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JOURNAL ONKOLOGIE – STUDIE

START: Safety and Anti-Tumor Activity of PeptiCRAd-1 in Treatment of Cancer

Rekrutierend

NCT-Nummer:
NCT05492682

Studienbeginn:
Februar 2023

Letztes Update:
12.01.2024

Wirkstoff:
PeptiCRAd-1, Cyclophosphamide, Pembrolizumab

Indikation (Clinical Trials):
Triple Negative Breast Neoplasms, Liposarcoma, Sarcoma, Synovial, Liposarcoma, Myxoid

Geschlecht:
Alle

Altersgruppe:
Erwachsene (18+)

Phase:
Phase 1

Sponsor:
Valo Therapeutics Oy

Collaborator:
-

Kontakt

Studienlocations
(3 von 3)

Onkologisches Zentrum Krankenhaus Nordwest
Steinbacher Hohl 2-26
60488 Frankfurt am Main
DeutschlandRekrutierend» Google-Maps
National Center for Tumor Diseases
Heidelberg
(Baden-Württemberg)
GermanyRekrutierend» Google-Maps
Viszeralonkologisches Zentrum Universitätsklinikum Tübingen
Hoppe-Seyler-Straße 3
72076 Tübingen
DeutschlandRekrutierend» Google-Maps

Studien-Informationen

Detailed Description:

This is a Phase I, open-label, non-randomized, first-in-human study. All patients will be

pre-treated with a low dose of intravenous (i.v.) Cyclophosphamide (CPO) followed by

monotherapy doses of PeptiCRAd-1. Patients will receive a total of 6 doses of PeptiCRAd-1

during the study. PeptiCRAd-1 will be administered by intratumoral (i.t.) injection with

priming doses administered on Days 1, 4, and 8, and the first booster dose on Day 15,

followed by combination therapy with PeptiCRAd-1 and i.v. CPI (pembrolizumab).

Ein-/Ausschlusskriterien

Inclusion Criteria:

1. Written informed consent.

2. Male or female, ≥18 years of age.

3. Patients with any 1 of the following histologically confirmed tumors and who qualifies

for new or continued CPI therapy and relapsing to/after standard therapy or the

patient has refused or does not tolerate standard therapy:

- Inoperable/metastatic cutaneous malignant melanoma

- Relapsed or newly diagnosed locally advanced inoperable/metastatic TNBC

- Inoperable advanced/metastatic non-squamous NSCLC

- Inoperable and/or advanced Synovial or myxoid round cell sarcoma

- Inoperable and/or advanced colorectal cancer, patients assessed as positive for

NY-ESO-1 or MAGE-A3 expression at baseline

4. Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST)

1.1.

5. Tumor lesion which is deemed feasible for biopsy and injection

6. ECOG/WHO performance status 0 to 1.

7. Acceptable liver and renal function, defined as:

- Total bilirubin ≤1.5 x upper limit of normal (ULN; does not include patients with

Gilbert's Disease), and

- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3.0 x ULN,

and

- Serum creatinine ≤1.5 x ULN

8. Acceptable hematological function, defined as:

- Hemoglobin ≥10 g/dL, and

- Neutrophils ≥1.5 x 109/L, and

- Platelet count ≥100 x 109/L Patients may be transfused to meet the hemoglobin

entry criteria.

9. Acceptable coagulation status defined by international normalized ratio (INR) of blood

clotting, prothrombin time and activated partial thromboplastin time within ≤1.5 x

upper limit of normal.

10. Negative pregnancy test at screening in all women of childbearing potential (WOCBP).

Such patients must agree to use a highly effective method of contraception (Appendix

1) during study intervention and for 3 months after the last virus treatment, 4 months

after the last dose of pembrolizumab, and 12 months after CPO dosing. Male patients

and male partners of female patients must also use barrier contraception, i.e.,

condom, for the time periods specified for WOCBP, plus a further 3 month period.

Urine pregnancy tests should have a sensitivity of at least 25 mIU/mL for human

chorionic gonadotropin (hCG). If the urine test is positive, it must be followed by a

quantitative analysis of hCG concentration in blood.

11. Prior therapy with an immune CPI is allowed provided a 6-week washout period is

observed for patients with prior programmed cell death (PD)1 or PDL1 treatment

Exclusion Criteria:

1. Receipt of any oncolytic virus treatment, or administration of a vaccine containing

live virus within 4 weeks before Day 1.

2. Use of significant immunosuppressive medication, including high dose corticosteroid

(defined as the equivalent of >10 mg/day prednisone) within 4 weeks before Day 1.

Inhaled or topical corticosteroid use is allowed.

3. Prior or concomitant radiotherapy within 4 weeks before Day 1.

4. Participation in a study with an investigational drug or device within 4 weeks prior

to Day 1.

5. Active bacterial, viral, or fungal infection that requires systemic therapy.

6. Active autoimmune disease that has required systemic treatment in the past two years.

7. Concomitant disease or condition that could interfere with the conduct of the study,

or that would, in the opinion of the investigator, pose an unacceptable risk to the

patient, if included in this study.

