ClinicalTrials.gg
TerminatedNCT03495921VITAUpdated Apr 26, 2023Results posted

A Trial For Participants With Ewing's Sarcoma Treated With Vigil in Combination With Irinotecan and Temozolomide

A Phase 3 interventional study of Vigil and Irinotecan in Ewing Sarcoma, Ewing Family of Tumors and Ewing's Tumor Metastatic, sponsored by Gradalis, Inc.. Terminated at 15 sites in United States. Open to participants aged 2 Years and older. Per ClinicalTrials.gov, last updated 2023-04-26.

Sponsored by Gradalis, Inc. · Phase 3, Interventional, and Treatment

Why this study was terminated
Slow accrual and as a result, a strategic business decision was made to terminate enrollment.
Phase
Phase 3
Study type
Interventional
Enrollment
32
Allocation
Randomized
Ages
2 Years and older
Sex
All
01

Study summary

The goal of this clinical trial was to compare participants with first relapse or refractory Ewing's sarcoma when treated with investigational product (Vigil) in addition to the standard treatment of irinotecan and temozolomide compared to the standard treatment of irinotecan and temozolomide alone. The main question it aimed to answer is "Will participants who receive Vigil in addition to irinotecan and temozolomide have a prolonged time to progression and improved quality of life compared to the participants who receive irinotecan and temozolomide alone?".

Read the detailed description

This was a multicenter, Phase III study in participants with metastatic Ewing's sarcoma Family of Tumors (ESFT) refractory/intolerant or recurrent to 1 prior line of chemotherapy. Participants who agreed to participation had tumor tissue harvested from a scheduled standard surgical procedure (e.g., tumor biopsy or palliative resection). The tumor tissue removed was shipped to Gradalis, Inc. to attempt to manufacture the investigational product, Vigil.

Subjects who met eligibility criteria including manufacture of a minimum of 4 doses of Vigil were randomized 1:1 to either Group A (Vigil + Irinotecan + Temozolomide (Tem/Iri)) or Group B (Irinotecan + Temozolomide). Screening for the main portion of the study occurred as early as one week but no later than 8 weeks following tumor procurement.

Subjects received repeat cycles of treatment until disease progression, unacceptable toxicity, withdrawal of consent or other criterion was met for discontinuation from study. Subjects randomized to Group A (Vigil + Tem/Iri) received up to 12 doses depending upon the quantity of Vigil manufactured from the surgical specimen. 1 cycle = 21 days. If irinotecan + temozolomide was administered beyond 12 cycles, it was administered off study. Subjects randomized to Group B (Tem/Iri) may have crossed over to receive single agent Vigil every 21 days following End of Treatment assessment and documented disease progression confirmed by central radiology vendor, for up to 12 doses of Vigil depending upon the quantity of Vigil manufactured.

Participants were managed in an outpatient setting. Hematologic function, liver enzymes, renal function and electrolytes will be monitored. Blood for immune function analyses including IFNγ-ELISPOT analysis of cytotoxic T cell activation in response to autologous tumor antigens will be collected at tissue procurement, post-procurement screening and Day 1 (prior to chemotherapy administration) at Cycles 2, 4, and 6, end of treatment (EOT), 3 months after EOT, and every 6 months thereafter. Blood for ctDNA analysis was collected at tissue procurement, prior to chemotherapy administration at baseline and on Day 1 prior to chemotherapy administration at Cycles 2, 3, 4, and 6, and EOT. After progression, participants were contacted quarterly for documentation of post study therapies and survival status information.

