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Safety & Efficacy of NV1020 in Colorectal Cancer Metastatic to the Liver

Primary Purpose

Colorectal Cancer, Liver Neoplasms

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
NV1020
Sponsored by
MediGene
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring Colorectal cancer metastases to liver, Colorectal Cancer, Colorectal Carcinoma, Colorectal Tumors, Colorectal Neoplasms, Rectum Cancer, Rectum tumors, Rectum carcinoma, Colon cancer, Colon tumors, Colon carcinoma, Rectum Neoplasms, Colon Neoplasms, Liver Neoplasms, Hepatic Neoplasms, Liver Tumors, Liver cancer, Hepatic Cancer, Hepatic tumors, metastatic to the liver

Eligibility Criteria

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

Inclusion Criteria: Ability to understand and willingness to sign a written informed consent (includes willingness to avoid physical intimacy during and for 2 weeks post NV1020 treatment) 18 years or more of age Colorectal adenocarcinoma histologically confirmed within one year prior to enrollment in the study Liver dominant metastases (CT-measurable lesions with less than 50% total liver involvement), histologically confirmed Failed conventional chemotherapy for metastatic disease (e.g. tumors no longer responding to 5-FU/leucovorin in combination with irinotecan or oxaliplatin with or without one monoclonal antibody) Candidate for additional chemotherapy (and/or experimental anti-cancer therapy, if this is the only remaining treatment option) Karnofsky Performance Status 70% or greater Life expectancy greater than or equal to 4 months, based on the investigator's opinion Seropositive for herpes simplex virus-1 (HSV-1) Fecund females: negative for pregnancy test (urine or serum) Effective double-barrier contraception for a minimum of 2 months following final infusion of NV1020 Exclusion Criteria: Dominant extrahepatic disease, including cerebral metastases, significant malignant ascites or other extrahepatic metastases that are symptomatic, in critical locations or otherwise likely to confound NV1020 evaluations, in the opinion of the investigator Seronegative for HSV-1 Significant active/unstable non-malignant disease or laboratory test (hematology and chemistry) results that meet any of the following: White blood cell count (WBC) less than or equal to 3 x 10e3/mm3 Absolute neutrophil count (ANC) less than or equal to 1.5 x 10e3/mm3 Platelets less than or equal to 100,000/mm3 Hemoglobin (Hgb) less than or equal to 9.0 g/dL Prothrombin time/partial thromboplastin time (PT/PTT) > upper limit of normal (ULN) Serum creatinine > 2.0 mg/dL Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 times ULN or total bilirubin > 1.5 times ULN Alkaline phosphatase > 2.5 times ULN Chemotherapy < 4 weeks prior to the first NV1020 infusion (mitomycin or nitrosurea < 6 weeks) Immunotherapy < 6 weeks prior to the first NV1020 infusion Radiotherapy (external or internal) to the liver Major surgery (excluding pump placement and cholecystectomy) ≤ 2 weeks prior to the first NV1020 infusion but the subject must be clinically stable. Pump placement and cholecystectomy ≤ 1 week prior to the first NV1020 infusion but the subject must be clinically stable Female who is pregnant or nursing Patients wishing to conceive within 2 months after the last infusion of NV1020 Any investigational agent administered less than or equal to 4 weeks prior to NV1020 infusion Acute HSV infection requiring systemic antiviral therapy or history of serious HSV infection (e.g., ocular, encephalitic, etc.) Active viral hepatitis (evidence for infection with hepatitis A, B or C viruses) Known infection with HIV Known hypersensitivity to any component of the NV1020 formulation History of, or current, bleeding or coagulation disorder History of significant hepatic fibrosis, cirrhosis, or hemachromatosis History of malignancy other than colorectal cancer, within 5 years prior to start of study participation, with the exception of in situ cervical or skin carcinoma Active severe infection and any other concurrent disease or medical conditions that are likely to interfere with the study, as judged by the investigator Systemic corticosteroid administration < 4 weeks prior to starting NV1020 treatment Prior treatment with NV1020 or other putative oncolytic viruses

