TITAN (Tumoural Injection of T-VEC and Isolated Limb Perfusion)

NCT03555032 | Completed Phase 1

• 1 other identifier: CCR 4679
• Study Type: interventional
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

This study will look at the safety and effects of combining a new drug called Talimogene Laherparepvec (T-VEC) with chemotherapy delivered by Isolated Limb Perfusion (ILP). The investigators want to find out whether these two treatments can be combined safely and whether T-VEC with ILP is better at treating your cancer than with ILP alone.

Conditions

Melanoma and Sarcoma

Outcome Measures

Primary Outcomes (2)

• The number of dose limiting toxicities and adverse events when T-VEC administered by intratumoural injection is combined with Isolated Limb Perfusion [Safety and Tolerability]

  This will be assessed by serial blood tests and physical examinations from the first administration of T-VEC to 52 weeks follow-up

  From first T-Vec administration to 52 week follow up.

• The percentage of patients achieving complete/partial response following treatment [Efficacy]

  This will be assessed by serial physical examinations and/or imaging from 4 weeks following therapy until 52 weeks follow-up

  From T-Vec and ILP administration until 52 weeks follow up.

Study Arms (1)

All patients

EXPERIMENTAL

All patients will receive two pre-operative doses of T-VEC administered by intratumoural injection prior to a 3rd intratumoural dose given at the time of Isolated Limb Perfusion (ILP). No further treatment will be given.

Drug: Talimogene laherparepvec (T-VEC)

Interventions

Talimogene laherparepvec (T-VEC) DRUG

One dose of 1 x 106 PFU/mL. Two doses of 1 x 108 PFU/mL. Given by intra-tumoural (i.t.) injection.

All patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Males or females aged 18 years.
• A confirmed histological diagnosis of in-transit malignant melanoma with or without regional lymph node metastases or limited visceral metastatic disease (AJCC Stage IIIb/c and IVa/b) or locally advanced soft-tissue sarcoma with or without regional or distant metastases (T2a/b, N0/1, M0/1) suitable for isolated limb perfusion.
• Life expectancy of at least 3 months (as assessed, and documented by the Chief Investigator).
• ECOG Performance Score of 0 to 2.
• No continuing acute toxic effects of any prior radiotherapy, chemotherapy or surgical procedures, i.e., all such effects must have resolved to Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0) Grade 1.
• Completed any previous chemotherapy at least 28 days before entry into the study.
• Have baseline laboratory results as follows:
• Absolute neutrophil count (ANC) 1.5 × 109 \[SI units 109/L\];
• Platelets 100 ×109 \[SI units 109/L\] (without platelet transfusion);
• Haemoglobin 9.0 g/dL \[SI units gm/L\] (with or without red blood cell (RBC) transfusion);
• Serum creatinine 1.5 × upper limit of normal (ULN);
• Bilirubin \< 1.25 × ULN
• ALT, AST and and alkaline phosphatase \< 2 × ULN;
• Calcium \< 12 mg/dl (2.99 mmol/l).
• Provide written informed consent in accordance with all applicable regulations and follow the study procedures. Patients must be capable

You may not qualify if:

• Known cerebral metastases.
• Have had concurrent immunotherapy during, and for the number of days equal to the half-life of that agent before or during, the study therapy.
• Evidence of immunosuppression for any reason:
• Known HIV disease
• Acute or chronic hepatitis B or hepatitis C infection.
• Chronic oral or systemic steroid medication use at a dose of \> 10 mg/day of prednisolone or equivalent.
• Other signs or symptoms of clinical immune system suppression.
• Open herpetic skin lesions.
• A history of hypersensitivity to T-VEC or its excipients.
• Pregnant or breast-feeding female. Confirmation that women of childbearing potential are not pregnant with a negative serum and urine beta-human chorionic gonadotrophin (beta-hCG) pregnancy test results must be obtained within 7 days prior to treatment initiation (i.e. the 1st administration of T-VEC).
• Fertile males and females who are unwilling to employ highly effective means of contraception during study treatment and for 3 months after the last dose of study treatment.
• Previous treatment with T-VEC for active disease.
• Require intermittent or chronic treatment with an anti-herpetic drug (e.g. acyclovir), other than intermittent topical use.

Sponsors & Collaborators

• Royal Marsden NHS Foundation Trust: lead

Study Sites (1)

The Royal Marsden NHS Foundation Trust

London, SW3 6JJ, United Kingdom

Location

Related Publications (1)

• Tulokas SKA, Kohtamaki LM, Makela SP, Juteau S, Alback A, Vikatmaa PJ, Mattila KE, Skytta TK, Koivunen JP, Tyynela-Korhonen K, Hernberg MM. Isolated limb perfusion with melphalan as treatment for regionally advanced melanoma of the limbs: results of 60 patients treated in Finland during 2007-2018. Melanoma Res. 2021 Oct 1;31(5):456-463. doi: 10.1097/CMR.0000000000000755.

  PMID: 34132224 DERIVED

MeSH Terms

Conditions

Melanoma; Sarcoma

Interventions

talimogene laherparepvec

Condition Hierarchy (Ancestors)

Neuroendocrine Tumors; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Nerve Tissue; Nevi and Melanomas; Skin Neoplasms; Neoplasms by Site; Skin Diseases; Skin and Connective Tissue Diseases; Neoplasms, Connective and Soft Tissue

Study Officials

• Andrew Hayes

  The Royal Marsden Hospital NHS Foundation Trust

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Four Cohorts of patients staggered. Cohort 1: The first patient will need to be 30 days from the end of study treatment before patients can be consented to Cohort 2. Cohort 2: Assuming no Dose Limiting Toxicities in Cohort 1, two further patients will be recruited. Once these patients have passed 30 days from the end of study treatment Cohort 3 will open. Cohort 3: Three further patients will be recruited and be 30 days post before Cohort 4 opens. Cohort 4: Open recruitment for the remaining 9 patients.

Study Record Dates

• First Submitted: May 9, 2018
• First Posted: June 13, 2018
• Study Start: June 26, 2018
• Primary Completion: August 1, 2021
• Study Completion: August 1, 2021
• Last Updated: August 18, 2021

Record last verified: 2021-03

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)