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Safety, Tolerability and Pharmacokinetics Investigation of Stimotimagene Copolymerplasmid

Primary Purpose

Sarcoma, Melanoma, Squamous Cell Carcinoma of Head and Neck

Status
Recruiting
Phase
Phase 1
Locations
Russian Federation
Study Type
Interventional
Intervention
Intratumoral administration of Stimotimagene copolymerplasmid
Intravenous administration of Ganciclovir (Cymeven®)
Sponsored by
Gene Surgery LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women aged 18-75;
  2. Histologically confirmed diagnosis of a solid tumor and/or its metastases: Sarcoma, Melanoma, Squamous Cell Carcinoma of Head and Neck, Breast Neoplasms, Uterine Cervical Neoplasms, Vulvar Neoplasms, Penile Neoplasms, Anus Neoplasms
  3. Patients for whom surgery is not indicated;
  4. Patients with exhausted methods of drug and radiation therapy;
  5. Presence of clearly detectable and measurable by instrumental methods (ultrasound) tumor mass with a maximum size of at least 10 mm, palpable and accessible for intratumoral injection;
  6. The injected with the test drug tumor mass must not be located near large blood vessels or nerves;
  7. General health according to the ECOG scale 0-2;
  8. Life expectancy of at least 3 months;
  9. Hemoglobin ≥ 90 g/l;
  10. Absolute neutrophil count ≥ 1500/mm3;
  11. Platelet count ≥ 100,000/mm3;
  12. Creatinine clearance ≥ 70 ml/min;
  13. Quick Prothrombin Time more than 55%;
  14. At least 4 weeks or at least 5 elimination half-lives must elapse between previous chemotherapy, targeted therapy, radiotherapy, immunotherapy, or experimental antitumor therapy and administration of the study drug;
  15. Patients must recover from any previous surgery, radiotherapy, localized therapy, or systemic therapy to grade 1 or lower adverse reactions (except alopecia or anemia, for which grade 2 is acceptable);
  16. Women of childbearing age (not menopausal or surgically sterilized) and men who are sexually active should use a reliable method of contraception (acceptable methods of contraception in this study are: IUDs, oral contraceptives, contraceptive patch, long-acting injectable contraceptives, dual barrier method (condom and spermicide, diaphragm and spermicide) during the study and at least 30 days after the last dose of Cymeven® for female patients and at least 90 days after the last dose of Cymeven® for male patients;
  17. Ability to follow protocol procedures throughout the study;
  18. Presence of Patient Informed Consent to Participate in a Clinical Trial.

Exclusion Criteria:

  1. The investigator's concern that injecting the drug into the tumor mass may lead to life-threatening side effects, if tumor swelling or inflammation occurs after treatment;
  2. History of hypersensitivity to ganciclovir, valganciclovir, or any other component of Cymeven®;
  3. History of hypersensitivity to acyclovir or pencyclovir (or their prodrugs valacyclovir or famciclovir, respectively);
  4. History of allergic reactions to antibiotics;
  5. History of allergic reaction to polyethylene glycol or polyethyleneimine;
  6. The following medications are scheduled to be taken during the potential therapy period:

    • imipenem/cylastatin
    • drugs that have myelosuppressive effects or impair renal function: nucleoside analogues (e.g., zidovudine, didanosine, stavudine), immunosuppressants (e.g., cyclosporine, tacrolimus, mycophenolate mofetil), anticancer drugs (e.g, doxorubicin, vincristine, vinblastine, hydroxyurea) and anti-infective drugs (e.g., trimethoprim/sulfamides, dapsone, amphotericin B, flucytosine, pentamidine);
    • probenecid;
  7. Pregnancy or lactation;
  8. Presence of primary multiple malignant diseases;
  9. Presence of connection of the tumor mass with the main vessels according to ultrasound/CT/MRI data;
  10. Radiation damage (ulceration, necrosis);
  11. High risk/continued bleeding;
  12. Systemic connective tissue disease (scleroderma, etc.);
  13. Exacerbation of allergic diseases at the time of inclusion in the study;
  14. Liver function disorder;
  15. Presence of acute and acute chronic infections within the last 4 weeks before inclusion in the study (including tuberculosis, abscess, phlegmon);
  16. Exacerbations of chronic diseases of the cardiovascular, bronchopulmonary, urogenital, gastrointestinal, musculoskeletal, nervous and immune systems at the time of inclusion in the study;
  17. Presence of mental illness;
  18. A history of active primary immunodeficiency;
  19. Presence of HIV, active hepatitis B or C;
  20. Brain metastases, carcinomatous meningitis at the moment of inclusion in the study;
  21. Patient's participation in another clinical trial less than 30 days before inclusion in this study;
  22. Any condition that, in the opinion of the investigator, might interfere with adequate treatment delivery, including difficult contact with the patient (inadequate perception of information provided about the patient's condition and planned/conducted treatment, refusal to comply with recommendations).

