Evaluation of Ad-RTS-hIL-12 + Veledimex in Subjects With Recurrent or Progressive Glioblastoma, a Substudy to ATI001-102
Primary Purpose
Glioblastoma
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ad-RTS-hIL-12
veledimex
Sponsored by
About this trial
This is an interventional treatment trial for Glioblastoma
Eligibility Criteria
Inclusion Criteria:
- Male or female subject ≥18 and ≤75 years of age
- Provision of written informed consent for tumor resection, tumor biopsy, samples collection, and treatment with investigational products prior to undergoing any study specific procedures
- Histologically confirmed glioblastoma
- Evidence of supratentorial tumor recurrence/progression by magnetic resonance imaging (MRI) according to Response Assessment in Neuro-Oncology (RANO) criteria after standard initial therapy
Previous standard-of-care antitumor treatment including surgery and/or biopsy and chemoradiation. At the time of registration, subjects must have recovered from the toxic effects of previous treatments as determined by the treating physician. The washout periods from prior therapies are intended as follows: (windows other than what is listed below should be allowed only after consultation with the Medical Monitor)
- Nitrosureas: 6 weeks
- Other cytotoxic agents: 4 weeks
- Antiangiogenic agents: 4 weeks (NOTE: short use (< 4 doses) of bevacizumab for controlling edema is allowed)
- Targeted agents, including small molecule tyrosine kinase inhibitors: 2 weeks
- Vaccine-based therapy: 3 months
- Able to undergo standard MRI scans with contrast agent before enrollment and after treatment
- Karnofsky Performance Status ≥70
Adequate bone marrow reserves and liver and kidney function, as assessed by the following laboratory requirements:
- Hemoglobin ≥9 g/L
- Lymphocytes >500/mm3
- Absolute neutrophil count ≥1500/mm3
- Platelets ≥100,000/mm3
- Serum creatinine ≤1.5 x upper limit of normal (ULN)
- Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 x ULN. For subjects with documented liver metastases, ALT and AST ≤5 x ULN
- Total bilirubin <1.5 x ULN
- International normalized ratio (INR) and activated partial thromboplastin time (aPTT) or partial thromboplastin time (PTT) within normal institutional limits
- Male and female subjects must agree to use a highly reliable method of birth control (expected failure rate <5% per year) from the Screening Visit through 28 days after the last dose of study drug. Women of childbearing potential (perimenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential) must have a negative pregnancy test at screening
Exclusion Criteria:
- Previous treatment with bevacizumab for their disease (NOTE: short use (< 4 doses) of bevacizumab for controlling edema is allowed)
- Subjects receiving systemic corticosteroids during the previous 4 weeks
- Radiotherapy treatment within 4 weeks of starting veledimex
- Subjects with clinically significant increased intracranial pressure (eg, impending herniation or requirement for immediate palliative treatment) or uncontrolled seizures
- Known immunosuppressive disease, or autoimmune conditions, and/or chronic viral infections (eg, human immunodeficiency virus [HIV], hepatitis)
- Use of systemic antibacterial, antifungal, or antiviral medications for the treatment of acute clinically significant infection within 2 weeks of first veledimex dose. Concomitant therapy for chronic infections is not allowed. Subjects must be afebrile prior to Ad-RTS-hIL-12 injection; only prophylactic antibiotic use is allowed perioperatively
- Use of enzyme-inducing antiepileptic drugs (EIAED) within 7 days prior to the first dose of study drug. Note: Levetiracetam (Keppra®) is not an EIAED and is allowed
- Other concurrent clinically active malignant disease, requiring treatment, with the exception of non-melanoma cancers of the skin or carcinoma in situ of the cervix or nonmetastatic prostate cancer
- Nursing or pregnant females
- Prior exposure to veledimex
- Use of medications that induce, inhibit, or are substrates of CYP4503A4 within 7 days prior to veledimex dosing without consultation with the Medical Monitor
- Presence of any contraindication for a neurosurgical procedure
- Unstable or clinically significant concurrent medical condition that would, in the opinion of the Investigator or Medical Monitor, jeopardize the safety of a subject and/or their compliance with the protocol. Examples may include, but are not limited to, colitis, pneumonitis, unstable angina, congestive heart failure, myocardial infarction within 2 months of screening, and ongoing maintenance therapy for life-threatening ventricular arrhythmia or uncontrolled asthma
Sites / Locations
- Cedars-Sinai Medical Center
- Northwestern Memorial Hospital
- NYU - Langone Health
- The University of Texas MD Anderson Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Ad-RTS-hIL-12 + veledimex
Arm Description
Intratumoral Ad-RTS-hIL-12 and oral veledimex
Outcomes
Primary Outcome Measures
Safety of intratumoral Ad-RTS-hIL-12 and oral veledimex in subjects with recurrent or progressive glioblastoma based on evaluation of adverse events summarized by incidence, intensity and type of adverse event.
Evaluation of adverse events as assessed by CTCAE v4.03. Adverse events will be summarized based on the incidence, intensity and type of adverse event.
