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A Study of onCARlytics (CF33-CD19) in Combination With Blinatumomab in Adults With Advanced or Metastatic Solid Tumors (OASIS)

Phase 1
Recruiting
Conditions
Solid Tumor, Adult
Interventions
Biological: CF33-CD19 IT Monotherapy
Biological: CF33-CD19 IV Monotherapy
Biological: CF33-CD19 IT Combination
Biological: CF33-CD19 IV Combination
Registration Number
NCT06063317
Lead Sponsor
Imugene Limited
Brief Summary

This is an open-label, dose escalation and dose expansion, multi-center phase I study evaluating the safety and tolerability of CF33-CD19 administered intravenously (IV) or intratumorally (IT) in combination with blinatumomab and with or without hydroxyurea in adults with advanced or metastatic solid tumors.

Detailed Description

CF33-CD19, a novel chimeric orthopoxvirus, will be administered as a monotherapy or in combination with blinatumomab and with or without hydroxyurea to assess the safety and efficacy of the treatment regimens as well as immunological changes in the tumour microenvironment.

Subjects eligible for treatment include those with any metastatic or advanced solid tumor who have documented radiological progression per RECIST following at least two prior lines of therapy.

All enrolled monotherapy subjects will be treated with CF33-CD19 on Day 1 and 8 of Cycle 1 and then on Day 1 of each 21-day cycle thereafter. Subjects treated with the combination regimen will receive CF33-CD19 on Days 1 and 15 of each 28-day cycle. In addition, they will receive blinatumomab as a 7-day continuous infusion from Days 2-9 and Days 16-23 of each cycle.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  1. Written informed consent from subject or legally authorized representative.
  2. Age ≥ 18 years old on the date of consent.
  3. Life expectancy of at least 3 months.
  4. Any histologically or cytologically confirmed advanced or metastatic solid tumor with documented radiological progression per RECIST v1.1. Eligible subjects must have received at least two prior lines of approved therapies, including targeted therapies, for which they are eligible and failed or relapsed on or after that treatment.
  5. Eastern Cooperative Oncology Group (ECOG) performance status 0 - 1.
  6. At least one measurable lesion as defined by RECIST v1.1 criteria.
  7. Adequate renal function.
  8. Adequate hepatic function.
  9. Adequate hematologic function.
  10. Willing and able to comply with scheduled visits, study treatment plan, laboratory tests, and other study procedures.
Exclusion Criteria
  1. Prior treatment with a poxvirus based oncolytic virus or a bispecific CD19-directed CD3 T-cell engager.
  2. 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.
  3. Any radiation within 2 weeks of start of study treatment.
  4. Active autoimmune disease.
  5. Current or history of severe skin disease with open wounds.
  6. History of (non-infectious) pneumonitis / interstitial lung disease that required steroids or has current pneumonitis / interstitial lung disease.
  7. History of pancreatitis.
  8. Prior allogeneic tissue/organ transplant or other medical conditions requiring ongoing treatment with immunosuppressive drugs or any condition resulting in a systemic immunosuppressed state.
  9. Medical history of central nervous system (CNS) metastases unless the subject has completed definitive treatment for the CNS lesions with whole brain radiation therapy (WBRT) or stereotactic radiosurgery (SRS) and are neurologically stable, asymptomatic, and off corticosteroids for at least 2 months prior to first dose.
  10. History of documented congestive heart failure (New York Heart Association [NYHA] class II - IV), unstable angina, poorly controlled hypertension, clinically significant valvular heart disease or high-risk uncontrolled arrhythmias.
  11. Bleeding diathesis due to underlying medical condition or ongoing anticoagulation medication.
  12. History or presence of clinically relevant CNS pathology, or any other CNS disability judged by the Investigator to be clinically significant and precluding informed consent or participation in the study.
  13. Active infection requiring systemic treatment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CF33-CD19 IT Administration MonotherapyCF33-CD19 IT Monotherapy-
CF33-CD19 IV Administration MonotherapyCF33-CD19 IV Monotherapy-
CF33-CD19 IT Administration in Combination with BlinatumomabCF33-CD19 IT Combination-
CF33-CD19 IT Administration in Combination with BlinatumomabBlinatumomab-
CF33-CD19 IV Administration in Combination with BlinatumomabCF33-CD19 IV Combination-
CF33-CD19 IV Administration in Combination with BlinatumomabBlinatumomab-
CF33-CD19 IT Administration in Combination with Blinatumomab and HydroxyureaCF33-CD19 IT Combination-
CF33-CD19 IT Administration in Combination with Blinatumomab and HydroxyureaBlinatumomab-
CF33-CD19 IT Administration in Combination with Blinatumomab and HydroxyureaHydroxyurea-
CF33-CD19 IV Administration in Combination with Blinatumomab and HydroxyureaCF33-CD19 IV Combination-
CF33-CD19 IV Administration in Combination with Blinatumomab and HydroxyureaBlinatumomab-
CF33-CD19 IV Administration in Combination with Blinatumomab and HydroxyureaHydroxyurea-
Primary Outcome Measures
NameTimeMethod
All Treatment Arms - Incidence and severity of Adverse EventsFrom 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.

