A Phase 1/2 interventional study of Cyclophosphamide and JX-594 dose escalation and Cyclophosphamide and JX-594 in Solid Tumors, Soft-tissue Sarcoma and Breast Cancer, sponsored by Institut Bergonié. Status unknown at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-02-02.
Sponsored by Institut Bergonié · Phase 1/2, Interventional, and Treatment
Assessment of the efficacy and safety of JX-594 and metronomic cyclophosphamide in patients with advanced soft-tissue sarcoma and advanced breast cancer, once the Maximum Tolerated Dose have been determined (phase I trial).
Phase I study: this is a prospective open-labeled phase I trial based on a dose escalating study design assessing two dose levels of JX594 when prescribed in combination with metronomic cyclophosphamide.
Phase II trials with two treatments strategies:
Metronomic CP + JX-594: phase II study sarcoma: this is a monocentric, randomized two-arm non comparative phase 2 study assessing efficacy and safety of JX-594 in association with metronomic cyclophosphamide in patients with advanced soft-tissue sarcoma.
Metronomic CP + JX-594: phase II study breast cancer: this is a monocentric, single-arm phase II study, assessing efficacy and safety of JX-594 in association with metronomic cyclophosphamide in patients with advanced breast cancer.
Metronomic CP + JX-594 + Avelumab: phase II study sarcoma: this is a monocentric, single arm phase II study assessing efficacy and safety of avelumab in combination with IT JX-594 and metronomic cyclophosphamide in patients with advanced soft-tissue sarcoma.
Metronomic CP + JX-594 + Avelumab:: phase II study breast cancer: this is a monocentric, single-arm phase II study, assessing efficacy and safety of avelumab in combination with IT JX-594 and metronomic cyclophosphamide in patients with advanced breast cancer.
For the phase I study, this is a prospective open-label phase I trial based on a dose escalating study design assessing two dose level of JX-594 when associated to metronomic cyclophosphamide.
For the phase II study, two distincts treatment strategies will be evaluated.
First, treatment by JX-594 and metronomic cyclophosphamide:
Second, treatment by Avelumab, intratumoral JX-594 and metronomic cyclophosphamide:
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Main Inclusion Criteria:
Histology:
Phase II :
Main Exclusion Criteria:
Concomitant diseases/conditions (non exhaustive list):
Prospective open-labeled phase I trial. Combination of cyclophosphamide and JX-594 dose escalation. Metronomic cyclophosphamide will be administered orally, 50 mg twice daily, one week on/one week off. JX-594 will be administered, as designated by assigned dose-level, intraveinously, on Days 8 and 22 of cycle 1, and on days 8 of each subsequent cycles. One cycle consits of 28 days. Number of subjects : 14
Drug: Cyclophosphamide and JX-594 dose escalation
Randomized non comparative phase II clinical trial : Arm 1. Experimental phase II soft-tissue sarcoma : Combination of cyclophosphamide and JX-594. Metronomic cyclophosphamide will be administered orally, 50 mg twice daily, one week on/one week off. JX-594 will be administered, as the dose recommended in the experimental phase I dose escalating study, intraveinously, on Days 8 and 22 of cycle 1, and on days 8 of each subsequent cycles. One cycle consits of 28 days. Number of subjects : 48
Drug: Cyclophosphamide and JX-594
Randomized non comparative phase II clinical trial : Arm 2. Control-arm phase II soft-tissue sarcoma : Patients will be treated by metronomic cyclophosphamide. Cyclophosphamide will be administered 50 mg twice daily orally, one week on/one week off. One cycle consits of 28 days. Number of subjects : 24
Drug: Cyclophosphamide
Single-arm phase II clinical trial. Experimental phase II Group breast cancer : Combination of cyclophosphamide and JX-594. Metronomic cyclophosphamide will be administered orally, 50 mg twice daily, one week on/one week off. JX-594 will be administered, as the dose recommended in the experimental phase I dose escalating study, intraveinously, on Days 8 and 22 of cycle 1, and on days 8 of each subsequent cycles. One cycle consits of 28 days. Number of subjects : 32
Drug: Cyclophosphamide and JX-594
Experimental phase II soft-tissue sarcoma : Combination of avelumab in combination with intratumoral JX-594 and metronomic cyclophosphamide. Avelumab will be administered by intravenous infusion every 2 weeks, starting at Day 15 of cycle 1. Cyclophosphamide wil be administered orally, 50 mg twice daily, one Week on/one Week off, starting 7 days prior to cycle 1 day 1 ("impregnation phase"). JX-594 will be administered by intratumoral injection on day 1 of cycle 1, every 2 weeks, for a maximum of 4 injections. Number of subjects : 47
