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Safety Study of Vaccinia Virus to Treat Superficial Injectable Tumors
This study is currently recruiting participants.
Verified by University of Pittsburgh, July 2009
First Received: December 13, 2007   Last Updated: July 9, 2009   History of Changes
Sponsored by: University of Pittsburgh
Information provided by: University of Pittsburgh
ClinicalTrials.gov Identifier: NCT00574977
  Purpose

The purpose of this study is to determine the safety and maximum tolerated dose tolerated from injecting this vaccinia virus into tumors.


Condition Intervention Phase
Melanoma
Breast Cancer
Head and Neck Squamous Cell Cancer
Hepatocellular Cancer
Colorectal Cancer
Pancreatic Adenocarcinoma
Biological: Vaccinia virus (vvDD-CDSR)
Phase I

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Parallel Assignment, Safety Study
Official Title: A Phase I Dose-Escalation Trial of vvDD-CDSR (Double-Deleted Vaccinia Virus Plus CD/ SMR) Administered by Intratumoral Injection

Resource links provided by NLM:


Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • Determine the maximally tolerated dose (MTD) and/or maximum-feasible dose (MFD) and Safety of vvDD-CDSR administered intratumoral (I.T.) injection. [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Determine the replication/pharmacokinetics of vvDD-CDSR following I.T. injection. [ Time Frame: 28 days ] [ Designated as safety issue: No ]
  • Determine the immune response to vvDD-CDSR and to the tumor following I.T. injection (inc. inflammatory cell infiltration at injected and uninjected sites; neutralizing antibody formation; cytokine responses). [ Time Frame: 28 days ] [ Designated as safety issue: No ]
  • Determine the antitumoral efficacy of vvDD-CDSR following I.T. injection at both the injected tumor site and at distant (non-injected) tumor sites. [ Time Frame: 28 days ] [ Designated as safety issue: No ]

Estimated Enrollment: 36
Study Start Date: February 2008
Estimated Study Completion Date: March 2012
Estimated Primary Completion Date: March 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental
Subjects who have been vaccinated with vaccinia virus (small pox)
Biological: Vaccinia virus (vvDD-CDSR)
Eligible subjects will receive 1 treatment of vvDD-CDSR. A dose can be divided between 1-3 lesions. The sum total of the maximal diameters of the lesion(s) to be injected must be < 10cm. Cohort 1: 3 x 107 p.f.u. Cohort 2: 1 x 108 p.f.u. Cohort 3: 3 x 108 p.f.u. Cohort 4: 1 x 109 p.f.u. Cohort 5: 3 x 109 p.f.u.
B: Experimental
Subjects will include those who have not been vaccinated with vaccinia virus (small pox).
Biological: Vaccinia virus (vvDD-CDSR)
Eligible subjects will receive 1 treatment of vvDD-CDSR. A dose can be divided between 1-3 lesions. The sum total of the maximal diameters of the lesion(s) to be injected must be < 10cm. Cohort 1: 3 x 107 p.f.u. Cohort 2: 1 x 108 p.f.u. Cohort 3: 3 x 108 p.f.u. Cohort 4: 1 x 109 p.f.u. Cohort 5: 3 x 109 p.f.u.

Detailed Description:

This is a Phase I, open-label, single dose, dose-escalation trial in subjects with injectable tumors from melanoma, breast cancer, or head and neck squamous cell cancer, hepatocellular, colorectal or pancreatic adenocarinoma. Subjects will be stratified into 2 groups. Group A includes those who have been vaccinated with vaccinia virus. A history of vaccination and a scar at vaccination site is required. Group B subjects will include those who have not been vaccinated. It is expected that the toxicity profile will be quite different between those who have been vaccinated previously with vaccinia virus and therefore subjects will be stratified separately in this phase I trial. All subjects who have refractory tumors will receive treatment at one of the five dose levels in a single dose sequential dose-escalating design. Eligible subjects will receive 1 treatment of vvDD-CDSR. A dose can be divided between 1-3 lesions. The sum total of the maximal diameters of the lesion(s) to be injected must be < 10cm. Three subjects in each group will be treated at each dose level unless a dose-limiting toxicity is observed (DLT). Enrollment will proceed independently in the two groups and will proceed to the next dose level if 0 of 3 subjects experiences a DLT; if one of the first 3 subjects experiences a DLT then additional subjects will be enrolled until a second DLT occurs (which defines the toxic dose) or until six total subjects have been treated, whichever comes first. If a second DLT is not experienced in that cohort, dose escalation may continue. A minimum of 4 weeks must pass after injection of the last subject in one cohort and all toxicity must have resolved before moving to the next cohort.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Greater than 18 years of age
  • Histologically-confirmed injectable cancer mass (≤ 10 cm. maximum diameter ) that has progressed despite standard therapy; and is amenable to injection and biopsy. They must have one of the following tumor-types: melanoma, breast cancer, or head and neck squamous cell cancer, hepatocellular, colorectal or pancreatic
  • Cancer is not surgically curable
  • Karnofsky Performance Status (KPS) of > 70
  • Anticipated survival of at least 16 weeks
  • If sexually-active, willingness to use condoms for 3 months following treatment with vvDD-CDSR
  • The ability to understand and willingness to sign a written informed consent
  • Able to comply with study procedures and follow-up examinations
  • Adequate bone marrow function: WBC > 3,500 and <50,000 cells/mm3 , ANC > 1,500 cells/mm3, hemoglobin > 10 g/dL, and platelet count > 150,000 cells/mm3
  • Adequate renal function: serum creatinine < 1.2 mg/dL
  • Adequate hepatic function: AST (≤ 1.5 ULN), ALT (≤ 1.5 ULN), total bilirubin (< 2.0 ULN)
  • Acceptable coagulation status: INR<(ULN +10%)

Exclusion Criteria:

  • Pregnant or nursing an infant
  • Active viral infection (including HIV, Hepatitis B or C)
  • Systemic corticosteroid or other immunosuppressive medication use within 4 weeks of the treatment
  • Clinically significant active infection or uncontrolled medical condition (e.g., pulmonary, neurological, cardiovascular, gastrointestinal, genitourinary) considered high risk for investigational new drug treatment
  • Significant immunodeficiency (e.g. due to underlying illness and/ or medication) in subject or household contacts
  • History of eczema requiring systemic therapy
  • Unstable cardiac disease which includes but is not limited to: Any of the following within 6 months prior to study entry: MI, unstable angina, congestive heart failure, myocarditis, arrhythmias diagnosed and requiring medication, or any clinically-significant change in cardiac status
  • Target tumor(s) adherent to a major vascular structure (e.g. carotid artery)
  • Participation in any investigational drug study, radiotherapy, chemotherapy or surgery within 4 weeks of study entry; NOTE: For subjects who have received radiotherapy, chemotherapy, or other potentially immunosuppressive therapy a CD4 T cell count will be performed as part of the screening procedures. If the CD4 T cell count is < 350 per µl blood subjects will not be allowed to participate due to their immunosuppressed state
  • Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions
  • Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination
  • Subjects with household contacts who are pregnant or nursing an infant, children < 5 years old, have history of eczema that at some stage has required systemic therapy, or have a significant immunodeficiency due to underlying illness (e.g. HIV) and/or medication (e.g. systemic corticosteroids) will be excluded unless alternate living arrangements can be made during the subject's active dosing period and for three weeks following the last dose of study medication
  • Inability or unwillingness to give informed consent.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00574977

Contacts
Contact: Herbert J. Zeh, MD, PhD (412) 692-2852 zehj@upmc.edu
Contact: Amy R. Schmotzer, RN, BSN (412) 647-6205 schmotzerar@upmc.edu

Locations
United States, Pennsylvania
University of Pittsburgh Cancer Institute Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: Herbert J. Zeh, MD     412-692-2852     zehh@upmc.edu    
Contact: Amy R. Schmotzer, RN, BSN     (412) 647-6205     schmotzerar@upmc.edu    
Principal Investigator: Herbert J. Zeh, MD            
Sponsors and Collaborators
University of Pittsburgh
Investigators
Principal Investigator: Herbert J. Zeh, MD, PhD University of Pittsburgh
  More Information

No publications provided

Responsible Party: University of Pittsburgh Cancer Institute ( Herbert J. Zeh, III, MD )
Study ID Numbers: 06-041
Study First Received: December 13, 2007
Last Updated: July 9, 2009
ClinicalTrials.gov Identifier: NCT00574977     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Pittsburgh:
vaccinia
virus
tumor
melanoma
breast cancer
squamous cell cancer
colorectal
hepatocellular
pancreatic
adenocarcinoma

Study placed in the following topic categories:
Gastrointestinal Diseases
Colonic Diseases
Squamous Cell Carcinoma
Rectal Diseases
Melanoma
Neoplasms, Germ Cell and Embryonal
Nevus, Pigmented
Neuroepithelioma
Neoplasms, Squamous Cell
Hepatocellular Carcinoma
Breast Diseases
Digestive System Neoplasms
Skin Diseases
Vaccinia
Breast Neoplasms
Intestinal Diseases
Intestinal Neoplasms
Carcinoma
Neuroendocrine Tumors
Virus Diseases
Neuroectodermal Tumors
Digestive System Diseases
Poxviridae Infections
Epidermoid Carcinoma
Gastrointestinal Neoplasms
DNA Virus Infections
Nevus
Adenocarcinoma
Carcinoma, Squamous Cell
Colorectal Neoplasms

Additional relevant MeSH terms:
Gastrointestinal Diseases
Neoplasms, Nerve Tissue
Colonic Diseases
Rectal Diseases
Melanoma
Neoplasms by Site
Neoplasms, Germ Cell and Embryonal
Nevi and Melanomas
Neoplasms, Squamous Cell
Breast Diseases
Neoplasms by Histologic Type
Digestive System Neoplasms
Skin Diseases
Vaccinia
Breast Neoplasms
Intestinal Diseases
Intestinal Neoplasms
Carcinoma
Neuroendocrine Tumors
Virus Diseases
Neuroectodermal Tumors
Neoplasms
Digestive System Diseases
Poxviridae Infections
Gastrointestinal Neoplasms
DNA Virus Infections
Carcinoma, Squamous Cell
Adenocarcinoma
Colorectal Neoplasms
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on September 11, 2009