INO-5401 + INO-9012 in Combination With Atezolizumab in Locally Advanced Unresectable or Metastatic/Recurrent Urothelial Carcinoma
Primary Purpose
Urothelial Carcinoma
Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
INO-5401
INO-9012
Atezolizumab
CELLECTRA™ 2000
Sponsored by
About this trial
This is an interventional treatment trial for Urothelial Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Sign an Informed Consent Form (ICF);
- Have histologically or cytologically documented locally advanced unresectable or metastatic/recurrent urothelial carcinoma (including renal pelvis, ureters, urinary bladder, and urethra);
- For Cohort A: Subjects who have radiographically confirmed disease progression during or following treatment with an anti-PD-1/PD-L1 based therapy;
- For Cohort B: No prior chemotherapy for inoperable locally advanced or metastatic or recurrent UCa and ineligible ("unfit") for cisplatin-based chemotherapy;
- Have measurable disease, as defined by RECIST version 1.1;
- Have a performance status of 0 or 1 on Eastern Cooperative Oncology Group (ECOG) Performance Scale;
- Have life expectancy of >/= 3 months;
- Be willing to provide a tissue sample for pre-treatment intra-tumoral assessment of proinflammatory and immunosuppressive factors;
- Have electrocardiogram (ECG) with no clinically significant findings as assessed by the investigator performed within 28 days prior to first dose;
- Demonstrate adequate hematological, renal, hepatic, and coagulation function;
- For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months after the last dose of study treatment;
- For male subjects: agreement not to father a child. Participants must be surgically sterile (e.g, vasectomy) or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months after the last dose of study treatment.
Exclusion Criteria:
- Any approved anti-cancer therapy including chemotherapy, targeted small molecule therapy or radiation therapy within 2 weeks prior to trial Day 0 as well as current participation or recipient of treatment on a clinical trial within 28 days prior to Day 0;
- Documented active or untreated central nervous system (CNS) metastases and/or carcinomatous meningitis;
- Malignancies other than UCa within 3 years prior to Day 0, with the exception of those with negligible risk of metastasis or death treated with expected curative outcome;
- Prior treatment with CD137 agonists or immune checkpoint blockade therapies;
- Treatment with systemic immunostimulatory agents;
- Treatment with systemic immunosuppressive medication;
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins;
- Known hypersensitivity allergy or contraindication to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the PD-1/PD-L1 inhibitor formulation;
- Active or history of autoimmune disease or immune deficiency;
- History or any evidence of interstitial lung disease;
- History of human immunodeficiency virus (HIV);
- Active hepatitis B or active hepatitis C;
- Severe infections within 4 weeks prior to enrollment;
- Received therapeutic oral or IV antibiotics within 2 weeks prior to Day 0;
- History or current evidence of any condition, therapy or laboratory abnormality that might confound the results of the trial; interfere with the subject's participation for the full duration of the trial, or is negatively impacted by EP treatment, or is not in the best interest of the subject to participate in the opinion of the treating investigator;
- Prior allogeneic stem cell or solid organ transplant;
- Uncontrolled tumor-related pain; pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures; or, hypercalcemia or symptomatic hypercalcemia requiring continued use of bisphosphonate therapy or denosumab.
Sites / Locations
- Alaska Clinical Research Center, LLC
- Cancer Treatment Centers of America at Western Regional Medical Center
- Mayo Clinic Cancer Center
- Mayo Clinic Hospital
- H. Lee Moffitt Cancer Center & Research Institute, Inc.
- Cancer Treatment Centers of America at Midwestern Regional Medical center
- Indiana University Simon Cancer Center
- University of Kansas Cancer Center and Medical Pavilion
- Johns Hopkins University School of Medicine
- Karmanos Cancer Institute
- Washington University School of Medicine in St. Louis
- University of Nebraska Medical Center
- New York University Langone Medical Center - Perlmutter Cancer Center
- Weill Cornell Medical College
- Columbia University, Herbert Irving Comprehensive Cancer Center
- University of North Carolina School of Medicine
- Wake Forest Baptist Medical Center
- University of Pittsburgh Medical Center
- Greenville Memorial Hospital
- Inova Melanoma and Skin Cancer Center
- Hospital de la Santa Creu i Sant Pau
- Hospital Clínic de Barcelona
- Catalan Institute of Oncology (ICO)
- Clinica Universidad de Navarra - Madrid location
- Hospital Universitario Fundacion Jimenez Diaz
- Hospital Universitario 12 de Octubre
- Centro Integral Oncológico Clara Campal (CIOCC)
- Clinica Universidad de Navarra - Pamplona location
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Cohort A
Cohort B
Arm Description
Participants with locally advanced unresectable or metastatic/recurrent UCa, who have confirmed disease progression during or following treatment with an anti-PD-1/PD-L1 therapy. Cohort A participants will be treated with INO-5401 and INO-9012 in combination with atezolizumab.
