- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT03502785
INO-5401 + INO-9012 en combinación con atezolizumab en carcinoma urotelial localmente avanzado no resecable o metastásico/recurrente
Un ensayo abierto y multicéntrico de INO-5401 + INO-9012 en combinación con atezolizumab en sujetos con carcinoma urotelial localmente avanzado no resecable o metastásico/recurrente
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 2
- Fase 1
Contactos y Ubicaciones
Ubicaciones de estudio
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Arizona
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Phoenix, Arizona, Estados Unidos, 85054
- Mayo Clinic Cancer Center
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Florida
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Tampa, Florida, Estados Unidos, 33612
- H. Lee Moffitt Cancer Center & Research Institute, Inc.
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Maryland
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Baltimore, Maryland, Estados Unidos, 21287
- Johns Hopkins University School Of Medicine
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Michigan
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Detroit, Michigan, Estados Unidos, 48201
- Karmanos Cancer Institute
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Missouri
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St Louis, Missouri, Estados Unidos, 63110
- Washington University School of Medicine in St. Louis
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New York
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New York, New York, Estados Unidos, 10032
- Columbia University, Herbert Irving Comprehensive Cancer Center
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New York, New York, Estados Unidos, 10016
- New York University Langone Medical Center - Perlmutter Cancer Center
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North Carolina
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Chapel Hill, North Carolina, Estados Unidos, 27599
- University of North Carolina School of Medicine
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Pennsylvania
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Pittsburgh, Pennsylvania, Estados Unidos, 15232
- University of Pittsburgh Medical Center
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South Carolina
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Greenville, South Carolina, Estados Unidos, 29615
- Greenville Memorial Hospital
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Virginia
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Fairfax, Virginia, Estados Unidos, 22031
- Inova Melanoma and Skin Cancer Center
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Descripción
Criterios de inclusión:
- Firmar un Formulario de Consentimiento Informado (ICF);
- Tener carcinoma urotelial recurrente o metastásico no resecable localmente avanzado documentado histológica o citológicamente (incluyendo pelvis renal, uréteres, vejiga urinaria y uretra);
- Para la cohorte A: Sujetos que tienen progresión de la enfermedad confirmada radiográficamente durante o después del tratamiento con una terapia basada en anti-PD-1/PD-L1;
- Para la cohorte B: sin quimioterapia previa para UCa inoperable localmente avanzado o metastásico o recurrente y no elegible ("no apto") para quimioterapia basada en cisplatino;
- Tener una enfermedad medible, según lo definido por RECIST versión 1.1;
- Tener un estado funcional de 0 o 1 en la escala de rendimiento del Grupo Oncológico Cooperativo del Este (ECOG);
- Tener una esperanza de vida >/= 3 meses;
- Estar dispuesto a proporcionar una muestra de tejido para la evaluación intratumoral previa al tratamiento de factores proinflamatorios e inmunosupresores;
- Tener un electrocardiograma (ECG) sin hallazgos clínicamente significativos según lo evaluado por el investigador realizado dentro de los 28 días anteriores a la primera dosis;
- Demostrar una adecuada función hematológica, renal, hepática y de coagulación;
- Para mujeres en edad fértil: acuerdo de permanecer en abstinencia (abstenerse de tener relaciones heterosexuales) o usar métodos anticonceptivos que resulten en una tasa de fracaso de < 1% por año durante el período de tratamiento y durante al menos 5 meses después de la última dosis del tratamiento del estudio;
- Para sujetos masculinos: acuerdo de no engendrar un hijo. Los participantes deben ser quirúrgicamente estériles (p. ej., vasectomía) o usar métodos anticonceptivos que den como resultado una tasa de fracaso de < 1 % por año durante el período de tratamiento y durante al menos 5 meses después de la última dosis del tratamiento del estudio.
