This is a Phase 1 open label study designed to assess the safety and tolerability of the oncolytic herpes simplex virus 1 (oHSV1) study drug, MVR-C5252, administered intratumorally by convection-enhanced delivery (CED) in patients with recurrent high-grade glioma. Once the safety and maximum tolerated dose (MTD) is established in the dose escalation portion of the trial, a dose expansion cohort at the recommended phase 2 dose (RP2D) in patients with isocitrate dehydrogenase (IDH) wildtype recurrent glioblastoma (GBM) will evaluate preliminary efficacy of the study drug.
Oncolytic HSV1 (oHSV1) was the first viral vector studied in clinical trials to treat malignant glioma with positive outcomes for tolerability and potential clinical benefits. MVR-C5252 is a genetically modified next generation oHSV1 with an active domain of human IL-12 and Fab fragment of anti-PD-1 antibody. During viral replication, IL-12 and anti-PD-1 antibody are expressed and secreted into the tumor microenvironment, acting synergistically by increasing the T cell infiltration, converting the cold (immune suppressing) tumor to hot (immune active) tumor, and inducing anti-tumor specific immunity. This study is investigating if oHSV1 MVR-C5252 administered via CED can overcome the BBB (Blood Brain Barrier) in patients with recurrent high-grade glioma. This study will enroll patients in 4 Stages. In Stage 1, externalized Synchromed II pump will be used to deliver Gadoliunium followed by MVR-C5252 for a single administration on Day 1. Stage 2, two infusions will be administered-on days 1 and 28 via the internalized pump. For patients accrued on Stage 3, the second infusion of study drug (Cycle 1, infusion 2) will occur 7 ± 1 days after 1st infusion for a total of 6 cycles (12 infusions). Stage 4, the dose expansion portion of the study, will commence once a MTD/RP2D is established. Within Stage 4 the efficacy of the study drug, as measured by progression-free 6 months survival will be evaluated.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
51
MVR-C5252 is a genetically modified next generation oncolytic herpes simplex virus 1 (oHSV1) with an active domain of human IL-12 and Fab fragment of anti-PD-1 antibody. This is a Phase 1 open label study designed to determine the safety and tolerability of MVR-C5252. The dose-escalation portion of the study will be conducted in 4 stages to evaluate the safety of infusion and determination of the MTD/RP2D followed by efficacy assessment.
Memorial Sloan Kettering
New York, New York, United States
RECRUITINGDuke University
Durham, North Carolina, United States
RECRUITINGStage 1: Proportion of patients with dose-limiting toxicity (DLT) during the single infusion
Proportion of patients with dose-limiting toxicity (DLT) during the single infusion
Time frame: Day 1 of treatment until 28 days post first infusion
Stage 2: Proportion of patients with dose-limiting toxicity (DLT) during 2 infusions using the internalized Ascenda catheter
Proportion of patients with DLT who have received two infusions on days 1 and 28
Time frame: Day 1 of treatment until 28 days post second infusion for a total of up to 56 days post first infusion
Stage 3a: Proportion of patients with dose-limiting toxicity (DLT) after each cycle with two infusions on days 1 and 8
Proportion of patients with DLT who have received two infusions on days 1 and 8
Time frame: Day 1 of treatment until 28 days post second infusion for a total of up to 35 days post first infusion
Stage 3b: Determine the MTD/RP2D
Maximal Tolerated Dose/Recommended Phase 2 Dose (MTD/RP2D)
Time frame: Day 1 of treatment until 28 days post second infusion for a total of up to 35 days post first infusion for all the cycles for all the patients enrolled in stages 1, 2 and 3
Stage 4: Progression Free Survival at 6 months
Progression Free Survival at 6 months will be estimated by the Kaplan-Meier method
Time frame: Day 1 of treatment until first documentation of disease progression or date of death, whichever comes first, assessed up to 6 months
Overall Survival
Day 1 of treatment until death to calculate Median overall survival by the Kaplan-Meier method.
Time frame: 5 years
Progression Free Survival
Day 1 of treatment until first documentation of disease progression or death to calculate Median progression free survival by the Kaplan-Meier method.
Time frame: 5 years
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