Tolerability of intratumoral Ad-RTS-hIL-12 and oral veledimex in subjects with recurrent or progressive glioblastoma will be assessed based on expected dose compliance
Evaluation will be based on expected dose compliance
Secondary Outcome Measures
Determine the overall survival (OS) of Ad-RTS-hIL-12 + veledimex
Veledimex pharmacokinetic profile: maximum plasma concentration (Cmax)
The maximum plasma concentration (Cmax)
Veledimex pharmacokinetic profile: Time to maximum plasma concentration (Tmax)
Time to maximum plasma concentration (Tmax)
Veledimex pharmacokinetic profile: Half-life (t1/2)
Half-life (t1/2)
Veledimex pharmacokinetic profile: Area-under-the-concentration versus time curve (AUC)
Area-under-the-concentration versus time curve (AUC)
Veledimex pharmacokinetic profile: Volume of distribution (Vd)
Volume of distribution (Vd)
Veledimex pharmacokinetic profile: Clearance (CL)
Clearance (CL)
Veledimex concentration ratio between the brain tumor and the blood
Tumor objective response rate (ORR)
Progression free survival (PFS)
Rate of pseudo-progression (PSP)
Changes from baseline in cellular responses elicited by Ad-RTS-hIL-12 and veledimex
Evaluation in changes in immune cell population markers, such as, but not limited to CD3, CD4 and CD8 in peripheral blood and tumor
Changes from baseline in humoral immune responses elicited by Ad-RTS-hIL-12 and veledimex
Evaluation of changes in levels of immunological and biological markers, such as, but not limited to IL-12 and IFN-gamma in peripheral serum samples
Full Information
NCT ID
NCT03679754
First Posted
August 29, 2018
Last Updated
September 21, 2021
Sponsor
Alaunos Therapeutics
1. Study Identification
Unique Protocol Identification Number
NCT03679754
Brief Title
Evaluation of Ad-RTS-hIL-12 + Veledimex in Subjects With Recurrent or Progressive Glioblastoma, a Substudy to ATI001-102
Official Title
Protocol ATI001-102 Expansion Substudy: Evaluation of Ad-RTS-hIL-12 + Veledimex in Subjects With Recurrent or Progressive Glioblastoma
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
September 5, 2018 (Actual)
Primary Completion Date
April 2, 2019 (Actual)
Study Completion Date
January 19, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alaunos Therapeutics
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This research study involves an investigational product: Ad-RTS-hIL-12 given with veledimex for production of human IL-12. IL-12 is a protein that can improve the body's natural response to disease by enhancing the ability of the immune system to kill tumor cells and may interfere with blood flow to the tumor.
The main purpose of this study is to evaluate the safety and tolerability of a single intratumoral injection of Ad-RTS-hIL-12 given with oral veledimex.
Detailed Description
Patients who are scheduled for craniotomy and tumor resection will receive one dose of veledimex before the resection procedure. Ad-RTS-hIL-12 will be administered by free-hand injection. Patients will continue on oral veledimex for 14 days.
The study is divided into three periods: the screening period, the treatment period and the follow-up period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ad-RTS-hIL-12 + veledimex
Arm Type
Experimental
Arm Description
Intratumoral Ad-RTS-hIL-12 and oral veledimex
Intervention Type
Biological
Intervention Name(s)
Ad-RTS-hIL-12
Intervention Description
2.0 x 10^11 viral particles (vp) per injection
intratumoral injection of Ad-RTS-hIL-12
Intervention Type
Drug
Intervention Name(s)
veledimex
Intervention Description
20mg/day
15 oral daily doses of veledimex
Primary Outcome Measure Information:
Title
Safety of intratumoral Ad-RTS-hIL-12 and oral veledimex in subjects with recurrent or progressive glioblastoma based on evaluation of adverse events summarized by incidence, intensity and type of adverse event.
Description
Evaluation of adverse events as assessed by CTCAE v4.03. Adverse events will be summarized based on the incidence, intensity and type of adverse event.