02

Conditions studied

  • Ewing Sarcoma
  • Ewing Family of Tumors
  • Ewing's Tumor Metastatic
  • Ewing's Sarcoma Metastatic
  • Ewing's Tumor Recurrent
  • Rare Diseases
  • Sarcoma
  • Neoplasms, Connective and Soft Tissue
  • Neoplasms by Histologic Type
  • Neoplasms, Bone Tissue
  • Neoplasms, Connective Tissue
  • Sarcoma, Ewing
  • Neoplasms

Keywords

  • ESFT
  • Immunotherapy
  • Phase 3
  • irinotecan
  • temozolomide
  • First Relapse
  • Second Line
  • Vigil
  • vaccine
  • orphan drug
  • soft bone
  • pediatric
  • FLI
  • EWS
  • Molecular Mechanisms of Pharmacological Action
  • Antineoplastic Agents
03

In context

Sarcoma, Ewing

250 studies on the registry are indexed under Sarcoma, Ewing; 69 are open to participants now.

This study's enrollment of 32 is below the median of 36 across 204 interventional studies indexed under Sarcoma, Ewing.

Browse Sarcoma, Ewing studies →

Lead sponsor

Gradalis, Inc. is the lead sponsor of 15 studies on the registry; none are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 4 (80%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Tissue Procurement Inclusion Criteria:

  1. confirmed Ewing's Sarcoma Family of Tumors (ESFT).
  2. Age greater than or equal to 2 years.
  3. Estimated survival greater than or equal to 6 months.
  4. Evidence of EWS translocation by FISH or RT-PCR or Next Generation Sequencing (NGS). If available, NGS sequencing report should be submitted to Gradalis.
  5. Recurrence or to 1 , including but not limited to doxorubicin, vincristine, and ifosfamide.
  6. Planned standard of care surgical procedure (e.g., tumor or palliative resection or thoracentesis) and expected availability of a cumulative soft-tissue mass of \~10-30 grams tissue ("grape" to "golf-ball" size / approximately 2 cm total diameter on imaging) or pleural fluid estimated volume ≥ 500mL (from a primary or secondary thoracentesis, yielding in a high volume of tumor cells) for immunotherapy manufacture.
  7. Tumor intended for immunotherapy manufacture is not embedded in bone and does not contain luminal tissue (e.g. bowel, ureter, bile duct).
  8. Ability to understand and the willingness to sign a written protocol specific for tissue harvest or a parental/guardian informed consent and pediatric assent when appropriate.

Tissue Procurement Exclusion Criteria:

  1. Medical condition requiring any form of chronic systemic therapy ( or other) except physiologic replacement doses of hydrocortisone or equivalent (no more than 30 mg hydrocortisone or 10 mg prednisone equivalent daily) for \< 30 days duration.
  2. Known history of other unless having undergone curative intent therapy without evidence of that disease for ≥ 3 years except cutaneous squamous cell and basal cell skin cancer, superficial bladder cancer, in situ cervical cancer or other in situ cancers are allowed if definitively resected.
  3. unless treated with curative intent (gamma knife or surgical resection) and without evidence of progression for ≥ 2 months.
  4. Any documented history of disease with exception of Type 1 diabetes on stable insulin regimen, hypothyroidism on stable dose of replacement thyroid medication, vitiligo, or asthma not requiring systemic steroids.
  5. Known or chronic or C infection.
  6. Known to any temozolomide component or to dacarbazine (DTIC).
  7. Known hypersensitivity to irinotecan or its .
  8. Known history of allergies or sensitivities to gentamicin.
  9. History of or current evidence of any condition (including medical, psychiatric or substance abuse disorder), therapy, or laboratory abnormality that might confound the results of the study, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate, in the opinion of the treating Investigator.

Study Enrollment Inclusion Criteria:

  1. Completed manufacture of at least 4 vials of Vigil.
  2. performance status (KPS) / Lansky performance status (LS) ≥80 percent.
  3. Normal organ and marrow function as defined below:

    Absolute granulocyte count ≥1,000/mm3, Absolute lymphocyte count ≥400/mm3, ≥75,000/mm3, ≥ 8.0 mg/dL, Total ≤ institutional *, (SGOT)/ALT(SGPT) ≤2x institutional upper limit of normal, Creatinine \<1.5 mg/dL

    * documented Gilbert's syndrome may be considered after medical monitor review

  4. Subject has recovered to Grade 1 (except for parameters noted in Item 3, above) or better from all adverse events associated with prior therapy or surgery. Pre-existing motor or sensory neurologic pathology or symptoms, or dermatologic must be recovered to CTCAE Grade 2 or better.
  5. If female of , has a negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a negative serum test will be required for study entry.
  6. Ability to understand and the willingness to sign a written informed protocol specific consent or a parental/guardian informed consent and pediatric assent when appropriate.