Drug: Avelumab and JX-594 and Cyclophosphamide
Experimental phase II breast cancer : Combination of avelumab in combination with intratumoral JX-594 and metronomic cyclophosphamide. Avelumab will be administered by intravenous infusion every 2 weeks, starting at Day 15 of cycle 1. Cyclophosphamide wil be administered orally, 50 mg twice daily, one Week on/one Week off, starting 7 days prior to cycle 1 day 1 ("impregnation phase"). JX-594 will be administered by intratumoral injection on day 1 of cycle 1, every 2 weeks, for a maximum of 4 injections. Number of subjects : 32
Drug: Avelumab and JX-594 and Cyclophosphamide
Metronomic cyclophosphamide will be administered orally, 50 mg twice daily, one week on/one week off. JX-594 will be administered, as designated by assigned dose-level, intraveinously, on Days 8 and 22 of cycle 1, and on days 8 of each subsequent cycles. One cycle consits of 28 days.
Also known as: Brand name : ENDOXAN, Brand name: Pexa-Vec
Metronomic cyclophosphamide will be administered orally, 50 mg twice daily, one week on/one week off. JX-594 will be administered, as the dose recommended in the experimental phase I dose escalating study, intraveinously, on Days 8 and 22 of cycle 1, and on days 8 of each subsequent cycles. One cycle consits of 28 days.
Also known as: Brand name : ENDOXAN, Brand name: Pexa-Vec
Metronomic cyclophosphamide will be administered orally, 50 mg twice daily, one week on/one week off.
Also known as: Brand name : ENDOXAN
Avelumab will be administered by intravenous infusion (10 mg/kg) every 2 weeks, starting at Day 15 of cycle 1. Cyclophosphamide wil be administered bi-daily (50 mg x 2), starting 7 days prior to cycle 1 day 1 ("impregnation phase") and given on a week on/week off schedule. JX-594 will be administered by intratumoral injection (1 x109 p.f.u) on day 1 of cycle 1, every 2 weeks, for a maximum of 4 injections .
Also known as: Brand name: ENDOXAN, Brand name: Pexa-Vec, Brand name: Avelumab
Phase Ib : Maximum Tolerated Dose evaluated on the first cycle (D1 to D28) of the combination of JX-594 And metronomic cyclophosphamide
the MTD is defined as the highest dose at which no more than 1 in 6 of the patients in the cohort experienced a DLT in the first treatment cycle
Time frame: during the first cycle (28 days)
Phase II : Advanced soft-tissue sarcoma: Assessment of the antitumor activity of the association of JX-594 and metronomic cyclophosphamide based on 6 month non-progression (CR, PR or SD more than 24 weeks) following RECIST v1.1 criteria
Non-progression is defined as complete or partial response or stable disease, as per RECIST v1.1
Time frame: Phase II : 6 months after the beginning of treatment
Phase II : Advanced Breast cancer: Assessment of the antitumor activity of the association of JX-594 and metronomic cyclophosphamide Efficacy will be defined based on objective response under treatment (CR or PR) following RECIST v1.1 criteria
Objective response is defined as complete or partial response as per RECIST v1.1
Time frame: Phase II : 6 months after the beginning of treatment
Phase II : Advanced soft-tissue sarcoma: Assessment of the antitumor activity of Avelumab in combination with IT JX-594 and metronomic cyclophosphamide based on 6 month non-progression (CR, PR or SD more than 24 weeks) following RECIST v1.1 criteria
Non-progression is defined as complete or partial response or stable disease, as per RECIST v1.1
Time frame: Phase II : 6 months after the beginning of treatment
Phase II : Advanced Breast cancer: Assessment of the antitumor activity of avelumab in combination with IT JX-594 and metronomic cyclophosphamide Efficacy will be defined based on objective response under treatment following RECIST v1.1 criteria
Objective response is defined as complete or partial response as per RECIST v1.1
Time frame: Phase II : 6 months after the beginning of treatment
Phase Ib : Recommended Phase II dose (RP2D) of the association of JX-594 and metronomic cyclophosphamide
Data from all cycles will be used to define the dose level of JX-594 to be recommended for further investigations in phase II
Time frame: Phase Ib : Throughout the 6 months of treatment period
Phase Ib: Objective response under treatment as per RECIST V1.1
Objective response is defined as complete or partial response as per RECIST v1.1
Time frame: an average of 6 months
Phase Ib: Best overall response as per RECIST V1.1
- Best overall response is defined as the best response recorded from the start of the study treatment until the end of treatment taking into account any requirement for confirmation (as per RECIST v1.1).