Sites / Locations

  • GBUZ Moscow Clinical Scientific Center named after Loginov MHDRecruiting
  • FSBI N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of RussiaRecruiting
  • FSBI National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov of the Ministry of Health of RussiaRecruiting
  • National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose escalation phase

Two times administration of Stimotimagene copolymerplasmid

Tree times administration of Stimotimagene copolymerplasmid

Arm Description

Stimotimagene copolymerplasmid will be administered intratumoral once in a dose of 20 mkg of DNA per 1 cm3 of tumor (for cohort 1) and 40 mkg of DNA per 1 cm3 of tumor (for cohort 2). Ganciclovir (Cimeven®) will be administrated intravenous twice a day at 12-hour intervals for 15 days.

Stimotimagene copolymerplasmid will be administered intratumorally twice with 5-day interval in the optimal dose selected at previous stage of the trial. Ganciclovir (Cimeven®) will be administrated intravenous twice a day at 12-hour intervals for 15 days.

Stimotimagene copolymerplasmid will be administered intratumorally three times with 5-day interval in the optimal dose selected at first stage of the trial. Ganciclovir (Cimeven®) will be administrated intravenous twice a day at 12-hour intervals for 15 days.

Outcomes

Primary Outcome Measures

Safety (Presence/absence of dose-limiting toxicities (DLTs))
Assessment of presence/absence of dose-limiting toxicities (DLTs)
Safety (Frequency and severity of adverse events (CTCAE classification))
Assessment of frequency and severity of adverse events (CTCAE classification)
Safety (Number of cases of early termination of participation in the study due to the development of Serious Adverse Events and Other Adverse Events associated with the study therapy)
Assessment of number of cases of early termination of participation in the study due to the development of Serious Adverse Events and Other Adverse Events associated with the study therapy)
Pharmacokinetics (Quantitative content of plasmid DNA (pTKhGM) in patients' peripheral blood)
Assessment of quantitative content of plasmid DNA (pTKhGM) in patients' peripheral blood at: Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Days 5, 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 1st step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Days 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 2nd step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Day 7, Day 11 (before drug administration and 8 h after drug administration), Days 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 3rd step of the
Pharmacokinetics (Quantitative content of plasmid DNA (pTKhGM) in patients' urine)
Assessment of quantitative content of plasmid DNA (pTKhGM) in patients' urine at: Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Days 5, 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 1st step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Days 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 2nd step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Day 7, Day 11 (before drug administration and 8 h after drug administration), Days 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 3rd step of the study.

Secondary Outcome Measures

Full Information

First Posted
October 3, 2022
Last Updated
October 17, 2023
Sponsor
Gene Surgery LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05578820
Brief Title
Safety, Tolerability and Pharmacokinetics Investigation of Stimotimagene Copolymerplasmid
Official Title
An Open Multicenter Study of the Safety, Tolerability, and Pharmacokinetics of Different Doses of Stimotimagene Copolymerplasmid at Patients With Advanced-stage Solid Tumors With Cymeven® (Ganciclovir) Infusions
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gene Surgery LLC

