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The purpose of this study is to determine the safety and tolerability of GL-ONC1 administered intravenously in combination with radiation therapy and cisplatin (CDDP)in patients with locoregionally advanced head and neck cancer.
GL-ONC1, an oncolytic vaccinia virus, has shown the ability to preferentially locate, colonize and destroy tumor cells in more than 40 different human tumors. A First-in-Man, Phase I clinical study focusing on the safety and tolerability of GL-ONC1 intravenously administered to patients with a variety of advanced solid tumor entities has shown that GL-ONC1 is well-tolerated at therapeutic dose levels, with documented evidence of antitumor activity. Preclinical studies have further shown synergistic effects with the use of chemotherapy (Cisplatin) and viral therapy with GL-ONC, as well as favorable results when cancer cells are irradiated and then treated with GL-ONC1 in animal models. This Phase I study seeks to evaluate the safety, tolerability and early signs of efficacy of GL-ONC1 administered intravenously in combination with standard of care (SOC) radiation therapy (RT) and cisplatin (CDDP)in patients with locoregionally advanced head and neck cancer. Patients will be individually assessed for safety and dose limiting toxicity. Viral colonization in tumors, replication and anti-tumoral activity will also be evaluated.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GL-ONC1 | Biological | A genetically-engineered vaccinia virus administered via intravenous infusion . Cohorts 1, 2, 3: Frequency: 1x in Week 1; Cohort 4: 1x again 1x in Week 2; Cohort 5: 1x Week 1, 1x Week 2, 1x Week 3, 1x Week 4. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability as measured by the number of patients with Adverse Events, as well as type of AE and frequency | Evaluation of changes in laboratory tests (hematological, chemistry), immunogenicity and physical examination | Baseline up to week 23 Post-treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Presence of Virus in Tumor | Analysis of tumor tissue (obtained through surgical or core biopsy if accessible from consenting patients) following viral treatment. | At baseline (Within 4 weeks of Treatment Day 1); 9-13 days post viral injection |
| Determine Initial Susceptibility of tumor to viral infection |
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Inclusion Criteria:
Confirmed diagnosis of histologically or cytologically documented Stage III to IVB primary, non-metastatic head and neck cancer for newly diagnosed patients with no prior disease-related treatment (e.g., chemotherapy, radiation treatment, surgery, etc.).
American Joint Committee on Cancer (AJCC) Stage III-IVB disease (2010 manual, 7th edition), based on standard diagnostic workup.
18 years or older.
ECOG performance status of ≤ 2.
Laboratory data obtained within 14 days prior to Treatment Day 1, with adequate hepatic and renal function defined as follows:
Pulse oximetry reading of 92% or higher at rest on room air.
Signed informed consent
Women of childbearing potential must have a negative serum pregnancy test and agree to practice effective birth control during treatment phase and up to 60 days after the last virus application.
Male patients must agree to practice effective birth control during the study and for 60 days following administration of last treatment of virus.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Loren K Mell, MD | Moores UC San Diego Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Moores UC San Diego Cancer Center | La Jolla | California | 92037 | United States |
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| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D014615 | Vaccinia |
| D002294 | Carcinoma, Squamous Cell |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D011213 | Poxviridae Infections |
| D004266 | DNA Virus Infections |
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Evaluate susceptibility of initial biopsied tumor to viral infection in cell cultures (for patients consenting to biopsy and where tumor is accessible). |
| At baseline (Within 4 weeks of Treatment Day 1) |
| Anti-Tumor Activity (Early Efficacy) | Assessing changes in tumor measurement through physical examination, CT or CT/PET scan | Change from baseline up to week 23 Post-treatment (week 23) |
| D014777 |
| Virus Diseases |
| D007239 | Infections |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D018307 | Neoplasms, Squamous Cell |