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Study of Talimogene Laherparepvec In Children With Advanced Non CNS Tumors

This study is not yet open for participant recruitment.
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Verified May 2017 by Amgen
Sponsor:
Information provided by (Responsible Party):
Amgen
ClinicalTrials.gov Identifier:
NCT02756845
First received: December 15, 2015
Last updated: May 29, 2017
Last verified: May 2017
  Purpose
This is a phase 1 study to evaluate the safety of intralesional talimogene laherparepvec administration in pediatric subjects with advanced non-CNS tumors that are amenable to direct injection

Condition Intervention Phase
Advanced Non CNS Tumors Drug: Talimogene Laherparepvec Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Intervention Model Description:

Approximately 18 treated pediatric subjects are expected to be enrolled into 2 cohorts stratified by age (permissible based on the incidence of DLTs, a minimum of 6 subjects/cohort and a minimum of 18 subjects total).

  • Cohort A1 (12 to . 21 years of age)
  • Cohort B1 (2 to < 12 years of age) Initially, 3 subjects 12 to . 21 years of age are to be enrolled and treated at 100% of the recommended adult dose regimen of talimogene laherparepvec (cohort A1). dose level review team (DLRT) will review the safety data of the first 3 subjects in the olderage cohort A1 to decide if the younger age cohort B1 can be opened for enrollment. If a DLT occurs in the first 3 DLT-evaluable subjects in the older age cohort (A1 or A2), the younger age cohort will not open until a DLT rate < 33% is observed with at least 6 DLT-evaluable subjects in the older age cohort (A1 or A2).
Masking: No masking
Primary Purpose: Treatment
Official Title: A Phase 1, Multi-center, Open-label, Dose De-escalation Study to Evaluate the Safety and Efficacy of Talimogene Laherparepvec in Pediatric Subjects With Advanced Non Central Nervous System Tumors That Are Amenable to Direct Injection

Resource links provided by NLM:


Further study details as provided by Amgen:

Primary Outcome Measures:
  • Subject incidence of DLT [ Time Frame: At least 35 days from administration of talimogene laherpaprevec. ]
    To evaluatethe safety of talimogene laherparepvec, as assessed by incidence of dose-limiting toxicities (DLT)


Secondary Outcome Measures:
  • Subject incidence of adverse events. [ Time Frame: Start of treatment through 30 (+7) days after end of treatment. ]
  • Subject incidence of laboratory abnormalities [ Time Frame: Start of treatment through 30 (+7) days after end of treatment. ]
  • Overall Response Rate (ORR) [ Time Frame: Up to 24 months of treatment. ]
    Response evaluation by Investigator using irRC-RECIST.

  • Duration of Response (DOR) [ Time Frame: Up to 24 months of treatment ]
    Response evaluation by Investigator using irRC-RECIST.

  • Time to Response (TTR) [ Time Frame: Up to 24 months of treatment ]
    Response evaluation by Investigator using irRC-RECIST.

  • Time to Progression (TTP) [ Time Frame: Up to 24 months of treatment ]
    Response evaluation by Investigator using irRC-RECIST.

  • Progression-free Survival (PFS) [ Time Frame: Up to 24 months of treatment ]
    Response evaluation by Investigator using irRC-RECIST.

  • Overall Survival (OS) [ Time Frame: Up to 24 months of treatment ]

Estimated Enrollment: 18
Anticipated Study Start Date: July 28, 2017
Estimated Study Completion Date: December 20, 2021
Estimated Primary Completion Date: February 4, 2020 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Talimogene Laherparepvec (TVEC)
The first dose of talimogene laherparepvec will be administered at a dose of up to 4.0 mL of 10ᶺ6 PFU/mL followed by a dose of up to 4.0 mL of 10ᶺ8 PFU/mL 21 days (+3 days) later. Subsequent doses of up to 4.0 mL of 10ᶺ8 PFU/mL will be administered every 14 days (± 3 days) thereafter. Cohorts will be assigned as follows: Cohort A1 (age 12 to <=21 years). Cohort B1 (age 2 to < 12 years). The DLRT will review the safety data of the first 3 subjects in the older age cohort A1 to decide if the younger age cohort B1 can be opened for enrollment. If dose de-escalation is needed and if permissible based on the incidence of DLTs, additional DLT-evaluable subjects will be enrolled and treated at a lower dose level of talimogene laherparepvec. Dose de-escalation cohorts will be assigned as follows and the same DLT rules will be applied: Cohort A2 (age 12 to <=21 years), Cohort B2 (age 2 to < 12 years).
Drug: Talimogene Laherparepvec
Talimogene laherparepvec will be administered by intralesional injection only into injectable cutaneous, subcutaneous, nodal tumors, and other non-visceral tumors with or without image ultrasound guidance. The first dose of talimogene laherparepvec will be up to 4.0 mL of 10^6 PFU/mL administered on day 1. The second injection, up to 4.0 mL of 10^8 PFU/mL (or up to 4.0 mL of 10^6 PFU/mL for a dose de-escalated cohort), will be administered 21 (+3) days after the initial injection. All subsequent injections, up to 4.0 mL of 10^8 PFU/mL (or up to 4.0 mL of 10^6 PFU/mL for a dose de-escalated cohort), will be administered every 14 (± 3) days. The treatment cycle interval may be increased due to toxicity.
Other Name: TVEC

Detailed Description:
This is a phase 1, multicenter, open-label study of talimogene laherparepvec in pediatric subjects with advanced non-CNS tumors that are amenable to direct injection in the clinical setting. Approximately 18 treated pediatric subjects are expected to be enrolled into 2 cohorts stratified by age (permissible based on the incidence of DLTs, a minimum of 6 subjects/cohort and a minimum of 18 subjects total). DLT will be evaluated based on 6 to 12 DLT-evaluable subjects in each cohort. The DLT evaluation period is 35 days from the initial administration of talimogene laherparepvec.
  Eligibility

Ages Eligible for Study:   2 Years to 21 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subject's legally acceptable representative has provided informed consent/assent when the subject is legally too young to provide informed consent/assent and the subject has provided written assent based on local regulations and/or guidelines prior to any study-specific activities/procedures being initiated.
  • Should be willing to submit local HSV-1 serostatus within 28 days prior to enrollment.
  • Subject must be a candidate for intralesional injection, defined as one or more of the following:

    • at least 1 injectable lesion ≥ 10 mm in longest diameter • multiple injectable lesions that in aggregate have a longest diameter of ≥ 10 mm

  • Life expectancy > 4 months from the date of enrollment.
  • Male or female subjects 2 to ≤ 21 years of age at the time of informed consent/assent.
  • Histologically or cytologically confirmed non-CNS solid tumor that recurred after standard/frontline therapy, or for which there is no standard/frontline therapy available.
  • Presence of measurable or non-measurable lesions as defined by irRC-RECIST
  • Performance status as per protocol
  • Adequate organ function as per protocol.
  • Female subject of childbearing potential should have a negative urine or serum pregnancy test within 72 hours prior to dosing.

Exclusion Criteria:

  • Diagnosis of leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, or other hematologic malignancy.
  • Radiotherapy to the bone marrow within 6 weeks prior to enrollment OR within3 months prior to enrollment if prior radiotherapy to the craniospinal axis or to at least 60% of the pelvis was received; within 2 weeks prior to enrollment if local palliative radiotherapy was received.
  • CNS tumor or clinically active brain metastases.
  • Primary ocular or mucosal melanoma.
  • History or evidence of giant congenital melanocytic nevi, dysplastic nevis syndrome or xeroderma pigmentosum.
  • History of other malignancy within the past 5 years with the following exception:

    . malignancy treated with curative intent and with no known active disease present and has not received chemotherapy for > 5 years before enrollment and felt to be at low risk for recurrence by the treating physician.