Study Enrollment Exclusion Criteria:

In addition to the procurement exclusion criteria, subjects will NOT be eligible for study registration and randomization if meeting any of the following additional criteria:

  1. Any anti-neoplastic therapy between tissue procurement for Vigil manufacture and start of study therapy.
  2. used for the prevention of infectious disease administered \< 30 days prior to the start of study therapy.
  3. Post-surgery complication that in the opinion of the treating investigator would interfere with the patient's study participation or make it not in the best interest of the patient to participate.

Inclusion criteria

Inclusion Criteria for Cross-Over:

Group B subjects will be eligible for cross-over, if they meet all of the following criteria:

  1. Evidence of radiologic disease progression by 1.1 after enrollment into Group B.
  2. Successful manufacturing of at least 4 vials of Vigil.
  3. Karnofsky performance status (KPS) / Lansky performance status (LS) ≥70%.
  4. Normal organ and marrow function as defined below:

    Absolute granulocyte count ≥1,000/mm3 Absolute lymphocyte count ≥400/mm3 Platelets ≥75,000/mm3 Total bilirubin ≤ institutional upper limit of normal AST(SGOT)/ALT(SGPT) ≤2x institutional upper limit of normal Creatinine \<1.5 mg/dL

    *documented Gilbert's syndrome may be considered after medical monitor review.

  5. Subject has recovered to CTCAE Grade 1 (except for parameters noted in Item 4, above) or better from all adverse events associated with prior therapy or surgery. Preexisting motor, sensory neurologic pathology or symptoms, or dermatologic toxicities must be recovered to CTCAE Grade 2 or better.
  6. If female of childbearing potential, has a negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a negative serum test will be required for study entry.
  7. Ability to understand and the willingness to sign a written informed protocol specific consent or a parental/guardian informed consent and pediatric assent when appropriate.

Exclusion criteria

Exclusion Criteria for Cross-Over:

In addition to the Procurement and Study Enrollment exclusion criteria, Subjects will not be eligible for cross-over if meeting any of the following criteria:

  1. With the exception of irinotecan and temozolomide while on study, any anti-neoplastic therapy between tissue procurement for Vigil manufacture and start of study therapy.
  2. used for the prevention of infectious disease administered \< 30 days prior to the start of study therapy.
Terms in these criteria, in plain language(24)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
32 participants (actual)

Study arms

  • Experimental
    Group A: Vigil + Irinotecan and Temozolomide

    Participants randomized to Group A received oral temozolomide 100 mg/m2 daily (Days 1-5), total dose 500 mg/m2/cycle) and oral irinotecan 50 mg/m2 daily (Days 1-5, total dose 250 mg/m2/cycle). Vigil immunotherapy was administered at a concentration of 1 X 10e6 cells/dose given via intradermal injection on Day 15 of each cycle. 1 cycle = 21 days Participants continued treatment for a maximum of 12 cycles, or until disease progression, unacceptable toxicity, withdrawal of consent or other criterion is met for discontinuation from study.

    Biological: Vigil · Drug: Irinotecan · Drug: Temozolomide

  • Active comparator
    Group B: Irinotecan and Temozolomide

    Participants randomized to Group B received oral temozolomide 100 mg/m2 daily (Days 1-5), total dose 500 mg/m2/cycle) and oral irinotecan 50 mg/m2 daily (Days 1-5, total dose 250 mg/m2/cycle). 1 cycle = 21 days Participants continued treatment for a maximum of 12 cycles, or until disease progression, unacceptable toxicity, withdrawal of consent or other criterion is met for discontinuation from study.