Sites / Locations

  • University of California, San Diego
  • Massachusetts General Hospital
  • University of Pittsburgh Cancer Center
  • University of Vanderbilt
  • Mary Crowley Medical Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Safety and antitumor effects of NV1020

Arm Description

Stage 1: Four escalating dose cohorts of NV1020 3x10^6 pfu, 1x10^7 pfu, 3x10^7 pfu, and 1x10^8 pfu administered via hepatic artery infusion, over 10 minutes and repeated every 1-2 weeks for 4-8 weeks followed by 2 cycles of chemotherapy. Stage 2: Expansion of one dose cohort from Stage 1 of optimal NV1020 dose administered via hepatic artery infusion, over 10 minutes and repeated every 1-2 weeks for 4-8 weeks followed by 2 cycles of chemotherapy.

Outcomes

Primary Outcome Measures

Incidence of Adverse Events and Dose Limiting Adverse Events
Incidence of adverse events for all patients (N=32); Overall incidence ≥20%; Adverse events listed by Medical Dictionary for Regulatory Activities (MedDRA) Preferred Term
NV1020 Pharmacokinetics - Presence of NV1020 in Body Fluids/Skin
Number of patients with NV1020 detected in saliva, skin, and/or mucosal surfaces; Analysis by polymerase chain reaction (PCR)
Clinical Laboratory Safety - Hematology
Number of patients with clinically significant hematology laboratory abnormalities by NV1020 dose cohort (Post baseline)
Clinical Laboratory Safety - Chemistry
Number of patients with post-baseline clinically significant laboratory chemistry abnormalities by NV1020 dose cohort
Clinical Laboratory Safety - Coagulation
Number of patients with post-baseline clinically significant laboratory coagulation abnormalities by NV1020 dose cohort

Secondary Outcome Measures

Mean Change From Baseline in Serum Carcinoembryonic Antigen (CEA) After Administration of NV1020 and 2 Cycles of Chemotherapy
Liver Tumor Response After Administration of NV1020 Followed by Chemotherapy, Determined by Radiological (Computed Tomography [CT] Scan) Assessment
Maximum percentage changes in tumor diameter after administration of NV1020 followed by chemotherapy as measured by CT scan and Modified Response Evaluation Criteria in Solid Tumors (RECIST) assessment
Pharmacodynamic Effects of NV1020: NV1020 Neutralizing Antibody Titer Assay
Mean change from baseline in NV1020 neutralizing antibody titer by dose cohort
Time to Disease Progression; Survival Time
Progression assessed from CT and PET measurements and is determined as an increase of greater than or equal to 25% in the sum of the products of perpendicular diameters of all tumors, or the appearance of any new lesion.
Pharmacodynamic Effects of NV1020: Serum Cytokines (INF Gamma)
Median change from baseline of Interferon (INF) gamma 8 hours post NV1020 infusion (Visits 1, 3, 5, 7)
Pharmacodynamic Effects of NV1020: Serum Cytokines (IL-6)
Median change from baseline of Interleukin-6 (IL-6) 8 hours post NV1020 infusion (Visits 1, 3, 5, 7)
Pharmacodynamic Effects of NV1020: Serum Cytokines (TNF-alpha)
Median change from baseline of tumor necrosis factor (TNF-alpha) 8 hours post NV1020 infusion (Visits 1, 3, 5, 7)

Full Information

First Posted
September 6, 2005
Last Updated
March 21, 2018
Sponsor
MediGene
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1. Study Identification

Unique Protocol Identification Number
NCT00149396
Brief Title
Safety & Efficacy of NV1020 in Colorectal Cancer Metastatic to the Liver
Official Title
A Phase I/II, Open-label Study to Evaluate the Safety and Anti-tumor Effects of NV1020 Administered Repeatedly Via Hepatic Artery Infusion Prior to Second-line Chemotherapy, in Patients With Colorectal Adenocarcinoma Metastatic to the Liver
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
July 2004 (undefined)
Primary Completion Date
October 2008 (Actual)
Study Completion Date
December 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MediGene

