A Phase I/IIa Study to Evaluate the Safety, Tolerability and Pharmacokinetics Characteristics of Recombinant Oncolytic Vaccinia Virus Injection T601 as a Single Drug or in Combination With Oral Flucytosine (5-FC), in Patients With Advanced Malignant Solid Tumors
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Advanced Malignant Solid Tumors
- Sponsor
- Tasly Tianjin Biopharmaceutical Co., Ltd.
- Enrollment
- 69
- Locations
- 2
- Primary Endpoint
- AEs (adverse events)
- Last Updated
- 5 years ago
Overview
Brief Summary
This open, dose-escalation and extended PhI/IIa clinical trial aims to evaluate the safety, tolerability of T601 as a single-agent as well as combined with prodrug 5-FC to treat patients with advanced malignant solid tumors and to explore the pharmacokinetic characteristics of T601, 5-FC, 5-FU, FBAL, which includes PhI study of dose-escalation study and Ph IIa study of extending study.
Detailed Description
Preclinical studies have confirmed that the combination of T601 and 5-FC can not only enhance the anti-tumor effect, but also reduce the toxicity of T601. Considering the risks and benefits of participants of the clinical trial, the protocol design is divided into 4 parts: Part 1: dose-escalation study of single-dose of T601 to evaluate the safety and tolerability of T601 and to determine the MTD; Part 2: dose-escalation study of single-dose of T601 combined with predrug 5-FC, to evaluate the safety and tolerability of the treatment of single dose of T601 combined with predrug 5-FC and to determine the MTD of single dose of T601 when combing with 5-FC; Part 3: dose-escalation study of multiple-dose of T601 combined with predrug 5-FC, to explore the safety and tolerability of the treatment of multiple dose of T601 combined with predrug 5-FC and to determine the MTD of multiple dose of T601 when combing with 5-FC, also to determine the RP2D (recommended dose for Phase II Trial); Part 4: extending study of multiple-dose of T601 combined with predrug 5-FC, to evaluate the efficacy of the treatment of multiple-dose of T601 combined with predrug 5-FC in patients with various specific tumors and to evaluate the ORR, DCR and PFS according to the RECIST v1.1.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Male or female, aged ≥18 years and ≤ 75;
- •Part1-Part3: histological or cytological confirmed advanced malignant solid tumors patients who have received standard therapeutic options in previous treatment and now there's no standard therapy available; Part4: patients with gastric cancer, pancreatic cancer and hepatocellular carcinoma will be enrolled in Phase IIa Clinical Trial;
- •Eastern Cooperative Oncology Group (ECOG) performance status 0-1;
- •Expected survival of at least 3 months;
- •Patient presenting with at least one evaluable lesion according to RECIST 1.1 in Part1-Part3; patient presenting with at least one measurable lesion according to RECIST 1.1 in Part4;
- •Adequate blood system function, liver function and kidney function:
- •ANC≥1.5×109/L，PLT≥80×109/L，Hb≥90 g/L;
- •TBIL≤1.5×ULN，ALT≤3×ULN，AST≤3×ULN (Patients with liver metastasis or liver cancer ALT≤5×ULN，AST≤5×ULN);
- •Cr≤1.5×ULN, creatinine clearance\>50mL/min (calculate according to Cockcroft-Gault Formula);
- •APTT≤1.5×ULN，PT≤1.5×ULN，INR≤1.5×ULN.
Exclusion Criteria
- •Received chemotherapy, radiation, biotherapy, endocrine therapy, immunotherapy and other anti-tumor treatments within 4 weeks prior to T601 treatment initiation, except for the following items:
- •Received nitrosourea or mitomycin C within 6 weeks before T601 treatment initiation; Orally taken fluorouracil and small-molecule targeted drugs within 2 weeks before T601 treatment initiation or within 5 half-lives of the above drugs (subject to whichever is longer); Received the Chinese medicines with anti-tumor indications within 2 weeks before T601 treatment initiation;
- •Prior participation in another clinical study involving an IMP with last intake within 4 weeks prior to T601 treatment initiation;
- •Received major organ surgery (excluding needle biopsy) or severe trauma within 4 weeks prior to T601 treatment initiation;
- •The adverse reactions of previous anti-tumor therapy have not yet returned to CTCAE 5.0 ≤1 (except the toxicity that the investigator judged as no safety risk, such as hair loss);
- •With clinical symptoms of brain metastasis, spinal cord compression, and cancerous meningitis, or other evidence indicates that the metastasis of the patient's brain and spinal cord has not been controlled, and the investigator judged that the patient was not suitable for inclusion. Patients with clinical symptoms suspected of cerebral or pia mater disease should be excluded by CT/MRI examination;
- •Uncontrolled bacterial, viral or fungal infections requiring systematic treatment;
- •History of immunodeficiency, including positive HIV antibody test;
- •Active chronic hepatitis B (HBV-DNA higher than the lower limit of detection), hepatitis C antibody positive;
- •Patients who are unable to swallow oral drugs;
Outcomes
Primary Outcomes
AEs (adverse events)
Time Frame: Throughout the whole clinical trial, around 2 years.
According to NCI CTCAE 5.0., evaluate the AEs and the frequency and severity of adverse events.
Assessment of PFS (progression free survival)
Time Frame: For Part 4, PFS is measured at the end of each cycle (for Part 4, each cycle is 46 days), until the date of disease progression or death, whichever came first, assessed up to 2 years.
According to RECIST v1.1, to assess the PFS of the patients, and to evaluate the efficacy of T601 or T601 in combination with 5-FC.
Assessment of DCR (disease control rate)
Time Frame: For Part 4, DCR is measured at the end of each cycle (for Part 4, each cycle is 46 days), until the date of disease progression or death, whichever came first, assessed up to 2 years.
According to RECIST v1.1, to assess the DCR of the patients, and to evaluate the efficacy of T601 or T601 in combination with 5-FC.
Assessment of ORR (objective response rate)
Time Frame: For Part 4, ORR is measured at the end of each cycle (for Part 4, each cycle is 46 days), until the date of disease progression or death, whichever came first, assessed up to 2 years.
According to RECIST v1.1, to assess the ORR of the patients, and to evaluate the efficacy of T601 or T601 in combination with 5-FC
Secondary Outcomes
- Quantification of viral genome in patients' blood samples by Quantitative Polymerase Chain Reaction.(For Part 3, blood samples are collected on Day8, Day15, Day32, Day46 of cycle 1.)
- Determination of 5-FC, 5-FU and FBAL concentration in plasma by updated LC/MS/MS method(For Part 3, blood samples are collected on Day19, Day20 of cycle 1.)
- T601 antibody test by ELISA(For Part 3, Baseline, Day14, Day32, Day46 for cycle 1 and Day46 for following cycles (for Part 3, each cycle is 46 days).)