A Phase 2b Study of Modified Vaccinia Virus to Treat Patients Advanced Liver Cancer Who Failed Sorafenib (TRAVERSE)
A Phase 2b Randomized Trial of JX-594 (Vaccinia GM-CSF / TK-deactivated Virus) Plus Best Supportive Care Versus Best Supportive Care in Patients With Advanced Hepatocellular Carcinoma Who Have Failed Sorafenib Treatment
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This Phase 2b, open-label, randomized, multi-center study is designed to evaluate the efficacy and safety of JX-594 (Pexa-Vec) in patients with advanced hepatocellular carcinoma (HCC) who have previously failed sorafenib treatment. Eligible patients are randomly assigned in a 2:1 ratio to receive either the experimental therapy (JX-594 plus Best Supportive Care [BSC]) or the control therapy (BSC alone).
Patients assigned to the experimental arm receive an initial intravenous (IV) infusion of JX-594 on Day 1. This is followed by intratumoral (IT) injections of JX-594 directly into viable liver tumors under imaging guidance on Day 8, Day 22, and Weeks 6, 12, and 18. These patients will also receive BSC, but active anti-cancer treatments are strictly prohibited. In contrast, patients in the control arm receive only Best Supportive Care (e.g., hydration, nutrition, pain management) at the treating physician's discretion without any study drug injections. Experimental or active anti-cancer therapies are not permitted in the control arm.
The primary objective of this study is to compare the Overall Survival (OS) between the two treatment arms. Secondary objectives include evaluating Time-to-Tumor Progression (TTP) and objective response rate based on mRECIST criteria for HCC. The study also evaluates Time-to-Symptomatic Progression (TSP), which is defined by changes in the FACT Hepatobiliary Symptom Index (FHSI-8) questionnaire and ECOG performance status. Additionally, the study assesses changes in Quality of Life (QoL) measured by EORTC and FACT-Hep questionnaires. Finally, overall safety and tolerability are closely monitored through the incidence and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs) graded according to NCI CTCAE v4.03, along with clinical laboratory evaluations.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Alberta
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Edmonton, Alberta, Canada, T6G 2B7
- University of Alberta
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British Columbia
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Vancouver, British Columbia, Canada
- University of British Columbia
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Ontario
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Hamilton, Ontario, Canada
- Juravinski Cancer Centre
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Ottawa, Ontario, Canada
- Ottawa Hopsital Research Institute
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Alsace
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Strasbourg, Alsace, France, 67091
- Hôpitaux Universitaires de Strasbourg - Hôpital Civil
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Aquitaine
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Bordeaux, Aquitaine, France, 33000
- Centre Hospitalier Universitaire Hôpital Saint André
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Auvergne
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Clermont-Ferrand, Auvergne, France, 63003
- CHU d'Estaing
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Auvergne-Rhône-Alpes
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Lyon, Auvergne-Rhône-Alpes, France, 69317
- Hopital de la croix rousse
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Midi-Pyrenees
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Toulouse, Midi-Pyrenees, France, 31059
- Hopital Purpan
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Île-de-France Region
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Paris, Île-de-France Region, France, 75571
- Hôpital Saint Antoine, CPP Ile de France V
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Hamburg, Germany, 20246
- Universitätsklinikum Hamburg-Eppendorf
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Bavaria
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München, Bavaria, Germany, 81675
- Klinikum rechts der Isar der Technischen Universität München
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Lower Saxony
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Hanover, Lower Saxony, Germany, 30625
- Medizinische Hochschule Hannover
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Rhineland-Palatinate
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Mainz, Rhineland-Palatinate, Germany, 55131
- Johannes Gutenberg-Universität Mainz
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Hong Kong, Hong Kong
- Queen Mary Hospital
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Daegu, South Korea
- Kyungpook National University Hospital
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Pusan, South Korea
- Pusan National University Hospital
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Seoul, South Korea
- Korea University Guro Hospital
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Seoul, South Korea
- Samsung Medical Center
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Seoul, South Korea
- Seoul National University Hospital
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Seoul, South Korea, 138-736
- Asan Medical Center
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Seoul, South Korea
- Severance Hospital,Yonsei University Health System
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Yangsan, South Korea
- Pusan National University Yangsan Hospital
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Gyeonggi-do
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Ansan-si, Gyeonggi-do, South Korea, 425-707
- Korea University Ansan Hospital
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Tainan, Taiwan
- National Cheng-Kung University Hospital
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Taipei, Taiwan
- National Taiwan University Hospital
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Taipei, Taiwan
- Taipei Veterans General Hospital
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California
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La Jolla, California, United States, 92093
- Moores University of California San Diego Cancer Center
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Orange, California, United States, 92868
- Chao Family Comprehensive Cancer Center
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San Francisco, California, United States
- California Pacific Medical Center
