GOAT; Phase I Open Label Study of CGTG-102, a GM-CSF Encoding Oncolytic Adenovirus, for Advanced Cancers
Oncolytic viruses are viruses that can be found in nature, but they have been modified so that they can no longer multiply in normal cells. These viruses "infect" cancer cells and kill them. Once the cancer cell dies thousands of the viruses are released and can potentially infect other cancer cells in the area. The effects of oncolytic viruses on the tumor are felt to be the result of a combination of the oncolytic viruses directly killing the tumor cells as well as the patient's immune system killing cancer cells that are infected with the oncolytic virus.
Modern oncolytic viruses have been used for treatment of thousands of patients. The safety of such treatments has been good and there have been no deaths caused by treatment with oncolytic viruses. Many patients have benefited from the treatment in the sense that their tumors have stopped growing, become smaller or even completely disappeared. Some benefits are temporary, but about one third of patients seem to gain longer lasting benefit likely to impact survival. The effect of oncolytic viruses on improving survival has not been demonstrated yet.
Oncolytic viruses can be created from many different types of viruses. In this study the investigators are using an oncolytic virus created from an adenovirus. Adenoviruses are the types of viruses that cause the common cold and the flu. Because replication in normal cells does not take place, these oncolytic viruses should not cause any diseases in normal cells. Further, to date there has been no incidence of passing the virus on to other humans from patients who were treated with oncolytic viruses.
The purpose of this study is to see the highest dose of CGTG-102 (the oncolytic virus being used in this study) that can safely be given to subjects. The investigators will also evaluate whether or not the CGTG-102 is helpful in reducing the size of the cancer and improving patient survival.
|Study Design:||Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||GOAT; Phase I Single-Center Open Label Dose Escalation Study of CGTG-102, a GM-CSF Encoding Oncolytic Adenovirus, for Therapy of Advanced Cancers|
- Safety of CGTC-102 in patients with solid tumors [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]To assess the safety of the maximum tolerated dose and/or maximum feasible dose of CGTG-102 administered by intratumoral injection in a patient population with unresectable, refractory solid tumors
- Efficacy of CGTC-102 in patients with solid tumors [ Time Frame: 28 days ] [ Designated as safety issue: No ]To determine the maximum tolerated dose and/or maximum feasible dose of CGTG-102 administered by intratumoral injection in a patient population with unresectable, refractory solid tumors
- Development of tumor following the injection [ Time Frame: 43 days ] [ Designated as safety issue: No ]To measure the development of adenovirus and tumor specific humoral responses following virus injection
- Development of cellular immune response following the injection [ Time Frame: 43 days ] [ Designated as safety issue: No ]To measure the development of cellular immune responses following virus injection
CGTG-102 is an oncolytic adenovirus
Dose Level 1: 3x10^10 VP/injection
Dose Level 2: 1x10^11 VP/injection
Dose Level 3: 3x10^11 VP/injection
Patients will receive 4 administrations of CGTG-102 (on days 1, 4, 8, 15).
Escalation to the next dose level will occur when the safety of all 4 administrations has been evaluated at day 43 on all patients in the preceding dose level.
The total dose will be injected into up to 10 tumors injectable by either direct visualization/palpitation and/or ultrasound. Typically, the largest safely injectable tumors are chosen.
Injections will be performed by a radiologist or other trained physician. Injections will be planned based on the baseline PET-CT: only PET-positive tumors or tumor regions should be injected. Injection needles designed for percutaneous insertion into tissues will be used.
Pre-treatment visit - subject will undergo a physical examination with vital signs, a blood sample will be taken and a PET (Positron emission tomography)-CT (Computer tomography) scan will be performed.
Thereafter, there will be 4 visits with injections performed on trial days 1, 4, 8 and 15.
The injections are given directly into the tumors with help from using an ultrasound. The total dose of oncolytic virus the subject will receive will be divided into 1-10 injections which will be injected into individual tumors in the body. The maximum number of tumors that can be injected for one treatment will be 10 tumors.
STUDY VISIT 1:
On the day 1 visit, blood samples will be taken as well as two biopsies from one of the tumors. In addition pleural fluids (fluids from the chest) or ascites (fluids from abdominal walls) may be collected if possible. Then the subject will receive the first set of injections with CGTG-102. Before the injections, the subject may be given a dose of Tylenol.
STUDY VISIT 2:
On the day 4 visit, in addition to blood samples being taken the subject will receive a second round of intratumoral injections into the same tumors selected for injections on day 1. Urine will also be collected right before the subject goes home.
STUDY VISIT 3:
The day 8 visit is identical to the day 4 visit. The same blood samples and urine sample are taken.
STUDY VISIT 4:
On the day 15 visit blood samples and a urine sample will be taken as well as a biopsy from one of the tumors.
Subjects will have to stay overnight at the hospital after each treatment.
A follow-up visit will be scheduled on days 29 where only blood samples and a urine sample will be taken.
The end of trial visit is scheduled around day 43 where in addition to lab samples a PET-CT scan will be performed.
Following day 43 the subject will be contacted by study staff at 6 week intervals for 3 months, then at 3 month intervals for up to one year and yearly thereafter.