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is an open-label study. It has two stages. Stage 1 is a dose escalation phase of the study to determine and evaluate the safety and tolerability of repeated treatments with a genetically engineered herpes simplex virus NV1020 administered locoregionally to the liver. Stage 2 is to evaluate the dose found in Stage 1 to be "optimally tolerated". Stage 2 is to assess the efficacy of the optimally tolerated dose of NV1020 by itself and in combination with second-line chemotherapy. Assignment to Stage 1 or Stage 2 of the study is determined by when the patient enters the study.
Detailed Description
This study is designed to evaluate the effects of repeated treatments with NV1020, prior to second-line chemotherapy, and to determine an appropriate dose level of NV1020 in a multiple dose regimen for later Phase II studies. Sequential, open-label cohort dose escalation of NV1020 (stage 1) followed by an expansion of one selected dose cohort (stage 2). Study results will be reviewed periodically by an independent DSMB who will approve each cohort dose escalation. During the dose escalation stage, 3 cohorts of patients (3 in each) will be treated with 4 fixed doses of NV1020, with the dose level increasing for successive cohorts. A patient will be observed for a minimum of 7 days after the first NV1020 infusion before the next patient in the same cohort is given NV1020. The first patient in the next higher dose cohort will receive NV1020 no earlier than 14 days after the last patient in the prior cohort has finished NV1020 infusions. One additional cohort (half log higher increment) may be approved by the DSMB, if considered necessary to define MTD. Dose-limiting toxicity will be determined using NCI CTC criteria and a suitable dose level for later evaluation will be selected. In the second stage of the study, the dose cohort considered to show the best therapeutic index will be expanded by the addition of 18 further patients. For all patients in this study, investigational treatment with NV1020 will be followed by a minimum of two cycles of second-line therapy using anti-neoplastic drugs approved by the FDA for colorectal cancer and selected by the investigator. All patients will be followed up periodically until death. Permission for autopsy will be sought.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Liver Neoplasms
Keywords
Colorectal cancer metastases to liver, Colorectal Cancer, Colorectal Carcinoma, Colorectal Tumors, Colorectal Neoplasms, Rectum Cancer, Rectum tumors, Rectum carcinoma, Colon cancer, Colon tumors, Colon carcinoma, Rectum Neoplasms, Colon Neoplasms, Liver Neoplasms, Hepatic Neoplasms, Liver Tumors, Liver cancer, Hepatic Cancer, Hepatic tumors, metastatic to the liver