Time frame: an average of 6 months
Phase Ib: 6-months non-progression as per RECIST V1.1
Non-progression is defined as complete or partial response or stable disease, as per RECIST v1.1
Time frame: 6-months after the beginning of treatment
Phase Ib: 1-year progression-free survival as per RECIST V1.1
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: 1-year after the beginning of treatment
Phase Ib: 2-year progression-free survival as per RECIST V1.1
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: 2-year after the beginning of treatment
Phase Ib : Pharmacokinetics (PK): PK measurements expressed as Area Under the curve forJX-594
Time frame: Day 8 of cycle 1, Day 15 of cycle 1, Day 22 of cycle 1, Day 1 of cycle 2, Day 8 of cycle 2, Day 22 of cycle 2, Day 8 of cycle 3, Day 8 of cycle 4, Day 8 of cycle 6 (Each cycle = 28 days)
Phase Ib : Pharmacokinetics (PK): PK measurements expressed as half-life forJX-594
Time frame: Day 8 of cycle 1, Day 15 of cycle 1, Day 22 of cycle 1, Day 1 of cycle 2, Day 8 of cycle 2, Day 22 of cycle 2, Day 8 of cycle 3, Day 8 of cycle 4, Day 8 of cycle 6 (Each cycle = 28 days)
Phase Ib : Pharmacokinetics (PK): PK measurements expressed as Concentration peak forJX-594
Time frame: Day 8 of cycle 1, Day 15 of cycle 1, Day 22 of cycle 1, Day 1 of cycle 2, Day 8 of cycle 2, Day 22 of cycle 2, Day 8 of cycle 3, Day 8 of cycle 4, Day 8 of cycle 6 (Each cycle = 28 days)
Phase Ib : Dose-Limiting toxicity of the association of JX-594 and metronomic cyclophosphamide
Time frame: during the first cycle (cycle = 28 days)
Phase Ib : Predictive biomarkers analysis (cytokines levels)
Time frame: baseline, day 8 of cycle 1, day 22 of cycle 1, day 8 of cycle 2, day 8 of cycle 4, day 8 of cycle 6. Each cycle = 28 days
Phase Ib : Predictive biomarkers analysis (lymphocytes levels)
Time frame: baseline, day 8 of cycle 1, day 22 of cycle 1, day 8 of cycle 2, day 8 of cycle 4, day 8 of cycle 6. Each cycle = 28 days
Phase II : Best overall response defined as per RECIST v1.1 criteria
Best overall response is defined as the best response recorded from the start of the study treatment until the end of treatment taking into account any requirement for confirmation (as per RECIST v1.1).
