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Trial of TG4023 Combined With Flucytosine in Liver Tumors
This study is currently recruiting participants.
Verified by Transgene, September 2009
First Received: September 15, 2009   Last Updated: September 17, 2009   History of Changes
Sponsor: Transgene
Information provided by: Transgene
ClinicalTrials.gov Identifier: NCT00978107
  Purpose

This trial is a phase I, open-label, dose-escalating study of the safety or percutaneous intra-tumoral injection of TG4023 (MVA-FCU1) combined with systemic administration of 5-fluorocytosine in patients with primary or secondary hepatic tumors.


Condition Intervention Phase
Hepatocellular Carcinoma
Biological: MVA-FCU1, flucytosine
Phase I

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety Study
Official Title: A Phase I, Open-label, Dose-escalating Study of the Safety or Percutaneous Intra-tumoral Injection of TG4023 (MVA-FCU1) Combined With Systemic Administration of 5-fluorocytosine in Patients With Primary or Secondary Hepatic Tumors.

Resource links provided by NLM:


Further study details as provided by Transgene:

Primary Outcome Measures:
  • Maximal tolerated dose [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Tumor response of injected and non-injected lesions Viral dissemination Proof of concept: 5-FU concentration in plasma and in tumors [ Time Frame: 1 year ] [ Designated as safety issue: No ]

Estimated Enrollment: 20
Study Start Date: September 2009
Estimated Study Completion Date: September 2010
Estimated Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Biological: MVA-FCU1, flucytosine
    1. TG4023: single IT injection; possibility to re-administer once,

      • Percutaneous IT injections, under radiological or ultrasound imaging guidance
      • Dose-escalating schedule of administration: 107 pfu (Cohort #1), 108 pfu (Cohort #2) and 4x108 pfu (Cohort #3),
      • MTD injected to up to 3 different lesions (Cohort #4)
    2. 5-FC (5-fluorocytosine)/flucytosine

      • Dose and dosing schedule:

        • Daily starting dose of 200 mg/kg; daily dose will be adjusted after measurement of 5-FC plasma concentration at steady state, which should be kept below 100 mg/L
        • Duration: 2 weeks.
      • Possible routes of administration:

        • PO: 500 mg tablets, qid
        • IV: 1% 250 mL vials, 45-minute infusions.
  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with advanced disease without any other standard of care treatment options:

    • hepatic metastases of colorectal cancer (CRC) or of other cancers
    • Hepatocellular carcinoma (HCC)
  • At least one unresectable target tumor located in the liver, measuring 2-5 cm and accessible to IT administration of TG4023 and amenable to radiological measurement using RECIST,
  • Weight ≤ 100 kg,
  • Patients with stable disease, who have to discontinue chemotherapy because of intolerance,
  • ECOG performance status ≤ 2,
  • Life expectancy ≥ 3 months,
  • Hematology:

    • Absolute neutrophil count > 1,500/mm3,
    • Hemoglobin > 9g/dL,
    • Platelet count > 100,000/mm3,
    • Prothrombin time international normalized ratio (INR) ≤ 2; partial thromboplastin time ≤ 1.66 times upper limit of normal (ULN),
  • Biochemistry:

    • Total bilirubin ≤ 3 x ULN,
    • Aspartate amino-transferase (AST), alanine amino-transferase (ALT), alkaline phosphatase

      • 5.0 x ULN,
    • Creatinin clearance ≥ 40 mL/min,
    • Total albumin ≥ 30 g/L,
  • Anti-vitamin K anticoagulants should have been switched for low-molecular weight heparin prior to TG4023 injection,
  • Signed, written Independent Ethics Committee (IEC)-approved informed consent.

