AdV-tk Therapy With Surgery and Chemoradiation for Pancreas Cancer (PaTK01) (PaTK01)

• ClinicalTrials.gov Identifier: NCT00638612
• Recruitment Status: Completed
• First Posted: March 19, 2008
• Last Update Posted: October 29, 2015
• Sponsor: Candel Therapeutics, Inc.
• Information provided by (Responsible Party): Candel Therapeutics, Inc.

Study Description

Brief Summary:

The purpose of this Phase 1 study is to evaluate the safety and potential efficacy of Gene Mediated Cytotoxic Immunotherapy for pancreatic cancer. The approach uses an adenoviral vector (disabled virus) engineered to express the Herpes thymidine kinase gene (AdV-tk), followed by an antiherpetic prodrug, valacyclovir.

Condition or disease	Intervention/treatment	Phase
Pancreatic Adenocarcinoma; Pancreatic Cancer	Biological: AdV-tk; Drug: Valacyclovir	Phase 1

Detailed Description:

The AdV-tk vector is injected into the tumor or tumor bed at the time of biopsy or standard tumor surgery after which valacyclovir pills are taken for 14 days. Two courses of AdV-tk, each followed by valacyclovir, are given as adjuvant to standard of care therapies (surgery and/or chemoradiation) which have been shown to work cooperatively with AdV-tk to kill tumor cells. Arm A is for resectable tumors in which the first course is given prior to surgery and the second is at the time of surgery. Arm B is for locally advanced disease in which both AdV-tk injections are administered by needle injection into the tumor before and during chemoradiation. The hypothesis is that this combination therapy can be safely delivered and will lead to improvement in the clinical outcome for patients with pancreatic cancer.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 27 participants
• Allocation: Non-Randomized
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: AdV-tk + Valacyclovir Therapy in Combination With Surgery and Chemoradiation for Pancreas Cancer
• Study Start Date: August 2008
• Actual Primary Completion Date: May 2013
• Actual Study Completion Date: June 2015

Arms and Interventions

Arm	Intervention/treatment
Experimental: A resectable; Arm A is for resectable tumors. The first AdV-tk course is given prior to surgery by CT or EUS guided injection into the tumor followed by 14 days of valacyclovir. The second AdV-tk injection is into the tumor bed at the time of surgery again followed by 14 days of valacyclovir.	Biological: AdV-tk; Four dose levels of AdV-tk with a fixed dose level of valacyclovir are evaluated independently in the two arms of the study due to differences in the concomitant standard of care treatments. The first AdV-tk course is given prior to surgery or radiation by CT or EUS guided injection into the tumor followed by 14 days of valacyclovir. The second AdV-tk injection is into the tumor bed at the time of surgery in Arm A or same as the first injection in Arm B again followed by 14 days of valacyclovir. The AdV-tk dose levels are: Level 1= 3x10e10 vector particles (vp), Level 2= 1x10e11 vp, Level 3= 3x10e11 vp, Level 4= 1x10e12 vp; Drug: Valacyclovir; Valacyclovir caplets at a dose of 2 grams orally three times per day is administered for 14 days starting 1-3 days after each of the two AdV-tk injections in both arms.; Other Name: Valtrex
Experimental: B locally advanced; Arm B is for locally advanced tumors for which chemoradiation is the planned standard of care treatment. AdV-tk is delivered by CT or EUS guided injection into the tumor. The first AdV-tk injection is given prior to starting chemoradiation and the second in week 3 of chemoradiation. Both injections are followed by 14 days of valacyclovir. Enrollment has been completed for Arm B.	Biological: AdV-tk; Four dose levels of AdV-tk with a fixed dose level of valacyclovir are evaluated independently in the two arms of the study due to differences in the concomitant standard of care treatments. The first AdV-tk course is given prior to surgery or radiation by CT or EUS guided injection into the tumor followed by 14 days of valacyclovir. The second AdV-tk injection is into the tumor bed at the time of surgery in Arm A or same as the first injection in Arm B again followed by 14 days of valacyclovir. The AdV-tk dose levels are: Level 1= 3x10e10 vector particles (vp), Level 2= 1x10e11 vp, Level 3= 3x10e11 vp, Level 4= 1x10e12 vp; Drug: Valacyclovir; Valacyclovir caplets at a dose of 2 grams orally three times per day is administered for 14 days starting 1-3 days after each of the two AdV-tk injections in both arms.; Other Name: Valtrex