Criterio de exclusión:
- Cualquier terapia contra el cáncer aprobada, incluida la quimioterapia, la terapia de molécula pequeña dirigida o la radioterapia dentro de las 2 semanas anteriores al Día 0 del ensayo, así como la participación actual o el receptor del tratamiento en un ensayo clínico dentro de los 28 días anteriores al Día 0;
- Metástasis del sistema nervioso central (SNC) activas o no tratadas documentadas y/o meningitis carcinomatosa;
- Neoplasias malignas distintas de UCa dentro de los 3 años anteriores al Día 0, con la excepción de aquellas con riesgo insignificante de metástasis o muerte tratadas con resultado curativo esperado;
- Tratamiento previo con agonistas de CD137 o terapias de bloqueo del punto de control inmunitario;
- Tratamiento con agentes inmunoestimuladores sistémicos;
- Tratamiento con medicación inmunosupresora sistémica;
- Antecedentes de reacciones alérgicas, anafilácticas u otras reacciones de hipersensibilidad graves a anticuerpos quiméricos o humanizados o proteínas de fusión;
- Alergia de hipersensibilidad conocida o contraindicación a biofarmacéuticos producidos en células de ovario de hámster chino o cualquier componente de la formulación inhibidora de PD-1/PD-L1;
- Activo o antecedentes de enfermedad autoinmune o inmunodeficiencia;
- Antecedentes o cualquier evidencia de enfermedad pulmonar intersticial;
- Historia del virus de la inmunodeficiencia humana (VIH);
- hepatitis B activa o hepatitis C activa;
- Infecciones graves dentro de las 4 semanas anteriores a la inscripción;
- Recibió antibióticos orales o intravenosos terapéuticos dentro de las 2 semanas anteriores al Día 0;
- Historial o evidencia actual de cualquier condición, terapia o anormalidad de laboratorio que pueda confundir los resultados del ensayo; interfiere con la participación del sujeto durante toda la duración del ensayo, o se ve afectado negativamente por el tratamiento de EP, o no es lo mejor para el interés del sujeto participar en la opinión del investigador tratante;
- Trasplante alogénico previo de células madre o de órganos sólidos;
- Dolor relacionado con el tumor no controlado; derrame pleural, derrame pericárdico o ascitis que requieran procedimientos de drenaje recurrentes; o, hipercalcemia o hipercalcemia sintomática que requiere el uso continuo de terapia con bisfosfonatos o denosumab.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Cohort A: Prior Anti-PD-1/PD-L1
Participants with locally advanced unresectable or metastatic/recurrent UCa, who had confirmed disease progression during or following treatment with anti- programmed death receptor-1/ programmed cell death-ligand 1 (PD-1/PD-L1) therapy received INO-5401 9 milligrams (mg) and INO-9012 1 mg, intramuscular (IM) injection, followed by electroporation (EP) by CELLECTRA® 2000 device, every 3 weeks until Week 9, then every 6 weeks for 6 more doses (until Week 45), thereafter every 12 weeks, until confirmed disease progression, unacceptable toxicity, or deemed intolerable by the investigator in combination with atezolizumab 1200 mg, intravenous (IV) infusion, every 3 weeks, until confirmed disease progression, unacceptable toxicity, or deemed intolerable by the investigator.
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INO-5401: A mixture of 3 synthetic plasmids that target Wilms' tumor gene-1 (WT1) antigen, prostate-specific membrane antigen (PSMA) and human telomerase reverse transcriptase (hTERT) antigen. IM injection INO-9012: A synthetic plasmid that expresses human interleukin-12 (IL-12). IM injection.
IV-Infusion.
IM injection.
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Experimental: Cohort B: Naïve Anti-PD-1/PD-L1
Participants with locally advanced unresectable or metastatic/recurrent UCa who are treatment naïve and ineligible for cisplatin-based chemotherapy received INO-5401 9 mg and INO-9012 1 mg, IM injection, followed by EP by CELLECTRA® 2000 device, every 3 weeks until Week 9, then every 6 weeks for 6 more doses (until Week 45), thereafter every 12 weeks, until confirmed disease progression, unacceptable toxicity, or deemed intolerable by the investigator in combination with atezolizumab 1200 mg, IV infusion, every 3 weeks, until confirmed disease progression, unacceptable toxicity, or deemed intolerable by the investigator.
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INO-5401: A mixture of 3 synthetic plasmids that target Wilms' tumor gene-1 (WT1) antigen, prostate-specific membrane antigen (PSMA) and human telomerase reverse transcriptase (hTERT) antigen. IM injection INO-9012: A synthetic plasmid that expresses human interleukin-12 (IL-12). IM injection.
IV-Infusion.
IM injection.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Adverse Events of Special Interest (AESIs) Treatment
Periodo de tiempo: Up to approximately 71 months
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An adverse event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.
TEAEs were defined as any AEs that occurred on or after Day 0. AESIs were toxicities and immune-mediated AEs that may have occurred up to 90 days after the last dose of trial treatment.
AESIs were reported by the investigator to the Sponsor within 24 hours after learning of the event.
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Up to approximately 71 months
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Number of Participants With Clinically Significant Changes in Hematological Parameters
Periodo de tiempo: Up to approximately 71 months
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Clinically significant changes in hematological parameters were determined based on the investigator's discretion.
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Up to approximately 71 months
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Number of Participants With Clinically Significant Changes in Serum Chemistry Parameters
Periodo de tiempo: Up to approximately 71 months
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Clinically significant changes in serum chemistry parameters were determined based on the investigator's discretion.
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Up to approximately 71 months
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Number of Participants With Clinically Significant Changes in Urinalysis Parameters
Periodo de tiempo: At baseline, Weeks 3, 6, 9, then every 6 weeks thereafter, up to 71 months
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Clinically significant changes in urinalysis parameters were determined based on the investigator's discretion.
