The goal of this clinical trial is to first define the Safety and Optimal Biological Dose (OBD) of study drug TGX-007 and to then further investigate the safety and efficacy in patients with newly diagnosed or recurrent Glioblastoma. TGX-007 is a gene therapy drug delivered by a harmless adeno-associated virus (AAV) vector which delivers two combined therapeutic payloads to enable killing of proliferative cells and activation of an anti-tumour immune response. One is herpes simplex virus thymidine kinase (HSV-tk), which converts the pro-drug valaciclovir into an active drug that can kill tumour cells and the other is interleukin 12 (IL-12), which activates the body's immune system to recognise and fight the tumour. Patients newly diagnosed with glioblastoma suitable for standard of care surgery and chemoradiotherapy or patients with recurrent glioblastoma suitable for further surgery may be eligible for the study. Patients will receive TGX-007 by a direct intratumoural injection and will then take the pro-drug valacyclovir orally for up to 21 days before proceeding to standard of care surgery. The study is split into two phases. Phase I will treat patients at different dose levels of TGX-007 to identify the Optimal Biological Dose that will be used to further expand the study into Phase II. Phase II will expand the number of patients treated at the selected OBD to investigate how effective TGX-007 is at treating newly diagnosed and recurrent GBM. Approximately 68 people aged 18-70 will take part in the study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
68
TGX-007 administered as single intratumoural injection
Oral valaciclovir administered 3 times daily for 14 - 21 days
Ohio State University Hospital
Columbus, Ohio, United States
RECRUITINGRoyal Infirmary of Edinburgh
Edinburgh, United Kingdom
RECRUITINGSafety and tolerability of TGX-007 when administered to patients with newly diagnosed HGG or recurrent GBM and to identify the OBD
Incidence of AEs/SAEs, incidence of DLT within 28 days of TGX-007 administration at each dose level, and incidence of HSV-tk mRNA expression, or equivalent, in tissue
Time frame: Day 0 (TGX-007 injection) to 28 days post administration of TGX-007
Overall Survival rate of patients with newly diagnosed HGG or recurrent GBM treated with TGX-007
Overall Survival at 18 months (newly diagnosed patients) and 6 months (recurrent patients).
Time frame: Day 0 (TGX-007 injection) to 18 months (newly diagnosed); Day 0 (TGX-007 injection) to 6 months (recurrent patients)
Overall Survival
Median OS and OS up to 5 years by Kaplan-Meier analysis.
Time frame: Baseline to 5 year follow up
Viral shedding in body fluids following delivery of TGX-007.
Detection of vector genomes by droplet digital polymerase chain reaction (ddPCR) in patient samples
Time frame: Baseline until 3 consecutive negative samples, assessed up to 5 years post treatment.
Progression-free survival (PFS) of patients with newly diagnosed HGG or recurrent GBM treated with TGX-007.
PFS as determined by the Investigator
Time frame: Date of surgery to the earliest date progression is documented or death from any cause, measured out to 5 years post surgery
Objective response rate (ORR) of patients with newly diagnosed HGG or recurrent GBM treated with TGX-007.
ORR on pre-operative MRI per Response Assessment in Neuro-Oncology 2.0 (RANO 2.0) criteria.
Time frame: Baseline to 21 days
Assess the safety and tolerability of TGX-007 when administered to patients with newly diagnosed HGG or recurrent GBM
Incidence of AEs/SAEs.
Time frame: Baseline to 5 year follow up
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