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Safety and Efficacy Study of REOLYSIN® in the Treatment of Recurrent Malignant Gliomas

Study Purpose

RATIONALE: Oncolytic viruses such as reovirus (REOLYSIN®) can specifically kill tumor cells while leaving healthy cells unharmed. PURPOSE: This phase I/II study investigates the maximum tolerated dose (MTD), dose limiting toxicity (DLT) and anti-tumor effect of intralesional administration of REOLYSIN® therapeutic reovirus in patients with malignant glioma with evaluable disease which is progressive/recurrent despite surgery and/or radiotherapy with or without chemotherapy. (The phase I portion of the study is currently enrolling patients.)

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Abbreviated

Inclusion Criteria:

  • - PHASE I: 1st, 2nd or 3rd recurrence of: glioblastoma multiforme; gliosarcoma; anaplastic astrocytoma; anaplastic mixed glioma; or anaplastic oligodendroglioma.
  • - PHASE II: 1st recurrence of glioblastoma multiforme (only) - Progressing/recurrent lesion which is ≥1cmx1cm.
For the Phase II study the lesion must be ≤5cmx5cm, defined by MRI only.
  • - Be fully recovered from any prior therapy.
  • - Have been treated at the time of original diagnosis by surgery and external beam radiation to a dose of at least 5000 cGy; radiotherapy completed at least 6 weeks before REOLYSIN® therapy.
  • - Any intracranial surgery, except for stereotactic needle biopsy, must have occurred at least 4 weeks before REOLYSIN® therapy.
  • - Any anti-cancer drug therapy must have been completed at least 4 weeks (6 weeks in the case of prior nitrosourea therapy) before REOLYSIN® therapy.
  • - Have a life expectancy of ≥8 weeks and a Karnofsky Performance Status (KPS) of ≥60.
  • - Absolute neutrophils ≥1.5 x10^9/L; hemoglobin ≥100g/L; platelets ≥100 x 10^9/L.
  • - ALT ≥1.5 x ULN; total bilirubin ≥1.5 x ULN.
  • - Serum creatinine ≤1.5 x ULN.
  • - EKG with no evidence of active, acute cardiovascular disease.
  • - PT within normal limit.
  • - Women of childbearing potential must have a negative pregnancy test.
  • - Reside or have suitable living arrangements within a reasonable geographical area of the study site and be able to participate in all follow-up visits.
  • - Patients requiring corticosteroids must be on a stable dose of steroid for at least two weeks prior to baseline MRI and when entered in the study.
Maximum daily dose of 24 mg/day of dexamethasone/decadron or equivalent.Abbreviated

Exclusion Criteria:

  • - Patients who are sexually active and not willing to use barrier methods of contraception; women who are breastfeeding.
  • - Patients with unstable or serious concurrent medical or psychiatric conditions that would interfere with study treatment or follow-up.
  • - Patients with more than one discrete enhancing lesion on MRI, or radiographic evidence of satellite lesions or leptomeningeal disease not obviously contiguous by FLAIR imaging.
  • - Patients who may require further neurosurgery within 4 weeks after REOLYSIN® treatment.
  • - Patients with a prior history of encephalitis, multiple sclerosis or other significant chronic CNS disease.
  • - Patients who have evidence of a current CNS infection, meningeal gliomatosis or gliomatosis cerebri.
  • - Patients with tumor that to be treated would require needle or catheter passage through a ventricle, the posterior fossa or basal ganglia; or patients with tumors invading the ventricle.
  • - Patients who have previously participated in experimental viral therapy protocols.
  • - Patients who have had prior intratumoral gene therapy or other intratumoral therapies.
  • - Patients who have had Gliadel wafer therapy less than 6 months prior to enrollment.
  • - Patients who have a history of bleeding disorders including congenital or acquired coagulopathies.
  • - Patients who have a known history of hepatitis or tuberculosis.
  • - Patients who have a known history of hereditary or acquired immunodeficiency including HIV infection.
  • - Patients who have impaired non-neurological organ function (>Grade 1) - Patients who have used systemic antiviral (or potentially antiviral) therapies within 28 days of enrollment.
  • - Patients who have had brachytherapy or radiosurgery to the brain at any time.
- Patients with previous or concurrent malignancies at other sites (except surgically-cured carcinoma in situ of the cervix and non-melanoma skin cancer) - Prior or current medical history indicating that a patient may be significantly immunosuppressed

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT00528684
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Oncolytics Biotech
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

James M Markert, MD
Principal Investigator Affiliation University of Alabama at Birmingham
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Completed
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Malignant Glioma
Additional Details

Oncolytic viruses, such as reovirus, are those viruses which specifically destroy cancer cells. Reovirus is a common virus that does not cause disease, and has been shown to be associated with only minor flu-like symptoms. REOLYSIN® is a formulation of the live, replication-competent wild-type reovirus that selectively replicates in tumor cells, while leaving healthy cells unharmed. This phase I/II multi-center study follows a standard design utilizing therapeutic viral dosage escalation. The phase I portion of the trial will evaluate the doses of intralesional REOLYSIN titrated to a maximum tolerated dose (MTD). The objective of the phase II portion of the study is to assess tumor response. The proportion of patients surviving to six months and the safety of REOLYSIN® are secondary objectives. Each patient enrolled in the study will receive a single infusion of REOLYSIN® over 72 hours. Patients will remain in hospital for at least 90 hours after initiation of infusion. Following REOLYSIN® administration, each patient will be followed for at least 12 weeks (Phase I) and at least 6 months (Phase II) with regular evaluation visits (weekly and then monthly). Evaluations will include tumor measurements, serial neurologic exams and functional performance status assessments at baseline, prior to hospital discharge, and at weeks 4, 8, 12, 16 and 24 after REOLYSIN® therapy. Changes in performance will be assessed using the Karnofsky Performance Status scale. Subjects will also undergo serial blood sampling for evaluation of viral RNA, hematology and biochemistry.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

University of Alabama at Birmingham, Birmingham, Alabama

Status

Address

University of Alabama at Birmingham

Birmingham, Alabama, 35294

Cedars-Sinai Medical Center, Los Angeles, California

Status

Address

Cedars-Sinai Medical Center

Los Angeles, California, 90048

Columbus, Ohio

Status

Address

The Ohio State University Medical Center and Arthur G. James Cancer Hospital and Richard J. Solove Research Center

Columbus, Ohio, 43210