Safety Study of Recombinant Vaccinia Virus to Treat Refractory Solid Tumors
Primary Purpose
Melanoma, Lung Cancer, Renal Cell Carcinoma
Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Recombinant Vaccinia GM-CSF; RAC VAC GM-CSF (JX-594)
Sponsored by
About this trial
This is an interventional treatment trial for Melanoma focused on measuring phase I, advanced metastatic solid tumors, oncolytic virus, vaccinia virus, melanoma, lung cancer, renal cell carcinoma, squamous cell carcinoma of the head and neck, Pexa-Vec
Eligibility Criteria
Inclusion Criteria:
- Histologically-confirmed, advanced/metastatic solid tumor refractory to standard therapy or the patient has refused or does not tolerate the standard therapy; tumors may include malignant melanoma, non-small cell lung cancer, renal cell carcinoma, and squamous cell carcinoma of the head and neck
- At least one measurable tumor mass by CT/MRI (i.e. lesion that can accurately be measured in at least one dimension with longest diameter > 1 cm)
- At least one tumor mass amenable to biopsy and/or FNA
- Expected survival for approximately 16 weeks or longer
- Karnofsky Performance Score (KPS) ≥ 70
- Age ≥18 years
- WBC ≥ 3,500 cells/mm3 and ≤ 50,000 cells/mm3
- ANC ≥ 1,500 cells/mm3
- Hemoglobin ≥ 10 g/dL
- Platelet count ≥ 100,000 plts/mm3
- Total bilirubin ≤ 1.5 x ULN
- AST, ALT ≤ 2.5 x ULN
- Serum chemistries within normal limits (WNL) or Grade 1 - If patients are diabetic or have a screening random glucose > 160 mg/dL, a fasting glucose must be done and patients must be WNL or Grade 1 in order to be eligible for the study.
- Acceptable coagulation status: INR ≤ (ULN + 10%)
- CD4 count ≥ 500/mm3
Exclusion Criteria:
- Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or medication (e.g. systemic corticosteroids)
- Known myeloproliferative disorders requiring systemic therapy
- History of exfoliative skin condition (e.g. eczema or ectopic dermatitis) requiring systemic therapy
- Tumor(s) invading a major vascular structure (e.g. carotid artery)
- Tumor(s) in location that would potentially result in significant clinical adverse effects if post-treatment tumor swelling were to occur (e.g. tumors impinging on the upper airway or affecting biliary tract drainage, etc.)
- Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions
- Severe or unstable cardiac disease
- Current, known CNS malignancy (history of completely resected or irradiated brain metastases allowed)
- Received anti-cancer therapy within 4 weeks prior to first treatment (6 weeks in case of mitomycin C or nitrosoureas)
- Use of anti-viral, anti-platelet, or anti-coagulation medication [Patients who discontinue such medications within 7 days prior to first treatment may be eligible for this study.]
- Pulse oximetry O2 saturation <90% at rest
- Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination
Household contact exclusions:
- Women who are pregnant or nursing an infant
- Children < 5 years old
- History of exfoliative skin condition (e.g. eczema) that at some stage has required systemic therapy
- Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or medication (e.g. systemic corticosteroids)
Sites / Locations
- Billings Clinic
- University of Pennsylvania
- Cancer Centers of the Carolinas
- Ottawa Health Research Institute
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Single Arm, dose escalation
Arm Description
dose escalation starting dose 1e5 pfu/kg bw to 3e7 pfu/kg bw; Recombinant Vaccinia GM-CSF (JX-594)
Outcomes
Primary Outcome Measures
Maximally-tolerated dose (MTD) and/or maximum-feasible dose (MFD) of JX-594 administered by intravenous (IV) infusion
Safety/Toxicity: Incidence of treatment-related adverse events; treatment-related serious adverse events; treatment-related Grade 3/4 toxicities; and clinically-significant, treatment-related changes from baseline in routine laboratory parameters
Secondary Outcome Measures
Determine the JX-594 pharmacokinetics and pharmacodynamics over time following IV infusion
Determine the immune response to JX-594 following IV infusion
Determine the delivery of JX-594 to, and concentration within, solid tumors following IV infusion
Full Information
NCT ID
NCT00625456
First Posted
February 19, 2008
Last Updated
November 30, 2015
Sponsor
Jennerex Biotherapeutics
1. Study Identification
Unique Protocol Identification Number
NCT00625456
Brief Title
Safety Study of Recombinant Vaccinia Virus to Treat Refractory Solid Tumors
Official Title
A Phase I Dose Escalation Study of JX-594 (Thymidine Kinase-deleted Vaccinia Virus Plus GM-CSF) Administered by Intravenous Infusion in Patients With Refractory Solid Tumors
Study Type
Interventional
2. Study Status
Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
June 2008 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
June 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jennerex Biotherapeutics