    Drug: Irinotecan · Drug: Temozolomide

  • Other
    Cross-Over: Vigil monotherapy

    Participants randomized to Group B were able to receive Vigil immunotherapy at a concentration of 1 X 10e6 cells/dose given via intradermal injection on Day 15 of each cycle. Confirmation of progression by central radiologist and pre-approval from sponsor was required. 1 cycle = 21 days

    Biological: Vigil

Interventions

  • BiologicalVigil

    Drug pages: Diclobutrazol · FANG vaccine

    Vigil is composed of autologous tumor cells harvested from the patient at the time of initial de-bulking surgery which are then transfected extracorporeally, with a plasmid encoding for the gene for GM-CSF, an immune-stimulatory cytokine, and a bifunctional, short hairpin RNA which specifically knocks down the expression of furin, the critical convertase responsible for production of the two TGβ isoforms.

    Also known as: Bi-shRNAfurin and GMCSF Augmented Autologous Tumor Cell Immunotherapy, FANG vaccine

  • Injectable formulation of irinotecan was distributed from central supplier. 1 Cycle (5 doses of 50 mg/m2 per syringe) was drawn into provided oral syringes and dispenses to the subject with instructions to refrigerate until administration.

    Also known as: Camptosar, Camptothecin-11, CPT-11

  • Dose: 100 mg/m2 daily, oral Schedule: Days 1-5, every 21 days Administered at least 1 hour before Irinotecan.

    Also known as: Temodar

06

What researchers measure

Primary outcomes

  1. Progression Free Survival (PFS)

    Progression Free Survival (PFS) is defined as the time from randomization to the event of disease recurrence/progression according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria (version 1.1) for target lesions and assessed CT/MRI by local investigator.

    Time frame: From date of randomization until the date of first documented progression (assessed up to 3 years).

Secondary outcomes

  1. Overall Survival (OS)

    OS is defined as time from randomization to death or to the date of last follow-up. The date of last follow-up confirming survival will be used as the censoring date for subjects who are alive and/or do not have a known date of death.

    Time frame: From date of randomization until date of death from any cause, whichever came first (assessed up to 3 years).

  2. Overall Response Rate (ORR)

    ORR is defined as the proportion of participants who have prolonged stable disease or a partial or complete response or complete response to therapy according to RECIST 1.1.

    Time frame: 6 months after treatment with Vigil.

  3. Vigil Manufacture Success Rate: Number of Participants Eligible for Treatment on the Main Study.

    Participants were considered eligible for treatment, if the tissue submitted to Gradalis met all criteria, including manufacturing product release criteria.

    Time frame: From manufacturing start date until 4 weeks post manufacturing for each tissue procurement (assessed up to 17 months).

07

Results

Posted Apr 26, 2023
Limitations and caveats
Early termination of trial leading to small numbers of subjects analyzed. Technical problems with measurement leading to unreliable or uninterpretable data.

Participant flow

Main Study
Participant flow — Main Study
MilestoneGroup A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and Temozolomide
Started32
Completed32
Not completed00
Group B Crossover to Vigil Alone
Participant flow — Group B Crossover to Vigil Alone
MilestoneGroup A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and Temozolomide
Started01
Completed01
Not completed00

Outcome measures

PrimaryProgression Free Survival (PFS)

Progression Free Survival (PFS) is defined as the time from randomization to the event of disease recurrence/progression according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria (version 1.1) for target lesions and assessed CT/MRI by local investigator.

Time frame:
From date of randomization until the date of first documented progression (assessed up to 3 years).
Reported as:
Median · Months
Progression Free Survival (PFS)
MonthsGroup A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and Temozolomide
Progression Free Survival (PFS)2.8 (2.7 to NA)9.1 (2.8 to NA)
SecondaryOverall Survival (OS)

OS is defined as time from randomization to death or to the date of last follow-up. The date of last follow-up confirming survival will be used as the censoring date for subjects who are alive and/or do not have a known date of death.

