MV-NIS Infected Mesenchymal Stem Cells in Treating Patients With Recurrent Ovarian, Primary Peritoneal or Fallopian Tube Cancer
Primary Purpose
Fallopian Tube Clear Cell Adenocarcinoma, Fallopian Tube Endometrioid Adenocarcinoma, Fallopian Tube Mucinous Adenocarcinoma
Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Laboratory Biomarker Analysis
Mesenchymal Stem Cell Transplantation
Oncolytic Measles Virus Encoding Thyroidal Sodium Iodide Symporter
Sponsored by
About this trial
This is an interventional treatment trial for Fallopian Tube Clear Cell Adenocarcinoma
Eligibility Criteria
Inclusion Criteria:
Must have:
- Recurrent or progressive ovarian cancer, primary peritoneal cancer or fallopian tube cancer after prior treatment with platinum and taxanes
- Histologic confirmation of the original primary tumor
- Prior bilateral oophorectomy
- The following histologic epithelial cell types are eligible: serous adenocarcinoma, endometrioid adenocarcinoma, mucinous adenocarcinoma, undifferentiated carcinoma, clear cell adenocarcinoma, mixed epithelial carcinoma, transitional cell carcinoma, malignant Brenner's tumor, or adenocarcinoma not otherwise specified (NOS)
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, 2
- Absolute neutrophil count (ANC) >= 1500/uL (obtained =< 7 days prior to registration)
- Platelet (PLT) >= 100,000/uL (obtained =< 7 days prior to registration)
- Total bilirubin =< upper normal limit (obtained =< 7 days prior to registration)
- Aspartate aminotransferase (AST) =< 2 x upper limit of normal (ULN) (obtained =< 7 days prior to registration)
- Creatinine =< 1.5 x ULN (obtained =< 7 days prior to registration)
- Hemoglobin (Hgb) >= 9.0 g/dL (obtained =< 7 days prior to registration)
- Normal cardiac function as defined by a normal ejection fraction by multi gated acquisition scan (MUGA) or echocardiogram
- Provide informed written consent
- Willing to return to Mayo Clinic Rochester for follow-up
- Life expectancy >= 12 weeks
- Willing to provide all biologic specimens as required by the protocol
- Measurable disease by exam or CT scan, or for patients with cancer antigen (CA)-125 elevation or with microscopic residual but without measurable disease on imaging, willingness to undergo laparoscopy for evaluation of treatment effect if no radiographic progression after 6 treatment cycles
- CD4 count >= 200/uL or >= 15% of peripheral blood lymphocytes
Exclusion Criteria:
- Epithelial tumors of low malignant potential, stromal tumors, and germ cell tumors of the ovary
- Known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy; subjects will be excluded if this is their first relapse and they have recurred > 6 months from completion of primary (adjuvant) chemotherapy
- Active infection =< 5 days prior to registration
- History of tuberculosis or history of tuberculosis skin test purified protein derivative (PPD) positivity
- History of other malignancy =< 5 years prior to registration except for non-melanoma skin cancer, carcinoma in situ of the cervix, and ductal carcinoma in situ (DCIS)
Any of the following prior therapies:
- Chemotherapy =< 3 weeks prior to registration
- Immunotherapy =< 4 weeks prior to registration
- Biologic therapy =< 4 weeks prior to registration
- Extensive abdominal surgery if it includes enterotomy(ies) =< 3 weeks prior to registration; this criterion does not apply to placement of the peritoneal Port-A-Cath or lysis of adhesions at the time of registration
- Any viral or gene therapy prior to registration
- Radiation therapy to the abdomen or pelvis
- New York Heart Association classification III or IV, known symptomatic coronary artery disease, or symptoms of coronary artery disease on systems review, or known cardiac arrhythmias (atrial fibrillation or supraventricular tachycardia [SVT])
- Other cardiac or pulmonary disease that, at the investigators discretion, can impair treatment safety
- Requiring blood product support
- Central nervous system (CNS) metastases or seizure disorder
- Human immunodeficiency virus (HIV)-positive test result or history of other immunodeficiency
- History of organ transplantation
- History of chronic hepatitis B or C
- Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational (utilized for a non-Food and Drug Administration [FDA]-approved indication and in the context of a research investigation)
- Intra-abdominal disease > 8 cm in diameter at the time of registration, intrahepatic disease, or disease beyond the abdominal cavity; patients with intra-abdominal lymph node involvement are eligible based on biodistribution data indicating viral dissemination to lymph nodes following intraperitoneal administration
- Treatment with oral/systemic corticosteroids, with the exception of topical or inhaled steroids
- Exposure to household contacts =< 15 months old or household contact with known immunodeficiency
- Allergy to measles vaccine or history of severe reaction to prior measles vaccination
- Allergy to iodine; this does not include reactions to intravenous contrast materials
- Any other pathology or condition where the principle investigator may deem to negatively impact treatment safety
Sites / Locations
- Mayo Clinic in RochesterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment (MV-NIS infected mesenchymal stem cells)
Arm Description
Patients receive oncolytic measles virus encoding thyroidal sodium iodide symporter IP over 30 minutes on day 1 of cycle 1 and MV-NIS infected MSC (if MSC are not available, MV-NIS may be given alone) IP over 30 minutes of subsequent cycles. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
Outcomes
Primary Outcome Measures
Maximum tolerated dose (MTD) (Phase I)
Will be defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least one-third of patients (at least 2 of a maximum of 6 new patients).
