An Open-Label, Multiple-Center, Phase IIa/IIb Clinical Trial to Evaluate the Efficacy, Safety and Tolerability of VG161 as Monotherapy and in Combination With Nivolumab for Treatment of Patients With Hepatocellular Carcinoma or Intrahepatic Cholangiocarcinoma

Last updated: August 7, 2024
Sponsor: Virogin Biotech Canada Ltd
Overall Status: Active - Recruiting

Phase

2

Condition

Carcinoma

Liver Cancer

Liver Disorders

Treatment

VG161

Nivolumab Injection [Opdivo]

Clinical Study ID

NCT05223816
VG161-A201
  • Ages > 18
  • All Genders

Study Summary

Safety Run-in Cohort (cohort 1):

10 patients will be treated with IT injection of VG161 in the cohort 1 at dose level of 1.0x10E8 PFU x 3 days.

Monotherapy Cohorts (Cohort 2 and 3) Cohort 2 (HCC) This part is a single-agent, single one-dose level and single-arm design. Approximately 39 subjects will be enrolled in the study to receive VG161. In the first stage, 21 subjects will be enrolled. If there is only 1 or fewer subjects has been observed with objective response and no more than 12 (<13) subjects have PFS longer than 3 months, the trial will be stopped. Otherwise, this study will continue to enter the second stage, and 18 additional subjects will be added, and the total number of trial subjects will reach 39.

Cohort 3 (ICC) This part is a single-agent, single one-dose level and single-arm design. The trial will be carried out in two periods. In the first period, a total of 20 subjects will be enrolled. If there is only 1 or fewer response case in the 20 subjects, the trial will be stopped to investigate the efficacy of the IP, otherwise, subjects will continue to enter the second period, and 13 additional subjects will be added, and the total number of trial cases will reach 33.

Cohort 4 (ICC and HCC) Combination with Nivolumab Combination cohort and subjects will receive VG161 at the same schedule as the monotherapy cohorts and 240 mg of intravenous Nivolumab on days 8 and 15 of each treatment cycle. The Nivolumab dose can be changed to 480 mg every 4 weeks after cycle one based on investigator's discretion.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Signed written informed consent.

  2. Males or females aged 18 years and older.

  3. Performance status: Eastern Cooperative Oncology Group (ECOG) 0 or 1.

  4. For subject in Cohort 2: cytologically confirmed advanced/metastatic or surgicallyunresectable HCC, with documented disease progression after at least two lines ofFDA approved systemic therapy, including immunotherapy or anti-angiogenesis therapyas the first line treatment and at least one regimen of the following agents as thesecond line: anti-angiogenesis agents, tyrosine kinase inhibitors or immunotherapy.

  5. For subject in Cohort 3: Histologically or cytologically confirmedadvanced/metastatic or surgically unresectable ICC, with documented diseaseprogression after chemotherapy as the first line systemic therapy. For patients withknown IDH1 mutation, they must receive the appropriate targeted therapy with a IDH1inhibitor and for patients with MSI-H tumors, they must receive immunotherapy withPD-1 inhibitors.

  6. For subjects in Cohort 1 and Cohort 4: should fulfill either inclusion criteria 4)or 5).

  7. Liver function: Child-Pugh A-B for cohort 1 and 2.

  8. At least one measurable lesion per RECIST 1.1

  9. At least 1 injectable lesion; ≥15 mm in longest diameter and deemed injectable asper Investigator's discretion. Subjects with deep or visceral lesions (such ashepatic or intraperitoneal lymph nodes) that can be safely injected under guidedimaging can be considered for intratumoral injection of VG161..

Exclusion

Exclusion Criteria:

  1. Participation in any trial of any other investigational agent within the last 4weeks prior to dosing. Wash out periods to be reviewed on a case by case basis withMedical Monitor, as required.

  2. Tumors to be injected lying in mucosal regions or close to an airway, major bloodvessel or spinal cord that, in the opinion of the Investigators, could causeocclusion or compression in the case of tumor swelling or erosion into a majorvessel in the case of necrosis.

  3. Subjects with any primary Central Nervous System (CNS) malignancy including gliomaand current, active, progressing CNS malignancy, including carcinomatosis meningitisare excluded. Subjects with treated brain metastases are eligible if there is noevidence of progression for at least 4 weeks after CNS-directed treatment, asascertained by clinical examination and brain imaging (magnetic resonance imaging [MRI] or computed tomography [CT] scan) during the screening period and off steroids (for at least 2 weeks prior to first dose of IP).

  4. Major surgery within 14 days prior to dosing.

  5. Intercurrent serious infections within 28 days prior to Screening or treatedsystematically with antibiotics within 14 days prior to signing ICF.

  6. Life-threatening illness unrelated to cancer.

  7. Active Herpes infection.

  8. Treatment with antiviral agents within 14 days prior to dosing.

  9. Uncontrolled congestive heart failure.

  10. Known to test positive for human immunodeficiency virus (HIV) or syphilis.

  11. Active infection including hepatitis B (HBV) or hepatitis C (HCV) that currentlyunder anti-virus treatment which can affect study drug treatment as perinvestigator's decision.

  12. Use of ganciclovir or acyclovir within 14 days prior to dosing.

  13. Subjects with a condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days prior to dosing. Inhaled or topical steroids, and adrenal replacementsteroid doses ≤10 mg daily prednisone equivalent, are permitted in the absence ofactive autoimmune disease.

  14. Subjects who have been on systemic anticoagulants within 14 days prior to dosingand/or with International Normalized Ratio (INR) > 1.5 x the upper limit of thereference range are excluded from this study.

  15. Subjects with prior radiation therapy to the tumor lesion to be injected areexcluded from the study, unless there is evidence of tumor progression in the mostrecent imaging, following completion of radiotherapy.

Study Design

Total Participants: 97
Treatment Group(s): 2
Primary Treatment: VG161
Phase: 2
Study Start date:
January 24, 2024
Estimated Completion Date:
December 31, 2025

Connect with a study center

  • Mayo Clinic

    Phoenix, Arizona 85054
    United States

    Active - Recruiting

  • Mayo Clinic Florida

    Jacksonville, Florida 32224
    United States

    Active - Recruiting

  • Mayo Clinic

    Rochester, Minnesota 55905
    United States

    Active - Recruiting

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