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 purpose of this study is to evaluate the safety and tolerability of different doses and administration regimens of Stimotimagene copolymerplasmid in patients with histologically confirmed diagnosis of solid tumor and/or its metastases.
Detailed Description
Stimotimagene copolymerplasmid is an anti-tumor gene therapy drug, contains super-coiled plasmid DNA encapsulated in polycationic envelope (PPT: polyethyleneimine (PEI) - polyethylene glycol (PEG) - TAT peptide). The plasmid encodes two therapeutic genes: herpes simplex virus thymidine kinase (HSVtk) and human granulocyte-macrophage colony-stimulating factor (hGM-CSF). HSVtk converts the prodrug ganciclovir to a toxin in cells that have been transfected by Stimotimagene copolymerplasmid, GM-CSF stimulates proliferation and differentiation of antigen-presenting cells. Stimotimagene copolymerplasmid therapy is two-staged: (1) intratumoral injection of Stimotimagene copolymerplasmid, (2) intravenous administration of ganciclovir (Cimeven®) This is the first-in-human study of Stimotimagene copolymerplasmid which will be conducted in three arms. In this study dose escalation (Arm1) and number of drug administrations (Arms 2 and 3) will be explored. All study parts will investigate the safety, tolerability and pharmacokinetic profile of Stimotimagene copolymerplasmid.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Melanoma, Squamous Cell Carcinoma of Head and Neck, Breast Neoplasms, Uterine Cervical Neoplasms, Vulvar Neoplasms, Penile Neoplasms, Anus Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose escalation phase
Arm Type
Experimental
Arm Description
Stimotimagene copolymerplasmid will be administered intratumoral once in a dose of 20 mkg of DNA per 1 cm3 of tumor (for cohort 1) and 40 mkg of DNA per 1 cm3 of tumor (for cohort 2). Ganciclovir (Cimeven®) will be administrated intravenous twice a day at 12-hour intervals for 15 days.
Arm Title
Two times administration of Stimotimagene copolymerplasmid
Arm Type
Experimental
Arm Description
Stimotimagene copolymerplasmid will be administered intratumorally twice with 5-day interval in the optimal dose selected at previous stage of the trial. Ganciclovir (Cimeven®) will be administrated intravenous twice a day at 12-hour intervals for 15 days.
Arm Title
Tree times administration of Stimotimagene copolymerplasmid
Arm Type
Experimental
Arm Description
Stimotimagene copolymerplasmid will be administered intratumorally three times with 5-day interval in the optimal dose selected at first stage of the trial. Ganciclovir (Cimeven®) will be administrated intravenous twice a day at 12-hour intervals for 15 days.
Intervention Type
Biological
Intervention Name(s)
Intratumoral administration of Stimotimagene copolymerplasmid
Intervention Description
Intratumoral administration of gene therapy drug Stimotimagene copolymerplasmid
Intervention Type
Drug
Intervention Name(s)
Intravenous administration of Ganciclovir (Cymeven®)
Intervention Description
Intravenous administration of prodrug Ganciclovir (Cymeven®)
Primary Outcome Measure Information:
Title
Safety (Presence/absence of dose-limiting toxicities (DLTs))
Description
Assessment of presence/absence of dose-limiting toxicities (DLTs)
Time Frame
Through study completion, an average of 1 year
Title
Safety (Frequency and severity of adverse events (CTCAE classification))
Description
Assessment of frequency and severity of adverse events (CTCAE classification)
Time Frame
Through study completion, an average of 1 year
Title
Safety (Number of cases of early termination of participation in the study due to the development of Serious Adverse Events and Other Adverse Events associated with the study therapy)
Description
Assessment of number of cases of early termination of participation in the study due to the development of Serious Adverse Events and Other Adverse Events associated with the study therapy)
Time Frame
Through study completion, an average of 1 year
Title
Pharmacokinetics (Quantitative content of plasmid DNA (pTKhGM) in patients' peripheral blood)
Description
Assessment of quantitative content of plasmid DNA (pTKhGM) in patients' peripheral blood at: Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Days 5, 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 1st step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Days 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 2nd step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Day 7, Day 11 (before drug administration and 8 h after drug administration), Days 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 3rd step of the
Time Frame
Through study completion, an average of 1 year
Title
Pharmacokinetics (Quantitative content of plasmid DNA (pTKhGM) in patients' urine)
Description
Assessment of quantitative content of plasmid DNA (pTKhGM) in patients' urine at: Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Days 5, 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 1st step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Days 7, 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 2nd step of the study; Day -1 (baseline), Day 1 (4 h and 8 h after drug administration), Day 2 (24 h after drug administration), Day 3 (48 h after drug administration), Day 6 (before drug administration and 8 h after drug administration), Day 7, Day 11 (before drug administration and 8 h after drug administration), Days 12, 17, 25, 30±3, 60±5, 90±7, 130±3 for patients from 3rd step of the study.
Time Frame
Through study completion, an average of 1 year