Number and severity of adverse events (Phase I)
All adverse events (overall, and by dose-level) will be tabulated and summarized. The grade 3+ adverse events will also be described and summarized in a similar fashion.
Overall toxicity incidence (Phase I)
Frequency distributions, graphical techniques and other descriptive measures will form the basis of these analyses.
Toxicity profiles by dose level and patient (Phase I)
Frequency distributions, graphical techniques and other descriptive measures will form the basis of these analyses.
Proportion of patients alive at 12 months (Phase II)
The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients. Ninety-five percent binomial confidence intervals for the true success proportion will be calculated.
Secondary Outcome Measures
Tumor response (Phase II)
Will be defined as complete response or partial response.
Rate of progression free survival (Phase II)
Kaplan-Meier survival curves and logrank tests will be used to estimate the progression-free time distributions of the study patients and study patient subsets defined by disease and/or correlative characteristics.
Overall survival (Phase II)
The distribution of survival time will be estimated using Kaplan-Meier survival curves and logrank tests. In addition, comparisons of overall survival in patients treated with oncolytic measles virus encoding thyroidal sodium iodide symporter (MV-NIS)/mesenchymal stem cells (MSC) will be made to patients enrolled on the prior MV-carcinoembryonic antigen (CEA) and MV-NIS trial in an exploratory manner.
Progression free survival (Phase II)
The distribution of progression-free survival will be estimated using Kaplan-Meier survival curves and logrank tests. In addition, comparisons of overall progression free survival in patients treated with MV-NIS/MSC will be made to patients enrolled on the prior MV-CEA and MV-NIS trial in an exploratory manner.
Maximum grade for each type of toxicity (Phase II)
Full Information
NCT ID
NCT02068794
First Posted
February 19, 2014
Last Updated
June 27, 2023
Sponsor
Mayo Clinic
Collaborators
National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT02068794
Brief Title
MV-NIS Infected Mesenchymal Stem Cells in Treating Patients With Recurrent Ovarian, Primary Peritoneal or Fallopian Tube Cancer
Official Title
Phase I/II Trial of Intraperitoneal Administration of Adipose Tissue Derived Mesenchymal Stem Cells Infected With a NIS-Expressing Derivative Manufactured From a Genetically Engineered Strain of Measles Virus in Patients With Recurrent Ovarian Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 31, 2014 (Actual)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
June 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mayo Clinic
Collaborators
National Cancer Institute (NCI)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This phase I/II trial studies the side effects and best dose of oncolytic measles virus encoding thyroidal sodium iodide symporter (MV-NIS) infected mesenchymal stem cells and to see how well it works in treating patients with ovarian, primary peritoneal or fallopian tube cancer that has come back. Mesenchymal stem cells may be able to carry tumor-killing substances directly to ovarian, primary peritoneal and fallopian tube cancer cells.
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the maximally tolerated dose (MTD) of intraperitoneal administration of an Edmonston's strain measles virus genetically engineered to produce sodium iodine symporter (NIS) (measles virus [MV]-NIS) in patients with recurrent ovarian cancer, delivered by adipose tissue derived mesenchymal stem cells (MSC). (Phase I) II. To assess the 12 month overall survival of patients treated with this regimen. (Phase II)
SECONDARY OBJECTIVES:
I. To assess the tolerability of this regimen. (Phase II) II. To assess the 4 month progression free survival of patients treated with this regimen. (Phase II) III. To assess the response rate, progression-free survival, and overall survival of patients treated with this regimen. (Phase II)
TRANSLATIONAL OBJECTIVES:
I. To assess the time course of viral gene expression and virus elimination and biodistribution of virally infected cells at various time points after infection with MV-NIS versus MSC delivered MV-NIS using single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging. (Phase II) II. To assess viremia, viral replication, and measles virus shedding/persistence following intraperitoneal administration. (Phase II) III. To assess humoral and cellular immune response to the injected virus. (Phase II) IV. To assess in a preliminary fashion the development of antitumor immune response. (Phase II)
OUTLINE: This is a phase I, dose-escalation study followed by phase II study.
Patients receive oncolytic measles virus encoding thyroidal sodium iodide symporter intraperitoneally (IP) over 30 minutes on day 1 of cycle 1 and MV-NIS infected mesenchymal stem cells (MSC) (if MSC are not available, MV-NIS may be given alone) IP over 30 minutes of subsequent cycles. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 6 months for up to 5 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fallopian Tube Clear Cell Adenocarcinoma, Fallopian Tube Endometrioid Adenocarcinoma, Fallopian Tube Mucinous Adenocarcinoma, Fallopian Tube Serous Adenocarcinoma, Fallopian Tube Transitional Cell Carcinoma, Fallopian Tube Undifferentiated Carcinoma, Malignant Ovarian Brenner Tumor, Ovarian Clear Cell Adenocarcinoma, Ovarian Endometrioid Adenocarcinoma, Ovarian Mucinous Adenocarcinoma, Ovarian Seromucinous Carcinoma, Ovarian Serous Adenocarcinoma, Ovarian Transitional Cell Carcinoma, Ovarian Undifferentiated Carcinoma, Primary Peritoneal Serous Adenocarcinoma, Recurrent Fallopian Tube Carcinoma, Recurrent Ovarian Carcinoma, Recurrent Primary Peritoneal Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
57 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Treatment (MV-NIS infected mesenchymal stem cells)
Arm Type
Experimental
Arm Description
Patients receive oncolytic measles virus encoding thyroidal sodium iodide symporter IP over 30 minutes on day 1 of cycle 1 and MV-NIS infected MSC (if MSC are not available, MV-NIS may be given alone) IP over 30 minutes of subsequent cycles. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Procedure
Intervention Name(s)
Mesenchymal Stem Cell Transplantation
Intervention Description
Given IP
Intervention Type
Biological
Intervention Name(s)
Oncolytic Measles Virus Encoding Thyroidal Sodium Iodide Symporter
Other Intervention Name(s)
MV-NIS
Intervention Description
Given IP
Primary Outcome Measure Information:
Title
Maximum tolerated dose (MTD) (Phase I)
Description
Will be defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least one-third of patients (at least 2 of a maximum of 6 new patients).
Time Frame
28 days
Title
Number and severity of adverse events (Phase I)
Description
All adverse events (overall, and by dose-level) will be tabulated and summarized. The grade 3+ adverse events will also be described and summarized in a similar fashion.
Time Frame
Up to 5 years
Title
Overall toxicity incidence (Phase I)
Description
Frequency distributions, graphical techniques and other descriptive measures will form the basis of these analyses.
Time Frame
Up to 5 years
Title
Toxicity profiles by dose level and patient (Phase I)
Description
Frequency distributions, graphical techniques and other descriptive measures will form the basis of these analyses.
Time Frame
28 days
Title
Proportion of patients alive at 12 months (Phase II)
Description
The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients. Ninety-five percent binomial confidence intervals for the true success proportion will be calculated.
Time Frame
At 12 months after study registration
Secondary Outcome Measure Information:
Title
Tumor response (Phase II)
Description
Will be defined as complete response or partial response.
Time Frame
Up to 5 years
Title
Rate of progression free survival (Phase II)
Description
Kaplan-Meier survival curves and logrank tests will be used to estimate the progression-free time distributions of the study patients and study patient subsets defined by disease and/or correlative characteristics.
Time Frame
Length of time from study registration to the first of either death due to any cause or progression, assessed at 4 months
Title
Overall survival (Phase II)
Description
The distribution of survival time will be estimated using Kaplan-Meier survival curves and logrank tests. In addition, comparisons of overall survival in patients treated with oncolytic measles virus encoding thyroidal sodium iodide symporter (MV-NIS)/mesenchymal stem cells (MSC) will be made to patients enrolled on the prior MV-carcinoembryonic antigen (CEA) and MV-NIS trial in an exploratory manner.
Time Frame
Length of time from study registration to date of death due to any cause or last follow up assessed up to 5 years
Title
Progression free survival (Phase II)
Description
The distribution of progression-free survival will be estimated using Kaplan-Meier survival curves and logrank tests. In addition, comparisons of overall progression free survival in patients treated with MV-NIS/MSC will be made to patients enrolled on the prior MV-CEA and MV-NIS trial in an exploratory manner.
Time Frame
Length of time from study registration to the first of either death due to any cause or progression assessed at 5 years
Title
Maximum grade for each type of toxicity (Phase II)
Time Frame
Up to 5 years
Other Pre-specified Outcome Measures:
Title
Time course of viral gene expression (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Virus elimination and biodistribution of virally infected cells by single photon emission computed tomography imaging (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Incidence of viremia (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Incidence of viral replication (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Measles virus shedding/persistence following intraperitoneal administration (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Humoral immune response to the injected virus (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Cellular immune response to the injected virus (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
Title
Antitumor immune response (Phase II)
Description
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out using Spearman's coefficients, chi squared tests, Wilcoxon rank-sum tests, Kaplan-Meier curves, and Cox proportional hazards models, where appropriate.
