First in Man Clinical Study to Evaluate Safety and Tolerability of an Oncolytic Adenovirus in Prostate Cancer Patients.
- Conditions
- Adenocarcinoma of the Prostate
- Interventions
- Biological: ORCA-010
- Registration Number
- NCT04097002
- Lead Sponsor
- Orca Therapeutics B.V.
- Brief Summary
This open label, dose escalating study is a phase I/IIa first in man study designed to evaluate the safety and tolerability of intratumoral administration of a novel oncolytic adenovirus (ORCA-010) in treating diagnosed treatment naïve Patients with localized prostate cancer.
- Detailed Description
The study is divided into two parts. In Part A of the study, cohorts of subjects will be administered escalating doses of ORCA-010, using the 3+3 design. When the Maximum Tolerated Dose has been determined in Part A, a group of 12 new subjects will be treated in Part B of the study at this dose, with two administrations separated by a 2-week interval.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Male
- Target Recruitment
- 24
- Histologically confirmed adenocarcinoma of the prostate, which is localized to the prostate ( within 24 months of screening)
- Absence of lymph node, bone or other metastases as determined by MRI and CT scan, Bone Scan or nano-MRI (≤3 months prior to first administration)
- Men between 18 and 75 years inclusive
- ECOG status 0 or 1
- Ability to understand and willingness to sign informed consent
- Adequate liver, renal and bone marrow function: AST & ALT < 2.5 x ULN, total bilirubin < 1.5 x ULN, Alkaline phosphatase < 3 x ULN, Serum creatinine < 1.5 x ULN, Haemoglobin > 9.0 g/dL (5.59 mmol/L), Platelet count > 100x10*9/L, Neutrophils > 1.5x10*9/L, INR < 1.5xULN
- eGFR ≥ 30 mL/min, using the Cockcroft - Gault Equation: Creatinine Clearance = [{(140 - age in years) x (weight in kg)} x 1.23] /serum Creatinine in Mmol/L
- Tumor not accessible for injection
- Prior treatment of prostate cancer with radiation therapy or brachytherapy
- Prior use of chemotherapy/hormone therapy for treatment of cancer
- Target tumor adherent to a major vascular structure
- Participation in any investigational drug study within the last 12 months prior to first administration of ORCA-010
- Clinically significant active infection (viral or bacterial)
- Known immunosuppressive diseases (e.g. HIV, Hepatitis B and C)
- History of any other oncological malignancy, excluding basal cell carcinoma of the skin, in the past 5 years
- Not willing to refrain from sexual activities or use a double barrier contraceptive device (condom with foam or vaginal suppository, diaphragm with spermicide) after administration of ORCA-010 and until 42 days after the last ORCA-010 administration
- Severe obesity defined as Body Mass Index (BMI) > 30 kg/m2
- Positive for adenovirus in throat swap or serum as determined by PCR at screening
- Recent (within 3 months prior to enrolment in the study) history of alcohol abuse or other substances such as barbiturates, cannabinoids and amphetamines or a positive urine screen for drugs of abuse
- Use of medication known to have immunosuppressive effects, except topical/inhaled steroids under 10 mg/day prednisolone equivalent (See Appendix 7)
- Use of systemic antiviral medication within 3 months prior to enrolment in the study
- Use of any anti-coagulants/blood thinner except for ASA 81mg
- Any condition that in the opinion of the Investigator could interfere with the conduct of the study
- For Part B only: Subjects enrolled in Part A of the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SEQUENTIAL
- Arm && Interventions
Group Intervention Description Phase I, Part A, Cohort 2 ORCA-010 Single dose-escalation of ORCA-010, Dose Cohort 2: 5x10\*11 viral particles. Group of 3 subjects. Dose will be escalated to the next cohort based on safety and toxicity results from the 3 treated subjects to determine the Maximum Tolerated Dose, if not determined by this cohort. Phase IIa, Part B, Cohort 4 ORCA-010 Two dose administration of ORCA-010 seperated by 2 weeks, Dose Cohort 4: The Maximum Tolerated Dose depending on Phase I/ Part A results. Group of 12 subjects. Phase I, Part A, Cohort 1 ORCA-010 Single dose-escalation of ORCA-010, Dose Cohort 1: 1x10\*11 viral particles. Single dose of ORCA-010 will be administered for the first subject only and all relevant safety data for this subject will be reviewed by the DSMB prior to enrolling additional subjects. After the DSMB review, subjects will be enrolled in groups of three (including the first subject) and assessed for safety and Dose-Limiting Toxicity (DLT) after a single dose of ORCA-010. Group of 3 subjects. Dose will be escalated to the next cohort based on safety and toxicity results from the 3 treated subjects to determine the Maximum Tolerated Dose, if not determined by this cohort. Phase I, Part A, Cohort 3 ORCA-010 Single dose-escalation of ORCA-010, Dose Cohort 3: 1.5x10\*12 viral particles. Group of 3 subjects. Dose will be considered as the Maximum Tolerated Dose based on safety and toxicity results from the 3 treated subjects.
- Primary Outcome Measures
Name Time Method Safety profile of ORCA-010 365 days To evaluate safety and tolerability of intratumoral administration of ORCA-010 according to CTCAE V5.0. The primary endpoint of this study is to assess Dose Limiting Toxicities (DLTs) and the Maximum Tolerated Dose (MTD) for ORCA-010 to determine the final safety dose of administration for Phase IIa/Part B.
- Secondary Outcome Measures
Name Time Method Biological activity of ORCA-010 365 days To explore the biological activity of intratumoral administration of ORCA-010. Biological activity of ORCA-010 will be measured by assessing viral replication by measuring ORCA-010 virus DNA in blood. In addition, virus replication and spread will be assessed by staining prostate cancer tissue obtained through prostate biopsies with adenovirus specific antibodies. Subject's serum will be assayed for antibody responses against ORCA-010.
Shedding of ORCA-010 365 days Shedding of ORCA-010 will be assessed by detection of vector DNA in blood and urine using quantitative-PCR (Q-PCR).
Antitumor immune responses 365 days To evaluate potential antitumor immune responses following ORCA-010 administration. Subject's serum will be analyzed for antibody responses against tumor-associated antigens (e.g. PSA, PSMA, PCA3, and Prostein). Subject's Peripheral Blood Mononuclear Cells (PBMCs) will also be analyzed for cellular immune responses against tumor-associated antigens.
Prostate biopsies will be taken to detect local antitumor immunological reactions (eg. infiltration and activation of T cells).
Trial Locations
- Locations (5)
Urology and Male Infertility Clinic
🇨🇦Scarborough, Ontario, Canada
G. Kenneth Jansz Medicine Professional Corporation
🇨🇦Burlington, Ontario, Canada
Jonathan Giddens Medicine Professional Corporation
🇨🇦Brampton, Ontario, Canada
Research St. Joseph's - Hamilton
🇨🇦Hamilton, Ontario, Canada
The Fe/Male Health Centres Recruiting
🇨🇦Oakville, Ontario, Canada