First-line Maintenance of OH2 Injection for Advanced Colorectal Cancer

A Prospective, Multicenter, Open, Randomized Controlled Phase II Clinical Study Evaluating Recombinant Oncolytic HSV2（OH2）Therapeutic Injecta(Vero Cell) for Human Use(rHSV2hGM-CSF) in Combination With Capecitabine for First-line Maintenance Therapy in Advanced Colorectal Cancer

This is a prospective, multicenter, open, randomized controlled Phase II clinical study to evaluate the efficacy and safety of intratumoral injection of OH2 combined with capecitabine for first-line maintenance of advanced colorectal cancer.

Study Overview

• Status: Terminated
• Conditions: Advanced Colorectal Carcinoma
• Intervention / Treatment: Biological: OH2; Drug: Capecitabine; Drug: Bevacizumab

• Study Type: Interventional
• Enrollment (Actual): 7
• Phase: Phase 2

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100021
      • National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years to 71 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Age 18 to 75 years old (including boundary values), male or female;
2. Patients with advanced colorectal adenocarcinoma (Stage IV) with a definite histological or cytological diagnosis;
3. Partial response (PR) or stable disease (SD) was evaluated in advanced colorectal cancer patients after 16 to 24 weeks of first-line treatment with fluorouracil-based chemotherapy combined with or without targeted drugs, and before the last chemotherapy to trial drug administration;
4. The physical status score of the Eastern Oncology Consortium (ECOG) was 0~1;
5. Have at least one measurable or evaluable lesion according to RECIST 1.1;
6. There are lesions suitable for intratumoral injection;
7. At least 2 weeks and no more than 4 weeks after the end of the last first-line chemotherapy;
8. Expected survival ≥12 weeks;
9. Patients with asymptomatic BMS after treatment who are free of disease progression by computed tomography (CT) or magnetic resonance imaging (MRI), stable for at least 12 weeks and without steroid medication for at least 4 weeks;

10. Laboratory examination (no blood transfusion or use of blood products, no correction therapy with granulocyte colony stimulating factor or other hematopoietic stimulating factor within 14 days prior to the first dose) :

    1. WBC≥3.0×109/L, ANC≥1.5×109/L, PLT≥100×109/L, Hb≥90 g/L;
    2. Serum creatinine ≤1.5×ULN;
    3. TBIL≤1.5×ULN;
    4. ALT and AST≤2.5×ULN; Patients with liver metastasis ≤5×ULN;
    5. Normal coagulation: International normalized ratio INR≤1.5×ULN or prothrombin time (PT, APTT) ≤1.5×ULN;
11. For patients with herpes, it takes 3 months after the herpes subsides;
12. I have fully understood the research and voluntarily signed the informed consent, and I expect good compliance;
13. For women of childbearing age, the blood pregnancy test must be negative within 7 days before the first medication;
14. The use of at least one medically approved contraceptive method (e.g. surgical sterilization, oral contraceptives, intrauterine devices, controlled sexual desire or barrier contraception combined with spermicide) by fertile women and men with a partner of a woman of reproductive age for at least six months from the signing of the informed consent form until the last trial drug treatment.

Exclusion Criteria:

1. Patients who plan to undergo radical excision of metastatic lesions；
2. Unrelieved intestinal obstruction or malabsorption syndrome;
3. Adverse reactions caused by first-line chemotherapy drugs did not recover to ≤ grade 1 before randomization (except hair loss and peripheral neurotoxicity less than or equal to grade 2);
4. Cardiovascular disease meets one of the following criteria: Congestive heart failure with ≥NYHA Level III heart function; Severe arrhythmias requiring medical treatment; Acute myocardial infarction, severe or unstable angina, coronary or peripheral artery bypass grafting, or stenting within 6 months prior to initial administration; Left ventricular ejection fraction (LVEF) <50%; Adjusted QTc interval (Fridericia formula correction) >450 ms for men and >470 ms for women, or risk factors for tip twisting ventricular tachycardia such as clinically significant hypokalemia as determined by the investigator, a family history of long QT syndrome, or a family history of arrhythmia (such as pre-excited syndrome); High blood pressure that is not effectively controlled;
5. Patients had active infection or unexplained fever >38.5℃ during screening or before initial administration;
6. Patients with congenital or acquired immune deficiency (such as HIV infection), syphilis antibody positive and syphilis rapid plasma reactin-positive, active hepatitis (hepatitis B: HBsAg positive and HBV DNA≥2000 IU/mL; Hepatitis C: HCV antibody positive and HCV virus copy number > upper limit of normal);
7. Had received or was receiving or still required to receive other experimental agents or antiviral therapy within 4 weeks before randomization (hepatitis B patients were treated with entecavir, tenofovir fumarate dipifurofurl, adefovir dipivoxil sustainably);
8. Participated in other clinical studies within 4 weeks prior to randomization;
9. Known to be allergic to the test drug or its active ingredients or excipients, or severely allergic;
10. A known history of psychotropic substance abuse, alcohol or drug abuse;
11. Patients who developed other malignant tumors within 5 years prior to inclusion, except for cervical carcinoma in situ, low-risk gastrointestinal stromal tumor, in situ or early stage breast cancer, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, and papillary carcinoma of the thyroid, which were effectively resected and required no further antitumor therapy and had a recurrence survival rate of more than 70% in 5 years;