Monotherapy Treatment Arms - Determination of RP2D to apply to Dose Escalation Combination Phase as supported by immune response as seen in cytokinesFrom first dose of study drug through treatment discontinuation, an average of 6 months

Change in cytokine levels in peripheral blood pre and post dose

Monotherapy Treatment Arms - Determination of the Recommended Phase 2 Dose (RP2D) to apply to Dose Escalation Combination Phase as supported by immune response as seen in lymphocyte subsetsFrom first dose of study drug through treatment discontinuation, an average of 6 months

Change in lymphocyte subset expression in tumor tissue and peripheral blood pre and post dose

Monotherapy Treatment Arms - Determination of RP2D to apply to Dose Escalation Combination Phase as supported by anti-tumor activityFrom first dose of study drug through treatment discontinuation, an average of 6 months

Stable Disease and Response (PR and CR) based on RECIST v1.1 and iRECIST v1.0.

Secondary Outcome Measures
NameTimeMethod
Combination Treatment Arms - Determination of the Recommended Phase 2 Dose (RP2D) for CF33-CD19 + blinatumomab + hydroxyurea combination as supported by immune response as seen in lymphocyte subsetsFrom first dose of study drug through treatment discontinuation, an average of 6 months

Change in lymphocyte subset expression in tumor tissue and peripheral blood pre and post dose

Combination Treatment Arms - Determination of RP2D for CF33-CD19 + blinatumomab + hydroxyurea combination as supported by immune response as seen in cytokinesFrom first dose of study drug through treatment discontinuation, an average of 6 months

Change in cytokine levels in peripheral blood pre and post dose

Combination Treatment Arms - Determination of RP2D for CF33-CD19 + blinatumomab + hydroxyurea combination as supported by anti-tumor activityFrom first dose of study drug through treatment discontinuation, an average of 6 months

Stable Disease and Response (PR and CR) based on RECIST v1.1 and iRECIST v1.0.

All Treatment Arms - Overall Response RateFrom first dose of study drug through treatment discontinuation, an average of 6 months

Overall Response Rate (ORR) is defined as the proportion of subjects in the efficacy population who achieve a radiographic Investigator-assessed confirmed CR or PR, per RECIST v1.1 or confirmed iCR or iPR per iRECIST v1.0.

All Treatment Arms - Progression Free SurvivalFrom first dose of study drug through treatment discontinuation, an average of 6 months

Progression Free Survival (PFS) defined as the time from first dose of study drug to first documentation of PD based on RECIST 1.1, or to death from any cause.

All Treatment Arms - Duration of ResponseFrom first dose of study drug through treatment discontinuation, an average of 6 months

Duration of Response (DoR) measured 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.

All Treatment Arms - Disease Control RateFrom first dose of study drug through treatment discontinuation, an average of 6 months

Disease Control Rate (DCR), measured as the proportion of subjects 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.

Trial Locations

Locations (8)

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

City of Hope

🇺🇸

Duarte, California, United States

Emory Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Northwestern

🇺🇸

Chicago, Illinois, United States

Roswell Park Comprehensive Cancer Center

🇺🇸

Buffalo, New York, United States

University of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

University of Pittsburgh Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

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