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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT03256344
Registration number
NCT03256344
Ethics application status
Date submitted
8/08/2017
Date registered
22/08/2017
Date last updated
14/05/2024
Titles & IDs
Public title
Study of Talimogene Laherparepvec With Atezolizumab for Triple Negative Breast Cancer and Colorectal Cancer With Liver Metastases
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Scientific title
A Phase 1b Study of Talimogene Laherparepvec in Combination With Atezolizumab in Subjects With Triple Negative Breast Cancer and Colorectal Cancer With Liver Metastases
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Secondary ID [1]
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20140299
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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:
Metastatic Triple Negative Breast Cancer
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Metastatic Colorectal Cancer
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Condition category
Condition code
Cancer
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Breast
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Cancer
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Bowel - Back passage (rectum) or large bowel (colon)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Talimogene Laherparepvec
Other interventions - Atezolizumab
Experimental: Talimogene Laherparepvec with Atezolizumab: Triple Negative Breast Cancer (TNBC) - Participants with TNBC with liver metastases administered intrahepatic injection of talimogene laherparepvec into liver metastases via guided injection (either ultrasound or computerized tomography) on Day 1 of each cycle for a maximum of 12 cycles, where each cycle is 21 days. Participants administered 10^6 plaque-forming units/milliliter (PFU/mL) on Day 1 of Cycle 1 and 10^8 PFU/mL on Day 1 of each cycle thereafter. Participants also administered 1200 mg atezolizumab via intravenous injection on Day 1 of each cycle.
Experimental: Talimogene Laherparepvec with Atezolizumab: Colorectal Cancer (CRC) - Participants with CRC with liver metastases administered intrahepatic injection of talimogene laherparepvec into liver metastases via guided injection (either ultrasound or computerized tomography) on Day 1 of each cycle for a maximum of 12 cycles, where each cycle is 21 days. Participants administered 10^6 PFU/mL on Day 1 of Cycle 1 and 10^8 PFU/mL on Day 1 of each cycle thereafter. Participants also administered 1200 mg atezolizumab via intravenous injection on Day 1 of each cycle.
Other interventions: Talimogene Laherparepvec
Virally based anti-cancer immunotherapy given by direct injection into tumors.
Other interventions: Atezolizumab
A monoclonal antibody given by intravenous injection.
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Intervention code [1]
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Other interventions
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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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Number of Participants Who Experienced a Dose-Limiting Toxicity (DLT)
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Assessment method [1]
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Toxicities were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. A DLT was considered as any of the below, if judged by the investigator to be related to either treatment:
Grade = 4 neutropenia (absolute neutrophil count [ANC] < 500/µl) lasting = 7 days
Grade = 3 febrile neutropenia
Grade = 4 thrombocytopenia
Grade = 4 anemia
Grade = 4 rash
Serious herpetic events
Grade = 3 symptomatic hepatic toxicities that do not resolve to Grade = 2 within 48 hours or Grade = 3 asymptomatic hepatic toxicities that do not resolve to Grade = 1 within 3 weeks of onset
Grade = 3 non-hematologic, non-hepatic organ toxicity
Grade 5 toxicity (ie, death)
Any other intolerable toxicity leading to permanent discontinuation of treatment
DLTs were to occur within the DLT evaluation period, defined as the period between the initial 10^6 PFU/mL dose and 3 weeks following the initial 10^8 PFU/mL dose or the start of Cycle 3, whichever occurred first.
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Timepoint [1]
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From Day 1 up to the start of Cycle 3 (each cycle is 21 days)
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Secondary outcome [1]
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Objective Response Rate (ORR)
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Assessment method [1]
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ORR was defined as the incidence rate of either a complete response (CR) or partial response (PR) based on modified immune-related response criteria simulating Response Evaluation Criteria in Solid Tumors(irRC-RECIST) criteria. A CR was a complete disappearance of all lesions and a PR was a decrease in tumor burden 30% or more relative to baseline.
