Phase 1 Study of Intratumoral Administration of VAX014 With Expansion in Combination With a Checkpoint Inhibitor in Subjects With Advanced Solid Tumors
Summary
The purpose of this research study is to evaluate the safety, tolerability and activity of VAX014 for intratumoral injections (VAX014) as a single agent as well as in combination with Investigator's choice of nivolumab or pembrolizumab in patients with advanced solid tumors. VAX014 is a targeted oncolytic agent designed to kill tumor cells following intratumoral injection into advanced solid tumors.
Detailed description
This study will evaluate the safety and tolerability of VAX014 using a 3+3 dose escalation design to determine a maximum tolerated dose (MTD) or maximum practical dose (MPD) of single agent VAX014. The DLT assessment period will be the initial 21-days of injections. Subjects will receive weekly injections for the initial 8 weeks. Up to six dose levels will be evaluated (i.e., \[starting dose\], \[starting dose\] x 3, \[starting dose\] x 10, \[starting dose\] x 30, \[starting dose\] x 100, \[starting dose\] x 300). Subjects may continue on treatment following discussion between the Principal Investigator and Sponsor/Medical Monitor. After the determination of a single agent RP2D by the SRC for single agent intratumoral VAX014, an Expansion Phase will be conducted combining intratumoral VAX014 with Investigator's choice of nivolumab or pembrolizumab. The SRC may adjust the RP2D of VAX014 used during the Expansion Phase based on accumulating safety data. The Expansion Phase will consist of up to 25 subjects. For the first 3 subjects treated with the combination of VAX014 and either nivolumab or pembrolizumab, the initial 2 doses of intratumoral VAX014 will be reduced by one dose level from the VAX014 RP2D. If the initial 3 subjects are able to escalate to the RP2D for VAX014, all subsequent subjects will then receive VAX014 at the RP2D starting with the first dose of VAX014.
Arms & interventions
- DrugVAX014
Intratumorally administered oncolytic agent comprised of recombinant bacterial minicells. VAX014 is not infectious and is not capable of replication
- Combination ProductNivolumab or pembrolizumab
VAX014 will be given in combination with Investigator's choice of nivolumab or pembrolizumab.
Outcome measures
Primary
Maximum tolerated dose (MTD) of VAX014
The MTD will be defined as the dose level at which at most one of six patients experiences a dose limiting toxicity (DLT) after 21 days of treatment have occurred, with the next higher dose having at least 2/3 or 2/6 patients experiencing a DLT
Time frame: up to 21 days
Incidence of Treatment-Emergency Adverse Events (Safety and Tolerability)
Toxicities will be assessed in each subject by tracking the occurrence of graded Adverse Events (AEs). AEs will be graded according to the National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) v5.0
Time frame: Through study completion, an average of 20 weeks
Recommended Phase 2 Dose (RP2D) for single agent intratumoral VAX014
The RP2D will be determined following the determination of the MTD and with agreement by the Safety Review Committee
Time frame: up to 5 weeks
Acceptable dose of VAX014 in combination with PD-1 Inhibitor
Determine the acceptable dose of VAX014 when used in combination with Investigator's choice of nivolumab or pembrolizumab
Time frame: 3 months
Evaluation of efficacy of VAX014 in combination with either nivolumab or pembrolizumab
Evaluate efficacy including overall response rate (ORR), response of injected tumor(s) of VAX014 in combination with Investigator's choice of nivolumab or pembrolizumab
Time frame: 18 months
Secondary
Characterize systemic exposure by evaluating pharmacokinetics of intratumoral VAX014 as monotherapy and (if appropriate) in combination with nivolumab or pembrolizumab [systemic PK]
Time frame: up to 1 week
Anti-Drug Antibodies (Immunogenicity) [systemic ADA]
Time frame: Up to 20 weeks
Overall Response Rate as VAX014 alone and in combination with either nivolumab or pembrolizumab
Time frame: Up to 20 weeks
Eligibility criteria
Study locations (7)
University of Arizona Cancer Center
Tucson, Arizona, 85719
Sarah Cannon Research Institute at HealthONE
Denver, Colorado, 80218
George Washington University
Washington D.C., District of Columbia, 20052
Dana Farber Cancer Institute
Boston, Massachusetts, 02215
Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Atlantic Health System
Morristown, New Jersey, 07960
Cleveland Clinic
Cleveland, Ohio, 44195