Pembrolizumab With Intratumoral Injection of Clostridium Novyi-NT (NCT03435952) | Clinical Trial Compass
Active — Not RecruitingPhase 1
Pembrolizumab With Intratumoral Injection of Clostridium Novyi-NT
United States18 participantsStarted 2018-07-10
Plain-language summary
Some tumors are difficult to treat with chemotherapy or radiation. One of the reasons is that areas of the tumor do not have many blood vessels, which makes it difficult for drugs to reach those areas. One way that researchers have recently tried to overcome this problem is by injecting special kinds of bacteria into the tumors. These bacteria have been genetically changed to remove the chemicals that are poisonous to humans, but are still able to cause tumor cells to break down and die. The idea is that these bacteria may be able to assist chemotherapy drugs in fighting cancer.
The goal of this clinical research study is to find the highest tolerable dose of one of these bacterial therapies (Clostridium novyi-NT spores) that can be given in combination with pembrolizumab to patients with advanced solid tumors. The safety of this drug will also be studied, as well as whether it can help to control the disease.
This is an investigational study. Clostridium novyi-NT is not FDA approved or commercially available. It is currently being used for research purposes only. Pembrolizumab is FDA approved for the treatment of melanoma and different types of head and neck and non-small cell lung cancers. It is investigational to use these drugs in combination with each other in various types of advanced cancers.
The study doctor can describe how the study drugs are designed to work.
Up to 18 participants will be enrolled in this study. All will take part at MD Anderson.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Diagnosis of an advanced solid tumor malignancy. There must be a target tumor which is measureable, palpable or clearly identifiable under ultrasound or radiographic guidance and amenable to percutaneous injection of C. novyi-NT spores. The targeted lesion must have a longest diameter \>/= 1 cm and \< 12 cm and be measurable as defined by RECIST 1.1 criteria. The target lesion must not be located in either the thoracic, abdominal or pelvic cavities or in the brain. There must be no clinical, no functional, and no radiographic evidence of bone involvement at the site of the target lesion.
✓. History of prior treatment with at least one line of systemic anticancer therapy, when an approved systemic therapy is available, and no curative option is available for continued treatment.
✓. At least 4 weeks have elapsed since the completion of major surgery, and the patient has fully recovered from this surgery and any post-surgical complications.
✓. Patient must have adequate organ function as indicated by the following laboratory values. Hematological: Absolute neutrophil count (ANC) \>/=1,500/mcL; Platelets \>/=100,000/mcL; Hemoglobin \>/=9g/dL or \>/= 5.6 mmol/L. Renal: Serum creatinine \</= 1.5 X upper limit of normal (ULN. Hepatic: serum total bilirubin \</= 1.5 X ULN OR Direct bilirubin \</= ULN for patients with total bilirubin levels \> 1.5 ULN; AST (SGOT) and ALT (SPGT) \</= 2.5 X ULN OR \</= 5 X ULN for patients with liver metastases. Coagulation: International Normalized ration (INR) or Prothrombin Time (PT) \</= 1.5 X ULN unless patient is receiving anticoagulant therapy as long as PT of PTT is within therapeutic range of intended use of anticoagulants; Activated partial Thromboplastin Time (aPTT) \</= 1.5 X ULN unless patient is receiving anticoagulant therapy as long as PT of PTT is within therapeutic range of intended use of anticoagulants.
What they're measuring
1
Maximum Tolerated Dose (MTD) of Intratumoral Injection of Clostridium Novyi-NT with Pembrolizumab
✓. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
✓. Patient is at least 18 years of age.
✓. Patient is capable of giving informed consent.
✓. Female patient of childbearing potential has a negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. The serum pregnancy test must be negative for the patient to be eligible.
Exclusion criteria
✕. Patient who has had chemotherapy, radiation therapy, or biological cancer therapy within four weeks prior to the first dose of study drug, or who has not recovered to CTCAE Grade 1 or better from the AEs due to cancer therapeutics administered more than four weeks earlier.
✕. Patient is currently participating or has participated in a study of an investigational agent or using an investigational device within 30 days of the first dose of study drug. (A patient in the survival Follow up phase of an investigational agent where no further treatment is expected is eligible).
✕. Patient is on any systemic corticosteroid therapy within one week before the planned date for first dose of treatment or on any other form of immunosuppressive medication.
✕. Documented primary brain malignancy or brain metastases.
✕. Patient previously had a severe hypersensitivity reaction to treatment with another mAb.
✕. Patient has an active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents. Patients with vitiligo or resolved childhood asthma/atopy would be an exception to this rule. Patients that require intermittent use of bronchodilators or local steroid injections would not be excluded from the study. Patients with hypothyroidism stable on hormone replacement will not be excluded from the study.
✕. Patient has an active infection requiring systemic therapy.
✕. Patient has known history of Human Immunodeficiency Virus (HIV) (HIV ½ antibodies).