VG161 is a recombinant human-IL12/15/PDL1B oncolytic HSV-1 injection. This study will be conducted in combination with nivolumab injection in HSV seropositive subjects with advanced metastatic gastric or gastroesophageal junction adenocarcinoma who have previously received two or more systemic treatment regimens (which must include anti-PD-1 monoclonal antibodies). This is an open-label study divided into two parts. Part 1: This part is an escalating dose trial to explore the safety of the combination and determine the recommended safe dose of the combination. Part 2: This part is an extension trial to investigate the preliminary efficacy of the combination at a safe dose.
Part1(Phase Ib primary objective): To evaluate the safety and tolerability of VG161 administered by intratumoral injection combined with Nivolumab Injection in the treatment of patients with advanced metastatic gastric or gastroesophageal junction adenocarcinoma who have previously received two or more systemic treatment regimens (including anti-PD-1 monoclonal antibodies), explore the most suitable recommended Phase II dose (RP2D) for combination therapy, and determine the recommended regimen for combination therapy in Phase IIa clinical trials. Secondary objectives: 1) To preliminarily evaluate the antitumor activity of VG161 combined with nivolumab injection in the treatment of patients with advanced gastric cancer; 2) To monitor the changes of immunological parameters related to pharmacodynamics; 3) To evaluate the relevant immunological characteristics of tumor biopsy samples; 4) To evaluate the pharmacokinetic (PK) characteristics and viral excretion of single and multiple intratumoral injections of VG161; Part2(Phase IIa Primary Objective): To further evaluate the safety and efficacy of intratumoral injection of VG161 combined with nivolumab injection in patients with advanced metastatic gastric or gastroesophageal junction adenocarcinoma who have previously received two or more systemic treatment regimens (which must include anti-PD-1 monoclonal antibodies), with the primary outcome measure of efficacy being objective response rate (ORR). Secondary objectives: 1) To evaluate the secondary outcome measures of the efficacy of combined treatment; 2) To monitor the pharmacodynamic-related changes in immunological parameters; 3) To evaluate the relevant immunological characteristics of tumor biopsy samples;
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
43
Intratumoral injection only. Dosing days may be Day 1 or Days 1-3 only.
Administered once at 3 mg/kg intravenously on Days 8 and 22 of each cycle.
Peking University Cancer Hospital
Beijing, Beijing Municipality, China
RECRUITINGPhase Ib:RP2D/MTD
RP2D/MTD for VG161 in Combination with Nivolumab
Time frame: through Phase Ib study completion, an average of 1 year
Phase Ib:Incidence and number of DLT
Incidence and number of DLT (dose-limiting toxicity)
Time frame: through Phase Ib study completion, an average of 1 year
Phase Ib and Phase IIa:AE, SAE occurrence and frequency
Occurrence and frequency of AE (Adverse Event) and SAE(Serious adverse event)
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase IIa:ORR
Objective response rate (ORR)
Time frame: through Phase IIa study completion, an average of 1 year
Phase Ib and Phase IIa:ORR and DCR
Objective response rate (ORR) and disease control rate (DCR)
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib and Phase IIa:PFSand OS
Progression Free Survival (PFS) and Overall Survival (OS)
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib and Phase IIa:DOR
Duration of Response (DOR)
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib and Phase IIa: Immunological indicators
Immunological parameters: peripheral blood lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 +/CD8 + ratio, CD19 +, CD16 + CD56 + (NK) cells), cytokines (IL-12, IL-15, IL-6, TNF-α, IFN-γ);
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib and Phase IIa:Correlation of PD-L1 combined positive score (CPS) with safety and efficacy
Correlation of PD-L1 combined positive score (CPS) with safety and efficacy
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib and Phase IIa:Correlation of herpes simplex virus type I antibodies with safety and efficacy
Correlation of herpes simplex virus type I antibodies with safety and efficacy
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib and Phase IIa:Immunohistochemical detection of HER2、CD68、 CD3、 CD4、 CD8、CD47
Immunohistochemical detection of HER2、CD68、 CD3、 CD4、 CD8、CD47
Time frame: through Phase Ib and Phase IIa study completion, an average of 2 year
Phase Ib :Pharmacokinetic parameters: Blood concentrations of VG161 at different time points after single and multiple doses
Pharmacokinetic parameters: Blood concentrations of VG161 at different time points after single and multiple doses
Time frame: through Phase Ib study completion, an average of 1 year
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