Time Frame
3 years
Title
Tolerability of intratumoral Ad-RTS-hIL-12 and oral veledimex in subjects with recurrent or progressive glioblastoma will be assessed based on expected dose compliance
Description
Evaluation will be based on expected dose compliance
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Determine the overall survival (OS) of Ad-RTS-hIL-12 + veledimex
Time Frame
3 years
Title
Veledimex pharmacokinetic profile: maximum plasma concentration (Cmax)
Description
The maximum plasma concentration (Cmax)
Time Frame
3 years
Title
Veledimex pharmacokinetic profile: Time to maximum plasma concentration (Tmax)
Description
Time to maximum plasma concentration (Tmax)
Time Frame
3 years
Title
Veledimex pharmacokinetic profile: Half-life (t1/2)
Description
Half-life (t1/2)
Time Frame
3 years
Title
Veledimex pharmacokinetic profile: Area-under-the-concentration versus time curve (AUC)
Description
Area-under-the-concentration versus time curve (AUC)
Time Frame
3 years
Title
Veledimex pharmacokinetic profile: Volume of distribution (Vd)
Description
Volume of distribution (Vd)
Time Frame
3 years
Title
Veledimex pharmacokinetic profile: Clearance (CL)
Description
Clearance (CL)
Time Frame
3 years
Title
Veledimex concentration ratio between the brain tumor and the blood
Time Frame
3 years
Title
Tumor objective response rate (ORR)
Time Frame
3 years
Title
Progression free survival (PFS)
Time Frame
3 years
Title
Rate of pseudo-progression (PSP)
Time Frame
3 years
Title
Changes from baseline in cellular responses elicited by Ad-RTS-hIL-12 and veledimex
Description
Evaluation in changes in immune cell population markers, such as, but not limited to CD3, CD4 and CD8 in peripheral blood and tumor
Time Frame
3 years
Title
Changes from baseline in humoral immune responses elicited by Ad-RTS-hIL-12 and veledimex
Description
Evaluation of changes in levels of immunological and biological markers, such as, but not limited to IL-12 and IFN-gamma in peripheral serum samples
Time Frame
3 years
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:
Male or female subject ≥18 and ≤75 years of age
Provision of written informed consent for tumor resection, tumor biopsy, samples collection, and treatment with investigational products prior to undergoing any study specific procedures
Histologically confirmed glioblastoma
Evidence of supratentorial tumor recurrence/progression by magnetic resonance imaging (MRI) according to Response Assessment in Neuro-Oncology (RANO) criteria after standard initial therapy
Previous standard-of-care antitumor treatment including surgery and/or biopsy and chemoradiation. At the time of registration, subjects must have recovered from the toxic effects of previous treatments as determined by the treating physician. The washout periods from prior therapies are intended as follows: (windows other than what is listed below should be allowed only after consultation with the Medical Monitor)
Nitrosureas: 6 weeks
Other cytotoxic agents: 4 weeks
Antiangiogenic agents: 4 weeks (NOTE: short use (< 4 doses) of bevacizumab for controlling edema is allowed)
Targeted agents, including small molecule tyrosine kinase inhibitors: 2 weeks
Vaccine-based therapy: 3 months
Able to undergo standard MRI scans with contrast agent before enrollment and after treatment
Karnofsky Performance Status ≥70
Adequate bone marrow reserves and liver and kidney function, as assessed by the following laboratory requirements:
Hemoglobin ≥9 g/L
Lymphocytes >500/mm3
Absolute neutrophil count ≥1500/mm3
Platelets ≥100,000/mm3
Serum creatinine ≤1.5 x upper limit of normal (ULN)
Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 x ULN. For subjects with documented liver metastases, ALT and AST ≤5 x ULN
Total bilirubin <1.5 x ULN
International normalized ratio (INR) and activated partial thromboplastin time (aPTT) or partial thromboplastin time (PTT) within normal institutional limits
Male and female subjects must agree to use a highly reliable method of birth control (expected failure rate <5% per year) from the Screening Visit through 28 days after the last dose of study drug. Women of childbearing potential (perimenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential) must have a negative pregnancy test at screening
Exclusion Criteria:
Previous treatment with bevacizumab for their disease (NOTE: short use (< 4 doses) of bevacizumab for controlling edema is allowed)
Subjects receiving systemic corticosteroids during the previous 4 weeks
Radiotherapy treatment within 4 weeks of starting veledimex
Subjects with clinically significant increased intracranial pressure (eg, impending herniation or requirement for immediate palliative treatment) or uncontrolled seizures
Known immunosuppressive disease, or autoimmune conditions, and/or chronic viral infections (eg, human immunodeficiency virus [HIV], hepatitis)
Use of systemic antibacterial, antifungal, or antiviral medications for the treatment of acute clinically significant infection within 2 weeks of first veledimex dose. Concomitant therapy for chronic infections is not allowed. Subjects must be afebrile prior to Ad-RTS-hIL-12 injection; only prophylactic antibiotic use is allowed perioperatively
Use of enzyme-inducing antiepileptic drugs (EIAED) within 7 days prior to the first dose of study drug. Note: Levetiracetam (Keppra®) is not an EIAED and is allowed
Other concurrent clinically active malignant disease, requiring treatment, with the exception of non-melanoma cancers of the skin or carcinoma in situ of the cervix or nonmetastatic prostate cancer
Nursing or pregnant females
Prior exposure to veledimex
Use of medications that induce, inhibit, or are substrates of CYP4503A4 within 7 days prior to veledimex dosing without consultation with the Medical Monitor
Presence of any contraindication for a neurosurgical procedure
Unstable or clinically significant concurrent medical condition that would, in the opinion of the Investigator or Medical Monitor, jeopardize the safety of a subject and/or their compliance with the protocol. Examples may include, but are not limited to, colitis, pneumonitis, unstable angina, congestive heart failure, myocardial infarction within 2 months of screening, and ongoing maintenance therapy for life-threatening ventricular arrhythmia or uncontrolled asthma
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arnold Gelb, MD
Organizational Affiliation
Ziopharm Oncology Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Northwestern Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
NYU - Langone Health
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Evaluation of Ad-RTS-hIL-12 + Veledimex in Subjects With Recurrent or Progressive Glioblastoma, a Substudy to ATI001-102
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