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Timepoint [1]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [2]
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Best Overall Response (BOR)
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Assessment method [2]
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BOR was defined as the best visit response based on modified irRC-RECIST criteria:
CR: a complete disappearance of all lesions
PR: a decrease in tumor burden 30% or more relative to baseline
Stable disease (SD): neither sufficient shrinkage to qualify for CR or PR nor sufficient increase to qualify for progressive disease (PD)
PD: an increase in tumor burden of 20% or more and at least 5 mm absolute increase relative to nadir (minimum recorded tumor burden)
Unevaluable (UE): any lesion present at baseline which was not assessed or was unable to be evaluated leading to an inability to determine the status of that particular tumor
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Timepoint [2]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [3]
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Duration of Response (DOR)
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Assessment method [3]
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DOR was defined as the time from the date of an initial response that is subsequently confirmed to the earlier of PD per modified irRC RECIST or death. Participants who have not ended their response at the time of analysis were censored at the last evaluable tumor assessment.
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Timepoint [3]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [4]
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Lesion Level Response in Injected Tumor Lesions
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Assessment method [4]
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Responses for individual tumor lesions for hepatic and non-hepatic tumors injected wtih treatment were assessed for the following responses:
Lesion complete response rate (L-CRR): Disappearance of lesion
Lesion partial response rate (L-PRR): Decrease in tumor burden 30% or more relative to baseline
Lesion objective response rate (L-ORR): Either a L-CRR or L-PRR based on modified irRC-RECIST criteria
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Timepoint [4]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [5]
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Lesion Level Response in Uninjected Tumor Lesions
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Assessment method [5]
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Responses for individual tumor lesions for hepatic and non-hepatic tumors that were not injected with treatment were assessed for the following responses:
L-CRR: Disappearance of lesion
L-PRR: Decrease in tumor burden 30% or more relative to baseline
L-ORR: Either a L-CRR or L-PRR based on modified irRC-RECIST criteria
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Timepoint [5]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [6]
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Durable Response Rate (DRR)
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Assessment method [6]
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DRR was defined as the percentage of participants with an objective response with a DOR of at least 6 months.
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Timepoint [6]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [7]
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Disease Control Rate (DCR)
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Assessment method [7]
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DCR was defined as the percentage of participants that have a best overall response in one of the following categories: CR/PR/SD.
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Timepoint [7]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [8]
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Progression-free Survival (PFS)
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Assessment method [8]
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PFS was defined as time from first dose to the date of first of confirmed disease progression per modified irRC-RECIST criteria, or death (whichever occurred first). Results were estimated using the Kaplan-Meier method.
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Timepoint [8]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Secondary outcome [9]
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Overall Survival (OS)
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Assessment method [9]
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OS was defined as the time from the date of first dose to the date of death from any cause. Results were estimated using the Kaplan-Meier method.
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Timepoint [9]
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Every 12 weeks (± 28 days) up to approximately 3.5 years.
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Eligibility
Key inclusion criteria
- Criteria1, Participant provided informed consent prior to any study-specific
activities/procedures.
- Criteria 2, Confirmation of triple negative breast cancer or colorectal cancer with
liver metastases by laboratory testing.
- Criteria 3, Subjects with triple negative breast cancer with liver metastases, or
subjects with colorectal cancer with liver metastases are eligible if they have had
disease progression during or after one or more prior standard of care systemic
anti-cancer therapy (eg,chemotherapy, targeted therapy) for metastatic disease or if
they progress during or within 6 months of receiving adjuvant therapy. If subjects, in
the opinion of the investigator, are deemed not appropriate candidates for systemic
anti-cancer therapy for metastatic disease or if they refuse systemic anti-cancer
therapy for metastatic disease, they may be eligible after investigator discussion
with Sponsor medical monitor for approval.
- Criteria 4, Participants have measurable disease which is equal to one or more
metastatic liver lesions that can be accurately and serially measured that are greater
than or equal to 1 cm dimension and for which the longest diameter is greater or equal
to 1 cm as measured by CT (Computed Tomography) scan or magnetic resonance imaging.
The metastatic liver lesion(s) must not be in an area that received prior localized
therapies.
- Criteria 5, Metastatic liver lesions for injection must be without necrosis (dead
tissue )and must be be located where any tumor swelling will not lead to gall bladder
tract obstruction or lead to bleeding risk.