12. Patients with active autoimmune disease or a history of autoimmune disease that may recur, but patients with the following diseases are not excluded and can be further screened:

    1. Type 1 diabetes
    2. Hypothyroidism (if controlled with hormone replacement therapy alone)
    3. Controlled celiac disease
    4. Skin diseases that do not require systemic treatment (e.g. vitiligo, psoriasis, hair loss)

13. Patients for any condition requiring systemic therapy with glucocorticoids (prednisone >10 mg/ day or equivalent dose of the same drug) or other immunosuppressant within 14 days prior to the administration of the investigational drug, but who are currently or previously on any of the following steroid regimens may be enrolled:

    1. Epinephrine substitute steroid (prednisone ≤10 mg/ day or equivalent dose of similar drugs)
    2. Systemic absorption of minimal amounts of local, ocular, intra-articular, intranasal or inhaled corticosteroids
    3. Prophylactic short-term (≤7 days) use of corticosteroids (e.g., allergy to contrast media) or to treat non-autoimmune conditions (e.g., delayed hypersensitivity caused by contact allergens)
14. Patients with grade 2 or above radiation pneumonia during previous antitumor therapy, or pulmonary diseases such as pulmonary fibrosis history, interstitial pneumonia, pneumoconiosis, drug-related pneumonia, and severe impairment of lung function;
15. Pleural effusion or ascites with clinical symptoms requiring repeated drainage (≥1 time/month);
16. Other researchers did not consider it appropriate to participate in this study.

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

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: OH2+Capecitabine; OH2: 10^7 CCID50/mL intratumoral injection, once every 2 weeks; Capecitabine: 1000 mg/m2, orally administered twice a day, D1 to D14, repeated every 3 weeks	Biological: OH2; Oncolytic Type 2 Herpes Simplex Virus; Drug: Capecitabine; 1000 mg/m2, orally administered twice a day, D1 to D14, repeated every 3 weeks
Active Comparator: Capecitabine/Capecitabine+Bevacizumab; Capecitabine: 1000 mg/m2, orally administered twice a day, D1 to D14, repeated every 3 weeks Bevacizumab: 7.5 mg/kg, intravenously, once every 3 weeks.	Drug: Capecitabine; 1000 mg/m2, orally administered twice a day, D1 to D14, repeated every 3 weeks; Drug: Bevacizumab; Bevacizumab: 7.5 mg/kg, intravenously, once every 3 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Progression-free survival	Time after treatment to clinical and radiographic disease progression will be evaluated.	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Durable response rate (DRR)	objective response lasting continuously 6 months	2 years
Overall survival (OS)	The overall survival for each patient receiving treatment will be calculated.	2 years
Objective response rate (ORR)	Determination of the ORR will be calculated based on the proportion of patients achieving CR or PR using the RECIST v1.1 and iRECIST as assessed by investigators.	2 years
Disease control rate (DCR)	DCR will be calculated based on the proportion of patients achieving CR, PR, or who have SD at least 6 weeks after receiving first dose of study treatment.	2 years
Duration of response (DoR)	DOR will be calculated from the time of initial response (CR or PR) documentation to the time of progressive disease (PD). If a subject who had CR or PR dies without the evidence of disease progression, the case will be censored at the time point of death when analyzing DOR	2 years
Immune-progression-free survival (iPFS)	Time after treatment to disease progression using the iRECIST will be evaluated.	2 years
Toxicity by CTCAE v5.0	Safety assessments should be conducted for all subjects who received treatment at least once. Adverse events will be graded according to CTCAE v5.0.	2 years

Collaborators and Investigators

• Sponsor: Binhui Biopharmaceutical Co., Ltd.

Study record dates

Study Major Dates

• Study Start (Actual): October 17, 2023
• Primary Completion (Actual): April 15, 2024
• Study Completion (Actual): April 15, 2024

Study Registration Dates

• First Submitted: December 5, 2022
• First Submitted That Met QC Criteria: December 5, 2022
• First Posted (Actual): December 13, 2022

Study Record Updates

• Last Update Posted (Actual): April 30, 2024
• Last Update Submitted That Met QC Criteria: April 28, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: Oncolytic Virus
• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colorectal Neoplasms; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Antimetabolites, Antineoplastic; Antimetabolites; Antineoplastic Agents; Antineoplastic Agents, Immunological; Angiogenesis Inhibitors; Angiogenesis Modulating Agents; Growth Substances; Growth Inhibitors; Capecitabine; Bevacizumab
• Other Study ID Numbers: BH-OH2-010

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No