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Safety Study of Modified Vaccinia Virus to Cancer

Primary Purpose

Melanoma, Breast Cancer, Head and Neck Squamous Cell Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Vaccinia virus (vvDD-CDSR)
Vaccinia virus (vvDD-CDSR)
Vaccinia virus (vvDD-CDSR)
Sponsored by
David Bartlett
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring vaccinia, virus, tumor, melanoma, breast cancer, squamous cell cancer, colorectal, liver, pancreatic, adenocarcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Greater than 18 years of age
  • Histologically-confirmed cancer that has progressed despite standard therapy. They must have one of the following tumor-types: melanoma, breast cancer, or head and neck squamous cell cancer, liver, colorectal or pancreatic
  • Cancer is not surgically curable
  • Karnofsky Performance Status (KPS) of > 70 (See Appendix B)
  • Anticipated survival of at least 16 weeks
  • If sexually-active, willingness to use condoms for 3 months following study treatment with vvDD-CDSR
  • The ability to understand and willingness to sign a written informed consent
  • Able to comply with study procedures and follow-up examinations
  • Adequate bone marrow function: WBC > 3,500 and <50,000 cells/mm3, ANC > 1,500 cells/mm3, hemoglobin > 10 g/dL, and platelet count > 150,000 cells/mm3
  • Adequate renal function: serum creatinine level ≤ 1.2 x ULN

Exclusion Criteria:

  • Pregnant or nursing an infant
  • Active viral infection (including HIV, Hepatitis B and C)
  • Systemic corticosteroid or other immunosuppressive medication use within 4 weeks of the treatment
  • Clinically significant active infection or uncontrolled medical condition (e.g., pulmonary, neurological, cardiovascular, gastrointestinal, genitourinary) considered high risk for investigational new drug treatment
  • Significant immunodeficiency (e.g. due to underlying illness and/ or medication) in subject or household contacts
  • History of eczema requiring systemic therapy
  • Unstable cardiac disease which includes but is not limited to: Any of the following within 6 months prior to study entry: MI, unstable angina, congestive heart failure, myocarditis, arrhythmias diagnosed and requiring medication, or any clinically-significant change in cardiac status
  • Target tumor(s) adherent to a major vascular structure (e.g. carotid artery)
  • Subjects who have received radiation, chemotherapy or other potentially immunosuppressive therapy in 4 weeks prior to study screening
  • Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions
  • Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination
  • Subjects with household contacts who are pregnant or nursing an infant, children < 5 years old, have history of eczema that at some stage has required systemic therapy, or have a significant immunodeficiency due to underlying illness (e.g. HIV) and/or medication (e.g. systemic corticosteroids) will be excluded unless alternate living arrangements can be made during the subject's active dosing period and for three weeks following the last dose of study medication
  • Inability or unwillingness to give informed consent.
  • CD4 T cell count < 350 per µL blood

Sites / Locations

  • University of Pittsburgh Cancer Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

A

B

C

Arm Description

Subjects who have been vaccinated with vaccinia virus (small pox)and will receive vvDD-CDSR by intratumoral injection

Subjects will include those who have not been vaccinated with vaccinia virus (small pox)and will receive vvDD-CDSR by intratumoral injection.

Subjects will be those who have been vaccinated with vaccinia virus (small pox)and will be receiving the vvCD-CDSR via intravenous infusion

Outcomes

Primary Outcome Measures

Determine the maximally tolerated dose (MTD) and/or maximum-feasible dose (MFD) and Safety of vvDD-CDSR administered by intratumoral (I.T.) injection and intravenous (I.V.) infusion.

Secondary Outcome Measures

Replication/pharmacokinetics of vvDD-CDSR
Immune response to vvDD-CDSR and to the tumor following administration
Antitumoral efficacy of vvDD-CDSR

Full Information

First Posted
December 13, 2007
Last Updated
December 23, 2015
Sponsor
David Bartlett
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1. Study Identification

Unique Protocol Identification Number
NCT00574977
Brief Title
Safety Study of Modified Vaccinia Virus to Cancer
Official Title
A Phase I Dose-escalation Trial of vvDD-CDSR (Double-deleted Vaccinia Virus Plus CD/ SMR) Administered by Intratumoral Injection or Intravenous Injection
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
May 2008 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
David Bartlett

