A Phase 1/2 Safety Study of Intratumorally Dosed INT230-6



Status:Recruiting
Conditions:Breast Cancer, Lung Cancer, Colorectal Cancer, Skin Cancer, Liver Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Brain Cancer, Lymphoma, Pancreatic Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:11/23/2018
Start Date:February 9, 2017
End Date:August 2020
Contact:Jeanne Lewis
Email:jlewis@ce3inc.com
Phone:860-815-7185

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A Phase 1/2 Safety Study of Intratumorally Administered INT230-6 in Adult Subjects With Advanced Refractory Cancers

This study evaluates the intratumoral administration of escalating doses of a novel,
experimental drug, INT230-6. The study is being conducted in patients with several types of
refractory cancers including those at the surface of the skin (melanoma, head and neck,
lymphoma, breast) and tumors within the body such (pancreatic, colon, liver, lung, etc.).
Sponsor also plans to test INT230-6 in combination with anti-PD-1 antibodies.

INT230-6 is comprised of a 3 agents in a fixed ratio - a cell permeation enhancer and two,
potent anti-cancer payloads (cisplatin and vinblastine sulfate). The penetration enhancer
facilitates dispersion of the two drugs throughout injected tumors and enables increased
diffusion into cancer cells. (Nonclinical safety studies showed no findings following drug
injection into healthy tissues.)

Historically physicians administer the two active drugs comprising INT230-6 by intravenous
(IV) infusion to achieve a systemic blood level at the limit of tolerability. The objective
is destroy both visible tumors and unseen circulating cancer cells (micro-metastases).
Unfortunately, dosing drugs IV delivers only a small amount with a low concentration at the
tumor site. This approach especially for late stage cancers is not highly effective and often
quite toxic to the patient.

Attempts at direct intratumoral injection with chemotherapeutic agents have not shown the
ability to treat the injected tumor, non-injected tumors or micro-metastases. This lack of
efficacy for local administration is due possibly to poor dispersion and a lack of cell
uptake of the agents.

Due to the use of the novel cell penetration enhancing agent INT230-6 treatment demonstrates
strong efficacy in animals having large tumors. The Sponsor's in vivo, non-clinical data
shows that INT230-6 thoroughly saturates and kills injected tumors. In addition, the drug
induces an adaptive (T-cell mediated) immune response that attacks not only the injected
tumor, but non-injected tumors and unseen micro-metastases. Cured animals become permanently
immunized against the type of cancer that INT230-6 eliminates.

Clinical trial IT-01 will thus seek to determine the safety and potential efficacy of dosing
INT230-6 directly into several different types of cancers. In addition animal studies showed
a strong synergy of INT230-6 with immune modulation agents. Thus as part of study IT-01 the
Sponsor will seek to understand the safety and efficacy of INT230-6 when administered in
combination with immuno-therapeutic agents such as antibodies that target Programmed Cell
Death (PD-1 or anti-PD-1) receptors.

This study seek to understand whether tumor regression can be achieved and patient outcomes
improved.

Inclusion Criteria:

1. Men and Women > 18 years of age with Eastern Cooperative Oncology Group (ECOG)
performance status < 2;

2a. Eligibility: U.S. Sites

Includes subjects with loco-regional disease that have relapsed/recurred within 6 months of
chemo-radiation and who have no standard of care.

Includes patients (subjects) with metastatic disease having injections into only
superficial lesions that have failed (includes progression, relapse or intolerance) or not
be a candidate for approved therapies. Note, patients (subjects) that have approved
therapies available, which might confer clinical benefit, may be enrolled as long as the
physician properly explains the nature of the treatment, and obtains consent ".

Includes patients (subjects) with metastatic disease having at least one deep tumor
injection who have failed (includes progression, relapse or intolerance) all approved lines
of therapy prior to enrollment unless they are not an appropriate candidate for a
particular approved therapy or no approved therapy exists.

Note: There is no limit on the number of prior therapies that a patient (subject) may have
received prior to enrollment in any cohort.

2b. Eligibility: Canadian Sites

Subjects with advanced or metastatic solid tumors that have disease progression after
treatment with approved, available therapies (in site's country) for the cancer type or for
whom available therapies have limited benefit and the subject refuses the available
therapy. Includes subjects with locoregional disease that have relapsed/recurred within 6
months of chemo-radiation; or who have no standard of care or beneficial options. No limit
on the number of prior treatments;

3. Subjects must have measurable disease by RECIST 1.1 criteria including one target tumor
for injection. Superficial tumors must have one tumor greater than or equal to 1.0 cm, deep
tumors greater than or equal to 1.0 cm (as measured by caliper (for non-injected tumors
only) or image guidance);

4. Subjects must have a minimum of one injectable lesion as determined by the investigator
(for superficial tumors) or radiologist (deep tumors).