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: Men and women aged 18-75; Histologically confirmed diagnosis of a solid tumor and/or its metastases: Sarcoma, Melanoma, Squamous Cell Carcinoma of Head and Neck, Breast Neoplasms, Uterine Cervical Neoplasms, Vulvar Neoplasms, Penile Neoplasms, Anus Neoplasms Patients for whom surgery is not indicated; Patients with exhausted methods of drug and radiation therapy; Presence of clearly detectable and measurable by instrumental methods (ultrasound) tumor mass with a maximum size of at least 10 mm, palpable and accessible for intratumoral injection; The injected with the test drug tumor mass must not be located near large blood vessels or nerves; General health according to the ECOG scale 0-2; Life expectancy of at least 3 months; Hemoglobin ≥ 90 g/l; Absolute neutrophil count ≥ 1500/mm3; Platelet count ≥ 100,000/mm3; Creatinine clearance ≥ 70 ml/min; Quick Prothrombin Time more than 55%; At least 4 weeks or at least 5 elimination half-lives must elapse between previous chemotherapy, targeted therapy, radiotherapy, immunotherapy, or experimental antitumor therapy and administration of the study drug; Patients must recover from any previous surgery, radiotherapy, localized therapy, or systemic therapy to grade 1 or lower adverse reactions (except alopecia or anemia, for which grade 2 is acceptable); Women of childbearing age (not menopausal or surgically sterilized) and men who are sexually active should use a reliable method of contraception (acceptable methods of contraception in this study are: IUDs, oral contraceptives, contraceptive patch, long-acting injectable contraceptives, dual barrier method (condom and spermicide, diaphragm and spermicide) during the study and at least 30 days after the last dose of Cymeven® for female patients and at least 90 days after the last dose of Cymeven® for male patients; Ability to follow protocol procedures throughout the study; Presence of Patient Informed Consent to Participate in a Clinical Trial. Exclusion Criteria: The investigator's concern that injecting the drug into the tumor mass may lead to life-threatening side effects, if tumor swelling or inflammation occurs after treatment; History of hypersensitivity to ganciclovir, valganciclovir, or any other component of Cymeven®; History of hypersensitivity to acyclovir or pencyclovir (or their prodrugs valacyclovir or famciclovir, respectively); History of allergic reactions to antibiotics; History of allergic reaction to polyethylene glycol or polyethyleneimine; The following medications are scheduled to be taken during the potential therapy period: imipenem/cylastatin drugs that have myelosuppressive effects or impair renal function: nucleoside analogues (e.g., zidovudine, didanosine, stavudine), immunosuppressants (e.g., cyclosporine, tacrolimus, mycophenolate mofetil), anticancer drugs (e.g, doxorubicin, vincristine, vinblastine, hydroxyurea) and anti-infective drugs (e.g., trimethoprim/sulfamides, dapsone, amphotericin B, flucytosine, pentamidine); probenecid; Pregnancy or lactation; Presence of primary multiple malignant diseases; Presence of connection of the tumor mass with the main vessels according to ultrasound/CT/MRI data; Radiation damage (ulceration, necrosis); High risk/continued bleeding; Systemic connective tissue disease (scleroderma, etc.); Exacerbation of allergic diseases at the time of inclusion in the study; Liver function disorder; Presence of acute and acute chronic infections within the last 4 weeks before inclusion in the study (including tuberculosis, abscess, phlegmon); Exacerbations of chronic diseases of the cardiovascular, bronchopulmonary, urogenital, gastrointestinal, musculoskeletal, nervous and immune systems at the time of inclusion in the study; Presence of mental illness; A history of active primary immunodeficiency; Presence of HIV, active hepatitis B or C; Brain metastases, carcinomatous meningitis at the moment of inclusion in the study; Patient's participation in another clinical trial less than 30 days before inclusion in this study; Any condition that, in the opinion of the investigator, might interfere with adequate treatment delivery, including difficult contact with the patient (inadequate perception of information provided about the patient's condition and planned/conducted treatment, refusal to comply with recommendations).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Max Koksharov
Phone
+79617697651
Email
med@genesurgery.ru
Facility Information:
Facility Name
GBUZ Moscow Clinical Scientific Center named after Loginov MHD
City
Moscow
ZIP/Postal Code
111123
Country
Russian Federation
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ludmila Zhukova
Phone
+7 (495) 304-30-39
Email
info@mknc.ru
Facility Name
FSBI N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia
City
Moscow
ZIP/Postal Code
115478
Country
Russian Federation
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Igor Samoylenko
Phone
+7 (499) 324-24-24
Email
info@ronc.ru
Facility Name
FSBI National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov of the Ministry of Health of Russia
City
Moscow
ZIP/Postal Code
117997
Country
Russian Federation
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lev Ashrafian
Phone
+7(495)531-44-44
Facility Name
National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation
City
Moscow
ZIP/Postal Code
125284
Country
Russian Federation
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aleksander Fedenko
Phone
+7 (495) 150-11-22

12. IPD Sharing Statement

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Safety, Tolerability and Pharmacokinetics Investigation of Stimotimagene Copolymerplasmid

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