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QUILT-3.091 NANT Chordoma Vaccine vs Radiation in Subjects With Unresectable Chordoma.

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ClinicalTrials.gov Identifier: NCT03647423
Recruitment Status : Withdrawn (Trial not initiated)
First Posted : August 27, 2018
Last Update Posted : May 14, 2019
Sponsor:
Information provided by (Responsible Party):
NantKwest, Inc.

Tracking Information
First Submitted Date  ICMJE August 9, 2018
First Posted Date  ICMJE August 27, 2018
Last Update Posted Date May 14, 2019
Estimated Study Start Date  ICMJE August 31, 2018
Estimated Primary Completion Date August 31, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: August 23, 2018)
  • Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03. [ Time Frame: 9 weeks ]
    Phase 1b primary endpoint
  • Progression-free survival (PFS) by RECIST v1.1 [ Time Frame: 1 years ]
    Phase 2 primary endpoint
Original Primary Outcome Measures  ICMJE Same as current
Change History Complete list of historical versions of study NCT03647423 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: August 23, 2018)
  • Objective response rate by RECIST v1.1 [ Time Frame: 9 weeks ]
    Phase 1b secondary endpoint
  • Objective response rate by irRC [ Time Frame: 9 weeks ]
    Phase 1b secondary endpoint
  • Progression-free survival (PFS) by RECIST v1.1 [ Time Frame: 9 weeks ]
    Phase 1b secondary endpoint
  • Progression-free survival (PFS) by irRC [ Time Frame: 9 weeks ]
    Phase 1b secondary endpoint
  • Overall survival [ Time Frame: 9 weeks ]
    Phase 1b secondary endpoint
  • Disease control rate by RECIST v1.1 and irRC. [ Time Frame: 1 year ]
    Phase 1b secondary endpoint
  • Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST v1.1 and irRC. [ Time Frame: 1 year ]
    Phase 1b secondary endpoint
  • Patient-reported outcomes of Chordoma cancer symptoms [ Time Frame: 1 year ]
    Phase 1b secondary endpoint (by RECIST v1.1 and irRC and FACT-Hep questionnaire)
  • Progression-free survival (PFS) by irRC [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Objective response rate by RECIST 1.1 [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Objective response rate by irRC [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Overall survival [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Duration of response by RECIST and irRC [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Disease control rate (confirmed complete response, partial response, or stable disease lasting for at least 2 months) by RECIST and irRC. [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Patient-reported outcomes of Chordoma cancer [ Time Frame: 1 year ]
    Phase 2 secondary endpoint
  • Incidence of treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs), graded using the NCI CTCAE Version 4.03. [ Time Frame: 1 year ]
    Phase 2 secondary endpoint by (RECIST v1.1 and irRC and FACT-Hep questionnaire)
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE QUILT-3.091 NANT Chordoma Vaccine vs Radiation in Subjects With Unresectable Chordoma.
Official Title  ICMJE QUILT-3.091 NANT Chordoma Vaccine: A Randomized Phase 1b/2 Trial of the NANT Chordoma Vaccine vs. Radiation in Subjects With Unresectable Chordoma.
Brief Summary QUILT 3.091 Chordoma Vaccine: Phase 1B/2 NANT Chordoma Vaccine vs Radiation in Subjects with Unresectable Chordoma.
Detailed Description

The NANT Chordoma Vaccine regimen will be administered in 2 phases, an induction and a maintenance phase.

Subjects will continue induction treatment for up to 1 year. Those who have a confirmed complete response (CR) in the induction phase will enter the maintenance phase of the study. Subjects who experience ongoing stable disease (SD) or an ongoing partial response (PR) at 1 year may enter the maintenance phase at the Investigator's and Sponsor's discretion. Subjects may remain in the maintenance phase of the study for up to 1 year.

In the randomized component of the phase 2 portion of the study, the control arm will be treated with radiation according to established SoC protocols as determined by the Investigator.

