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Trial record 2 of 2 for:    LOAd703

Trial Investigating an Immunostimulatory Oncolytic Adenovirus for Cancer

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ClinicalTrials.gov Identifier: NCT03225989
Recruitment Status : Not yet recruiting
First Posted : July 21, 2017
Last Update Posted : July 21, 2017
Sponsor:
Collaborator:
Information provided by (Responsible Party):

Study Description
Brief Summary:

This Phase I/II trial evaluates LOAd703 in patients with cancer (pancreatic, biliary, colorectal or ovarian) together with their standard of care chemotherapy or using gemcitabine immune-conditioning. LOAd703 is administered by intratumoral image-guided injections. Maximum 50 patients can be enrolled.

LOAd703 is an immunostimulatory gene therapy using an selection replication competent adenovirus as a gene vehicle. The virus is derived from serotype 5 adenovirus with the fiber from serotype 35. It expresses the transgenes trimerized membrane-bound isoleucine zipper (TMZ) TMZ-CD40L and 41BBL under control of a cytomegalovirus (CMV) promoter.


Condition or disease Intervention/treatment Phase
Pancreatic Adenocarcinoma Ovarian Cancer Biliary Carcinoma Colorectal Cancer Drug: LOAd703 Phase 1 Phase 2

Detailed Description:
The trial is a Phase I/II trial evaluating the effect of LOAd703 in patients with pancreatic cancer, biliary cancer, ovarian cancer and colorectal cancer. LOAd703 is an oncolytic adenovirus serotype 5/35 encoding immunostimulatory transgenes: TMZ-CD40L and 41BBL. In Phase I, three doses (total viral load - 1x10e11, 5x10e11, 1x10e12 viral particles (VP)) of LOAd703 will be tested as add-on to standard of care or immune-conditioning gemcitabine chemotherapy. 12 treatments of LOAd703 will be delivered by image-guided intratumoral injection at the same time of chemotherapy. In Phase II stage of the study, patients will be treated at maximum tolerated dose/maximum tolerated study dose as defined in the Phase I stage. In both phases: tumor biopsies, blood samples and radiological imaging will be performed to evaluate safety, effect and mechanisms of action. A selection of patients in Phase II (n=15) will be subjected to oral swabs, and urine sampling to determine virus shedding. The patients will be monitored for time to progression, progression free survival and overall survival.

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I/II Trial Investigating an Immunostimulatory Oncolytic Adenovirus for Cancer
Anticipated Study Start Date : October 1, 2017
Estimated Primary Completion Date : May 1, 2020
Estimated Study Completion Date : November 1, 2020

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: LOAd703
LOAd703 oncolytic adenovirus administered add-on to standard of care chemotherapy or gemcitabine immune-conditioning if standard of care is no longer an option (e.g. after last line)
Drug: LOAd703
Oncolytic adenovirus serotype 5/35 encoding TMZ-CD40L and 4-1BBL


Outcome Measures

Primary Outcome Measures :
  1. Safety: Toxicity symptoms graded according to CTCAE v4.x. [ Time Frame: Up to 50 weeks ]
    Toxicity symptoms graded according to CTCAE v4.x.

  2. Tolerability: Immune reactions to LOAd703 virus as assessed by anti-adenovirus Ig ELISA [ Time Frame: Up to 50 weeks ]
    Immune reactions to LOAd703 virus as assessed by anti-adenovirus Ig ELISA


Secondary Outcome Measures :
  1. Response on tumor size [ Time Frame: Up to 50 weeks ]
    Local and distant anti-tumoral size changes assessed by appropriate imaging accordingly to RECIST 1.1

  2. Overall survival [ Time Frame: From registration date to date of death, assessed up to 40 months ]
    Months of survival from registration

  3. Time to progression [ Time Frame: From registration date to date of progression, assessed up to 40 months ]
    Time to progression from registration

  4. Progression free survival [ Time Frame: From registration date to date of progression, or date of death, which ever came first, assessed up to 40 months ]
    Months of progression free survival from registration

  5. Systemic immune activation [ Time Frame: Up to 50 weeks ]
    Cytokine relative increase in blood evaluated by cytokine array

  6. Immune cell activation [ Time Frame: Up to 50 weeks ]
    Upregulation of activation marker compared to baseline (fold change) evaluated by flow cytometry

  7. Presence LOAd703 virus in blood [ Time Frame: Up to 50 weeks ]
    LOAd703 virus particles (vp) detected in blood (VP/ml) investigated by quantitative PCR at several time points before and after LOAd703 virus treatment


Eligibility Criteria

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Have histologic or cytologic evidence of colorectal carcinoma (CRC), pancreatic carcinoma (PC), biliary cancer, or epithelial ovarian carcinoma (EOC which may encompass epithelial ovarian, fallopian tube or primary peritoneal carcinoma).
  2. Have advanced disease, defined as cancer that is either metastatic or locally advanced, unresectable, and for which radiotherapy or other locoregional therapies are not considered treatment of choice but systemic chemotherapy or no therapy is planned.
  3. Have one of the following treatment situations apply:

    1. Colorectal carcinoma (CRC) I. A patient with refractory or recurrent metastatic CRC who has either received all conventional therapy; or is entering a "resting" phase between reasonable conventional treatments. II. A patient who is amenable to treatment with LOAd703 plus gemcitabine as a single agent conditioning regimen.
    2. Pancreatic cancer I. A patient with either locally advanced, unresectable or metastatic disease who is eligible to receive any line of conventional treatment consisting of gemcitabine and/or nab-paclitaxel. II. A patient who is amenable to treatment with LOAd703 as an "add-on" to standard-of-care gemcitabine-based or nab-paclitaxel- based regimens or gemcitabine or nab-paclitaxel as single agents. c. Biliary cancer I. A patient with either locally advanced unresectable or metastatic biliary cancer who is either treatment-naïve or has received any number of lines of treatment. II. Patient who is amenable to treatment with LOAd703 as an "add-on" to standard-of-care treatment consisting of gemcitabine combined with other agents (e.g. gemcitabine/low-dose cisplatin, gemcitabine/oxaliplatin, etc) in the first line setting or gemcitabine in a combination regimen or as a single agent in latter lines of treatment. d. Ovarian Cancer I. A patient with either epithelial ovarian, fallopian tube or primary peritoneal carcinoma.

    II. The patient has either:

    i) Residual disease following first-line standard-of-care combination chemotherapy. ii) Platinum-sensitive disease (platinum free interval ≥ 6 months) in early relapse following first-line standard-of care combination chemotherapy. iii) A history of having received at least 3 lines of standard treatment. These treatments should have included bevacizumab and/or PARP inhibitors if they are reasonable candidates for such. III. Amenable to treatment with LOAd703 as an "add-on" to standard-of-care paclitaxel-based regimens (excluding bevacizumab), paclitaxel as a single agent, or gemcitabine as a single agent.

  4. Have a disease burden that is considered low (i.e. low tumor burden), which is defined on a patient-by-patient basis as per principal investigator's discretion. A rough guideline for defining low tumor burden is that the sum of the product of the bidimensional measurements for all lesions is < 70 cm2.
  5. Have a measurable disease by standard imaging techniques per RECIST criteria. Measurable lesions must be outside of any prior radiation field(s), unless disease progression has been documented at that disease site subsequent to radiation.
  6. At least one non-irradiated (or irradiated but disease progression documented at the site subsequent to radiation) lesion must be suitable for image-guided intratumoral injection and needle biopsy.
  7. Be medically suited to sedation if required during intratumoral injections.
  8. Be at least 18 years-old.
  9. Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2A.
  10. Have no acute toxic effects from previous anticancer therapy > grade 1 except for any grade of alopecia.
  11. Have adequate baseline organ/hematological function, as demonstrated by the following:

    1. Absolute neutrophil count (ANC) ≥1.0 x 109/l
    2. Hemoglobin ≥9 g/dl
    3. Platelet count ≥ 100 x 109/l
    4. Bilirubin < 1.5 times the institutional upper limit of normal (ULN)
    5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <2.5 (4, if liver metastases are present) times the institutional ULN.
    6. Serum creatinine <1.5 times the institutional ULN or calculated creatinine clearance >45 mL/min
    7. Prothrombin (INR)<1.5 or prothrombin time (PT) <1.5 ULN; and either partial thromboplastin time or activated partial thromboplastin time (PTT or aPTT) ≤ 1.5 times the ULN.
  12. The patient must understand and be willing to provide written informed consent.

Exclusion Criteria:

  1. Any concurrent treatment that would compromise the study including but not limited to continuous high dose corticosteroids (>0.5mg/kg), lymphodepleting antibodies or cytotoxic agents.
  2. Treatment with high dose immune inhibitors including lymphotoxic monoclonal antibodies such as alemtuzumab (CampathR), or sirolimus (RapamuneR) and its analogs, biological therapy, cytotoxic agents or any investigational agents within 21 days of registration.
  3. Ovarian carcinoma patients should not be eligible to PARP inhibitor treatment.
  4. Patients on warfarin are not eligible.
  5. Women who are pregnant, lactating, or planning to become pregnant during the study period, or women of childbearing potential who are not using acceptable contraceptive methods. A woman is considered of childbearing potential if she is not surgically sterile or is less than 1 year since last menstrual period. Acceptable contraceptive methods are: combined (estrogen and progesterone containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal), progesterone-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable), intrauterine device, intrauterine hormone-releasing system, bilateral tubal occlusion and vasectomized partner.
  6. Known active hepatitis B or C infection, or HIV infection.
  7. Patients with active autoimmune disease.
  8. Uncontrolled intercurrent illness including but not limited to psychiatric illness/social situations that in the opinion of the Investigator would compromise compliance of study requirements or put the patient at unacceptable risk.
  9. Other malignancies within the past 2 years (not including basal and squamous cell carcinoma of the skin, localized prostate cancer or in situ cervix carcinoma).
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03225989


Contacts
Contact: Gustav Ullenhag, MD PhD +46186110000 gustav.ullenhag@igp.uu.se

Locations
Sweden
Uppsala University Hospital Not yet recruiting
Uppsala, Sweden, 75185
Contact: Gustav Ullenhag, MD PhD    +46186110000    gustav.ullenhag@igp.uu.se   
Sponsors and Collaborators
Lokon Pharma AB
Uppsala University
Investigators
Study Chair: Angelica Loskog, PhD Lokon Pharma AB
More Information

Responsible Party: Lokon Pharma AB
ClinicalTrials.gov Identifier: NCT03225989     History of Changes
Other Study ID Numbers: LOKON002
First Posted: July 21, 2017    Key Record Dates
Last Update Posted: July 21, 2017
Last Verified: July 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: Yes

Additional relevant MeSH terms:
Colorectal Neoplasms
Adenocarcinoma
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type