive Bladder Cancer (NMIBC). VAX014 is a targeted oncolytic agent designed to kill tumor cells following instillation into the urinary bladder.
Detailed Description
This study will evaluate the safety and tolerability of VAX014 using a 3+3 dose escalation design to determine a maximum tolerated dose (MTD) followed by a dose expansion at the Recommended Phase 2 Dose (RP2D). Both phases of the study will use a Window of Opportunity study design where patients with a single, low-grade Ta lesion will receive VAX014 via a urinary catheter into the bladder, weekly for 6 weeks prior to undergoing Transurethral Resection of Bladder Tumor (TURBT) to assess antitumor activity against the mapped lesion. Patients enrolled in this study must have low-grade (Ta) Non-Muscle Invasive Bladder Cancer. However, eligible patients may have up to 5 low-grade Ta lesions at screening, and all but a single mapped lesion will be resected prior to receiving VAX014. The mapped lesion is assessed for anti-tumor activity. VAX014 is a formulation of recombinant bacterial minicells which is designed to selectively target two NMIBC-associated integrin heterodimers to de-stabilize tumor cell membranes, with the result being tumor cell lysis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urothelial Carcinoma of the Urinary Bladder
Keywords
Non-Muscle Invasive Bladder Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
VAX014
Arm Type
Experimental
Arm Description
Intravesical VAX014 (dose: 3.33x10^10 - 9.0x10^11 recombinant bacterial minicells (rBMCs)), given once per week for Weeks 1-6
Intervention Type
Drug
Intervention Name(s)
VAX014
Intervention Description
Solution for intravesical infusion, 3.33x10^10 rBMCs per vial
Primary Outcome Measure Information:
Title
Maximum tolerated dose (MTD) of VAX014
Description
The MTD will be defined as the dose level at which at most one of six patients experiences a dose limiting toxicity (DLT) after 28 days of treatment have occurred, with the next higher dose having at least 2/3 or 2/6 patients experiencing a DLT
Time Frame
up to 28 days
Title
Incidence of Treatment-Emergence Adverse Events (Safety and Tolerability)
Description
Toxicities will be assessed in each subject by tracking the occurrence of graded Adverse Events (AEs). AEs will be graded according to the National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) v5.0
Time Frame
Through study completion, an average of 20 weeks
Secondary Outcome Measure Information:
Title
Recommended Phase 2 Dose (RP2D) of intravesical VAX014
Description
The RP2D will be determined following the determination of the MTD and an overall assessment of safety as determined by the Safety Committee
Time Frame
up to 5 weeks
Title
Peak Plasma Concentration (Cmax)
Description
The peak plasma concentration (Cmax) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Trough Plasma Concentration (Cmin)
Description
The trough plasma concentration (Cmin) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Time to Peak Plasma Concentration (Tmax)
Description
The time to peak plasma concentration (Tmax) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Volume and Distribution (Vd)
Description
The volume and distribution (Vd) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Half Life (t[1/2])
Description
The half life (t[1/2]) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Area Under Curve (AUC)
Description
The area under the plasma concentration versus time curve (AUC) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Clearance (Cl)
Description
The clearance (Cl) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time Frame
Day 1
Title
Overall Response Rate
Description
Response rate will be evaluated for low-grade Ta lesions. Lesions will be assessed with cystoscopy and change in tumor size will be recorded.
Time Frame
Up to 20 weeks
Title
Anti-Drug Antibodies (Immunogenicity)
Description
The presence or absence of anti-drug antibodies (ADA) in serum will be assessed by assay.
Time Frame
Up to 20 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed, informed consent Age 18 or more years Pathologically confirmed low-grade Ta urothelial carcinoma (UC) of the urinary bladder NMIBC with one solitary measurable tumor at the start of study, measuring ≥ 5 mm and ≤ 15 mm in greatest diameter (up to 4 additional low-grade Ta lesions, each measuring no more than 15 mm may be removed at screening provided a single lesion remains) Treatment-naïve or failed one previous regimen of intravesical therapy (BCG or chemotherapy) If recurrent disease, then more than 6 months from prior resection, more than 3 months from completion of last intravesical therapy with BCG, and more than 6 weeks from completion of last therapeutic intravesical therapy with chemotherapy If previously treated, recovered from prior treatment-related toxicity to ≤ Grade 1 Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 116 Absolute neutrophil count (ANC) ≥ 1,500/mm3 Platelet count ≥ 100,000/mm3 Total bilirubin ≤ 1.5 x upper limit of normal (ULN), or ≤ 3 x ULN in subjects with Gilberts disease Serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 30 mL/min Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) ≤ 2.5 x ULN Willingness to participate in collection of pharmacokinetic samples Women of childbearing potential must have a negative serum pregnancy test. All subjects of childbearing potential must be willing to use effective contraception while on treatment and for 3 months after the last dose of VAX014 Exclusion Criteria: Additional papillary disease at screening (in addition to the solitary low-grade Ta lesion detailed in the inclusion criteria) that Consist of 6 or more lesions Consists of any lesion with a maximal diameter of greater than 15 mm Confirmed or suspected perforated bladder History of difficult catheterization that in the opinion of the investigator will prevent administration of VAX014 Presence or history of any high-grade urothelial cancer (including CIS) or high-grade urine cytology Intravesical chemo-or biological therapy within 6 months of first administration of VAX014 UC of the ureters or urethra History of interstitial cystitis History of radiation to the pelvis History of vesicoureteral reflux or an indwelling urinary stent Other known active cancer(s) likely to require treatment or interfere with study objectives over the next two (2) years Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy Known HIV, Hepatitis B, or Hepatitis C infection Significant cardiovascular risk (e.g., coronary stenting within 8 weeks, myocardial infarction within 6 months) Major surgery other than diagnostic surgery within 4 weeks of first administration of VAX014 Pregnant or currently breast-feeding Psychiatric illness/social situations that would interfere with compliance with study requirements Presence of any sessile appearing tumor suspected of being invasive or high-grade
Facility Information:
Facility Name
The Urology Center of Colorado
City
Denver
State/Province
Colorado
ZIP/Postal Code
80211
Country
United States
Facility Name
University of Iowa Hospital and Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
New Jersey Urology, LLC.
City
Edison
State/Province
New Jersey
ZIP/Postal Code
08837
Country
United States
Facility Name
Carolina Urologic Research Center
City
Myrtle Beach
State/Province
South Carolina
ZIP/Postal Code
29572
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 1 Study of Intravesical VAX014 for Instillation in Subjects With Non-Muscle Invasive Bladder Cancer

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