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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03294083
Registration number
NCT03294083
Ethics application status
Date submitted
19/09/2017
Date registered
26/09/2017
Date last updated
27/10/2022
Titles & IDs
Public title
A Study of Recombinant Vaccinia Virus in Combination With Cemiplimab for Renal Cell Carcinoma
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Scientific title
A Phase 1b/2a Dose-escalation and Safety/Efficacy Evaluation Study of Pexa-Vec (Thymidine Kinase-Deactivated Vaccinia Virus Plus GM-CSF) in Combination With Cemiplimab (REGN2810; Anti-PD-1) in Patients With Metastatic or Unresectable Renal Cell Carcinoma (RCC)
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Secondary ID [1]
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JX594-REN026
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Renal Cell Carcinoma
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Condition category
Condition code
Infection
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Other infectious diseases
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Cancer
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Non melanoma skin cancer
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Cancer
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Kidney
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Pexastimogene Devacirepvec (Pexa-Vec)
Treatment: Other - Cemiplimab
Experimental: Part 1, Dose escalation - Pexa-Vec will be administered via IV infusion at a dose of 3 x 10\^8 pfu once per week for 4 treatments. Based on the occurrence of dose-limiting toxicities, patients may subsequently be enrolled to receive Pexa-Vec on the same schedule at a dose of 1 x 10\^9 pfu.
Cemiplimab will be administered via IV infusion every 3 weeks.
Experimental: Part 2-Arm A, Pexa-Vec (IT) and Cemiplimab - Pexa-Vec will be administered via IT (intratumoral) injection every 2 weeks for 3 treatments.
Cemiplimab will be administered via IV infusion every 3 weeks.
Experimental: Part 2-Arm B, Cemiplimab - Cemiplimab will be administered via IV infusion every 3 weeks.
At disease progression, Pexa-Vec will be administered via IT (intratumoral) injection every 2 weeks for 3 treatments. Cemiplimab will continue every 3 weeks.
Experimental: Part 2-Arm C, Pexa-Vec (IV) and Cemiplimab - Pexa-Vec will be administered via IV infusion once per week for 4 treatments.
Cemiplimab will be administered via IV infusion every 3 weeks.
Experimental: Part 2-Arm D, Pexa-Vec (IV) and Cemiplimab - Pexa-Vec will be administered via IV infusion once per week for 4 treatments.
Cemiplimab will be administered via IV infusion every 3 weeks.
Treatment: Other: Pexastimogene Devacirepvec (Pexa-Vec)
Pexa-Vec is a vaccinia virus based oncolytic immunotherapy designed to stimulate the immune system following infection and replication within tumor cells
Treatment: Other: Cemiplimab
Cemiplimab is a monoclonal antibody to Programmed Death-1 (PD-1)
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Maximum tolerated dose(MTD) / Maximum feasible dose (MFD)
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Assessment method [1]
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MTD/MFD of Pexa-Vec administered by IV infusion in combination with Cemiplimab
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Timepoint [1]
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36 days after first treatment
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Primary outcome [2]
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Severity and frequency of adverse events to determine safety of Pexa-Vec administered by IV infusions or IT injections in combination with IV Cemiplimab
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Assessment method [2]
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Safety will be determined by assessing the severity and frequency of adverse events and laboratory toxicity using CTCAE v4.03
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Timepoint [2]
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From date of first treatment until 28 days after last treatment
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Primary outcome [3]
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Overall response rate
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Assessment method [3]
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Evaluate anti-tumor activity and efficacy of IV or IT Pexa-Vec combined with IV Cemiplimab with respect to overall response rate (ORR) per Response Evaluation Criteria In Solid Tumors (RECIST 1.1)
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Timepoint [3]
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Every 9 weeks, then every 12 weeks after 1 year until date of first documented progression, up to 72 months
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Secondary outcome [1]
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Progression free survival
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Assessment method [1]
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Timepoint [1]
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Every 9 weeks, then every 12 weeks after 1 year until date of first documented progression, up to 72 months
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Secondary outcome [2]
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Disease control rate
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Assessment method [2]
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Timepoint [2]
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Every 9 weeks, then every 12 weeks after 1 year until date of first documented progression, up to 72 months
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Secondary outcome [3]
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Best radiographic response
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Assessment method [3]
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Timepoint [3]
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Every 9 weeks, then every 12 weeks after 1 year until date of first documented progression, up to 72 months
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Secondary outcome [4]
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Overall survival
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Assessment method [4]
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Timepoint [4]
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Every 9 weeks, then every 12 weeks after 1 year until date of death from any cause, up to 72 months
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Eligibility
Key inclusion criteria
* Histologically or cytologically confirmed metastatic or unresectable clear cell renal cell carcinoma (ccRCC)
* Part 2 Arm D ONLY: Patients must be refractory to anti PD-1 or anti-PD-L1 (either as monotherapy or in-combination with other approved checkpoint inhibitors or targeted therapies according to their approved label) and patients must meet all of the following criteria:
1. Received treatment of approved anti PD-1 or anti-PD-L1 (dosed per label of the country providing the clinical site) for at least 6 weeks. History of anti-PD-L1 only is not allowed.