  • History or evidence of active autoimmune disease that requires systemic treatment (ie, with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • Active herpetic skin lesions or prior complications of herpetic infection (eg, herpetic keratitis or encephalitis).
  • Prior treatment with talimogene laherparepvec or any other oncolytic virus.
  • Prior treatment with a tumor vaccine.
  • Requires intermittent or chronic treatment with an antiherpetic drug (eg, acyclovir), other than intermittent topical use.
  • Currently receiving treatment in another investigational device or drug study, or less than 28 days since ending treatment on another investigational device or drug study(ies). Other investigational procedures while participating in this study are excluded.
  • Major surgery . 28 days prior to enrollment.
  • Expected to require other cancer therapy while on study with the exception of local palliative radiation treatment.
  • Has acute or chronic active hepatitis B virus or hepatitis C virus infection or received treatment with nucleotide analogs such as those used in the treatment of hepatitis B virus (eg, lamivudine, adefovir, tenofovir, telbivudine, and entecavir), ribavirin, or interferon alpha within 12 weeks of initiation of study treatment.
  • Known or suspected human immunodeficiency virus (HIV) infection.
  • Received live vaccine within 28 days prior to enrollment.
  • No antiplatelet or anticoagulation medications allowed within 7 days prior to talimogene laherparepvec injection except low-dose heparin needed to maintain venous catheter patency.
  • Female subject is pregnant or breast-feeding, or planning to become pregnant during study treatment and through 3 months after the last dose of talimogene laherparepvec.
  • Female subject of childbearing potential who is unwilling to use acceptable method(s) of effective contraception during study treatment and through 3 months after the last dose of talimogene laherparepvec. Note: Acceptable methods of effective contraception are defined in the informed consent/assent form. Where required by local laws and regulations, additional country-specific contraception requirements may be outlined in a country-specific protocol supplement at the end of the Appendix Section of protocol.
  • Sexually active subjects and their partners unwilling to use a male or female latex condom to avoid potential viral transmission during sexual contact while on treatment and within 30 days after treatment with talimogene laherparepvec.
  • Subject has known sensitivity to any of the products or components to be administered during dosing.
  • Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures to the best of the subject and investigator's knowledge.
  • History or evidence of any psychiatric disorder, substance abuse or any other clinically significant disorder, condition or disease (with the exception of those outlined above) that, in the opinion of the investigator or Amgen physician, if consulted, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.
  • Subject who is unwilling to minimize exposure with his/her blood or other body fluids to individuals who are at higher risks for HSV-1 induced complications (immunosuppressed individuals, HIV-positive individuals, pregnant women, or children under the age of 1 year) during talimogene laherparepvec treatment and through 28 days after the last dose of talimogene laherparepvec.
  • Evidence of clinically significant immunosuppression
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT02756845

Contacts
Contact: Amgen Call Center 866-572-6436 medinfo@amgen.com

Locations
United States, Delaware
Research Site Recruiting
Wilmington, Delaware, United States, 19803
United States, Indiana
Research Site Recruiting
Indianapolis, Indiana, United States, 46202
United States, New York
Research Site Recruiting
New York, New York, United States, 10032
United States, Ohio
Research Site Recruiting
Columbus, Ohio, United States, 43205
Canada, Quebec
Research Site Recruiting
Montreal, Quebec, Canada, H3T 1C5
Spain
Research Site Recruiting
Barcelona, Cataluña, Spain, 08035
Research Site Recruiting
Esplugues de Llobregat, Cataluña, Spain, 08950
Research Site Recruiting
Valencia, Comunidad Valenciana, Spain, 46026
Research Site Recruiting
Madrid, Spain, 28009
Switzerland
Research Site Recruiting
Basel, Switzerland, 4056
Research Site Recruiting
Zurich, Switzerland, 8032
Sponsors and Collaborators
Amgen
Investigators
Study Director: MD Amgen
  More Information

Additional Information:
Responsible Party: Amgen
ClinicalTrials.gov Identifier: NCT02756845     History of Changes
Other Study ID Numbers: 20110261
2015-003645-25 ( EudraCT Number )
Study First Received: December 15, 2015
Last Updated: May 29, 2017

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Amgen:
Non CNS Tumor

ClinicalTrials.gov processed this record on June 23, 2017