A Trial of Vigil for Participants With Ovarian Cancer

Sponsor: Gradalis, Inc.

Sponsor score: 0

ClinicalTrials ID:NCT02346747

This Phase 2 trial evaluates Vigil, an engineered autologous tumor cell vaccine, versus placebo in women with Stage IIIb-IV ovarian, fallopian tube, or primary peritoneal cancer post-surgery and chemotherapy. Eligible participants must have a complete clinical response and meet specific health criteria. Vigil or placebo is administered monthly for 4-6 doses, with follow-up imaging and survival tracking.

Patient Parameters

Program Overview

The goal of this clinical trial is to compare participants with ovarian, fallopian tube or primary peritoneal cancer when treated with investigational product (Vigil) compared to placebo. The main question it aims to answer is "Will participants who receive treatment with Vigil have a longer time to disease recurrence versus the participants that were not given Vigil?"

Description

This is a multicenter, randomized, double-blind, placebo-controlled, Phase 2 study of maintenance Vigil Ovarian (gemogenovatucel-T) engineered autologous tumor cells (EATC) in women with Stage IIIb, IIIc or IV high-grade papillary serous/ clear cell / endometrioid ovarian, fallopian tube or primary peritoneal cancer. Subjects will have had a minimum of 4 and a maximum of 12 doses of Vigil prepared and stored from ovarian tumor cells obtained at the time of primary surgical debulking or initial diagnostic / evaluative laparoscopy (tissue for immunotherapy manufacture must be procured prior to initiation of neoadjuvant chemotherapy). An equal number of placebo doses will be manufactured. Subjects eligible for randomization will have achieved a clinically defined complete response following primary surgery and adjuvant chemotherapy. Clinical complete response (cCR) is defined as no evidence of maligancy on chest x-ray and CT scan or MRI of the abdomen and pelvis, CA-125 antigen level ≤ units/mL, and no findings on physical examination or symptoms suggestive of active cancer.

Investigational treatment must start no less than 3 weeks and no more than 8 weeks following completion of chemotherapy.

Approximately 86 subjects will be randomized 1:1 to to Group A (Vigil 1.0 X 10e7 cells/injection) or Group B (placebo). Randomization will be stratified by (i) extent of surgical cytoreduction (complete/microscopic versus macroscopic residual disease) and (ii) neoadjuvant versus adjuvant chemotherapy. Participants will receive Vigil or placebo by intradermal injection once a month for at least 4 and up to a maximum of 6 doses determined by the number of doses of Vigil manufactured for that subject.

Participants will be managed in an outpatient setting. Image assessment with chest x-ray and CT scan or MRI of the abdomen and pelvis will be completed every 3 months in Years 1-3, then every 6 months in Years 4 and 5 and yearly through Year 10. At the time the participant recurs, the participant will enter long term follow-up for survival status and post treatment therapies received.

Eligibility Criteria

Inclusion Criteria

  1. Histologically confirmed Stage IIIb, IIIc or IV high-grade papillary serous/clear cell/endometrioid ovarian, fallopian tube or primary peritoneal.
  2. Completion of primary surgical debulking including hysterectomy and bilateral salpingo oophorectomy, and at least 5 but no more than 8 cycles of platinum / taxane adjuvant chemotherapy or chemotherapy as per Category 1 recommendations of the NCCN guidelines, including 5-8 cycles adjuvant intraperitoneal + intravenous (IP/IV) chemotherapy, or 5-8 cycles of intravenous chemotherapy divided and administered as neoadjuvant and adjuvant therapy flanking primary debulking surgery.
  3. Clinically defined complete response (cCR) following completion of primary surgical debulking and eligible chemotherapy. cCR defined as no evidence of malignancy on chest x-ray (CT scan is acceptable) and CT scan or MRI of the abdomen and pelvis, normal physical examination, CA-125 antigen level ≤ 35 U/ml (assessed ≥ 2 weeks following removal of catheter in subjects receiving intraperitoneal/intravenous chemotherapy) and no findings on physical examination or symptoms suggestive of active cancer.
  4. Subjects must have initiated adjuvant chemotherapy no more than 8 weeks following primary debulking surgery.
  5. Successful manufacturing of at least 4 doses (vials) of Vigil and placebo.
  6. Recovered from all clinically relevant toxicities related to prior therapy (including neuropathy ≤Grade 2).
  7. ECOG performance status (PS) 0-1.
  8. Normal organ and marrow function as defined below: Absolute granulocyte count ≥ 1,500/mm^3, Absolute lymphocyte count ≥ 500/mm^3, Platelets ≥ 75,000/mm^3, Total bilirubin ≤ 2 mg/dL, AST(SGOT)/ALT(SGPT)≤ 2x institutional upper limit of normal, Creatinine < 1.5 mg/dL
  9. Ability to understand and the willingness to sign a written informed protocol specific consent.

Exclusion Criteria

Subjects will be excluded from this study if they meet any of the following criteria (at the time of tissue procurement or at randomization):

  1. Surgery involving general anesthesia, radiotherapy, immunotherapy, or investigational agents within 4 weeks prior to randomization.
  2. Histologically confirmed papillary serous adenocarcinoma of the uterus or disease involving myometrium/endometrium.
  3. Systemic immunosuppressive therapy within 14 days of randomization.
  4. Subjects requiring chronic steroid or immunosuppressive regimens are excluded except inhaled / intranasal steroids and short term systemic steroids <30 days duration and ≤0.25 mg/kg prednisone-equivalent per day are allowed.
  5. Congestive heart failure (NYHA Class II, III, or IV), unstable angina, ventricular or hemodynamically significant atrial arrhythmia, or cardiovascular disease such as stroke or myocardial infarction (current or within the past 6 months).
  6. Psychiatric illness/social situations that would limit compliance with study requirements.
  7. Subjects with history of brain metastases.
  8. Subjects with known HIV or chronic Hepatitis B or C infection.
  9. Prior solid organ or bone marrow transplant.
  10. History of or active autoimmune disease (e.g., autoimmune neutropenia, thrombocytopenia, or hemolytic anemia, systemic lupus erythematosus, Sjogren's syndrome, scleroderma, myasthenia gravis, Goodpasture's syndrome, Addison's disease, Hashimoto's thyroiditis, or Graves disease). Persons with vitiligo are not excluded. Diabetics are not excluded if the condition is well controlled.

Locations

FACILITYZIPCITYSTATE
University of South Alabama Mitchell Cancer Institute36604MobileAlabama
Southern California Permanente Medical Group92618IrvineCalifornia
Palo Alto Foundation Medical Group94115San FranciscoCalifornia
University Of Miami Sylvester Comprehensive Cancer Center33136MiamiFlorida
Moffitt Cancer Center33612TampaFlorida
Florida Cancer Specialists33401West Palm BeachFlorida
Georgia Cancer Center at Augusta University30912AugustaGeorgia
University Of Kentucky Markey Cancer Center40536LexingtonKentucky
Maine Medical Center: MMP Women's Health04074ScarboroughMaine
Dana Farber Cancer Institute: Gynecologic Oncology02215BostonMassachusetts

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