This phase I trial tests the safety, side effects, and best dose of CF33-hNIS-antiPDL1 in treating patients with triple negative breast cancer that has spread to other places in the body (metastatic). CF33-hNIS-antiPDL1 is an oncolytic virus. This is a virus that is designed to infect tumor cells and break them down.
PRIMARY OBJECTIVE: I. To determine the safety and tolerability of a novel chimeric oncolytic orthopoxvirus, oncolytic virus CF33-expressing hNIS/Anti-PD-L1 antibody (CF33-hNIS-antiPDL1), by the evaluation of toxicities including: type, frequency, severity, attribution, time course, reversibility and duration according to Common Terminology Criteria for Adverse Events (CTCAE) 5.0 criteria. SECONDARY OBJECTIVES: I. To determine the optimal biologic dose (OBD) (defined as a safe dose that induces an immune response in tumors \[increase checkpoint target PD-L1 by at least 5% and/or increase T cell infiltration by at least 10%\]) and the recommended phase II dose (RP2D) for future expansion trial. II. To determine tumor response rates by Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1 (primary) and immune-modified (i)RECIST (secondary). III. To document possible therapeutic efficacy and evaluate progression-free survival, overall survival and response. EXPLORATORY OBJECTIVE: I. To determine the immune and genomic profiles of tumors before and after CF33-hNIS-antiPDL1 therapy. OUTLINE: This is a dose-escalation study. Patients receive CF33-hNIS-antiPDL1 intratumorally (IT) on days 1 and 15. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days, then every 3 months for 1 year.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
Given IT
City of Hope Medical Center
Duarte, California, United States
Incidence of adverse events
Toxicity will be graded according to the National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0. Observed toxicities/adverse events will be summarized in terms of type (organ affected or laboratory determination), severity, time of onset, duration, probable association with the study treatment and reversibility or outcome.
Time frame: Up to 30 days
Immune Biomarker Expression
Changes (%) in PD1 expression compared to baseline by immunohistochemistry Changes (%) in PD-L1 expression compared to baseline by immunohistochemistry Changes (%) CTLA-4 expression compared to baseline by immunohistochemistry Changes (%) CD8 cell quantification compared to baseline by Immunohistochemistry
Time frame: Up to 6 months
Optimal biologic dose
Defined as safe dose that induces an immune response in tumors (increase checkpoint target PD-L1 by at least 5% and/or increase T cell infiltration by at least 10%).
Time frame: Up to 3 months
Response rate based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
Will estimate the response rate by the percent of evaluable patients and its 95% confidence interval (C.I.) by the exact method.
Time frame: Up to 6 months
Response rate based on immune related iRECIST
Will estimate the response rate by the percent of evaluable patients and its 95% C.I. by the exact method.
Time frame: Up to 6 months
Progression free survival
Will be estimated using the Kaplan-Meier product-limit method.
Time frame: Up to 1 year
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Clinical benefit rate
Percentage of patients who achieved Partial Response/ Complete Response/ Stable disease at 6 months
Time frame: Up to 6 months
Event-free survival
Event-free survival (EFS): defined as the duration of time from start of protocol treatment to time of disease relapse/progression or death due to any cause, whichever occurs earlier.
Time frame: Up to 3 years
Duration of response
Duration of response (DOR): defined as the time from the first achievement of PR and CR to time of PD.
Time frame: Up to 3 years
Overall survival
Will be estimated using the Kaplan-Meier product-limit method.
Time frame: Up to 3 years