2. Progressive disease after anti PD-1 or anti-PD-L1 will be defined according to RECIST 1.1. The initial evidence of progressive disease is to be confirmed by a second assessment, no less than 4 weeks from the date of the first documented progressive disease, in the absence of rapid clinical progression. (This determination is made by the Investigator; the Sponsor will collect imaging scans for retrospective analysis. Once progressive disease is confirmed, the initial date of progressive disease documentation will be considered the date of disease progression).
3. Documented disease progression within 12 weeks of the last dose of anti PD-1 or anti-PD-L1. Patients who were re-treated or on maintenance with anti-PD-1 or anti-PD-L1 will be allowed to enter the study as long as there is documented progressive disease within 12 weeks of the last treatment date.
* Naive to systemic therapy for RCC or have progressed after, or were intolerant of, prior systemic therapy.
* Measurable disease based on RECIST 1.1 criteria. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions
* Karnofsky performance status of 70-100
* Age =20 years old (or appropriate age of consent for the region)
* Adequate hematological, hepatic, and renal function
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Known significant immunodeficiency due to underlying illness (e.g., human immunodeficiency virus [HIV] / acquired immune deficiency syndrome [AIDS]) and/or immune-suppressive medication including high-dose corticosteroids
* Part 2 only: Arm A,B,C: Prior treatment with any anti-cancer immunotherapy, including therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent (prior IL-2 or interferon allowed) . For Part 1: patients are excluded if they were intolerant to anti-PD-1 or anti-PD-L1 targeted therapies
* Major surgery within 4 weeks of study treatment (minor surgical procedures are allowed)
* Ongoing severe inflammatory skin condition requiring prior medical treatment
* History of eczema requiring prior medical treatment
* Tumor(s) invading a major vascular structure (e.g., carotid artery) or other key anatomical structure (e.g., pulmonary airway) OR viable central nervous system malignancy
* Clinically significant and/or rapidly accumulating ascites, pericardial and/or pleural effusions.
* Symptomatic cardiovascular disease, including but not limited to significant coronary artery disease (e.g., requiring angioplasty or stenting) or congestive heart failure within the preceding 12 months.
* Asymptomatic cardiovascular disease (current or past history) unless cardiology consultation and clearance has been obtained for study participation.
* Inability to suspend treatment with anti-hypertensive medication for 48 hours prior to and 48 hours after all Pexa-Vec treatments
* Use of interferon/pegylated interferon (PEG-IFN) or ribavirin that cannot be discontinued within 14 days prior to any Pexa-Vec dose
* Known active Hepatitis B or Hepatitis C
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
7/06/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/11/2023
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Actual
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Sample size
Target
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Accrual to date
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Final
89
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Site 2632 Flinders Medical Centre - Bedford Park
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Recruitment postcode(s) [1]
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SA5042 - Bedford Park
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Recruitment outside Australia
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United States of America
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California
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United States of America
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Florida
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United States of America
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Missouri
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United States of America
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Ohio
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Korea, Republic of
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Daegu
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Korea, Republic of
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Daejeon
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Korea, Republic of
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Gwangju
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Korea, Republic of
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Incheon
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Korea, Republic of
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Pusan
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Korea, Republic of
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Seongnam-si
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Korea, Republic of
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Seongnam
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Korea, Republic of
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Seoul
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Korea, Republic of
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Suwon
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Korea, Republic of
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Wonju
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Korea, Republic of
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Yangsan
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
SillaJen, Inc.
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Regeneron Pharmaceuticals
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a Phase 1b/2a, open-label, multi-center, dose-escalation and safety/efficacy evaluation trial of Pexa-Vec plus Cemiplimab in patients with metastatic or unresectable renal cell carcinoma (RCC). The trial consists of a dose-escalation stage, where the maximum feasible dose of Pexa-Vec in combination with Cemiplimab will be determined, followed by an expansion stage. During the expansion patients will receive Cemiplimab alone or in combination with Pexa-Vec, which will be administered either through intravenous (IV) or intratumoral (IT) injection.
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Trial website
https://clinicaltrials.gov/study/NCT03294083
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Contact person for public queries
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03294083
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