Participants with locally advanced unresectable or metastatic/recurrent UCa who are treatment naïve and ineligible for cisplatin-based chemotherapy. Cohort B participants will be treated with INO-5401 and INO-9012 in combination with atezolizumab.
Outcomes
Primary Outcome Measures
Number of Adverse Events
Antigen-Specific Cellular Immune Response
Objective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by Investigator Review in Cohort A
Secondary Outcome Measures
ORR by RECIST version 1.1 by Investigator Review in Cohort B
ORR by Immune RECIST (iRECIST)
Duration of Response (DoR)
Progression Free Survival (PFS) as Assessed by RECIST version 1.1 and iRECIST
Overall Survival (OS)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03502785
Brief Title
INO-5401 + INO-9012 in Combination With Atezolizumab in Locally Advanced Unresectable or Metastatic/Recurrent Urothelial Carcinoma
Official Title
An Open-Label, Multi-Center Trial of INO-5401 + INO-9012 in Combination With Atezolizumab in Subjects With Locally Advanced Unresectable or Metastatic/Recurrent Urothelial Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 24, 2018 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Inovio Pharmaceuticals
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
5. Study Description
Brief Summary
This is a Phase I/IIA, open-label, multi-center trial to evaluate the safety, immunogenicity and preliminary clinical efficacy of INO-5401 + INO-9012 delivered by intramuscular (IM) injection followed by electroporation (EP), in combination with atezolizumab in participants with locally advanced unresectable or metastatic/recurrent Urothelial Carcinoma (UCa). The trial population is divided into two cohorts: Cohort A: Participants with locally advanced unresectable or metastatic/recurrent UCa, who have confirmed disease progression during or following treatment with anti-Programmed Death receptor-1/Programmed Death receptor Ligand-1 (anti-PD-1/PD-L1) therapy; Cohort B: Participants with locally advanced unresectable or metastatic/recurrent UCa, who are treatment naïve and ineligible for cisplatin-based chemotherapy. A safety run-in will be performed with up to six participants (safety analysis participants) from cohort A.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urothelial Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
35 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Cohort A
Arm Type
Experimental
Arm Description
Participants with locally advanced unresectable or metastatic/recurrent UCa, who have confirmed disease progression during or following treatment with an anti-PD-1/PD-L1 therapy. Cohort A participants will be treated with INO-5401 and INO-9012 in combination with atezolizumab.
Arm Title
Cohort B
Arm Type
Experimental
Arm Description
Participants with locally advanced unresectable or metastatic/recurrent UCa who are treatment naïve and ineligible for cisplatin-based chemotherapy. Cohort B participants will be treated with INO-5401 and INO-9012 in combination with atezolizumab.
Intervention Type
Biological
Intervention Name(s)
INO-5401
Intervention Description
INO-5401 (9 milligram [mg] dose IM): mixture of 3 synthetic plasmids that target Wilms' tumor gene-1 (WT1) antigen, prostate-specific membrane antigen (PSMA) and human telomerase reverse transcriptase (hTERT) antigen.
Intervention Type
Biological
Intervention Name(s)
INO-9012
Intervention Description
INO-9012 (1 mg dose IM): A synthetic plasmid that expresses human interleukin-12 (IL-12).
INO-5401 + INO-9012 will be administered IM followed by EP with CELLECTRA™ 2000 device every 3 weeks for 4 doses then every 6 weeks for 6 additional doses, thereafter every 12 weeks until confirmed disease progression, unacceptable toxicity, or deemed intolerable by the investigator.
Intervention Type
Drug
Intervention Name(s)
Atezolizumab
Intervention Description
Atezolizumab will be administered by intravenous (IV) infusion every 3 weeks until confirmed disease progression, unacceptable toxicity, or deemed intolerable by the investigator.
Intervention Type
Device
Intervention Name(s)
CELLECTRA™ 2000
Intervention Description
IM injection of INO-5401 and INO-9012 is followed by EP with the CELLECTRA™ 2000 device.