- Criteria 6, Eastern Cooperative Oncology Group performance status (ECOG PS) 0 or 1.
- Criteria 7, Life expectancy greater than or equal to 5 months.
- Criteria 8, Adequate organ function within 4 weeks prior to enrollment. This includes
hematology, renal, hepatic and blood-clotting functions as defined by protocol.
- Criteria 9, Female subjects of childbearing potential should have a negative serum
pregnancy test within 1 week prior to enrollment.
- Criteria 10, Other Inclusion Criteria May Apply.
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Minimum age
18
Years
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Maximum age
99
Years
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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
Exclusion criteria:
- Criteria 1, Participant is a candidate for hepatic surgery or local regional therapy
of liver metastases with curative intent.
- Criteria 2, More than one third of the liver is estimated to be involved with
metastases.
- Criteria 3, There is invasion by cancer into the main blood vessels such as the portal
vein, hepatic vein or the vena cava.
- Criteria 4, Participant is currently receiving or has received liver
metastatic-directed therapy ( eg: radiation, ablation, embolization) less than 4 wks
prior to enrollment or hepatic surgery.
- Criteria 5, History of other malignancy within the past 5 years prior to enrollment
with some exceptions, as outlined in the protocol.
- Criteria 6, Active or untreated central nervous system (CNS) metastases per CT or
magnetic resonance imagine (MRI) evaluation during screening.
- Participants with a history of CNS metastases are eligible provided they are stable
and meet the criteria details in the protocol.
- Criteria 7, Other Medical Conditions as noted in the protocol.
- Criteria 8, Other Exclusion Criteria May Apply.
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Study design
Purpose of the study
Other
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Allocation to intervention
Non-randomised 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
Single group
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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
Completed
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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
19/03/2018
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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
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Actual
3/12/2021
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Sample size
Target
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Accrual to date
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Final
36
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,WA
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Recruitment hospital [1]
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Liverpool Hospital - Liverpool
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Recruitment hospital [2]
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Monash Medical Centre - Clayton
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Recruitment hospital [3]
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [4]
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Breast Cancer Research Centre - WA - Nedlands
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Recruitment postcode(s) [1]
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2170 - Liverpool
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Recruitment postcode(s) [2]
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3168 - Clayton
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Recruitment postcode(s) [3]
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6150 - Murdoch
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Recruitment postcode(s) [4]
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6009 - Nedlands
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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New York
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Country [3]
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Belgium
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State/province [3]
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Bruxelles
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Belgium
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State/province [4]
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Gent
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Country [5]
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Germany
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State/province [5]
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Berlin
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Country [6]
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Germany
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State/province [6]
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Bonn
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Country [7]
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Germany
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State/province [7]
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Tübingen
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Country [8]
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Spain
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State/province [8]
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Cataluña
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Country [9]
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Spain
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State/province [9]
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Madrid
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Country [10]
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Switzerland
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State/province [10]
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Bern
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Country [11]
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Switzerland
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State/province [11]
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Geneva 14
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Amgen
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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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Roche-Genentech
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Approximately 36 DLT-evaluable subjects will be enrolled in this study. The locations of the
study will be in the United States, Australia, Europe and Switzerland.
The goal of this study is to evaluate the safety of intrahepatic injection (directly into the
liver) of talimogene laherparepvec in combination with intravenously administered
atezolizumab in subjects with triple negative breast cancer and colorectal cancer with liver
metastases.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT03256344
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Trial related presentations / publications
Hecht JR, Raman SS, Chan A, Kalinsky K, Baurain JF, Jimenez MM, Garcia MM, Berger MD, Lauer UM, Khattak A, Carrato A, Zhang Y, Liu K, Cha E, Keegan A, Bhatta S, Strassburg CP, Roohullah A. Phase Ib study of talimogene laherparepvec in combination with atezolizumab in patients with triple negative breast cancer and colorectal cancer with liver metastases. ESMO Open. 2023 Apr;8(2):100884. doi: 10.1016/j.esmoop.2023.100884. Epub 2023 Feb 28.
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Public notes
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Contacts
Principal investigator
Name
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MD
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Address
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Amgen
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Fax
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Email
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Contact person for public queries
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Address
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Fax
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT03256344
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