This study aims to determine the safety and tolerability of TMV-018 when given alone or in combination with the prodrug 5-Fluorocytosine (5-FC) or an anti-PD-1 checkpoint inhibitor in patients with gastrointestinal tumors. Furthermore, the maximum tolerated dose (MTD) and recommended Phase II dose of TMV-018 shall be determined.
This is an open-label, multicenter, dose-escalation phase I trial that aims to determine the safety and tolerability of TMV-018, an oncolytic measles virus encoding the prodrug converting enzyme "super cytosine deaminase", when given alone or in combination with the prodrug 5-Fluorocytosine (5-FC) or an anti-PD-1 checkpoint inhibitor up to day 72 in patients with colorectal carcinoma (left-sided or rectal), esophageal carcinoma, or gastric cancer. Furthermore, the maximum tolerated dose (MTD) and recommended Phase II dose of TMV-018 shall be determined. At least 15 patients will be enrolled. Patients will be randomized to different treatment groups: all patients will receive intra-tumoral TMV-018 on four visits and additionally 5-FC and/or anti-PD-1 treatment. All adverse events will be documented and analyzed for the primary safety endpoint. Blood and tumor samples will be collected up to day 72 to determine the safety, tolerability and immunogenicity of the treatment. The patients will be followed-up for another two years to determine long-term safety.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
TMV-018: liquid frozen, life attenuated, oncolytic measles virus encoding the prodrug converting enzyme "super cytosine deaminase"; 1E+06 TCID50 to 1E+08 TCID50 per dose. 5-FC: 150 mg/kg/day for 2 days during each treatment.
TMV-018: liquid frozen, life attenuated, oncolytic measles virus encoding the prodrug converting enzyme "super cytosine deaminase"; 1E+06 TCID50 to 1E+08 TCID50 per dose. Anti-PD-1 inhibitor dose according to its SMPC.
TMV-018: liquid frozen, life attenuated, oncolytic measles virus encoding the prodrug converting enzyme "super cytosine deaminase"; 1E+06 TCID50 to 1E+08 TCID50 per dose. 5-FC: 150 mg/kg/day for 2 days during each treatment cycle. Anti-PD-1 Inhibitor: dose according to its SMPC.
University Hospital Bonn
Bonn, Germany
University Hospital Tübingen
Tübingen, Germany
Frequency of Adverse Events
Incidence of solicited and unsolicited adverse events from enrollment until end of study.
Time frame: 4 years
Determine MTD and dose for phase II
Determine the maximum tolerated dose (MTD) and recommended Phase II dose of TMV-018
Time frame: 1.5 years
Viral replication
Assess viral replication at injected tumor sites, viremia (distribution of i.t. applied TMV-018 into the blood stream), and shedding as well as possible persistence phenomena of TMV-018
Time frame: 2 years
Viral distribution
Assess viremia (distribution of i.t. applied TMV-018 into the blood stream) and shedding as well as possible persistence phenomena of TMV-018
Time frame: 2 years
Efficacy of therapy assessed by RECIST 1.1
Assess the therapeutic efficacy of TMV-018 with 5-FC or anti-PD-1 therapy by radiologic assessment (RECIST 1.1, time to progression).
Time frame: 4 years
Efficacy of therapy assessed by changes in tumor marker level
Assess the therapeutic efficacy of TMV-018 with 5-FC or anti-PD-1 therapy by changes in tumor marker level.
Time frame: 4 years
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