5. Prior chemotherapy or immunotherapy (tumor vaccine, cytokine, or growth factor given to
control the cancer: systemic or IT) must have been completed at least 4 weeks prior to
enrollment and all adverse events have either returned to baseline (or resolved to < grade
1); note: subjects who have received prior platinum therapy are eligible irrespective of
their response.

6. Prior systemic radiation therapy (either IV, intrahepatic or oral) completed at least 4
weeks prior to study drug administration.

7. Prior focal radiotherapy completed at least 4 weeks prior to study drug administration.

8. Prior major treatment-related surgery completed at least 4 weeks prior to study drug
administration;

9. No prior primary or metastatic brain or meningeal tumors unless clinically and
radiographically stable as well as off steroid therapy for at least 2 months;

10a. Life expectancy ≥8 weeks all (US); 10b. Life expectancy ≥12 weeks; ≥ 8 weeks
superficial tumors (Canada);

11. Subjects who may become pregnant or who are sexually active with a partner who could
become pregnant are to use an effective form of barrier contraception during the study and
for at least 60 days for female patients and 180 days for male patients after
administration of study drug; and

12. Screening laboratory values must meet the following criteria:

1. White Blood Cell (WBC) ≥2000/μL (≥2 x 10^9/L)

2. Neutrophils ≥1000/μL (≥1 x 10^9/L)

3. Platelets ≥70x103/μL (≥ 70 x 10^9/L) (superficial tumor dosing only)

4. Hemoglobin ≥8 g/dL (≥80 g/L) (superficial tumor dosing only)

5. Creatinine within the institution's laboratory upper limit of normal (ULN) or
calculated creatinine clearance >50 ml/min

6. alanine aminotransferase /aspartate aminotransferase (ALT/AST) ≤2.5 x ULN without, and
≤ 5 x ULN with hepatic metastases

7. Bilirubin ≤2 x ULN (except subjects with Gilbert's syndrome, who must have total
bilirubin < 3.0 mg/dL (<52 µmol/L))

8. For patients with planned deep tumor injections: prothrombin time (PT), activated
partial thromboplastin time (aPPT), and international normalized ratio (INR) within
normal limits; Platelet count ≥100,000/μL; hemoglobin ≥ 9 gm/dL.

13. Additional criteria for cohort D (anti-PD1 combo) will be supplied in an appendix
at a later date.

Exclusion Criteria:

1. History of severe hypersensitivity reactions to cisplatin or vinblastine or other
products of the same class;

2. Other prior malignancy, except for adequately treated basal or squamous cell skin
cancer or superficial bladder cancer, or any other cancer from which the subject
has been disease-free for at least 5 years;

3. Underlying medical condition that, in the Principal Investigator's opinion, will
make the administration of study drug hazardous or obscure the interpretation of
toxicity determination or adverse events;

4. Concurrent medical condition requiring the use of immunosuppressive medications,
or systemic or topical corticosteroids; systemic or topical corticosteroids must
be discontinued at least 4 weeks prior to enrollment. Inhaled or intranasal
corticosteroids (with minimal systemic absorption may be continued if the subject
is on a stable dose). Non-absorbed intra-articular steroid injections will be
permitted; or use of other investigational drugs (drugs not marketed for any
indication) within 30 days prior to study drug administration. Use of steroids as
prophylactic treatment for subjects with contrast allergies to diagnostic imaging
contrast dyes will be permitted;

5. For deep tumor cohorts, patients who require uninterrupted anticoagulants of any
type, on daily aspirin therapy, or NSAIAs.

6. U.S. ONLY: For all Cohorts, patients who refuse approved therapy for which they
are a suitable candidate are not eligible for enrollment on this trial.

7. Additional criteria for cohort D (anti-PD1 combo) will be supplied in an appendix
at a later date.
We found this trial at
6
sites
Philadelphia, Pennsylvania 19111
Principal Investigator: Anthony J. Olszanski, MD, RPh
Phone: 215-728-2195
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Baltimore, Maryland 21231
410-955-6190
Principal Investigator: Nilofer Azad, MD
Phone: 410-502-5140
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins The name Johns Hopkins has become synonymous...
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Los Angeles, California 90033
Phone: 323-409-4368
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500-520 Superior Avenue
Newport Beach, California 92663
Phone: 949-764-6755
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610 University Avenue
Toronto, Ontario M5G 2M9
Phone: 416-946-4575
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Toronto,
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Worcester, Massachusetts 01605
Phone: 508-856-3216
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Worcester, MA
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