Protocol ATI001-102 Expansion Substudy: Evaluation of Ad-RTS-hIL-12 + Veledimex in Subjects With Recurrent or Progressive Glioblastoma
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 36
- 试验地点
- 4
- 主要终点
- Safety of Intratumoral Ad-RTS-hIL-12 and Oral Veledimex in Subjects With Recurrent or Progressive Glioblastoma Based on Evaluation of Adverse Events Summarized by Incidence, Intensity and Type of Adverse Event.
研究概览
简要总结
This research study involves an investigational product: Ad-RTS-hIL-12 given with veledimex for production of human IL-12. IL-12 is a protein that can improve the body's natural response to disease by enhancing the ability of the immune system to kill tumor cells and may interfere with blood flow to the tumor.
The main purpose of this study is to evaluate the safety and tolerability of a single intratumoral injection of Ad-RTS-hIL-12 given with oral veledimex.
详细描述
Patients who are scheduled for craniotomy and tumor resection will receive one dose of veledimex before the resection procedure. Ad-RTS-hIL-12 will be administered by free-hand injection. Patients will continue on oral veledimex for 14 days.
The study is divided into three periods: the screening period, the treatment period and the follow-up period.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Male or female subject ≥18 and ≤75 years of age
- •Provision of written informed consent for tumor resection, tumor biopsy, samples collection, and treatment with investigational products prior to undergoing any study specific procedures
- •Histologically confirmed glioblastoma
- •Evidence of supratentorial tumor recurrence/progression by magnetic resonance imaging (MRI) according to Response Assessment in Neuro-Oncology (RANO) criteria after standard initial therapy
- •Previous standard-of-care antitumor treatment including surgery and/or biopsy and chemoradiation. At the time of registration, subjects must have recovered from the toxic effects of previous treatments as determined by the treating physician. The washout periods from prior therapies are intended as follows: (windows other than what is listed below should be allowed only after consultation with the Medical Monitor)
- •Nitrosureas: 6 weeks
- •Other cytotoxic agents: 4 weeks
- •Antiangiogenic agents: 4 weeks (NOTE: short use (< 4 doses) of bevacizumab for controlling edema is allowed)
- •Targeted agents, including small molecule tyrosine kinase inhibitors: 2 weeks
- •Vaccine-based therapy: 3 months
- •Able to undergo standard MRI scans with contrast agent before enrollment and after treatment
- •Karnofsky Performance Status ≥70
- •Adequate bone marrow reserves and liver and kidney function, as assessed by the following laboratory requirements:
- •Hemoglobin ≥9 g/L
- •Lymphocytes >500/mm3
- •Absolute neutrophil count ≥1500/mm3
- •Platelets ≥100,000/mm3
- •Serum creatinine ≤1.5 x upper limit of normal (ULN)
- •Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 x ULN. For subjects with documented liver metastases, ALT and AST ≤5 x ULN
- •Total bilirubin <1.5 x ULN
- •International normalized ratio (INR) and activated partial thromboplastin time (aPTT) or partial thromboplastin time (PTT) within normal institutional limits
- •Male and female subjects must agree to use a highly reliable method of birth control (expected failure rate <5% per year) from the Screening Visit through 28 days after the last dose of study drug. Women of childbearing potential (perimenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential) must have a negative pregnancy test at screening
排除标准
- •Previous treatment with bevacizumab for their disease (NOTE: short use (< 4 doses) of bevacizumab for controlling edema is allowed)
- •Subjects receiving systemic corticosteroids during the previous 4 weeks
- •Radiotherapy treatment within 4 weeks of starting veledimex
- •Subjects with clinically significant increased intracranial pressure (eg, impending herniation or requirement for immediate palliative treatment) or uncontrolled seizures
- •Known immunosuppressive disease, or autoimmune conditions, and/or chronic viral infections (eg, human immunodeficiency virus [HIV], hepatitis)
