This is a phase 1b/2 study to evaluate the safety and efficacy of metronomic combination therapy in subjects with advanced, unresectable, and untransplantable HCC.
Treatment will be administered in two phases, an induction and a maintenance phase. Subjects will continue induction treatment for up to 1 year. Those who have a CR in the induction phase will enter the maintenance phase of the study. Subjects who experience ongoing SD or an ongoing 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. Treatment in the study will be discontinued if the subject experiences confirmed PD or unacceptable toxicity (not corrected with dose reduction), withdraws consent, undergoes liver transplantation or surgical resection, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. Subjects with an initial assessment of PD may, at the discretion of the Investigator, continue to receive study treatment until PD is confirmed. The maximum time on study treatment is 2 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Ad5 \[E1-, E2b-\]-CEA
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant RAS proteins
NK-92 \[CD16.158V, ER IL-2\]
Chan Soon-Shiong Institute for Medicine
El Segundo, California, United States
Incidence of treatment-emergent AEs and SAEs, graded using the NCI CTCAE Version 4.03
Phase 1b
Time frame: 2 years
Evaluate the overall safety profile in subjects with advanced, unresectable, untransplantable HCC who have progressed or experienced unacceptable toxicity on prior sorafenib treatment. Measured / reported based on the tumor size imaging per RECIST 1.1.
Phase 1b
Time frame: 2 years
Progression Free Survival from baseline to progression, per RECIST 1.1
Phase 2 Randomized Component
Time frame: 2 years
Overall Response Rate, as determined by the percentage of patients achieving Partial or Complete Response per RECIST 1.1
Phase 2 Single Arm Component
Time frame: 2 years
ORR for Phase 1b and Phase 2 Randomized Component
Overall Response Rate, as determined by the percentage of patients achieving Partial or Complete response per RECIST 1.1 and irRC
Time frame: 2 years
PFS for Phase 1b and Phase 2 Single Arm Component
Progression Free Survival from baseline to progression per RECIST 1.1 and irRC
Time frame: 1 year
OS for Phase 1b, Phase 2 Randomized, and Phase 2 Single Arm Component
Overall Survival from first treatment to date of death (any cause)
Time frame: 2 years
DOR for Phase 1b, Phase 2 Randomized, and Phase 2 Single Arm Component
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Recombinant human anti-PD-L1 IgG1 monoclonal antibody
5'-deoxy-5-fluoro-N-\[(pentyloxy) carbonyl\]-cytidine
anhydrous
5-FU; Fluorouracil
Leucovorin calcium salt
ABRAXANE® \[paclitaxel protein-bound particles for injectable suspension\] \[albumin-bound\]
NEXAVAR® tablets, for oral use
Stereotactic Body Radiation Therapy
HCl
Ad5 \[E1-, E2b-\]-Brachyury vaccine
Ad5 \[E1-, E2b-\]-mucin 1 \[MUC1\] vaccine
CEA yeast vaccine
Brachyury yeast vaccine
ERBITUX® injection, for IV infusion)
Recombinant human super agonist IL-15 complex \[also known as IL-15N72D:IL- 15RαSu/IgG1 Fc complex\]
Duration of Response from date of first response to date of disease progression or death (any cause), per RECIST 1.1 and irRC
Time frame: 2 years
DCR for Phase 1b, Phase 2 Randomized, and Phase 2 Single Arm Component
Disease Control Rate: the number of patients with a CR, PR or SD lasting at least 2 months per RECIST 1.1 and irRC
Time frame: 1 year
QoL for Phase 1b, Phase 2 Randomized, and Phase 2 Single Arm Component
Quality of Life as assessed by Patient Reported Outcomes using the FACT-C questionnaire
Time frame: 1 year
PFS for Phase 2 Randomized Component
Progression Free Survival from baseline to progression per irRC
Time frame: 2 years
Safety for Phase 2 Randomized and Single Arm Component
Incidence of treatment-emergent AEs and SAEs, graded using the NCI CTCAE Version 4.03
Time frame: 2 years
ORR for Phase 2 Single Arm Component
Overall Response Rate, as determined by the percentage of patients achieving Partial or Complete response per irRC
Time frame: 2 years