Time frame:
From date of randomization until date of death from any cause, whichever came first (assessed up to 3 years).
Reported as:
Median · Months
Overall Survival (OS)
MonthsGroup A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and Temozolomide
Overall Survival (OS)16.1 (14.6 to NA)3.3 (3.3 to NA)
SecondaryOverall Response Rate (ORR)

ORR is defined as the proportion of participants who have prolonged stable disease or a partial or complete response or complete response to therapy according to RECIST 1.1.

Time frame:
6 months after treatment with Vigil.
Reported as:
Number · Proportion of participants.
Overall Response Rate (ORR)
Proportion of participants.Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and Temozolomide
Overall Response Rate (ORR)00
SecondaryVigil Manufacture Success Rate: Number of Participants Eligible for Treatment on the Main Study.

Participants were considered eligible for treatment, if the tissue submitted to Gradalis met all criteria, including manufacturing product release criteria.

Time frame:
From manufacturing start date until 4 weeks post manufacturing for each tissue procurement (assessed up to 17 months).
Reported as:
Count of participants · Participants
Vigil Manufacture Success Rate: Number of Participants Eligible for Treatment on the Main Study.
ParticipantsTotal Number of Tissue Procurements
Vigil Manufacture Success Rate: Number of Participants Eligible for Treatment on the Main Study.4

Adverse events

Collected over SAEs and Other Adverse Events: following procurement of the subject's tissue for tissue manufacture and for up to 30 days following the last study treatment, a duration of approximately 12 months. All-cause Mortality: from randomization date and until death or protocol termination, up to 3 years.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Group A: Vigil in Combination With Irinotecan and Temozolomide2/3 (66.7%)0/3 (0%)3/3 (100%)
Group B: Irinotecan and Temozolomide1/2 (50%)1/2 (50%)2/2 (100%)
Cross-over to Vigil Alone0/1 (0%)0/1 (0%)1/1 (100%)
Most frequent serious events
Most frequent serious events
EventGroup A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideCross-over to Vigil Alone
DyspneaRespiratory, thoracic and mediastinal disorders0/31/20/1
Pleural effusionRespiratory, thoracic and mediastinal disorders0/31/20/1
HypoxiaRespiratory, thoracic and mediastinal disorders0/31/20/1
AtelectasisRespiratory, thoracic and mediastinal disorders0/31/20/1
Pulmonary EdemaRespiratory, thoracic and mediastinal disorders0/31/20/1
Most frequent other events
Showing 10 of 49
Most frequent other events
EventGroup A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideCross-over to Vigil Alone
PhotophobiaEye disorders0/30/21/1
NauseaGastrointestinal disorders3/32/20/1
VomitingGastrointestinal disorders2/32/20/1
FatigueGeneral disorders0/32/20/1
Injection site reactionGeneral disorders0/30/21/1
Chloride increasedInvestigations0/30/21/1
Creatinine increasedInvestigations0/30/21/1
Hemoglobin increasedInvestigations0/31/21/1
Lymphocyte count increasedInvestigations0/30/21/1
WBC decreasedInvestigations0/31/21/1

Baseline characteristics

Only 1 subject randomized to Group B was eligible to Cross-over to receive Vigil.

Age, Categorical
Age, Categorical(Participants)Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideTotal
<=18 years022
Between 18 and 65 years303
>=65 years000
Sex: Female, Male
Sex: Female, Male(Participants)Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideTotal
Female112
Male213
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideTotal
Hispanic or Latino202
Not Hispanic or Latino123
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American000
White325
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideTotal
United States325
Baseline Performance Status
Baseline Performance Status(Participants)Group A: Vigil in Combination With Irinotecan and TemozolomideGroup B: Irinotecan and TemozolomideTotal
80022
100303
08

