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Study of a Retroviral Replicating Vector Combined With a Prodrug to Treat Patients Undergoing Surgery for a Recurrent Malignant Brain Tumor

Study Purpose

This is a multicenter study evaluating the safety and tolerability of increasing doses of Toca 511, a retroviral replicating vector, injected into the resection cavity of patients with Grade III or Grade IV Gliomas who have elected to undergo surgical removal of their tumor. Approximately 6 weeks after injection of Toca 511, patients will begin an oral courses of Toca FC, an antifungal agent. These one week courses of Toca FC will be repeated during the approximately 30 week study. Two separate cohorts of patients treated with Toca 511 and Toca FC will also be evaluated with either of the following standard treatments for glioma: lomustine or bevacizumab. After completion of this study, all patients will be eligible for enrollment and encouraged to enter a long-term continuation protocol that enables additional Toca FC treatment cycles to be given, as well as permits the collection of long-term safety and survival data.

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 - 80 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria (must all be answered "Yes"):

  • - Has the patient given written informed consent? - Is the patient between 18 years old and 80 years old inclusive? - Has the patient had histologically proven HGG with recurrence or progression following initial definitive therapy(s) such as surgery with or without adjuvant radiation therapy and/or chemotherapy (confirmed by diagnostic biopsy or contrast-enhanced MRI and evaluable by Macdonald criteria)? Note if first recurrence of GBM is documented by MRI, an interval of at least 12 weeks after the end of prior radiation therapy is required unless there is either: i) histopathologic confirmation of recurrent tumor, or ii) new enhancement on MRI outside of the radiotherapy treatment field.
  • - Does the patient have a single, HGG tumor recurrence/progression that is ≤ 5 cm in its greatest dimension? - Based on the pre-operative evaluation, is the tumor recurrence/progression a candidate for ≥ 80% resection? - Has the patient elected not to undergo treatment with the Gliadel® wafer? - Does the patient have a Karnofsky performance status ≥ 70? - Does the patient have an absolute neutrophil count (ANC) ≥ 1500/mm3? - Does the patient have an absolute lymphocyte count ≥ 500/mm3? - Does the patient have a platelet count ≥ 100,000/mm3? - Does the patient have a Hgb ≥ 10 g/dL? - Does the patient have a normal PT/PTT? (subnormal PT/PTT acceptable) - Does the patient have an estimated glomerular filtration rate of at least 50 mL/min (inclusive) by the Cockcroft-Gault formula? - Does the patient have an ALT < 3 times the upper limit of the laboratory reference range and total bilirubin < 1.5 mg/dL? - If the patient is a female of childbearing potential, has she had a negative serum pregnancy test within the past 21 days? - Is the patient willing to use condoms for contraception for 6 months after receiving Toca 511 or until there is no evidence of the virus in his/her blood, whichever is longer.
If the patient is a fertile female, is she willing to use contraception for at least 12 months? - Is the patient willing and able to abide by the protocol? Exclusion Criteria (must all be answered "No"): - Has the patient received cytotoxic chemotherapy within the past 3 weeks (6 weeks for nitrosoureas) of the planned surgery date? - Does the patient have, or has the subject had, within the past 4 weeks any infection requiring antibiotic, antifungal or antiviral therapy? - Has the patient had a surgical procedure in the last 28 days or a surgical wound that is not healed? - Does the patient have any bleeding diathesis, or must the subject take any anticoagulants, or antiplatelet agents, including NSAIDs that cannot be stopped for surgery? - Does the patient have a history of allergy or intolerance to flucytosine? - Is the patient HIV positive? - Does the patient have any gastrointestinal disease that would prevent him or her from being able to ingest or absorb flucytosine? - Has the patient received any investigational treatment within the past 30 days? - Is the patient breast feeding? - Has the patient received Avastin® (bevacizumab) for this recurrence/progression, or within the past 5 weeks? - Does the patient have a history of prior malignancy, excluding basal or squamous cell carcinoma of the skin, with an expected survival of less than five years?

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.

NCT01470794
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.

Tocagen Inc.
Principal Investigator

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

Asha Das, MDTimothy Cloughesy, MD, NO
Principal Investigator Affiliation Tocagen Inc.University of California, Los Angeles
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.

Glioblastoma Multiforme, Anaplastic Astrocytoma, Anaplastic Oligodendroglioma, Anaplastic Oligoastrocytoma
Arms & Interventions

Arms

Experimental: Single Arm

Toca 511 vector/Toca FC prodrug

Interventions

Biological: - Toca 511 vector

All patients will receive Toca 511, a retroviral replicating vector that expresses the cytosine deaminase (CD) gene. CD converts the antifungal 5-FC to the anti-cancer drug 5-FU in cells that have been infected by the Toca 511 vector. Beginning approximately 6 weeks after administration of Toca 511, patients will begin courses of oral Toca FC at pre-specified intervals, depending on cohort, during the approximately 30 week study.

Drug: - Toca FC

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.

UCLA, Los Angeles, California

Status

Address

UCLA

Los Angeles, California, 90095

University of California at San Diego, San Diego, California

Status

Address

University of California at San Diego

San Diego, California, 92093

Henry Ford Hospital, Detroit, Michigan

Status

Address

Henry Ford Hospital

Detroit, Michigan, 48202

JFK Medical Center, Edison, New Jersey

Status

Address

JFK Medical Center

Edison, New Jersey, 08820

Hackensack University Medical Center, Hackensack, New Jersey

Status

Address

Hackensack University Medical Center

Hackensack, New Jersey, 07601

Cleveland Clinic Foundation, Cleveland, Ohio

Status

Address

Cleveland Clinic Foundation

Cleveland, Ohio, 44195

Ohio State University, Columbus, Ohio

Status

Address

Ohio State University

Columbus, Ohio, 43210

Swedish Neuroscience Institute, Seattle, Washington

Status

Address

Swedish Neuroscience Institute

Seattle, Washington, 98122