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a Phase I, open-label, dose-escalation trial in patients with advanced/metastatic solid tumors refractory to standard therapy; tumors may include malignant melanoma, non-small cell lung cancer, renal cell carcinoma, and squamous cell carcinoma of the head and neck. These tumor types were selected because evidence of biological activity was observed in these tumor types in a Phase I study of JX-594 (Pexa-Vec) administered by intratumoral injection in patients with metastatic disease to the liver. Patients will receive treatment at one of five 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, Lung Cancer, Renal Cell Carcinoma, Squamous Cell Carcinoma of the Head and Neck
Keywords
phase I, advanced metastatic solid tumors, oncolytic virus, vaccinia virus, melanoma, lung cancer, renal cell carcinoma, squamous cell carcinoma of the head and neck, Pexa-Vec
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
23 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Single Arm, dose escalation
Arm Type
Experimental
Arm Description
dose escalation starting dose 1e5 pfu/kg bw to 3e7 pfu/kg bw; Recombinant Vaccinia GM-CSF (JX-594)
Intervention Type
Drug
Intervention Name(s)
Recombinant Vaccinia GM-CSF; RAC VAC GM-CSF (JX-594)
Other Intervention Name(s)
JX-594
Intervention Description
Intravenous Dosage from 1 x 10^5 pfu/kg to 3 x 10^7 pfu/kg Intravenous infusion is administered once over a 60 minute period
Primary Outcome Measure Information:
Title
Maximally-tolerated dose (MTD) and/or maximum-feasible dose (MFD) of JX-594 administered by intravenous (IV) infusion
Time Frame
4 weeks
Title
Safety/Toxicity: Incidence of treatment-related adverse events; treatment-related serious adverse events; treatment-related Grade 3/4 toxicities; and clinically-significant, treatment-related changes from baseline in routine laboratory parameters
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Determine the JX-594 pharmacokinetics and pharmacodynamics over time following IV infusion
Time Frame
4 weeks
Title
Determine the immune response to JX-594 following IV infusion
Time Frame
4 weeks
Title
Determine the delivery of JX-594 to, and concentration within, solid tumors following IV infusion
Time Frame
4 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically-confirmed, advanced/metastatic solid tumor refractory to standard therapy or the patient has refused or does not tolerate the standard therapy; tumors may include malignant melanoma, non-small cell lung cancer, renal cell carcinoma, and squamous cell carcinoma of the head and neck
At least one measurable tumor mass by CT/MRI (i.e. lesion that can accurately be measured in at least one dimension with longest diameter > 1 cm)
At least one tumor mass amenable to biopsy and/or FNA
Expected survival for approximately 16 weeks or longer
Karnofsky Performance Score (KPS) ≥ 70
Age ≥18 years
WBC ≥ 3,500 cells/mm3 and ≤ 50,000 cells/mm3
ANC ≥ 1,500 cells/mm3
Hemoglobin ≥ 10 g/dL
Platelet count ≥ 100,000 plts/mm3
Total bilirubin ≤ 1.5 x ULN
AST, ALT ≤ 2.5 x ULN
Serum chemistries within normal limits (WNL) or Grade 1 - If patients are diabetic or have a screening random glucose > 160 mg/dL, a fasting glucose must be done and patients must be WNL or Grade 1 in order to be eligible for the study.
Acceptable coagulation status: INR ≤ (ULN + 10%)
CD4 count ≥ 500/mm3
Exclusion Criteria:
Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or medication (e.g. systemic corticosteroids)
Known myeloproliferative disorders requiring systemic therapy
History of exfoliative skin condition (e.g. eczema or ectopic dermatitis) requiring systemic therapy
Tumor(s) invading a major vascular structure (e.g. carotid artery)
Tumor(s) in location that would potentially result in significant clinical adverse effects if post-treatment tumor swelling were to occur (e.g. tumors impinging on the upper airway or affecting biliary tract drainage, etc.)
Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions
Severe or unstable cardiac disease
Current, known CNS malignancy (history of completely resected or irradiated brain metastases allowed)
Received anti-cancer therapy within 4 weeks prior to first treatment (6 weeks in case of mitomycin C or nitrosoureas)
Use of anti-viral, anti-platelet, or anti-coagulation medication [Patients who discontinue such medications within 7 days prior to first treatment may be eligible for this study.]
Pulse oximetry O2 saturation <90% at rest
Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination
Household contact exclusions:
Women who are pregnant or nursing an infant
Children < 5 years old
History of exfoliative skin condition (e.g. eczema) that at some stage has required systemic therapy
Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or medication (e.g. systemic corticosteroids)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Kirn, MD
Organizational Affiliation
Jennerex Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Billings Clinic
City
Billings
State/Province
Montana
ZIP/Postal Code
59101
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
Country
United States
Facility Name
Cancer Centers of the Carolinas
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29605
Country
United States
Facility Name
Ottawa Health Research Institute
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
12. IPD Sharing Statement
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Safety Study of Recombinant Vaccinia Virus to Treat Refractory Solid Tumors
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