Outcome Measures

Primary Outcome Measures :

1. Safety based on symptoms and laboratory abnormalities not expected from standard of care treatments or natural history of the disease process. Toxicity grading uses NCI CTC version 3. Dose limiting toxicity is specifically defined in the protocol. [ Time Frame: 2 months ]

Secondary Outcome Measures :

1. Overall survival [ Time Frame: 2 years ]
2. Progression free survival [ Time Frame: 2 years ]
3. Tumor response including pathologic response [ Time Frame: 2 months ]
4. Quality of life [ Time Frame: 2 years ]
5. Resectability [ Time Frame: 2 years ]
6. CA 19-9 response [ Time Frame: 2 years ]

Eligibility Criteria

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

Criteria

Inclusion Criteria:

• Must have presumed pancreatic adenocarcinoma based on clinical and radiologic evaluation with identifiable tumor accessible for injection (pathologic diagnosis of pancreatic adenocarcinoma must be made prior to AdV-tk injection
• For Arm A, resectable disease. Arm B for locally advanced disease has completed accrual.
• Performance status must be ECOG 0-2
• SGOT (AST)<3x upper limit of normal
• Serum creatinine<2mg/dl and calculated creatinine clearance >10ml/min
• Platelets>100,000/mm3 and WBC>3000/mm3 and ANC>1500/mm3
• Must give study specific informed consent prior to enrollment

Exclusion Criteria:

• Primary hepatic dysfunction including active hepatitis but not to exclude patients due to obstructive jaundice. If obstructive jaundice is clinically significant, bilirubin should be stable or decreasing prior to enrollment.
• Evidence of clinically significant pancreatitis as determined by the investigator.
• Patients on corticosteroids or other immunosuppressive drugs
• Known HIV+ patients
• Patients with acute infections (viral, bacterial or fungal infections requiring therapy)
• Pregnant or breast-feeding patients. Female patients of childbearing age must have negative serum or urine pregnancy test within 1 week of beginning therapy
• Evidence of distant metastatic disease at the time of enrollment or other malignancy (except squamous or basal cell skin cancers) and no prior abdominal radiation therapy or prior treatment for pancreatic cancer
• Other serious co-morbid illness or compromised organ function

Contacts and Locations

Locations

United States, California

City of Hope Medical Center

Duarte, California, United States, 91010

Scripps Green Hospital/Scripps Cancer Center

La Jolla, California, United States, 92037

United States, Ohio

The Ohio State University

Columbus, Ohio, United States, 43210

Sponsors and Collaborators

Candel Therapeutics, Inc.

Investigators

• Principal Investigator: Mark Bloomston, MD; Ohio State University

More Information

Publications of Results:

Aguilar LK, Shirley LA, Chung VM, Marsh CL, Walker J, Coyle W, Marx H, Bekaii-Saab T, Lesinski GB, Swanson B, Sanchez D, Manzanera AG, Aguilar-Cordova E, Bloomston M. Gene-mediated cytotoxic immunotherapy as adjuvant to surgery or chemoradiation for pancreatic adenocarcinoma. Cancer Immunol Immunother. 2015 Jun;64(6):727-36. doi: 10.1007/s00262-015-1679-3. Epub 2015 Mar 21.

• Responsible Party: Candel Therapeutics, Inc.
• ClinicalTrials.gov Identifier: NCT00638612
• Other Study ID Numbers: PaTK01
• First Posted: March 19, 2008
• Last Update Posted: October 29, 2015
• Last Verified: October 2015

Keywords provided by Candel Therapeutics, Inc.:

Immunotherapy; Gene Therapy; Cytotoxicity; Tumor vaccine; Radiation; Surgery; Chemoradiation

Additional relevant MeSH terms:

Pancreatic Neoplasms; Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Endocrine Gland Neoplasms; Pancreatic Diseases; Digestive System Diseases; Endocrine System Diseases; Valacyclovir; Antiviral Agents; Anti-Infective Agents