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Phase 1b Study of AdV-tk + Valacyclovir Combined With Radiation Therapy for Malignant Gliomas (BrTK01)

Primary Purpose

Malignant Glioma, Glioblastoma Multiforme, Anaplastic Astrocytoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AdV-tk
Valacyclovir
Sponsored by
Candel Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Glioma focused on measuring Immunotherapy, Gene therapy, Tumor Vaccine, Cytotoxicity, Radiation

Eligibility Criteria

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

Inclusion Criteria:

  • Presumed malignant glioma based on clinical and radiologic evaluation (pathologic confirmation of malignant glioma must be made at the time of stereotactic biopsy or resection prior to AdV-tk injection; if this is not possible, the injection will not be performed and the subject will no longer be eligible for the study).
  • Tumor must be accessible for injection and must not be located in the brainstem, midbrain, contained within the ventricular system, or located in an infratentorial location.
  • Patients must be planning to undergo standard radiation therapy.
  • Patients must be 18 years of age or older.
  • Performance status must be KPS > or equal to 70.
  • Patients must have SGOT (AST) < 3x upper limit of normal.
  • Patients must have serum creatinine < 2mg/dl and calculated creatinine clearance >10ml/min.
  • Patients must have platelets > 100,000/mm3 and WBC > 3000/mm3.
  • Patients of reproductive age must agree to use a medically accepted form of birth control while on the study.
  • Patients must give study specific informed consent prior to enrollment.
  • Patients must be able to tolerate MRI scan procedure

Exclusion Criteria:

  • Prior or ongoing liver disease including known cirrhosis, hepatitis B or C infection but not to exclude patients with a distant history of resolved hepatitis A infection.
  • Patients on immunosuppressive drugs (with exception of corticosteroid)
  • Known HIV+ patients.
  • Patients with acute infections (viral, bacterial or fungal infections requiring therapy).
  • Pregnant or breast feeding patients. Female patients of childbearing age must have negative serum or urine pregnancy test within 1 week of beginning therapy.
  • Evidence of metastatic disease or other malignancy (except squamous or basal cell skin cancers).
  • Prior radiation therapy to the brain or prior treatment for brain tumor (except prior biopsy or subtotal resection).
  • Other serious co-morbid illness or compromised organ function.
  • Patients may not receive temozolomide until valacyclovir completed and may not receive other investigational anti-tumor agents within 30 days prior to study entry or during active participation in the study (defined as from study entry until tumor progression).

Sites / Locations

  • The Ohio State University Medical Center, Dept Neurosurgery
  • The Methodist Hosptial

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

A

B

Arm Description

Arm A for unresectable malignant glioma was closed due to poor accrual.

Arm B for resectable malignant glioma completed the Phase I accrual and long term follow up continues. A follow on study at dose level 3 was opened as a Phase 2a study (see BrTK02).

Outcomes

Primary Outcome Measures

Incidence of treatment emergent adverse events

Secondary Outcome Measures

Progression-free Survival
Overall Survival
Functional Assessment of Cancer Therapy - Brain (FACT-Br)

