The goal of this clinical trial is to learn about the safety and tolerability of GO321 recombinant oncolytic virus injection, and if GO321 recombinant oncolytic virus injection works to treat advanced solid tumors in adults whose cancers have progressed after standard-of-care therapy. It will also learn about the pharmacokinetic features, viral shedding, immunogenicity of GO321, immune markers, and genomic and proteomic changes in patients. The main questions it aims to answer are: What safety issues and tolerability limitations do participants experience when receiving GO321 via intratumoral or intracavitary injection? Does GO321 have preliminary anti-tumor efficacy against advanced solid tumors resistant to standard treatment? What changes take place in viral distribution, viral shedding, immunity, blood immune markers, tumor or blood genomics and proteomics after GO321 administration? Researchers will assess different doses and dosing schedules of GO321 given by intratumoral or intracavitary injection across two study phases to find a suitable administration dose and regimen and verify the study endpoints.
Participants will:
Receive either a single injection of GO321 at different dose levels (in Part 1) or repeated GO321 injections at the recommended Phase 2 dose (in Part 2) by intratumoral or intracavitary routes; Complete scheduled hospital visits to undergo laboratory tests, imaging examinations and biological sample collection; Have their safety indicators, anti-tumor response, viral parameters, immune indicators and molecular profiles tracked throughout the study.
Inclusion Criteria:
Age 18 years old and above, regardless of gender.
Histologically or cytologically confirmed advanced malignant solid tumors that are refractory to or have failed standard therapy (including disease progression and/or intolerance to toxicity), or for which no standard therapy is available.
For patients with malignant ascites secondary to malignant tumors (e.g., ovarian cancer, gastrointestinal solid malignancies) who are planned to receive intracavitary injection, the following criteria must be met:
Patients scheduled for intratumoral injection must meet the following requirements: At least one evaluable lesion confirmed by local imaging per RECIST v1.1 that is amenable to intratumoral injection. A lesion suitable for intratumoral injection (with or without CT/ultrasound guidance) is defined as a palpable mass or a mass visible by CT/ultrasound that can be injected under CT/ultrasound guidance, located in the skin, subcutaneous tissue, or deep-seated regions, with a longest diameter ≥ 1.0 cm (or short axis ≥ 1.5 cm if a lymph node), and deemed appropriate for intratumoral injection by the investigator. If the injection site has been previously irradiated, eligibility may be considered after discussion with the sponsor.
Eastern Cooperative Oncology Group (ECOG) score ≤2.
Expected survival time ≥3 months.
Study participants had adequate organ function at screening/baseline, and the laboratory indicators met the following criteria:
Study participants were willing and able to comply with protocol requirements for the duration of the trial, including but not limited to receiving treatment, use effective contraception throughout trial participation and for 6 months after the last study drug administration, and undergoing regular follow-up and examinations.
Exclusion Criteria:
Female participants who were pregnant or lactating.
Presence of another malignancy within the previous 2 years, except for cancers with a low risk of metastasis and death (5-year survival rate, >90%), such as adequately treated basal-cell or squamous-cell skin cancer or carcinoma in situ of the cervix and other cancers in situ.
Adverse events from prior anti-tumor therapy have not recovered to Grade ≤ 1 per CTCAE v6.0, or to the levels specified in the inclusion/exclusion criteria (with the exception of alopecia, skin hyperpigmentation, or other toxicities deemed by the investigator to have no safety risk). Participants with chronic Grade 2 toxicity may be eligible after discussion with the sponsor, provided the toxicity is asymptomatic or adequately controlled with stable medications.
Received nitrosoureas or mitomycin C within 6 weeks prior to the first dose of the investigational product; received oral fluoropyrimidines or small-molecule targeted agents within 2 weeks or 5 half-lives (whichever is longer) prior to the first dose; received traditional Chinese herbal medicines or proprietary Chinese medicines with anti-tumor indications within 2 weeks prior to the first dose; received other systemic anti-tumor therapies, including chemotherapy, radiotherapy, biotherapy, endocrine therapy, immunotherapy, etc., within 3 weeks or 5 half-lives (whichever is shorter) prior to the first dose.
Presence of any of the following infections or diseases:
Have a history of active autoimmune disease requiring systemic therapy such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis, etc., or have been receiving long-term systemic steroids (prednisone >10 mg/ day or equivalent dose of the same drug) or any other form of immunosuppressive therapy within 14 days before the first use of the investigational drug. The following patients are NOT excluded:
Received allogeneic tissue or solid organ transplantation.
A history of severe cardiovascular and cerebrovascular disease, including but not limited to:
History of severe skin diseases requiring systemic therapy within the past 2 years, such as eczema, atopic dermatitis, burns, seborrheic dermatitis, psoriasis, severe acne, etc.
Patients with history of hypersensitivity or anaphylactic reactions (including immediate severe hypersensitivity reactions) of CTCAE v6.0 Grade > 3 following prior use of any drug or biologic product.
Requirement for anticoagulant or antiplatelet therapy that cannot be interrupted prior to intratumoral injection, including: aspirin that cannot be discontinued within 7 days prior to injection; coumarins that cannot be discontinued within 7 days prior to injection; direct thrombin inhibitors (dabigatran) or direct Factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban) that cannot be discontinued within 4 days prior to injection; low-molecular-weight heparin (LMWH) that cannot be discontinued within 24 hours prior to injection; and unfractionated heparin (UFH) that cannot be discontinued for more than 4 hours prior to injection.
Use of immunomodulatory agents within 14 days prior to the first dose of the investigational product, including but not limited to thymosin, IL-2, IFN, etc.
Presence of other conditions requiring systemic anti-infective treatment within 4 weeks prior to the first dose of the investigational product, or active local infection at the target lesion intended for injection within 4 weeks prior to the first dose, including but not limited to hospitalization due to infectious complications, bacteremia, severe pneumonia, or active tuberculosis.
Receipt of other investigational drugs or therapies not yet approved for marketing within 4 weeks prior to the first dose of the investigational product, or receipt of live or live-attenuated vaccines within 4 weeks prior to the first dose.
Study participants who had undergone major surgery requiring hospitalization within 4 weeks before the first use of the investigational drug, or who were expected to undergo major surgery during the trial.
Inability to discontinue concomitant use of sensitive substrate drugs with a narrow therapeutic index that are metabolized by CYP450 enzymes within 5 half-lives prior to the first dose of the investigational product.
Any known mental illness or substance abuse that may interfere with the participant's ability to cooperate with the trial.
According to the evaluation of the investigators, the treatment risks are high, including but not limited to the high risk of bleeding, possible damage to the surrounding important tissue structures, the risk of shock caused by dizzy with blood and needles, and the risk of aggravating local infection.
If study participants plan to participate in another clinical trial during the trial period, plan to leave the trial site, or otherwise are not suitable for participation in the trial as assessed by the investigator.
lining@cicams.ac.cn
This is a single-arm, non-randomized study which comprises two parts: - Part 1: A 3+3 single-dose escalation phase to determine the Maximum Tolerated Dose (MTD), Dose-Limiting Toxicities (DLTs), and Recommended Dose (RD) of the investigational product. - Part 2: A multiple-dose expansion phase at the RD level to explore preliminary efficacy in specific tumor types.
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