Exclusion Criteria:

  • Child-Pugh stage C hepatic insufficiency,
  • Impaired renal function (creatinin clearance < 40 mL/min),
  • Known deficiency in dihydropyrimidine dehydrogenase (DPD) or total DPD deficiency diagnosed at baseline in those patients not previously treated with 5-FU-related compounds,
  • Ascites,
  • Brain metastases,
  • Significant impairment of gastro-intestinal (GI) tract absorption capacity, such as total gastrectomy, gastric mucosal atrophy, extensive intestinal resections or malabsorption disease will not be treated by oral 5-FC,
  • History of bleeding disorders,
  • Pregnant or breast-feeding women,
  • Human Immunodeficiency Virus (HIV) positive,
  • Chronic use of immunodepressants within 4 weeks prior to TG4023 injection or immune-depressed patients,
  • Hypersensitivity to 5-FC,
  • Hypersensitivity to egg proteins,
  • Concomitant or previous chemotherapy or targeted therapy within 4 weeks prior to TG4023 injection and last treatment with bevacizumab (Avastin®) within 2 months prior to TG4023 injection,
  • Concomitant treatment with anti-inflammatory drugs: systemic cortico-steroids and non-steroidal anti-inflammatory drugs (NSAIDs),
  • Prior gene therapy,
  • Prior participation in any other research protocol involving an IMP within 2 months prior to TG4023 injection,
  • Major surgery within 6 weeks of TG4023 injection,
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00978107

Contacts
Contact: Jean Emmanuel Kurtz, MD 33.388 12 84 36 J-Emmanuel.KURTZ@chru-strasbourg.fr

Locations
France
Hôpitaux Universitaires de Strasbourg Recruiting
Strasbourg, France, 67000
Contact: J Emmanuel Kurtz, MD     +33.(0)388 12 84 36     J-Emmanuel.KURTZ@chru-strasbourg.fr    
Principal Investigator: J Emmanuel Kurtz, MD            
Sub-Investigator: Patrick Dufour, MD            
Institut Paoli Calmette, Not yet recruiting
Marseille, France, 13000
Contact: Marc Giovannini, MD     +33.(0)491 22 37 40     giovanninim@wanadoo.fr    
Principal Investigator: Marc Giovannini, MD            
Sub-Investigator: Erwan Bories, MD            
Hôpitaux Civils de Lyon, Not yet recruiting
Pierre Benite, France, 69495
Contact: Véronique Trillet-Lenoir, MD     +33.(0)478 86 43 15     veronique.trillet-lenoir@chu-lyon.fr    
Sub-Investigator: Cécile Fournel-Federico, MD            
Centre René Gauducheau Not yet recruiting
SAINT HERBLAIN, France, 44800
Contact: Jaafar Bennouna, MD     +33.(0)240 67 99 00     j-bennouna@fnclcc.fr    
Principal Investigator: Jaafar Bennouna, MD            
Institut Claudius Regaud Not yet recruiting
Toulouse, France, 31000
Contact: Jean-Pierre Delord, MD     +33.(0)561 42 41 14     Delord.Jean-Pierre@claudiusregaud.fr    
Principal Investigator: Jean-Pierre Delord, MD            
Hôpitaux Civils de Colmar Not yet recruiting
Colmar, France, 68000
Contact: Fares Husseini, MD     +33.(0)389 12 41 04     fares.husseini@ch-colmar.rss.fr    
Principal Investigator: Fares Husseini, MD            
Sponsors and Collaborators
Transgene
  More Information

Publications:
Responsible Party: Hôpitaux Universitaires de Strasbourg ( Pr Jean-Emmanuel Kurtz )
Study ID Numbers: TG4023.01, Eudra CT 2008-005024-90
Study First Received: September 15, 2009
Last Updated: September 17, 2009
ClinicalTrials.gov Identifier: NCT00978107     History of Changes
Health Authority: France: Afssaps - French Health Products Safety Agency

Keywords provided by Transgene:
Hepatic tumors
Metastatic colorectal cancer

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Liver Diseases
Neoplasms by Histologic Type
Digestive System Neoplasms
Molecular Mechanisms of Pharmacological Action
Carcinoma, Hepatocellular
Flucytosine
Pharmacologic Actions
Carcinoma
Liver Neoplasms
Neoplasms
Neoplasms by Site
Digestive System Diseases
Therapeutic Uses
Antifungal Agents
Adenocarcinoma
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on February 08, 2010