In the phase 2 single-arm component of the study, subjects will be enrolled in the first stage of Simon's two-stage optimal design. If the study proceeds to the second stage of Simon's two-stage optimal design, additional subjects will be enrolled in the second stage.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:
Chordoma Vaccine: A randomized phase 1b/2 trial of the NANT chordoma vaccine vs. radiation in subjects with unresectable chordoma.
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Chordoma
  • Unresectable Malignant Neoplasm
Intervention  ICMJE
  • Biological: Aldoxorubicin Hydrochloride
    Aldoxorubicin Hydrochloride HCI
  • Biological: ALT-803
    Recombinant human super agonist interleukin-15 (IL-15) complex
  • Biological: ETBX-051
    Ad5 [E1-, E2b-]-Brachyury
  • Biological: ETBX-061
    Ad5 [E1-, E2b-]-mucin 1 [MUC1]
  • Biological: GI-6301
    Brachyury yeast
  • Biological: haNK
    haNK™, NK-92 [CD16.158V, ER IL-2]
  • Drug: Avelumab
    injection
    Other Name: BAVENCIO®
  • Drug: Cetuximab
    Injection
    Other Name: ERBITUX®
  • Drug: Cyclophosphamide
    Capsules
    Other Name: Cytoxan
  • Radiation: SBRT
    Stereotactic body radiation therapy
Study Arms  ICMJE
  • Experimental: NANT Chordoma Vaccine
    A combination of agents will be administered to subjects in this study: Aldoxorubicin Hydrochloride HCI, ALT-803, ETBX-051, ETBX-061, GI-6301, haNK, avelumab, cetuximab, cyclophosphamide, SBRT.
    Interventions:
    • Biological: Aldoxorubicin Hydrochloride
    • Biological: ALT-803
    • Biological: ETBX-051
    • Biological: ETBX-061
    • Biological: GI-6301
    • Biological: haNK
    • Drug: Avelumab
    • Drug: Cetuximab
    • Drug: Cyclophosphamide
  • Active Comparator: Controlled Arm - Radiation
    SBRT
    Intervention: Radiation: SBRT
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Withdrawn
Actual Enrollment  ICMJE
 (submitted: May 10, 2019)
0
Original Estimated Enrollment  ICMJE
 (submitted: August 23, 2018)
427
Estimated Study Completion Date  ICMJE August 30, 2022
Estimated Primary Completion Date August 31, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Age ≥ 18 years.
  2. Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
  3. Histologically-confirmed recurrent or unresectable chordoma that would require radiation as a primary means for treatment.
  4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  5. Have at least 1 measurable lesion of ≥ 1.0 cm.
  6. Must have a recent formalin-fixed, paraffin-embedded (FFPE) tumor biopsy specimen following the conclusion of the most recent anticancer treatment and be willing to release the specimen for prospective and exploratory tumor molecular profiling. If an historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period, if considered safe by the Investigator. If safety concerns preclude collection of a biopsy during the screening period, a tumor biopsy specimen collected prior to the conclusion of the most recent anticancer treatment may be used.
  7. Must be willing to provide blood samples prior to the start of treatment on this study for tumor molecular profiling and exploratory analyses.
  8. Must be willing to provide a tumor biopsy specimen 8 weeks after the start of treatment for exploratory analyses, if considered safe by the Investigator.
  9. Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
  10. Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non- sterile male subjects must agree to use a condom for up to 4 months after treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), and abstinence.

Randomized component only - 11. Must be able to be classified into at least 1 of the below 3 categories: i. Recurred within 6 months after treatment, ii. Have metastatic disease, iii. Meet ≥ 4 of the histopathologic and immunohistochemical criteria: • Poorly differentiated histopathologic sub type, • Mitotic figures ≥ 3, • Apoptosis present. • Prominent nucleoli present, • Necrosis present, • Ki67 ≥ 6%, • p53 ≥ 25%

Single-arm component only 12. Must have progressed on or after radiation monotherapy in the randomized portion of the study OR been ineligible for the randomized portion but had progressed or experienced unacceptable toxicity on SoC prior to enrollment on the study.

Exclusion Criteria:

  1. Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
  2. Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis,Addison's disease, or autoimmune disease associated with lymphoma).
  3. History of organ transplant requiring immunosuppression.
  4. History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
  5. Inadequate organ function, evidenced by the following laboratory results: a. Absolute neutrophil count < 1,000 cells/mm^3, b. Uncorrectable grade 3 anemia (hemoglobin < 8 g/dL), c. Platelet count < 75,000 cells/mm^3, d. Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome), e. Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases), f. Alkaline phosphatase levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases), g. Serum creatinine > 2.0 mg/dL or 177 μmol/L, h. Serum anion gap > 16 mEq/L or arterial blood with pH < 7.3.
  6. Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication. Subjects with uncontrolled hypertension should be medically managed on a stable regimen to control hypertension prior to study entry.
  7. Serious myocardial dysfunction defined by ECHO as absolute left ventricular ejection fraction (LVEF) 10% below the institution's lower limit of predicted normal.
  8. Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.
  9. Positive results of screening test for human immunodeficiency virus (HIV).
  10. Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
  11. Known hypersensitivity to any component of the study medication(s).
  12. Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
  13. Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.
  14. Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.
  15. Participation in an investigational drug study or history of receiving any investigational treatment within 30 days prior to screening for this study, except for testosterone- lowering therapy in men with prostate cancer.
  16. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
  17. Concurrent participation in any interventional clinical trial.
  18. Pregnant and nursing women.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03647423
Other Study ID Numbers  ICMJE QUILT-3.091
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party NantKwest, Inc.
Study Sponsor  ICMJE NantKwest, Inc.
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account NantKwest, Inc.
Verification Date August 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP