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EG-70 in Patients With BCG-Unresponsive NMIBC (LEGEND STUDY)

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ClinicalTrials.gov Identifier: NCT04752722
Recruitment Status : Recruiting
First Posted : February 12, 2021
Last Update Posted : March 17, 2021
Sponsor:
Information provided by (Responsible Party):
enGene, Inc.

Brief Summary:
This open-label, multicenter study will evaluate the safety and efficacy of intravesical administration of EG-70 and its effect on bladder tumors in patients with NMIBC who have failed BCG therapy and are recommended for radical cystectomy. This study study consists of two parts, a dose-escalation Phase (Phase 1) to establish safety and recommended phase 2 dose (RP2D), followed by a Phase 2 efficacy study at the RP2D to establish efficacy.

Condition or disease Intervention/treatment Phase
Superficial Bladder Cancer Drug: EG-70 Phase 1 Phase 2

Detailed Description:
EG-70 is a novel non-viral gene therapy. EG-70 is designed to elicit a local immune response following delivery of gene therapies to mucosal tissues, such as the bladder urothelium. This approach of local administration through bladder instillation has the potential to induce a potent immune response exclusively at the site of the tumor, resulting in greater therapeutic benefit while reducing undesirable systemic toxicity.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 124 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2 Study of EG-70 as an Intravesical Administration to Patients With BCG Unresponsive Non-Muscle Invasive Bladder Cancer (NMIBC)
Estimated Study Start Date : March 2021
Estimated Primary Completion Date : July 2024
Estimated Study Completion Date : February 2026

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bladder Cancer

Arm Intervention/treatment
Experimental: Phase 1
Dose escalation phase
Drug: EG-70
Patients will receive one cycle of EG-70 administered as a bladder instillation of a 50 mL volume of study drug via catheter with a targeted retention time of 60 minutes. One cycle is defined by 2 intravesical administrations separated by 1 week, and followed by another 10 weeks (1 cycle lasts approximately 12 weeks).
Other Name: Phase 1

Experimental: Phase 2
Recommended Phase 2 dose, up to 4 cycles of treatment with EG-70
Drug: EG-70
Patients will receive up to 4 cycles of EG-70 administered as a bladder instillation of a 50 mL volume of study drug via catheter with a targeted retention time of 60 minutes. One cycle is defined by 2 intravesical administrations separated by 1 week, and followed by another 10 weeks (1 cycle lasts approximately 12 weeks).
Other Name: Phase 2




Primary Outcome Measures :
  1. Phase 1: Nature, incidence, relatedness, and severity of all AEs and SAEs according to the CTCAE v5.0. [ Time Frame: Approximately 2 years ]
    The type, incidence, relatedness and severity of treatment emergent adverse events of EG-70 as assessed by NCI-CTCAE V5.0 will be monitored.

  2. Phase 2: Percentage of patients with cystoscopic CR at 48 weeks, based on exam, urine cytology and appropriate biopsies. [ Time Frame: Approximately 48 weeks ]
    Complete response rate will be measured by determining the number of patients without recurrence of high-grade disease.

  3. Phase 2: Nature, incidence, relatedness, and severity of treatment emergent adverse events (as assessed by CTCAE v5.0) [ Time Frame: Approximately 3 years ]
    The type, incidence, relatedness and severity of treatment emergent adverse events of EG-70 as assessed by NCI-CTCAE V5.0 will be monitored.


Secondary Outcome Measures :
  1. Phase 1: The number of patients who experience a DLT through the end of Cycle 1 [ Time Frame: Approximately 1 year ]
    To identify the number of patients who experience a DLT through the end of Cycle 1

  2. Phase 1: CR rate to EG-70 by cystoscopy at approximately 12 weeks. [ Time Frame: Approximately 12 weeks ]
    To evaluate preliminary efficacy of EG-70 by 12 weeks via cystoscopy

  3. Phase 2: Progression-free survival (PFS) [ Time Frame: Approximately 4 years ]
    To evaluate disease-free survival rate.

  4. Phase 2: CR rate at 12, 24, 36, and 96 weeks [ Time Frame: Approximately 12, 24, 36, and 96 weeks ]
    To further evaluate CR at the efficacy analysis following each cycle.

  5. Phase 2: Duration of response of the responding patients [ Time Frame: Approximately 3 years ]
    Durability will be measured by determining the number of patients without recurrence of high-grade disease.