Time Frame
Up to 5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Must have:
Recurrent or progressive ovarian cancer, primary peritoneal cancer or fallopian tube cancer after prior treatment with platinum and taxanes
Histologic confirmation of the original primary tumor
Prior bilateral oophorectomy
The following histologic epithelial cell types are eligible: serous adenocarcinoma, endometrioid adenocarcinoma, mucinous adenocarcinoma, undifferentiated carcinoma, clear cell adenocarcinoma, mixed epithelial carcinoma, transitional cell carcinoma, malignant Brenner's tumor, or adenocarcinoma not otherwise specified (NOS)
Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, 2
Absolute neutrophil count (ANC) >= 1500/uL (obtained =< 7 days prior to registration)
Platelet (PLT) >= 100,000/uL (obtained =< 7 days prior to registration)
Total bilirubin =< upper normal limit (obtained =< 7 days prior to registration)
Aspartate aminotransferase (AST) =< 2 x upper limit of normal (ULN) (obtained =< 7 days prior to registration)
Creatinine =< 1.5 x ULN (obtained =< 7 days prior to registration)
Hemoglobin (Hgb) >= 9.0 g/dL (obtained =< 7 days prior to registration)
Normal cardiac function as defined by a normal ejection fraction by multi gated acquisition scan (MUGA) or echocardiogram
Provide informed written consent
Willing to return to Mayo Clinic Rochester for follow-up
Life expectancy >= 12 weeks
Willing to provide all biologic specimens as required by the protocol
Measurable disease by exam or CT scan, or for patients with cancer antigen (CA)-125 elevation or with microscopic residual but without measurable disease on imaging, willingness to undergo laparoscopy for evaluation of treatment effect if no radiographic progression after 6 treatment cycles
CD4 count >= 200/uL or >= 15% of peripheral blood lymphocytes
Exclusion Criteria:
Epithelial tumors of low malignant potential, stromal tumors, and germ cell tumors of the ovary
Known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy; subjects will be excluded if this is their first relapse and they have recurred > 6 months from completion of primary (adjuvant) chemotherapy
Active infection =< 5 days prior to registration
History of tuberculosis or history of tuberculosis skin test purified protein derivative (PPD) positivity
History of other malignancy =< 5 years prior to registration except for non-melanoma skin cancer, carcinoma in situ of the cervix, and ductal carcinoma in situ (DCIS)
Any of the following prior therapies:
Chemotherapy =< 3 weeks prior to registration
Immunotherapy =< 4 weeks prior to registration
Biologic therapy =< 4 weeks prior to registration
Extensive abdominal surgery if it includes enterotomy(ies) =< 3 weeks prior to registration; this criterion does not apply to placement of the peritoneal Port-A-Cath or lysis of adhesions at the time of registration
Any viral or gene therapy prior to registration
Radiation therapy to the abdomen or pelvis
New York Heart Association classification III or IV, known symptomatic coronary artery disease, or symptoms of coronary artery disease on systems review, or known cardiac arrhythmias (atrial fibrillation or supraventricular tachycardia [SVT])
Other cardiac or pulmonary disease that, at the investigators discretion, can impair treatment safety
Requiring blood product support
Central nervous system (CNS) metastases or seizure disorder
Human immunodeficiency virus (HIV)-positive test result or history of other immunodeficiency
History of organ transplantation
History of chronic hepatitis B or C
Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational (utilized for a non-Food and Drug Administration [FDA]-approved indication and in the context of a research investigation)
Intra-abdominal disease > 8 cm in diameter at the time of registration, intrahepatic disease, or disease beyond the abdominal cavity; patients with intra-abdominal lymph node involvement are eligible based on biodistribution data indicating viral dissemination to lymph nodes following intraperitoneal administration
Treatment with oral/systemic corticosteroids, with the exception of topical or inhaled steroids
Exposure to household contacts =< 15 months old or household contact with known immunodeficiency
Allergy to measles vaccine or history of severe reaction to prior measles vaccination
Allergy to iodine; this does not include reactions to intravenous contrast materials
Any other pathology or condition where the principle investigator may deem to negatively impact treatment safety
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Evanthia Galanis
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Rochester
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clinical Trials Referral Office
Phone
855-776-0015
Email
mayocliniccancerstudies@mayo.edu
First Name & Middle Initial & Last Name & Degree
Evanthia Galanis, MD
12. IPD Sharing Statement
Learn more about this trial
MV-NIS Infected Mesenchymal Stem Cells in Treating Patients With Recurrent Ovarian, Primary Peritoneal or Fallopian Tube Cancer
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