The purpose of this research study is to evaluate the safety, tolerability and activity of VAX014 for Instillation (VAX014) in patients with low-grade Non-Muscle Invasive Bladder Cancer (NMIBC). VAX014 is a targeted oncolytic agent designed to kill tumor cells following instillation into the urinary bladder.
This study will evaluate the safety and tolerability of VAX014 using a 3+3 dose escalation design to determine a maximum tolerated dose (MTD) followed by a dose expansion at the Recommended Phase 2 Dose (RP2D). Both phases of the study will use a Window of Opportunity study design where patients with a single, low-grade Ta lesion will receive VAX014 via a urinary catheter into the bladder, weekly for 6 weeks prior to undergoing Transurethral Resection of Bladder Tumor (TURBT) to assess antitumor activity against the mapped lesion. Patients enrolled in this study must have low-grade (Ta) Non-Muscle Invasive Bladder Cancer. However, eligible patients may have up to 5 low-grade Ta lesions at screening, and all but a single mapped lesion will be resected prior to receiving VAX014. The mapped lesion is assessed for anti-tumor activity. VAX014 is a formulation of recombinant bacterial minicells which is designed to selectively target two NMIBC-associated integrin heterodimers to de-stabilize tumor cell membranes, with the result being tumor cell lysis.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Solution for intravesical infusion, 3.33x10\^10 rBMCs per vial
The Urology Center of Colorado
Denver, Colorado, United States
University of Iowa Hospital and Clinics
Iowa City, Iowa, United States
New Jersey Urology, LLC.
Edison, New Jersey, United States
Carolina Urologic Research Center
Myrtle Beach, South Carolina, United States
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 28 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 28 days
Incidence of Treatment-Emergence 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) of intravesical VAX014
The RP2D will be determined following the determination of the MTD and an overall assessment of safety as determined by the Safety Committee
Time frame: up to 5 weeks
Peak Plasma Concentration (Cmax)
The peak plasma concentration (Cmax) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time frame: Day 1
Trough Plasma Concentration (Cmin)
The trough plasma concentration (Cmin) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time frame: Day 1
Time to Peak Plasma Concentration (Tmax)
The time to peak plasma concentration (Tmax) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
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Baylor College of Medicine
Houston, Texas, United States
Time frame: Day 1
Volume and Distribution (Vd)
The volume and distribution (Vd) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time frame: Day 1
Half Life (t[1/2])
The half life (t\[1/2\]) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time frame: Day 1
Area Under Curve (AUC)
The area under the plasma concentration versus time curve (AUC) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time frame: Day 1
Clearance (Cl)
The clearance (Cl) will be measured as part of pharmacokinetic (PK) testing. In the event early analysis determines that VAX014 is not detectable in whole blood, PK sampling and analysis will be suspended.
Time frame: Day 1
Overall Response Rate
Response rate will be evaluated for low-grade Ta lesions. Lesions will be assessed with cystoscopy and change in tumor size will be recorded.
Time frame: Up to 20 weeks
Anti-Drug Antibodies (Immunogenicity)
The presence or absence of anti-drug antibodies (ADA) in serum will be assessed by assay.
Time frame: Up to 20 weeks