A Study of CF33-hNIS (VAXINIA), an Oncolytic Virus, as Monotherapy or in Combination With Pembrolizumab in Adults With Metastatic or Advanced Solid Tumors
- Conditions
- Solid TumorSolid CarcinomaSolid Tumor, AdultCholangiocarcinomaBile Duct CancerMetastatic CancerAdvanced Solid Tumor
- Interventions
- Registration Number
- NCT05346484
- Lead Sponsor
- Imugene Limited
- Brief Summary
This is an open-label, dose-escalation, multi-center phase I study evaluating the safety of CF33-hNIS (hNIS - human sodium iodide symporter) administered via two routes of administration, intratumoral (IT) or intravenous (IV), either as a monotherapy or in combination with pembrolizumab or mFOLFOX in patients with metastatic or advanced solid tumors.
- Detailed Description
CF33-hNIS, a novel chimeric orthopoxvirus, will be administered as a monotherapy or in combination with pembrolizumab or mFOLFOX to assess the safety and efficacy of the treatment regimens as well as immunological changes in the tumour microenvironment.
Patients eligible for treatment in dose escalation IT/IV cohorts include those with any metastatic or advanced solid tumor who have documented radiological progression per RECIST following at least two prior lines of therapy which may have included treatment with an Immune Checkpoint Inhibitor(ICI). For expansion IT and IV cholangiocarcinoma cohort patients, one prior line of systemic chemotherapy in metastatic/advanced setting is required and for patients with targetable tumor mutations, must have also received 1 line of an approved targeted therapy. For expansion IV cholangiocarcinoma cohort, prior treatment with leucovorin calcium, fluorouracil, or oxaliplatin is not permitted.
For IT/IV cohorts, patients will be treated with CF33-hNIS on Day 1 and 8 of Cycle 1 and then on Day 1 of each cycle thereafter. Patients treated with the combination regimen with pembrolizumab will also receive pembrolizumab Day 1 of each cycle beginning with Cycle 2.
For IV cholangiocarcinoma expansion cohort, patients will be treated with CF33-hNIS on Day 3 and Day 17 of each 28 day cycle along with a modified FOLFOX regimen.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 100
- Written informed consent from patient or legally authorized representative
- Age ≥ 18 years old on the date of consent
- IT/IV cohorts: Any metastatic or advanced solid tumor with documented radiological progression following at least two prior lines of treatment (which may have included prior immune checkpoint inhibitor (ICI) treatment). Expansion cholangiocarcinoma IT and IV cohorts: one prior line of chemotherapy in metastatic/advanced setting. Patients with targetable tumor mutations must have also received 1 line of approved targeted therapy.
- Expansion cholangiocarcinoma IV cohort: prior treatment with leucovorin calcium, fluorouracil, or oxaliplatin is not permitted.
- ECOG performance status 0 - 2
- At least one measurable lesion
- For IT administration, ideally < 5 total lesions no greater than 10cm and <33% of liver volume replaced by tumor.
- Adequate renal function
- Adequate liver function
- Adequate hematologic function
- Willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures
- Prior treatment with a poxvirus based oncolytic virus.
- Continuous systemic treatment with either corticosteroids (>10 mg daily prednisone equivalents) or other immunosuppressive medications within 4 weeks prior to first dose of study treatment.
- Prior radiotherapy within 2 weeks of start of study treatment.
- Active autoimmune disease
- Prior allogenic tissue/organ transplant or other medical conditions requiring ongoing treatment with immunosuppressive drugs or any condition resulting in a systemic immunosuppressed state
- Inadequate pulmonary function per Investigator assessment.
- Uncontrolled brain or other central nervous system (CNS) metastases.