Primary Outcome Measure Information:
Title
Number of Adverse Events
Time Frame
From baseline up to 90 days after last dose of study medication (up to approximately 2 years and 3 months)
Title
Antigen-Specific Cellular Immune Response
Time Frame
At baseline, Weeks 3, 6, 9, 12 and every 12 weeks thereafter up to end of study (up to approximately 2 years)
Title
Objective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by Investigator Review in Cohort A
Time Frame
From Baseline to disease progression or death, whichever occurs first (up to approximately 2 years)
Secondary Outcome Measure Information:
Title
ORR by RECIST version 1.1 by Investigator Review in Cohort B
Time Frame
From Baseline to disease progression or death, whichever occurs first (up to approximately 2 years)
Title
ORR by Immune RECIST (iRECIST)
Time Frame
From Baseline to disease progression or death, whichever occurs first (up to approximately 2 years)
Title
Duration of Response (DoR)
Time Frame
From Baseline to disease progression or death, whichever occurs first (up to approximately 2 years)
Title
Progression Free Survival (PFS) as Assessed by RECIST version 1.1 and iRECIST
Time Frame
From Baseline to disease progression or death, whichever occurs first (up to approximately 2 years)
Title
Overall Survival (OS)
Time Frame
: From Baseline to the time of death from any cause (up to approximately 2 years)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Sign an Informed Consent Form (ICF);
Have histologically or cytologically documented locally advanced unresectable or metastatic/recurrent urothelial carcinoma (including renal pelvis, ureters, urinary bladder, and urethra);
For Cohort A: Subjects who have radiographically confirmed disease progression during or following treatment with an anti-PD-1/PD-L1 based therapy;
For Cohort B: No prior chemotherapy for inoperable locally advanced or metastatic or recurrent UCa and ineligible ("unfit") for cisplatin-based chemotherapy;
Have measurable disease, as defined by RECIST version 1.1;
Have a performance status of 0 or 1 on Eastern Cooperative Oncology Group (ECOG) Performance Scale;
Have life expectancy of >/= 3 months;
Be willing to provide a tissue sample for pre-treatment intra-tumoral assessment of proinflammatory and immunosuppressive factors;
Have electrocardiogram (ECG) with no clinically significant findings as assessed by the investigator performed within 28 days prior to first dose;
Demonstrate adequate hematological, renal, hepatic, and coagulation function;
For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months after the last dose of study treatment;
For male subjects: agreement not to father a child. Participants must be surgically sterile (e.g, vasectomy) or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months after the last dose of study treatment.
Exclusion Criteria:
Any approved anti-cancer therapy including chemotherapy, targeted small molecule therapy or radiation therapy within 2 weeks prior to trial Day 0 as well as current participation or recipient of treatment on a clinical trial within 28 days prior to Day 0;
Documented active or untreated central nervous system (CNS) metastases and/or carcinomatous meningitis;
Malignancies other than UCa within 3 years prior to Day 0, with the exception of those with negligible risk of metastasis or death treated with expected curative outcome;
Prior treatment with CD137 agonists or immune checkpoint blockade therapies;
Treatment with systemic immunostimulatory agents;
Treatment with systemic immunosuppressive medication;
History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins;
Known hypersensitivity allergy or contraindication to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the PD-1/PD-L1 inhibitor formulation;
Active or history of autoimmune disease or immune deficiency;
History or any evidence of interstitial lung disease;
History of human immunodeficiency virus (HIV);
Active hepatitis B or active hepatitis C;
Severe infections within 4 weeks prior to enrollment;
Received therapeutic oral or IV antibiotics within 2 weeks prior to Day 0;
History or current evidence of any condition, therapy or laboratory abnormality that might confound the results of the trial; interfere with the subject's participation for the full duration of the trial, or is negatively impacted by EP treatment, or is not in the best interest of the subject to participate in the opinion of the treating investigator;
Prior allogeneic stem cell or solid organ transplant;
Uncontrolled tumor-related pain; pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures; or, hypercalcemia or symptomatic hypercalcemia requiring continued use of bisphosphonate therapy or denosumab.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Skolnik, MD
Organizational Affiliation
Inovio Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Alaska Clinical Research Center, LLC
City
Anchorage
State/Province
Alaska
ZIP/Postal Code
99503
Country
United States
Facility Name
Cancer Treatment Centers of America at Western Regional Medical Center
City
Goodyear
State/Province
Arizona
ZIP/Postal Code
85338
Country
United States
Facility Name
Mayo Clinic Cancer Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
Mayo Clinic Hospital
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
H. Lee Moffitt Cancer Center & Research Institute, Inc.
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Cancer Treatment Centers of America at Midwestern Regional Medical center
City
Zion
State/Province
Illinois
ZIP/Postal Code
60099
Country
United States
Facility Name
Indiana University Simon Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Kansas Cancer Center and Medical Pavilion
City
Westwood
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Facility Name
Johns Hopkins University School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Washington University School of Medicine in St. Louis
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States
Facility Name
New York University Langone Medical Center - Perlmutter Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Weill Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Columbia University, Herbert Irving Comprehensive Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
University of North Carolina School of Medicine
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Wake Forest Baptist Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Greenville Memorial Hospital
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29615
Country
United States
Facility Name
Inova Melanoma and Skin Cancer Center
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Facility Name
Hospital de la Santa Creu i Sant Pau
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Hospital Clínic de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Catalan Institute of Oncology (ICO)
City
Barcelona
ZIP/Postal Code
08908
Country
Spain
Facility Name
Clinica Universidad de Navarra - Madrid location
City
Madrid
ZIP/Postal Code
28027
Country
Spain
Facility Name
Hospital Universitario Fundacion Jimenez Diaz
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Centro Integral Oncológico Clara Campal (CIOCC)
City
Madrid
ZIP/Postal Code
28050
Country
Spain
Facility Name
Clinica Universidad de Navarra - Pamplona location
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
12. IPD Sharing Statement
Learn more about this trial
INO-5401 + INO-9012 in Combination With Atezolizumab in Locally Advanced Unresectable or Metastatic/Recurrent Urothelial Carcinoma
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