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
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Safety and antitumor effects of NV1020
Arm Type
Experimental
Arm Description
Stage 1: Four escalating dose cohorts of NV1020 3x10^6 pfu, 1x10^7 pfu, 3x10^7 pfu, and 1x10^8 pfu administered via hepatic artery infusion, over 10 minutes and repeated every 1-2 weeks for 4-8 weeks followed by 2 cycles of chemotherapy. Stage 2: Expansion of one dose cohort from Stage 1 of optimal NV1020 dose administered via hepatic artery infusion, over 10 minutes and repeated every 1-2 weeks for 4-8 weeks followed by 2 cycles of chemotherapy.
Intervention Type
Drug
Intervention Name(s)
NV1020
Intervention Description
NV1020 dose levels: 3x10^6, 1x10^7, 3x10^7, and 1x10^8 plaque forming units, administered via hepatic artery infusion, over 10 minutes and repeated every 1-2 weeks for 4-8 weeks
Primary Outcome Measure Information:
Title
Incidence of Adverse Events and Dose Limiting Adverse Events
Description
Incidence of adverse events for all patients (N=32); Overall incidence ≥20%; Adverse events listed by Medical Dictionary for Regulatory Activities (MedDRA) Preferred Term
Time Frame
From start of treatment through 12 months after completion of treatment
Title
NV1020 Pharmacokinetics - Presence of NV1020 in Body Fluids/Skin
Description
Number of patients with NV1020 detected in saliva, skin, and/or mucosal surfaces; Analysis by polymerase chain reaction (PCR)
Time Frame
Daily for 2 weeks after the first and last NV1020 infusions
Title
Clinical Laboratory Safety - Hematology
Description
Number of patients with clinically significant hematology laboratory abnormalities by NV1020 dose cohort (Post baseline)
Time Frame
Screening; after each NV1020 infusion; +7h, +24h, and +72h after NV1020 infusion; each chemotherapy visit; +3d, +7d, +14d after each chemo visit; 1 week after end of treatment
Title
Clinical Laboratory Safety - Chemistry
Description
Number of patients with post-baseline clinically significant laboratory chemistry abnormalities by NV1020 dose cohort
Time Frame
Screening; after each NV1020 infusion; +7h, +24h, and +72h after NV1020 infusion; each chemotherapy visit; +3d, +7d, +14d after each chemo visit; 1 week after end of treatment
Title
Clinical Laboratory Safety - Coagulation
Description
Number of patients with post-baseline clinically significant laboratory coagulation abnormalities by NV1020 dose cohort
Time Frame
Screening; after each NV1020 infusion; +7h, +24h, and +72h after NV1020 infusion; each chemotherapy visit; +3d, +7d, +14d after each chemo visit; 1 week after end of treatment
Secondary Outcome Measure Information:
Title
Mean Change From Baseline in Serum Carcinoembryonic Antigen (CEA) After Administration of NV1020 and 2 Cycles of Chemotherapy
Time Frame
Screening (baseline), Chemo visit 1, Chemo visit 2, Follow-up Visit 1 (1 week after end of treatment), Follow-up Visit 2 (+6M), Follow-up Visit 3 (+9M), Follow-up Visit 4 (+12M)
Title
Liver Tumor Response After Administration of NV1020 Followed by Chemotherapy, Determined by Radiological (Computed Tomography [CT] Scan) Assessment
Description
Maximum percentage changes in tumor diameter after administration of NV1020 followed by chemotherapy as measured by CT scan and Modified Response Evaluation Criteria in Solid Tumors (RECIST) assessment
Time Frame
Screening (baseline), Chemo visit 1, Follow-up visits 1 (1 week post end of treatment), 2 (+6M), 3 (+9M), 4 (+12M)
Title
Pharmacodynamic Effects of NV1020: NV1020 Neutralizing Antibody Titer Assay
Description
Mean change from baseline in NV1020 neutralizing antibody titer by dose cohort
Time Frame
Screening, Chemo Visit 1, Follow-up Visits 1 (1 week post end of treatment), 2 (+6M), 3 (+9M), 4 (+12M)
Title
Time to Disease Progression; Survival Time
Description
Progression assessed from CT and PET measurements and is determined as an increase of greater than or equal to 25% in the sum of the products of perpendicular diameters of all tumors, or the appearance of any new lesion.
Time Frame
Progression: Chemo visit 1, FU1 (1 week post treatment), FU2 (+6M), FU3 (+9M), FU4 (+12M); Survival: death of patient
Title
Pharmacodynamic Effects of NV1020: Serum Cytokines (INF Gamma)
Description
Median change from baseline of Interferon (INF) gamma 8 hours post NV1020 infusion (Visits 1, 3, 5, 7)
Time Frame
Baseline, after each NV1020 infusion (Visit 1, Visit 3, Visit 5, Visit 7)
Title
Pharmacodynamic Effects of NV1020: Serum Cytokines (IL-6)
Description
Median change from baseline of Interleukin-6 (IL-6) 8 hours post NV1020 infusion (Visits 1, 3, 5, 7)
Time Frame
Baseline, after each NV1020 infusion (Visit 1, Visit 3, Visit 5, Visit 7)
Title
Pharmacodynamic Effects of NV1020: Serum Cytokines (TNF-alpha)
Description
