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Glioblastoma (GBM) and gliosarcoma (GS) are the most common and aggressive forms of malignant primary brain tumor in adults and can be resistant to conventional therapies. The purpose of this Phase Ib study is to evaluate how well a recurrent glioblastoma or gliosarcoma tumor responds to one injection of DNX-2401, a genetically modified, conditionally replicative and oncolytic human-derived adenovirus. DNX-2401 is delivered directly into the tumor where it may establish an active infection by replicating in and killing tumor cells.
Enrollment has been completed for the randomized portion of the study with ongoing evaluation of tumor response and safety. No additional subjects will be randomized or receive interferon gamma (IFN-γ).
The non-randomized portion of the study is open for screening and enrollment. Eligible subjects will receive a single intratumoral injection of DNX-2401 into a recurrent glioblastoma or gliosarcoma brain tumor using the Alcyone MEMS Cannula (AMC™) System (cannula). Tumor response and safety will be evaluated.
After receiving DNX-2401, subjects will return to the clinic for study visits at regular intervals for safety monitoring, MRI scans and other assessments for up to 18 months. Thereafter, they will be followed closely for safety and survival.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DNX-2401 alone | Experimental | Single intratumoral injection of DNX-2401 |
|
| DNX-2401 + Interferon gamma (IFN-γ) | Experimental | Interferon gamma (IFN-γ) beginning at Day 14 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Single intratumoral injection of DNX-2401 | Drug | In the randomized group, following brain tumor biopsy and histological confirmation of recurrent glioblastoma/gliosarcoma, a single injection of DNX-2401 was administered directly into the brain tumor with or without subsequent interferon gamma (IFN-γ) No additional subjects will be randomized. A single intratumoral dose of DNX-2401 will be delivered by cannula. |
| Measure | Description | Time Frame |
|---|---|---|
| Objective response rate (ORR) determined by MRI scan review | Interval tumor size change will be measured | 1.5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence and severity of adverse events, including changes in laboratory test results and neurological examination findings | Events are classified using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 | 1.5 years |
| Number of subjects with immunological and biological effects after DNX-2401 with Interferon gamma |
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Inclusion Criteria:
Exclusion Criteria:
Other protocol-defined inclusion/exclusion criteria may apply as outlined in the relevant protocol version
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| Name | Affiliation | Role |
|---|---|---|
| Nam Tran, MD, PhD | Moffitt Cancer Center | Principal Investigator |
| Karen Fink, MD, PhD | Baylor University: Charles A. Sammons Cancer Center | Principal Investigator |
| Vinay Puduvalli, MBBS | Ohio State University: James Cancer Center | Principal Investigator |
| Frederick Lang, MD | M.D. Anderson Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Moffitt Cancer Center | Tampa | Florida | 33612 | United States | ||
| The Ohio State University |
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| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| D018316 | Gliosarcoma |
| D001932 | Brain Neoplasms |
| D002493 | Central Nervous System Diseases |
| D016543 | Central Nervous System Neoplasms |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D009422 | Nervous System Diseases |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D009369 | Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D050130 | Oncolytic Virotherapy |
| D007371 | Interferon-gamma |
| C554125 | interferon gamma-1b |
| D007167 | Immunotherapy |
| ID | Term |
|---|---|
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
| D007372 | Interferons |
| D016207 | Cytokines |
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|
|
| Interferon-gamma | Drug | In the randomized group, a single injection of DNX-2401 was followed by interferon gamma (IFN-γ). No additional subjects will be randomized or receive IFN-γ following DNX-2401 |
|
|
Laboratory test results and other assessments will be utilized to determine effects |
| 1.5 years |
| Changes in steroid use (dose and frequency) and clinical and KPS status overall and per study arm assignment | 1.5 years |
| Overall survival (OS), progression-free survival (PFS), and clinical benefit rate (CBR). | 1.5 years |
| Changes in responses to quality of life questionnaires | 1.5 years |
| Columbus |
| Ohio |
| 43210 |
| United States |
| Baylor University: Charles A. Sammons Cancer Center | Dallas | Texas | 75246 | United States |
| UT MD Anderson Cancer Center | Houston | Texas | 77030 | United States |
| D001927 |
| Brain Diseases |
| D036341 |
| Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D016215 | Macrophage-Activating Factors |
| D008222 | Lymphokines |
| D011506 | Proteins |
| D001685 | Biological Factors |
| D056747 | Immunomodulation |