- History of documented congestive heart failure (New York Heart Association [NYHA] class III - IV), unstable angina, poorly controlled hypertension, clinically significant valvular heart disease or high-risk uncontrolled arrhythmias
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SEQUENTIAL
- Arm && Interventions
Group Intervention Description CF33-hNIS IT Administration Monotherapy CF33-hNIS - CF33-hNIS IV Administration Monotherapy CF33-hNIS - CF33-hNIS IT Administration in Combination with Pembrolizumab CF33-hNIS - CF33-hNIS IT Administration in Combination with Pembrolizumab Pembrolizumab - CF33-hNIS IV Administration in Combination with Pembrolizumab CF33-hNIS - CF33-hNIS IV Administration in Combination with Pembrolizumab Pembrolizumab - CF33-hNIS IV Administration in Combination with modified FOLFOX CF33-hNIS - CF33-hNIS IV Administration in Combination with modified FOLFOX Modified FOLFOX -
- Primary Outcome Measures
Name Time Method Frequency and severity of Adverse Events of IV and IT CF33-hNIS as a monotherapy or in combination with pembrolizumab From first dose of study drug through 30 days following the last dose of study treatment. Adverse events will be graded according to CTCAE v5.0.
Recommended Phase 2 Dose (RP2D) of CF33-hNIS as a monotherapy or in combination with pembrolizumab From first dose of study drug through 21-42 days following the first dose of study treatment. RP2D determination will be based on evaluation of Dose Limiting Toxicities (DLT) as well as other safety, efficacy and correlative data.
- Secondary Outcome Measures
Name Time Method Objective Response Rate (ORR) of CF33-hNIS administered as a monotherapy or in combination with pembrolizumab or modified FOLFOX Up to 2 years from first dose of study drug. ORR is defined as the proportion of patients in the efficacy population who achieve a radiographic Investigator-assessed confirmed complete response (CR) or partial response (PR), per RECIST v1.1 or confirmed immune complete response (iCR) or immune partial response (iPR) per iRECIST v1.0.
Duration of Response (DOR) of CF33-hNIS administered as a monotherapy or in combination with pembrolizumab or modified FOLFOX Up to 2 years from first dose of study drug. DOR is defined as the time from the date a response of PR/iPR or better was first recorded to the date on which progressive disease was first noted or the date of death due to any cause.
Progression-free survival (PFS) of CF33-hNIS administered as a monotherapy or in combination with pembrolizumab or modified FOLFOX Up to 2 years from first dose of study drug. PFS, defined as the time from start of treatment to the first documentation of progressive disease (PD) or death from any cause, whichever occurs first.
To evaluate viral titers of CF33-hNIS Up to 2 years from first dose of study drug. Viral Plaque Assay (VPA) and polymerase chain reaction (PCR) testing from serum, urine, oral swab, rectal swab, injection site(s) swab and wound dressing swab.
Disease Control Rate (DCR) of CF33-hNIS administered as a monotherapy or in combination with pembrolizumab or modified FOLFOX Up to 2 years from first dose of study drug. DCR is defined as the proportion of patients who achieve an Investigator-assessed confirmed CR/iCR, PR/iPR, or Stable Disease (SD)/immune SD (iSD) per RECIST v1.1 and iRECIST v1.0.
To evaluate infection of tumors with CF33-hNIS 21 days from first dose of study drug hNIS-based imaging via SPECT technetium-99 (99TC).
Overall survival (OS) of CF33-hNIS administered as a monotherapy or in combination with pembrolizumab or modified FOLFOX Up to 2 years from first dose of study drug. defined as the time from the start of treatment until death due to any cause. Median OS and OS rate at 12 months will be reported.
Related Research Topics
Explore scientific publications, clinical data analysis, treatment approaches, and expert-compiled information related to the mechanisms and outcomes of this trial. Click any topic for comprehensive research insights.
Trial Locations
- Locations (12)
University of Arizona Cancer Center
🇺🇸Tucson, Arizona, United States
Highlands Oncology
🇺🇸Springdale, Arkansas, United States
City of Hope Medical Center
🇺🇸Duarte, California, United States
UC San Diego Moores Cancer Center
🇺🇸La Jolla, California, United States
University of Miami
🇺🇸Miami, Florida, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Corewell Health
🇺🇸Grand Rapids, Michigan, United States
University of Cincinnati
🇺🇸Cincinnati, Ohio, United States
Huntsman Cancer Institute
🇺🇸Salt Lake City, Utah, United States
NEXT Oncology
🇺🇸Fairfax, Virginia, United States
Scroll for more (2 remaining)University of Arizona Cancer Center🇺🇸Tucson, Arizona, United StatesSpencer WilliamsContactspencerwilliams@arizona.eduAaron Scott, MDPrincipal Investigator