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and maximum tolerated dose from injecting this vaccinia virus into tumors or infusion.
Detailed Description
This is a Phase I, open-label, single dose, dose-escalation trial in subjects with melanoma, breast cancer, or head and neck squamous cell cancer, liver, colorectal or pancreatic adenocarinoma. The intratumoral subjects will be stratified into 2 groups. Group A includes those who have been vaccinated with vaccinia virus. A history of vaccination and a scar at vaccination site is required. Group B subjects will include those who have not been vaccinated. It is expected that the toxicity profile will be quite different between those who have been vaccinated previously with vaccinia virus and therefore subjects will be stratified separately in this Phase I trial. All subjects who have refractory tumors will receive treatment at one of five dose levels in a single dose sequential dose-escalating design. Eligible subjects will receive 1 treatment of vvDD-CDSR. A dose can be divided between 1-3 lesions. The sum total of the maximal diameters of the lesion(s) to be injected must be < 10cm. Once the MTD and/or MFD has been defined in the vaccinated I.T. arm described above, additional subject may be enrolled at one dose level lower than the MTD/MFD and the I.V. infusion phase may begin. Patients enrolled in the IV infusion arm will receive a single administration of vvDD-CDSR at one of three dose levels in a sequential dose-escalating design.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma, Breast Cancer, Head and Neck Squamous Cell Cancer, Liver Cancer, Colorectal Cancer, Pancreatic Adenocarcinoma
Keywords
vaccinia, virus, tumor, melanoma, breast cancer, squamous cell cancer, colorectal, liver, pancreatic, adenocarcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Subjects who have been vaccinated with vaccinia virus (small pox)and will receive vvDD-CDSR by intratumoral injection
Arm Title
B
Arm Type
Experimental
Arm Description
Subjects will include those who have not been vaccinated with vaccinia virus (small pox)and will receive vvDD-CDSR by intratumoral injection.
Arm Title
C
Arm Type
Experimental
Arm Description
Subjects will be those who have been vaccinated with vaccinia virus (small pox)and will be receiving the vvCD-CDSR via intravenous infusion
Intervention Type
Biological
Intervention Name(s)
Vaccinia virus (vvDD-CDSR)
Intervention Description
Eligible subjects will receive 1 treatment of vvDD-CDSR. A dose can be divided between 1-3 lesions. The sum total of the maximal diameters of the lesion(s) to be injected must be < 10cm. Cohort 1: 3 x 10e7 p.f.u. Cohort 2: 1 x 10e8 p.f.u. Cohort 3: 3 x 10e8 p.f.u. Cohort 4: 1 x 10e9 p.f.u. Cohort 5: 3 x 10e9 p.f.u.
Intervention Type
Biological
Intervention Name(s)
Vaccinia virus (vvDD-CDSR)
Intervention Description
Eligible subjects will receive 1 treatment of vvDD-CDSR. A dose can be divided between 1-3 lesions. The sum total of the maximal diameters of the lesion(s) to be injected must be < 10cm. Cohort 1: 3 x 10e7 p.f.u. Cohort 2: 1 x 10e8 p.f.u. Cohort 3: 3 x 10e8 p.f.u. Cohort 4: 1 x 10e9 p.f.u. Cohort 5: 3 x 10e9 p.f.u.
Intervention Type
Biological
Intervention Name(s)
Vaccinia virus (vvDD-CDSR)
Intervention Description
Eligible subjects will receive 1 infusion of vvDD-CDSR. Cohort 1: 3 x 10e8 p.f.u; Cohort 2: 1 x 10e9 p.f.u.; Cohort 3: 3 x 10e9 p.f.u.
Primary Outcome Measure Information:
Title
Determine the maximally tolerated dose (MTD) and/or maximum-feasible dose (MFD) and Safety of vvDD-CDSR administered by intratumoral (I.T.) injection and intravenous (I.V.) infusion.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Replication/pharmacokinetics of vvDD-CDSR
Time Frame
28 days
Title
Immune response to vvDD-CDSR and to the tumor following administration
Time Frame
28 days
Title
Antitumoral efficacy of vvDD-CDSR
Time Frame
28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Greater than 18 years of age Histologically-confirmed cancer that has progressed despite standard therapy. They must have one of the following tumor-types: melanoma, breast cancer, or head and neck squamous cell cancer, liver, colorectal or pancreatic Cancer is not surgically curable Karnofsky Performance Status (KPS) of > 70 (See Appendix B) Anticipated survival of at least 16 weeks If sexually-active, willingness to use condoms for 3 months following study treatment with vvDD-CDSR The ability to understand and willingness to sign a written informed consent Able to comply with study procedures and follow-up examinations Adequate bone marrow function: WBC > 3,500 and <50,000 cells/mm3, ANC > 1,500 cells/mm3, hemoglobin > 10 g/dL, and platelet count > 150,000 cells/mm3 Adequate renal function: serum creatinine level ≤ 1.2 x ULN Exclusion Criteria: Pregnant or nursing an infant Active viral infection (including HIV, Hepatitis B and C) Systemic corticosteroid or other immunosuppressive medication use within 4 weeks of the treatment Clinically significant active infection or uncontrolled medical condition (e.g., pulmonary, neurological, cardiovascular, gastrointestinal, genitourinary) considered high risk for investigational new drug treatment Significant immunodeficiency (e.g. due to underlying illness and/ or medication) in subject or household contacts History of eczema requiring systemic therapy Unstable cardiac disease which includes but is not limited to: Any of the following within 6 months prior to study entry: MI, unstable angina, congestive heart failure, myocarditis, arrhythmias diagnosed and requiring medication, or any clinically-significant change in cardiac status Target tumor(s) adherent to a major vascular structure (e.g. carotid artery) Subjects who have received radiation, chemotherapy or other potentially immunosuppressive therapy in 4 weeks prior to study screening Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination Subjects with household contacts who are pregnant or nursing an infant, children < 5 years old, have history of eczema that at some stage has required systemic therapy, or have a significant immunodeficiency due to underlying illness (e.g. HIV) and/or medication (e.g. systemic corticosteroids) will be excluded unless alternate living arrangements can be made during the subject's active dosing period and for three weeks following the last dose of study medication Inability or unwillingness to give informed consent. CD4 T cell count < 350 per µL blood
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Herbert J. Zeh, MD, PhD
Organizational Affiliation
University of Pittsburgh
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Pittsburgh Cancer Institute
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States

12. IPD Sharing Statement

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Safety Study of Modified Vaccinia Virus to Cancer

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