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VG161 is a recombinant human-IL12/15/PDL1B oncolytic HSV-1 injection. This study will be conducted in combination with nivolumab injection in HSV seropositive subjects with advanced metastatic gastric or gastroesophageal junction adenocarcinoma who have previously received two or more systemic treatment regimens (which must include anti-PD-1 monoclonal antibodies). This is an open-label study divided into two parts.
Part 1: This part is an escalating dose trial to explore the safety of the combination and determine the recommended safe dose of the combination.
Part 2: This part is an extension trial to investigate the preliminary efficacy of the combination at a safe dose.
Part1(Phase Ib primary objective): To evaluate the safety and tolerability of VG161 administered by intratumoral injection combined with Nivolumab Injection in the treatment of patients with advanced metastatic gastric or gastroesophageal junction adenocarcinoma who have previously received two or more systemic treatment regimens (including anti-PD-1 monoclonal antibodies), explore the most suitable recommended Phase II dose (RP2D) for combination therapy, and determine the recommended regimen for combination therapy in Phase IIa clinical trials. Secondary objectives: 1) To preliminarily evaluate the antitumor activity of VG161 combined with nivolumab injection in the treatment of patients with advanced gastric cancer; 2) To monitor the changes of immunological parameters related to pharmacodynamics; 3) To evaluate the relevant immunological characteristics of tumor biopsy samples; 4) To evaluate the pharmacokinetic (PK) characteristics and viral excretion of single and multiple intratumoral injections of VG161;
Part2(Phase IIa Primary Objective): To further evaluate the safety and efficacy of intratumoral injection of VG161 combined with nivolumab injection in patients with advanced metastatic gastric or gastroesophageal junction adenocarcinoma who have previously received two or more systemic treatment regimens (which must include anti-PD-1 monoclonal antibodies), with the primary outcome measure of efficacy being objective response rate (ORR). Secondary objectives: 1) To evaluate the secondary outcome measures of the efficacy of combined treatment; 2) To monitor the pharmacodynamic-related changes in immunological parameters; 3) To evaluate the relevant immunological characteristics of tumor biopsy samples;
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single Arm | Experimental | Part1: VG161: 1) 1.0 × 10 ^ 8 PFU daily on Day 1 of each cycle (D1); 2)1.0 × 10 ^ 8 PFU daily for 2 consecutive days on Days 1-2 of each cycle (D1-D2); 3)1.0 × 10 ^ 8 PFU daily for 3 consecutive days on days 1-3 (D1-D3) in the first cycle; 1.0 × 10 ^ 8 PFU daily for 2 consecutive days on days 1-2 (D1-D2) in the second and subsequent cycles; Nivolumab Injection: 3 mg/kg every 2 weeks (D8, D22) Part2: Depends on the recommended dose in Part1 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Recombinant Human IL12/15-PDL1B Oncolytic HSV-1 Injection (Vero Cell)) | Drug | Intratumoral injection only. Dosing days may be Day 1 or Days 1-3 only. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Phase Ib:RP2D/MTD | RP2D/MTD for VG161 in Combination with Nivolumab | through Phase Ib study completion, an average of 1 year |
| Phase Ib:Incidence and number of DLT | Incidence and number of DLT (dose-limiting toxicity) | through Phase Ib study completion, an average of 1 year |
| Phase Ib and Phase IIa:AE, SAE occurrence and frequency | Occurrence and frequency of AE (Adverse Event) and SAE(Serious adverse event) | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase IIa:ORR | Objective response rate (ORR) | through Phase IIa study completion, an average of 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Phase Ib and Phase IIa:ORR and DCR | Objective response rate (ORR) and disease control rate (DCR) | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib and Phase IIa:PFSand OS |
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Inclusion Criteria:
- (Subjects must meet all of the following inclusion criteria to enter the trial)
Exclusion Criteria:
- (Any of the following criteria must be excluded)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lin Shen, Professor | Contact | 13911219511 | 010-88196561 | doctorshenlin@sina.cn |
| Name | Affiliation | Role |
|---|---|---|
| Lin Shen | Peking University Cancer Hospital & Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Cancer Hospital | Recruiting | Beijing | Beijing Municipality | China |
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| Nivolumab Injection | Drug | Administered once at 3 mg/kg intravenously on Days 8 and 22 of each cycle. |
|
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Progression Free Survival (PFS) and Overall Survival (OS)
| through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib and Phase IIa:DOR | Duration of Response (DOR) | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib and Phase IIa: Immunological indicators | Immunological parameters: peripheral blood lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 +/CD8 + ratio, CD19 +, CD16 + CD56 + (NK) cells), cytokines (IL-12, IL-15, IL-6, TNF-α, IFN-γ); | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib and Phase IIa:Correlation of PD-L1 combined positive score (CPS) with safety and efficacy | Correlation of PD-L1 combined positive score (CPS) with safety and efficacy | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib and Phase IIa:Correlation of herpes simplex virus type I antibodies with safety and efficacy | Correlation of herpes simplex virus type I antibodies with safety and efficacy | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib and Phase IIa:Immunohistochemical detection of HER2、CD68、 CD3、 CD4、 CD8、CD47 | Immunohistochemical detection of HER2、CD68、 CD3、 CD4、 CD8、CD47 | through Phase Ib and Phase IIa study completion, an average of 2 year |
| Phase Ib :Pharmacokinetic parameters: Blood concentrations of VG161 at different time points after single and multiple doses | Pharmacokinetic parameters: Blood concentrations of VG161 at different time points after single and multiple doses | through Phase Ib study completion, an average of 1 year |
| ID | Term |
|---|---|
| D013274 | Stomach Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |
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| ID | Term |
|---|---|
| D000077594 | Nivolumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
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