Median change from baseline of tumor necrosis factor (TNF-alpha) 8 hours post NV1020 infusion (Visits 1, 3, 5, 7)
Time Frame
Baseline, after each NV1020 infusion (Visit 1, Visit 3, Visit 5, Visit 7)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to understand and willingness to sign a written informed consent (includes willingness to avoid physical intimacy during and for 2 weeks post NV1020 treatment) 18 years or more of age Colorectal adenocarcinoma histologically confirmed within one year prior to enrollment in the study Liver dominant metastases (CT-measurable lesions with less than 50% total liver involvement), histologically confirmed Failed conventional chemotherapy for metastatic disease (e.g. tumors no longer responding to 5-FU/leucovorin in combination with irinotecan or oxaliplatin with or without one monoclonal antibody) Candidate for additional chemotherapy (and/or experimental anti-cancer therapy, if this is the only remaining treatment option) Karnofsky Performance Status 70% or greater Life expectancy greater than or equal to 4 months, based on the investigator's opinion Seropositive for herpes simplex virus-1 (HSV-1) Fecund females: negative for pregnancy test (urine or serum) Effective double-barrier contraception for a minimum of 2 months following final infusion of NV1020 Exclusion Criteria: Dominant extrahepatic disease, including cerebral metastases, significant malignant ascites or other extrahepatic metastases that are symptomatic, in critical locations or otherwise likely to confound NV1020 evaluations, in the opinion of the investigator Seronegative for HSV-1 Significant active/unstable non-malignant disease or laboratory test (hematology and chemistry) results that meet any of the following: White blood cell count (WBC) less than or equal to 3 x 10e3/mm3 Absolute neutrophil count (ANC) less than or equal to 1.5 x 10e3/mm3 Platelets less than or equal to 100,000/mm3 Hemoglobin (Hgb) less than or equal to 9.0 g/dL Prothrombin time/partial thromboplastin time (PT/PTT) > upper limit of normal (ULN) Serum creatinine > 2.0 mg/dL Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 times ULN or total bilirubin > 1.5 times ULN Alkaline phosphatase > 2.5 times ULN Chemotherapy < 4 weeks prior to the first NV1020 infusion (mitomycin or nitrosurea < 6 weeks) Immunotherapy < 6 weeks prior to the first NV1020 infusion Radiotherapy (external or internal) to the liver Major surgery (excluding pump placement and cholecystectomy) ≤ 2 weeks prior to the first NV1020 infusion but the subject must be clinically stable. Pump placement and cholecystectomy ≤ 1 week prior to the first NV1020 infusion but the subject must be clinically stable Female who is pregnant or nursing Patients wishing to conceive within 2 months after the last infusion of NV1020 Any investigational agent administered less than or equal to 4 weeks prior to NV1020 infusion Acute HSV infection requiring systemic antiviral therapy or history of serious HSV infection (e.g., ocular, encephalitic, etc.) Active viral hepatitis (evidence for infection with hepatitis A, B or C viruses) Known infection with HIV Known hypersensitivity to any component of the NV1020 formulation History of, or current, bleeding or coagulation disorder History of significant hepatic fibrosis, cirrhosis, or hemachromatosis History of malignancy other than colorectal cancer, within 5 years prior to start of study participation, with the exception of in situ cervical or skin carcinoma Active severe infection and any other concurrent disease or medical conditions that are likely to interfere with the study, as judged by the investigator Systemic corticosteroid administration < 4 weeks prior to starting NV1020 treatment Prior treatment with NV1020 or other putative oncolytic viruses
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hoda Tawfik, PhD
Organizational Affiliation
MediGene
Official's Role
Study Director
Facility Information:
Facility Name
University of California, San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
University of Pittsburgh Cancer Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
University of Vanderbilt
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
Mary Crowley Medical Research Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75201
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
21895536
Citation
Sze DY, Iagaru AH, Gambhir SS, De Haan HA, Reid TR. Response to intra-arterial oncolytic virotherapy with the herpes virus NV1020 evaluated by [18F]fluorodeoxyglucose positron emission tomography and computed tomography. Hum Gene Ther. 2012 Jan;23(1):91-7. doi: 10.1089/hum.2011.141. Epub 2011 Oct 14.
Results Reference
derived

Learn more about this trial

Safety & Efficacy of NV1020 in Colorectal Cancer Metastatic to the Liver

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