- •Use of systemic antibacterial, antifungal, or antiviral medications for the treatment of acute clinically significant infection within 2 weeks of first veledimex dose. Concomitant therapy for chronic infections is not allowed. Subjects must be afebrile prior to Ad-RTS-hIL-12 injection; only prophylactic antibiotic use is allowed perioperatively
- •Use of enzyme-inducing antiepileptic drugs (EIAED) within 7 days prior to the first dose of study drug. Note: Levetiracetam (Keppra®) is not an EIAED and is allowed
- •Other concurrent clinically active malignant disease, requiring treatment, with the exception of non-melanoma cancers of the skin or carcinoma in situ of the cervix or nonmetastatic prostate cancer
- •Nursing or pregnant females
- •Prior exposure to veledimex
- •Use of medications that induce, inhibit, or are substrates of CYP4503A4 within 7 days prior to veledimex dosing without consultation with the Medical Monitor
- •Presence of any contraindication for a neurosurgical procedure
- •Unstable or clinically significant concurrent medical condition that would, in the opinion of the Investigator or Medical Monitor, jeopardize the safety of a subject and/or their compliance with the protocol. Examples may include, but are not limited to, colitis, pneumonitis, unstable angina, congestive heart failure, myocardial infarction within 2 months of screening, and ongoing maintenance therapy for life-threatening ventricular arrhythmia or uncontrolled asthma
研究组 & 干预措施
Ad-RTS-hIL-12 + veledimex
Intratumoral Ad-RTS-hIL-12 and oral veledimex
干预措施: Ad-RTS-hIL-12 (Biological)
Ad-RTS-hIL-12 + veledimex
Intratumoral Ad-RTS-hIL-12 and oral veledimex
干预措施: veledimex (Drug)
结局指标
主要结局
Safety of Intratumoral Ad-RTS-hIL-12 and Oral Veledimex in Subjects With Recurrent or Progressive Glioblastoma Based on Evaluation of Adverse Events Summarized by Incidence, Intensity and Type of Adverse Event.
时间窗: From the first dose of study treatment until 30 days after the last dose of veledimex, lasting approximately 5 months.
Evaluation of adverse events as assessed by CTCAE v4.03. Adverse events will be summarized based on the incidence, intensity and type of adverse event.
Tolerability of Intratumoral Ad-RTS-hIL-12 and Oral Veledimex in Subjects With Recurrent or Progressive Glioblastoma Will be Assessed Based on Expected Dose Compliance
时间窗: Days 1 through 14 of each 21-day treatment cycle, over a total treatment period of up to 6 cycles (approximately 4 months)
The Day 0 (as applicable), and Day 1 doses of veledimex were administered by study personnel at the study center. Thereafter, subjects could self-administer the remaining once daily dose of veledimex. Subjects were instructed to document veledimex dosing compliance in a subject diary, including the time each dose was taken, the time the subject ate the last meal prior to administration of veledimex, the number of capsules taken, whether the subject missed any veledimex doses, and reason for any missed doses. Investigational product container(s) with any remaining capsules were returned to the study staff on Day 15, and staff assessed dose compliance.
次要结局
- Determine the Overall Survival (OS) of Ad-RTS-hIL-12 + Veledimex(From the first dose of study drug for up to 2 years.)
- Veledimex Pharmacokinetic Profile: Maximum Plasma Concentration (Cmax)(15 days)
- Veledimex Pharmacokinetic Profile: Time to Maximum Plasma Concentration (Tmax)(15 days)
- Veledimex Pharmacokinetic Profile: Half-life (t1/2)(15 days)
- Veledimex Pharmacokinetic Profile: Area-under-the-concentration Versus Time Curve (AUC)(15 days)
- Veledimex Pharmacokinetic Profile: Volume of Distribution (Vd)(15 days)
- Veledimex Pharmacokinetic Profile: Clearance (CL)(15 days)
- Veledimex Concentration Ratio Between the Brain Tumor and the Blood(Day 0 (at the time of tumor resection))
- Tumor Objective Response Rate (ORR)(48 weeks)
- Progression Free Survival (PFS)(From the first dose of study drug for up to 2 years.)
- Rate of Pseudo-progression (PSP)(From the first dose of study drug for up to 2 years.)
- Changes From Baseline in Cellular Responses Elicited by Ad-RTS-hIL-12 and Veledimex(Baseline and Week 6.)
- Peak Serum Concentration of Interleukin-12 (IL-12)(Samples were collected at Baseline (Day 1), Day 3, Day 8, and Day 15 of Cycle 1, and at the 30-day follow-up visit.)
- Peak Serum Concentration of Interferon-gamma (IFN-γ)(Samples were collected at Baseline (Day 1), Day 3, Day 8, and Day 15 of Cycle 1, and at the 30-day follow-up visit)