This study aims to evaluate safety and effect of combining an oncolytic adenovirus (delolimogene mupadenorepvec; LOAd703) with atezolizumab in patients with melanoma. LOAd703 will be administered intratumorally for up to 12 injections while atezolizumab will be administered intravenously for the duration of the active study visits (up to 57 weeks). The patients are then monitored for survival for maximum study participation of 48 months. The treatments will be given every 3 weeks. The patients will then be monitored for toxicity, PK, ADA, immune responses, virus shedding, tumor response by RECIST 1.1 and survival.
This is a single arm, open-label, multicenter trial. This study aims to evaluate safety and effect of combining an oncolytic adenovirus (delolimogene mupadenorepvec; LOAd703) with atezolizumab in patients with melanoma. Patients will receive up to 12 LOAd703 intratumoral treatments in combination with intravenous infusions of atezolizumab. LOAd703 will be tested at two dose levels to determine the maximum tolerated dose (MTD) of LOAd703 evaluated in the study using a BOIN design. The LOAd703 dose can be divided for intratumoral injection into as many as 3 tumor lesions. Atezolizumab will be tested at a fixed dose. At least 25 response evaluable patients will be enrolled at the MTD for evaluation of their response using binominal testing. The maximum number of evaluable patients in the study is 35. The patients will then be monitored for toxicity, PK, ADA, immune responses, virus shedding, tumor response by RECIST 1.1 and survival.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
LOAd703 is an oncolytic adenovirus encoding TMZ-CD40L and 4-1BBL
Atezolizumab is an anti-PD-L1 antibody
Cedars-Sinai Medical Center, The Angeles Clinic and Research Institute
Los Angeles, California, United States
Baylor St Luke's Medical Center
Houston, Texas, United States
Uppsala University Hospital
Uppsala, Sweden
Tolerability Evaluated by NCI CTCAE v5.0
The AE reporting period begins upon receiving the first LOAd703 and/or atezolizumab treatment and continues until final visit at week 57
Time frame: Up to 57 weeks post treatment initiation
Overall Response Rate
Tumor size evaluations accordingly to RECIST 1.1.Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Stable disease (SD), Neither PR nor progressive disease, Progressive disease (PD), \>20% increase in the sum of the longest diameter of target lesions. Overall Response (OR) = number of participants with CR or PR.
Time frame: Up to 57 weeks post treatment initiation
Overall Survival
Survival status of patients. Overall survival is defined as the time from the first dose of study treatment (LOAd703 and/or atezolizumab) until death.
Time frame: From treatment initiation until last patient last visit, assessed up till 36 months
Antibodies Against LOAd703
Fold change between baseline and evaluation visit for anti-adenovirus antibodies (LOAd703). The baseline is the last available measurement taken before the first LOAd703 treatment. Evaluation is a measurement taken from subjects receiving at least 3 LOAd703 treatments.
Time frame: Up to 57 weeks post treatment initiation
Immune Cell Phenotype
The ratio for CD8+/Treg cells analyzed in blood at baseline and evaluation visit as determined by flow cytometry. The baseline is the last available measurement taken before the first LOAd703 treatment. Evaluation is a measurement taken from subjects receiving at least 3 LOAd703 treatments.
Time frame: Up to 57 weeks post treatment initiation
Virus Shedding
Number of samples analyzed that were positive for virus particles in shedding samples.
Time frame: Up to 57 weeks post treatment initiation
Overall Survival (Number of Participants With Event)
Survival status of patients described by number of participants with event.
Time frame: From treatment initiation until last patient last visit, assessed up till 36 months
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