Full Information

First Posted
September 9, 2008
Last Updated
August 23, 2023
Sponsor
Candel Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00751270
Brief Title
Phase 1b Study of AdV-tk + Valacyclovir Combined With Radiation Therapy for Malignant Gliomas
Acronym
BrTK01
Official Title
A Phase 1b Study of AdV-tk + Valacyclovir Gene Therapy in Combination With Standard Radiation Therapy for Malignant Gliomas
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
November 2005 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
January 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Candel Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase I study evaluated a Gene Mediated Cytotoxic Immunotherapy approach for malignant gliomas, including glioblastoma multiforme and anaplastic astrocytoma. The purpose of this study was to assess the safety and feasibility of delivering an experimental approach called GliAtak which uses AdV-tk, an adenoviral vector containing the Herpes Simplex thymidine kinase gene, plus an oral anti-herpetic prodrug, valacyclovir, in combination with standard of care radiation.
Detailed Description
This study was designed to include patients with newly diagnosed unresectable (Arm A) and resectable (Arm B) malignant glioma. Three dose levels of AdV-tk were evaluated with a fixed dose level of valacyclovir prodrug. AdV-tk was delivered to tumor cells by stereotactic injection into the tumor at the time of biopsy (Arm A) or injection into the tumor bed following resection (Arm B). Oral valacyclovir began 1-3 days after the AdV-tk injection and continued for 14 days. Standard radiation therapy began 3-7 days following the AdV-tk injection to maximize synergy with radiation. Standard temozolomide could be administered after completion of valacyclovir.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Glioma, Glioblastoma Multiforme, Anaplastic Astrocytoma
Keywords
Immunotherapy, Gene therapy, Tumor Vaccine, Cytotoxicity, Radiation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Arm A for unresectable malignant glioma was closed due to poor accrual.
Arm Title
B
Arm Type
Experimental
Arm Description
Arm B for resectable malignant glioma completed the Phase I accrual and long term follow up continues. A follow on study at dose level 3 was opened as a Phase 2a study (see BrTK02).
Intervention Type
Biological
Intervention Name(s)
AdV-tk
Intervention Description
Three different dosing levels of AdV-tk (3x10e10, 1x10e11, 3X10e11) were evaluated. A single injection of AdV-tk at the assigned dose level was administered, followed by 14 days of the oral prodrug valacyclovir. Patients then received standard of care radiation therapy and chemotherapy.
Intervention Type
Drug
Intervention Name(s)
Valacyclovir
Intervention Description
The oral prodrug valacyclovir was given beginning 1-3 days following the AdV-tk. Valacyclovir tablets were taken three times a day for a total of 14 days.
Primary Outcome Measure Information:
Title
Incidence of treatment emergent adverse events
Time Frame
Through month 3 and long term follow up for late effects.
Secondary Outcome Measure Information:
Title
Progression-free Survival
Time Frame
Clinical monitoring, laboratory and radiological imagining and pathological/histological assessments (if performed)
Title
Overall Survival
Time Frame
5 years
Title
Functional Assessment of Cancer Therapy - Brain (FACT-Br)
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Presumed malignant glioma based on clinical and radiologic evaluation (pathologic confirmation of malignant glioma must be made at the time of stereotactic biopsy or resection prior to AdV-tk injection; if this is not possible, the injection will not be performed and the subject will no longer be eligible for the study). Tumor must be accessible for injection and must not be located in the brainstem, midbrain, contained within the ventricular system, or located in an infratentorial location. Patients must be planning to undergo standard radiation therapy. Patients must be 18 years of age or older. Performance status must be KPS > or equal to 70. Patients must have SGOT (AST) < 3x upper limit of normal. Patients must have serum creatinine < 2mg/dl and calculated creatinine clearance >10ml/min. Patients must have platelets > 100,000/mm3 and WBC > 3000/mm3. Patients of reproductive age must agree to use a medically accepted form of birth control while on the study. Patients must give study specific informed consent prior to enrollment. Patients must be able to tolerate MRI scan procedure Exclusion Criteria: Prior or ongoing liver disease including known cirrhosis, hepatitis B or C infection but not to exclude patients with a distant history of resolved hepatitis A infection. Patients on immunosuppressive drugs (with exception of corticosteroid) Known HIV+ patients. Patients with acute infections (viral, bacterial or fungal infections requiring therapy). Pregnant or breast feeding patients. Female patients of childbearing age must have negative serum or urine pregnancy test within 1 week of beginning therapy. Evidence of metastatic disease or other malignancy (except squamous or basal cell skin cancers). Prior radiation therapy to the brain or prior treatment for brain tumor (except prior biopsy or subtotal resection). Other serious co-morbid illness or compromised organ function. Patients may not receive temozolomide until valacyclovir completed and may not receive other investigational anti-tumor agents within 30 days prior to study entry or during active participation in the study (defined as from study entry until tumor progression).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
E. Antonio Chiocca, MD, PhD
Organizational Affiliation
Ohio State University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Ohio State University Medical Center, Dept Neurosurgery
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
The Methodist Hosptial
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
21844505
Citation
Chiocca EA, Aguilar LK, Bell SD, Kaur B, Hardcastle J, Cavaliere R, McGregor J, Lo S, Ray-Chaudhuri A, Chakravarti A, Grecula J, Newton H, Harris KS, Grossman RG, Trask TW, Baskin DS, Monterroso C, Manzanera AG, Aguilar-Cordova E, New PZ. Phase IB study of gene-mediated cytotoxic immunotherapy adjuvant to up-front surgery and intensive timing radiation for malignant glioma. J Clin Oncol. 2011 Sep 20;29(27):3611-9. doi: 10.1200/JCO.2011.35.5222. Epub 2011 Aug 15.
Results Reference
result
Links:
URL
http://www.ncbi.nlm.nih.gov/pubmed/21844505
Description
Phase IB study of gene-mediated cytotoxic immunotherapy adjuvant to up-front surgery and intensive timing radiation for malignant glioma

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Phase 1b Study of AdV-tk + Valacyclovir Combined With Radiation Therapy for Malignant Gliomas

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