Study locations

15 sites
  • Arkansas Children's Hospital
    Little Rock, Arkansas 72202, United States
  • Southern California Permanente Medical Group
    Los Angeles, California 90027, United States
  • Mayo Clinic Florida
    Jacksonville, Florida 32224, United States
  • Nicklaus Children's Hospital
    Miami, Florida 33155, United States
  • Dana-Farber/Boston Children's Cancer and Blood Disorders
    Boston, Massachusetts 02215, United States
  • Washington University Siteman Cancer Center
    Saint Louis, Missouri 63110, United States
  • Nebraska Methodist Hospital
    Omaha, Nebraska 68114, United States
  • Memorial Sloan Kettering Cancer Center
    New York, New York 10065, United States
  • Duke Children's Hospital and Health Center; Duke Cancer Institute
    Durham, North Carolina 27710, United States
  • Cincinnati Children's Hospital Medical Center
    Cincinnati, Ohio 45229, United States
  • Cleveland Clinic
    Cleveland, Ohio 44195, United States
  • Fox Chase Cancer Center
    Philadelphia, Pennsylvania 19111, United States
  • Texas Oncology - Pediatrics
    Dallas, Texas 75230, United States
  • Cook Children's Medical Center
    Fort Worth, Texas 76104, United States
  • Seattle Cancer Care Alliance
    Seattle, Washington 98109, United States
09

References and documents

Publications

  • Ghisoli M, Rutledge M, Stephens PJ, Mennel R, Barve M, Manley M, Oliai BR, Murphy KM, Manning L, Gutierrez B, Rangadass P, Walker A, Wang Z, Rao D, Adams N, Wallraven G, Senzer N, Nemunaitis J. Case Report: Immune-mediated Complete Response in a Patient With Recurrent Advanced Ewing Sarcoma (EWS) After Vigil Immunotherapy. J Pediatr Hematol Oncol. 2017 May;39(4):e183-e186. doi: 10.1097/MPH.0000000000000822. PubMed 28338569 ↗
  • Ghisoli M, Barve M, Mennel R, Lenarsky C, Horvath S, Wallraven G, Pappen BO, Whiting S, Rao D, Senzer N, Nemunaitis J. Three-year Follow up of GMCSF/bi-shRNA(furin) DNA-transfected Autologous Tumor Immunotherapy (Vigil) in Metastatic Advanced Ewing's Sarcoma. Mol Ther. 2016 Aug;24(8):1478-83. doi: 10.1038/mt.2016.86. Epub 2016 Apr 25. PubMed 27109631 ↗
  • Ghisoli M, Barve M, Schneider R, Mennel R, Lenarsky C, Wallraven G, Pappen BO, LaNoue J, Kumar P, Nemunaitis D, Roth A, Nemunaitis J, Whiting S, Senzer N, Fletcher FA, Nemunaitis J. Pilot Trial of FANG Immunotherapy in Ewing's Sarcoma. Mol Ther. 2015 Jun;23(6):1103-1109. doi: 10.1038/mt.2015.43. Epub 2015 Mar 19. PubMed 25917459 ↗
  • Senzer N, Barve M, Kuhn J, Melnyk A, Beitsch P, Lazar M, Lifshitz S, Magee M, Oh J, Mill SW, Bedell C, Higgs C, Kumar P, Yu Y, Norvell F, Phalon C, Taquet N, Rao DD, Wang Z, Jay CM, Pappen BO, Wallraven G, Brunicardi FC, Shanahan DM, Maples PB, Nemunaitis J. Phase I trial of "bi-shRNAi(furin)/GMCSF DNA/autologous tumor cell" vaccine (FANG) in advanced cancer. Mol Ther. 2012 Mar;20(3):679-86. doi: 10.1038/mt.2011.269. Epub 2011 Dec 20. PubMed 22186789 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 26, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03495921
Lead sponsor
Gradalis, Inc.
Responsible party
Sponsor
First posted
Apr 12, 2018
Start date
Aug 21, 2018
Primary completion
Jan 20, 2022
Completion
Jan 20, 2022
Results posted
Apr 26, 2023
Last update
Apr 26, 2023

Study contacts

John Nemunaitis, MD
study director · Gradalis, Inc.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Apr 2023. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drugs tested here: Diclobutrazol · FANG vaccine · Irinotecan · Temozolomide

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