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At baseline, Weeks 3, 6, 9, then every 6 weeks thereafter, up to 71 months
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Antigen-Specific Immune Response
Periodo de tiempo: Up to approximately 71 months
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Blood and tissue samples were collected to evaluate the antigen-specific immune response to INO-5401 + INO-9012 in combination with atezolizumab.
Planned assessments included: Enzyme Linked Immunosorbent Spot-forming (ELISpot) Assay, Flow cytometry, T cell receptor (TCR) sequencing, ELISA and/or gene expression analysis.
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Up to approximately 71 months
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Objective Response Rate (ORR) as Assessed by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 by Investigator Review in Cohort A
Periodo de tiempo: From date of treatment start until date of first PD or death (whichever occurred first), up to approximately 71 months
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ORR was defined as the percentage of participants who had a confirmed complete response (CR) or a partial response (PR).
CR was defined as disappearance of all target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 millimeters (mm).
PR was defined as at least a 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters) per RECIST 1.1.
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From date of treatment start until date of first PD or death (whichever occurred first), up to approximately 71 months
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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ORR as Assessed by RECIST Version 1.1 by Investigator Review in Cohort B
Periodo de tiempo: From date of treatment start until date of first PD or death (whichever occurred first), up to approximately 71 months
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ORR was defined as the percentage of participants who had a confirmed CR or a PR.
CR was defined as disappearance of all target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm.
PR was defined as at least a 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters) per RECIST 1.1.
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From date of treatment start until date of first PD or death (whichever occurred first), up to approximately 71 months
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Percentage of Participants With ORR by Immune Response Evaluation Criteria in Solid Tumors (iRECIST)
Periodo de tiempo: From date of treatment start until date of first PD or death (whichever occurred first), up to approximately 71 months
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ORR was defined as the percentage of participants who had a confirmed CR or a PR.
CR was defined as disappearance of all target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm.
PR was defined as at least a 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters) per iRECIST.
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From date of treatment start until date of first PD or death (whichever occurred first), up to approximately 71 months
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Duration of Response (DoR)
Periodo de tiempo: From first documented confirmed CR or PR until first documentation of PD or death, whichever occurred first (approximately 71 months)
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DOR was defined as the time from the date of the first PR or CR to the date of death from any cause or date that progressive disease (PD) was objectively documented, whichever occurred first.
CR was defined as disappearance of all target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm.
PR was defined as at least a 30% decrease in the sum of diameters of target lesions taking as reference the baseline sum of diameters).
PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on trial (nadir), including baseline.
The sum also had to demonstrate an absolute increase of at least 5 mm.
The appearance of one or more new lesions was also considered progression.
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From first documented confirmed CR or PR until first documentation of PD or death, whichever occurred first (approximately 71 months)
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Progression-Free Survival (PFS) Per RECIST Version 1.1
Periodo de tiempo: From the first dose of study drug to date of PD or death, whichever occurred first (up to approximately 71 months)
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PFS was defined as the time from the date of the start of investigational product treatment until the date of death from any cause or date that progression (+1 day) was objectively documented, whichever occurred first as assessed by RECIST Version 1.1.
PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on trial (nadir), including baseline.
The sum also had to demonstrate an absolute increase of at least 5 mm.
The appearance of one or more new lesions was also considered progression.
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From the first dose of study drug to date of PD or death, whichever occurred first (up to approximately 71 months)
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PFS Per Immune RECIST (iRECIST)
Periodo de tiempo: From Baseline to disease progression or death, whichever occurs first (up to approximately 71 months)
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PFS was defined as the time from the date of the start of investigational product treatment until the date of death from any cause or date that progression (+1 day) was objectively documented, whichever occurred first as assessed by iRECIST Version 1.1.
PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on trial (nadir), including baseline.
The sum also had to demonstrate an absolute increase of at least 5 mm.
The appearance of one or more new lesions was also considered progression.
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From Baseline to disease progression or death, whichever occurs first (up to approximately 71 months)
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Overall Survival (OS)
Periodo de tiempo: From date of first dose of study drug up to death from any cause, (approximately 71 months)
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OS was defined as the time from the date of the start of investigational product treatment until the date of death from any cause.
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From date of first dose of study drug up to death from any cause, (approximately 71 months)
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Director de estudio: Jeffrey Skolnik, MD, Inovio Pharmaceuticals
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
- Neoplasias
- Neoplasias por tipo histológico
- Neoplasias Glandulares y Epiteliales
- Carcinoma
- Carcinoma De Células De Transición
- Agentes antineoplásicos inmunológicos
- Inhibidores de puntos de control inmunitarios
- Agentes antineoplásicos
- Mecanismos moleculares de acción farmacológica.
- atezolizumab
- rocakinogeno disfuplásmido
Otros números de identificación del estudio
- UCa-001
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .