Lung Cancer Clinical Trial
Intratumoral Gene Mediated Cytotoxic Immunotherapy in Patients With Resectable Non-Small Cell Lung Cancer
Summary
This is a phase I study of Gene Mediated Cytotoxic Immunotherapy (GMCI) in patients with non-small cell lung cancer (NSCLC). The primary clinical end-point of the study is to evaluate the safety of GMCI when combined with standard surgery for NSCLC. The primary scientific objective is to determine the immunologic changes induced by GMCI.
Full Description
The purpose of this open-label, dose escalation clinical trial is to investigate the safety of CAN-2409 (aglatimagene besadenovec) plus prodrug prior to surgery in patients with NSCLC. CAN-2409 is a viral immunotherapy approach which utilizes intratumoral administration to selectively induce tumor cell death and elicit both an innate and an adaptive systemic anti-tumor immune response against the injected tumor and uninjected metastases. Local delivery enables these effects while aiming to minimize systemic toxicity. Standard of care surgical resection will be performed about 3 weeks after the CAN-2409 injection. Chemotherapy and/or radiation may begin 6-8 weeks after resection surgery. Choice of chemotherapy depends on the treating oncologist. CAN-2409 (aglatimagene besadenovec) was previously known as AdV-tk, and the combination of CAN-2409 plus prodrug was previously known as GMCI.
Eligibility Criteria
Inclusion Criteria:
Pathologically documented non-small cell carcinoma (cytology or histology) that is accessible via standard-of-care staging procedures: (1) EBUS or (2) surgical approaches (eg mediastinoscopy, mediastinotomy or VATS).
Resectable with negative lymph nodes based on imaging with histologic confirmation at time of the staging procedure prior to AdV-tk injection
The tumor must be 4cm or greater in diameter based on imaging
ECOG Performance status of 0 or 1.
Granulocyte count (ANC) ≥ 1,000/mm3
Peripheral lymphocyte count ≥ 500/mm3
Hemoglobin ≥ 9 g/dl
Platelets ≥ 100,000/mm3
Total bilirubin ≤ 1.5 x upper limit of normal
SGOT (AST) ≤ 3x upper limit of normal
Serum creatinine < 2mg/dl
Calculated creatinine clearance > 30ml/min
Patients must give study specific informed consent prior to enrollment
Exclusion Criteria:
Radiotherapy and/or treatment with chemotherapeutic, cytotoxic, or immunologic agents within 4 weeks prior to infusion of the vector.
Known immunodeficiency such as HIV infection
Active liver disease, including known cirrhosis or active hepatitis
Use of systemic corticosteroids (>10 mg prednisone per day or equivalent) or other systemic immunosuppressive drugs
Patient is pregnant or breast-feeding. Female patients of childbearing age must have negative serum or urine pregnancy test within 1 week of beginning therapy. Subjects must use acceptable means of birth control until 30 days after the vector injection.
Presence of any other life-threatening illness, such as unstable angina, severe oxygen dependence, significant chronic obstructive pulmonary disease (COPD), end-stage liver or renal disease. COPD will be considered significant if disease limits activities of daily living, results in the inability to walk up 1 flight of stair, or requires home oxygen.
Presence of known untreated brain metastases.
Prior bone marrow transplants (including stem cells) except autologous stem cell transplant without immunosuppression is NOT considered an exclusion.
Known sensitivity or allergic reactions to valacyclovir
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There is 1 Location for this study
Philadelphia Pennsylvania, 19104, United States
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