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Stanford, California, United States
- Stanford Hospital and Clinics
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Illinois
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Chicago, Illinois, United States
- University of Chicago Medical Center
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Montana
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Billings, Montana, United States
- Billings Clinic
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New Jersey
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Paterson, New Jersey, United States
- Saint Joseph's Hospital
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New York
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The Bronx, New York, United States
- Montefiore Medical Center
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Ohio
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Canton, Ohio, United States
- Gabrail Cancer Center
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Cleveland, Ohio, United States
- University Hospitals Case Medical Center
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Texas
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Houston, Texas, United States, 77030
- The Methodist Hospital Department of Surgery
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
KEY Inclusion Criteria:
- Diagnosis of primary HCC by tissue biopsy (histological/cytological diagnosis), or clinical diagnosis
- Previously treated with sorafenib for ≥ 14 days and has discontinued sorafenib treatment at least 14 days prior to randomization due to either intolerance or radiographic progression NOTE: Sorafenib is NOT required to be the most recent treatment received for HCC
- ECOG performance status 0, 1 or 2
- Child-Pugh Class A; or Child-Pugh Class B7 without clinically significant ascites
- Hematocrit ≥30% or Hemoglobin ≥10 g/dL
- Tumor status: Measurable viable tumor in the liver and injectable under imaging-guidance; At least one tumor in the liver that has not received prior local-regional treatment OR that has exhibited >25% growth in viable tumor size since prior local-regional treatment.
KEY Exclusion Criteria:
- Received sorafenib within 14 days prior to randomization
- Received systemic anti-cancer therapy other than sorafenib within 28 days of randomization
- Prior treatment with JX-594
- Platelet count < 50,000 PLT/ mm3
- Total white blood cell count < 2,000 cells/mm3
- Prior or planned organ transplant
- Known significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or medication
- Severe or unstable cardiac disease
- Viable CNS malignancy associated with clinical symptoms
- Pregnant or nursing an infant
- History of inflammatory skin condition (e.g., eczema requiring previous treatment, atopic dermatitis)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: JX-594 + Best Supportive Care
Patients on Arm A will receive 1 e9 pfu (plaque forming units) total dose of JX-594 (Vaccinia GM-CSF / TK-deactivated Virus) on each of six (6) treatments over 18 weeks.
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Patients will be randomised 2:1 to Arm A or Arm B and will receive 6 treatments on days 1, 8, 22, week 6, week 12, and week 18 plus best supportive care as needed.
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Other: Best Supportive Care
Patients on the control arm (Arm B) will have best supportive care over 18 weeks.
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Patients will be randomised 2:1 to Arm A or Arm B and will receive best supportive care as needed.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Survival
Time Frame: CT scan every six weeks until progression or death, assessed up to 21 months
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Determine overall survival for patients receiving JX-594 plus best supportive care (Arm A) compared with those patients receiving best supportive care (Arm B) in patients with advanced hepatocellular carcinoma (HCC) who have failed sorafenib treatment.
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CT scan every six weeks until progression or death, assessed up to 21 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Time to Tumor Progression
Time Frame: CT scan every six weeks until progression or death, assessed up to 21 months
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Determine time-to-tumor-progression (TTP) for Arm A compared with Arm B based on mRECIST for HCC.
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CT scan every six weeks until progression or death, assessed up to 21 months
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Quality of Life
Time Frame: assessed up to 21 months (average)
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Determine the Quality of Life (QoL) of patients treated in Arm A compared with Arm B.
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assessed up to 21 months (average)
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Tumor Response
Time Frame: CT scan every 6 weeks until progression or death, assessed up to 21 months (average)
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Determine tumor response based on mRECIST for HCC of Arm A versus Arm B
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CT scan every 6 weeks until progression or death, assessed up to 21 months (average)
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Safety profile of JX594
Time Frame: assessed up to 21 months (average)
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Safety will be assessed by the number of adverse events (AEs) and serious adverse events (SAEs)
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assessed up to 21 months (average)
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Time-to-symptomatic-progression
Time Frame: assessed up to 21 months (average)
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Determine time to progression of Arm A compared to Arm B.
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assessed up to 21 months (average)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: James Burke, MD, Jennerex Biotherapeutics
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Infections
- Virus Diseases
- Neoplasms by Histologic Type
- Digestive System Neoplasms
- Digestive System Diseases
- Liver Diseases
- Neoplasms, Glandular and Epithelial
- Adenocarcinoma
- Poxviridae Infections
- DNA Virus Infections
- Carcinoma
- Carcinoma, Hepatocellular
- Liver Neoplasms
- Vaccinia
- Oculocerebral hypopigmentation syndrome type Preus
Other Study ID Numbers
Other Study ID Numbers
- JX594-HEP018
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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