8. Any concomitant medical condition requiring receipt of a therapeutic anticoagulant

that, in the opinion of the treating physician, cannot safely be withheld to allow for

repeated injection of PeptiCRAd 1 and tumor biopsies.

9. Known infection with human immunodeficiency virus, hepatitis B, or hepatitis C or

active tuberculosis.

10. Known active central nervous system metastases. Patients with leptomeningeal disease,

carcinomatous meningitis, symptomatic brain metastases, or radiographic signs of CNS

hemorrhage are excluded.

Note: Participants with asymptomatic brain metastases (i.e. off corticosteroids and

anticonvulsants for at least 7 days) are permitted.

11. Any prior severe AE according to Common Terminology Criteria for Adverse Events

(CTCAE), severe hypersensitivity reaction attributed to prior anti-PD1 or PDL1 therapy

or components of the study intervention or has a history of any contraindication that,

in the investigator's opinion, would contraindicate pembrolizumab administration such

as:

- Resolution of side effect of prior anti-PD1 or PDL1 therapy to Grade 1

- Grade 2 or higher pneumonitis

- Grade 4 AST or ALT elevation

- Grade 3 or higher colitis attributable to immunotherapy Note: in the absence of

clinical symptoms of pancreatitis, elevations of amylase or lipase are not

contraindications to therapy on this trial.

12. History of or planned tissue / organ transplant.

13. Females who are pregnant or breast feeding or expecting to conceive within the

projected duration of the study starting with the screening visit or males expecting

to father children within the projected duration of the study starting with the

screening visit.

14. Unwillingness or inability to comply with the study protocol for any reason.

15. Admission to an institution by virtue of an order issued by the judicial or

administrative authorities.

16. Sponsor or Contract Research Organization employees, or employees under the direct

supervision of the investigator or the investigational sites and/or involved directly

in the study.

17. Prior or concurrent malignancy, unless the natural history or treatment of the disease

does not have the potential to interfere with the safety or efficacy assessment of the

investigational regimen.

Studien-Rationale

Primary outcome:

1. Measurement of Safety and tolerability indexes (Incidence of TEAEs, SAEs and DLTs as assessed by CTCAE version 5.0 and changes in assessed safety parameters) for PeptiCRAd-1 monotherapy. (Time Frame - From study protocol day 1 (baseline) until 1 month):
The incidence and characteristics of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs) and dose-limiting toxicities (DLTs) will be assessed by CTCAE version 5.0 and changes from baseline in assessed safety parameters (Hematology tests, Clinical Chemistry safety tests, urine analysis ECOG/WHO performance status, vital signs) are measured in patients receiving PeptiCRAd-1 monotherapy in order to evaluate the safety and tolerability.

2. Measurement of Safety and tolerability indexes (Incidence of TEAEs, SAEs and DLTs as assessed by CTCAE version 5.0 and changes in assessed safety parameters) for PeptiCRAd-1 and CPI combination. (Time Frame - From first month through study completion, an average of 4.5 months.):
The incidence and characteristics of TEAEs, SAEs and DLTs will be assessed by CTCAE version 5.0 and changes from baseline in assessed safety parameters (Hematology tests, Clinical Chemistry safety tests, urine analysis ECOG/WHO performance status, vital signs) are measured in patients receiving PeptiCRAd-1 and CPI combination in order to evaluate the safety and tolerability.

Secondary outcome:

1. Measurement of New York Esophageal Squamous Cell Carcinoma-1 (NY-ESO-1) and Melanoma-associated antigen 3 (MAGE A3) specific T-cells in peripheral blood. (Time Frame - Change from Baseline through study completion, an average of 5 months.):
Presence vs. no presence of cellular immune response.

2. Measurement of NY-ESO-1 and MAGE A3 antibodies in serum. (Time Frame - Change from Baseline to an average of 3,5 months):
Presence vs. no presence of humoral response.

3. To determine the number of tumor infiltrating lymphocytes (TILs) in tumor mass. (Time Frame - Change from Baseline to an average of 3 months):
Number of TILs in tumor biopsies.

4. To determine objective response rate (ORR). (Time Frame - Change from Baseline through study completion, an average of 5 months.):
Objective responses according to RECIST 1.1, iRECIST, itRECIST and PERCIST 1.0.

5. To determine overall survival. (Time Frame - Change from Baseline through study completion, an average of 5 months.):
Overall survival presented in Kaplan-Meier plot.

6. Correlation between immune activation in peripheral blood and tumor mass and clinical outcome. (Time Frame - Change from Baseline through study completion, an average of 5 months.):
Correlation between immune activation (immunological variables) in peripheral blood and tumor mass and clinical outcome (ORR, OS).

Geprüfte Regime

  • PeptiCRAd-1:
    All patients will receive 6 doses of PeptiCRAd-1.
  • Cyclophosphamide:
    All patients will be pre-treated with one single dose of Cyclophosphamide.
  • Pembrolizumab:
    All patients will receive 6 doses of Pembrolizumab within the study.

Quelle: ClinicalTrials.gov


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