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

Inclusion Criteria:

  1. BCG-unresponsive NMIBC with carcinoma in situ (CIS) with or without resected papillary tumors who are indicated for, ineligible for, or have elected not to undergo cystectomy:

    1. persistent high-grade disease (Ta, T1, or Tis) or recurrence within 6 months of receiving at least 2 courses of intravesical BCG (at least 5 of 6 induction doses and at least 2 of 3 maintenance doses).
    2. T1 high grade disease residual at the first evaluation following induction BCG (at least 5 of 6 doses).
  2. Patients who have previously been treated with an investigational or approved checkpoint inhibitor (e.g. pembrolizumab) and failed treatment are eligible for inclusion 30 days post-treatment (Phase 1) or 3 months post-treatment (Phase 2).
  3. Male or non-pregnant, non-lactating female, 18 years or older.
  4. Women of childbearing potential must have a negative pregnancy test at Screening. A female patient is considered to be of child-producing potential unless she:

    1. has had a hysterectomy or bilateral oophorectomy or
    2. is age ≥ 60 years and is amenorrhoeic or
    3. is age < 60 years and has been amenorrhoeic for ≥ 12 months (including no irregular menses or spotting) in the absence of any medication which induces a menopausal state and has documented ovarian failure by serum oestradiol and follicle-stimulating hormone levels within the institutional laboratory postmenopausal range).
  5. All patients of childbearing potential must be willing to consent to using effective double-barrier contraception, i.e., intrauterine device, birth control pills, depo-provera, and condoms while on treatment and for 3 months after their participation in the study ends.
  6. Performance Status: Eastern Cooperative Oncology Group (ECOG) 0, 1, and 2.
  7. Hematologic inclusion within 2 weeks of start of treatment:

    1. Absolute neutrophil count >1,500/mm3.
    2. Hemoglobin >9.0 g/dl.
    3. Platelet count >100,000/mm3.
  8. Hepatic inclusion within 2 weeks of Day 1:

    1. Total bilirubin must be ≤1.5 x the upper limit of normal (ULN).
    2. Adequate renal function with creatinine clearance >30 mL/min (measured using Cockcroft-Gault equation or the estimated glomerular filtration rate from the Modification of Diet in Renal Disease Study).
    3. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 x ULN for the institution, alkaline phosphatase ≤2.5 x ULN for the institution, unless bone metastasis is present in the absence of liver metastasis.
  9. Prothrombin time and partial thromboplastin time within the normal limits at Screening.
  10. Must have satisfactory bladder function with ability to retain study drug for a minimum of 60 minutes.
  11. Must be willing and able to comply with all protocol requirements.
  12. Must be willing and able to give informed consent and any authorizations required by local law for participation in the study.

Exclusion Criteria:

  1. Any other malignancy diagnosed within 1 year of study entry (except basal or squamous cell skin cancers or noninvasive cancer of the cervix) is excluded.
  2. Concurrent treatment with any chemotherapeutic agent.
  3. Treatment with pembrolizumab within 30 days (Phase 1) or 3 months (Phase 2) prior to Screening.
  4. Treatment with last therapeutic agent within 30 days of Screening (Phase 1 and Phase 2) or treatment with an investigational checkpoint inhibitor within 3 months of Screening (Phase 2 only).
  5. Women who are pregnant or lactating.
  6. History of vesicoureteral reflux or an indwelling urinary stent.
  7. Participation in any other research protocol involving administration of an investigational agent within 1 month prior to Day 1.
  8. History of radiation to the pelvis.
  9. History of interstitial lung disease and/or pneumonitis in patients who have previously received a PD-1 or PD-L1 inhibitor therapy.
  10. Evidence of metastatic disease.
  11. History of difficult catheterization that in the opinion of the Investigator will prevent administration of EG-70.
  12. History of interstitial cystitis.
  13. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
  14. Known human immunodeficiency virus (HIV), Hepatitis B, or Hepatitis C infection.
  15. Significant cardiovascular risk (e.g., coronary stenting within 8 weeks, myocardial infarction within 6 months).

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): NCT04752722


Contacts
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Contact: Bao Le 5143324888 clinicaltrials@engene.com
Contact: Loraine Warner 5143324888 clinicaltrials@engene.com

Locations
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United States, New Jersey
New Jersey Urology, LLC Recruiting
Voorhees, New Jersey, United States, 08043
Sponsors and Collaborators
enGene, Inc.
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Responsible Party: enGene, Inc.
ClinicalTrials.gov Identifier: NCT04752722    
Other Study ID Numbers: EG-70-101
First Posted: February 12, 2021    Key Record Dates
Last Update Posted: March 17, 2021
Last Verified: February 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by enGene, Inc.:
Non-muscle invasive bladder cancer (NMIBC)
Bacillus calmette- guerin (BCG) failure
BCG unresponsive
NMIBC
Bladder Cancer
LEGEND Study
EG-70
Additional relevant MeSH terms:
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Urinary Bladder Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Urinary Bladder Diseases
Urologic Diseases