Time frame: an average of 6 months
Phase II : For sarcoma only: objective response following CHOI criteria
Time frame: an average of 6 months
Phase II : For sarcoma only: best overall response following CHOI criteria
Time frame: an average of 6 months
Phase II : For sarcoma only: 6- month non-progression following CHOI criteria
Time frame: 6-months after the beginning of treatment
Phase II : 1-year Progression-Free Survival (PFS) defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause), whichever occurs first
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: one year after the beginning of treatment
Phase II : 2-year Progression-Free Survival (PFS) defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause), whichever occurs first
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: two years the beginning of treatment
Phase II : 1-year Overall Survial (OS) defined as the time from study treatment initiation to death (of any cause)
OS defined as the time from study treatment initiation to death (of any cause)
Time frame: one year after the beginning of treatment
Phase II : 2-year Overall Survial (OS) defined as the time from study treatment initiation to death (of any cause)
OS defined as the time from study treatment initiation to death (of any cause)
Time frame: two year after the beginning of treatment
Phase II : Toxicity graded using the common toxicity criteria from the NCI v4.0
assessef with NCI-CTCAE V4
Time frame: an average of 6 months
Predictive biomarkers (cytokines level)
Time frame: baseline, day 8 of cycle 1, day 22 of cycle 1, day 8 of cycle 2, day 8 of cycle 4, day 8 of cycle 6. Each cycle = 28 days
Predictive biomarkers (lymphocytes level)
Time frame: baseline, day 8 of cycle 1, day 22 of cycle 1, day 8 of cycle 2, day 8 of cycle 4, day 8 of cycle 6. Each cycle = 28 days
Phase II : Relationship between levels of anti-JX-594 antibodies and efficacy of CP + JX-594 in terms of 6-month non progression for sarcoma (as per RECIST V1.1)
Time frame: Six months after the beginning of treatment
Phase II : Relationship between levels of anti-JX-594 antibodies and efficacy of CP + JX-594 in terms of objective response for breast cancer (as per RECIST V1.1)
Time frame: an average of 6 months
Phase II : Relationship between activation of the pRB/E2F/TK pathway and efficacy of CP + JX-594 on available archived tumor tissue in terms of 6- month non progression for sarcoma (as per RECIST V1.1)
Time frame: Phase II : Six months after the beginning of treatment
Phase II : Relationship between activation of the pRB/E2F/TK pathway and efficacy of CP + JX-594 on available archived tumor tissue in terms objective response for breast cancer (as per RECIST V1.1)
Time frame: an average of 6 months
Phase II Soft-tissue sarcoma: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of best overall response
- Best overall response is defined as the best response recorded from the start of the study treatment until the end of treatment taking into account any requirement for confirmation (as per RECIST v1.1)
Time frame: an average of 6 months
Phase II Breast cancer: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of best overall response
- Best overall response is defined as the best response recorded from the start of the study treatment until the end of treatment taking into account any requirement for confirmation (as per RECIST v1.1)
Time frame: an average of 6 months
Phase II Breast cancer: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of 6-month non-progression
Non-progression is defined as complete or partial response or stable disease, as per RECIST v1.1
Time frame: 6 months
Phase II Soft-tissue sarcoma: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of objective response Under treatment
Objective response is defined as complete or partial response as per RECIST v1.1
Time frame: an average of 6 months
Phase II Soft-tissue sarcoma: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of 1-year progression-free survival
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: 1 year
Phase II Breast cancer: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of 1-year progression-free survival
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: 1 year
Phase II Soft-tissue sarcoma: antitumor actiivty of avelumab in combination with IT JX-594 and metronomic CP in terms of 2-year progression-free survival
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: 2 years
Phase II Breast cancer: antitumor activity of avelumab in combination with IT JX-594 and metronomic CP in terms of 2-year progression-free survival
PFS defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause)
Time frame: 2 years
Phase II Soft-tissue sarcoma: antitumor activity of avelumab in combination with IT JX-594 and metronomic CP in terms of 1-year overall survival
OS defined as the time from study treatment initiation to death (of any cause)
Time frame: 1 year
Phase II Breast cancer: antitumor activity of avelumab in combination with IT JX-594 and metronomic CP in terms of 1-year overall survival
OS defined as the time from study treatment initiation to death (of any cause)
Time frame: 1 year
Phase II Soft-tissue sarcoma: antitumor activity of avelumab in combination with IT JX-594 and metronomic CP in terms of 2-year overall survival
OS defined as the time from study treatment initiation to death (of any cause)
Time frame: 2 year
Phase II Breast cancer: antitumor activity of avelumab in combination with IT JX-594 and metronomic CP in terms of 2-year overall survival
OS defined as the time from study treatment initiation to death (of any cause)
Time frame: 2 year
Phase II Soft-tissue sarcoma: safety profile of avelumab in combination with IT JX-594 and metronomic CP
Safety profile will be assessed as per NCI-CTCAE v5
Time frame: throughout the treatment period, an expected average of 6 months
Phase II breast cancer: safety profile of avelumab in combination with IT JX-594 and metronomic CP
Safety profile will be assessed as per NCI-CTCAE v5
Time frame: throughout the treatment period, an expected average of 6 months
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Institut Bergonié