Clinical Trials /

Convection-Enhanced Delivery (CED) of MDNA55 in Adults With Recurrent or Progressive Glioblastoma

NCT02858895

Description:

This is a single-arm, open-label, multicenter study in approximately 52 adults with primary (de novo) GB that has recurred or progressed (first or second recurrence, including this recurrence) after treatment(s) including surgery and radiotherapy with or without chemotherapy and following discontinuation of any previous standard or investigational lines of therapy.

Related Conditions:
  • Glioblastoma
Recruiting Status:

Completed

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Convection-Enhanced Delivery (CED) of MDNA55 in Adults With Recurrent or Progressive Glioblastoma
  • Official Title: An Open-Label Non-Randomized, Multi-Center Phase-2 Study of Convection-Enhanced Delivery (CED) of MDNA55 in Adults With Recurrent or Progressive Glioblastoma

Clinical Trial IDs

  • ORG STUDY ID: MDNA55-05
  • NCT ID: NCT02858895

Conditions

  • Glioblastoma
  • Grade IV Astrocytoma
  • Glioblastoma Multiforme
  • Grade IV Glioma

Interventions

DrugSynonymsArms
MDNA55IL4-PE, Interleukin-4 Pseudomonas Exotoxin, Interleukin-4 Pseudomonas Toxin, IL4 Pseudomonas Exotoxin, NBI-3001, cpIL4-PEMDNA55

Purpose

This is a single-arm, open-label, multicenter study in approximately 52 adults with primary (de novo) GB that has recurred or progressed (first or second recurrence, including this recurrence) after treatment(s) including surgery and radiotherapy with or without chemotherapy and following discontinuation of any previous standard or investigational lines of therapy.

Detailed Description

      The study drug, MDNA55, is a fusion protein comprising a genetically engineered Interleukin-4
      (IL-4) linked to a modified version of the Pseudomonas aeruginosa exotoxin A (PE). MDNA55
      binds to the IL-4 receptor (IL4R), over-expressed by cancer cells and non-malignant
      immunosuppressive cells of the tumor microenvironment (TME), and delivers a potent
      cell-killing agent, PE.

      The study will be conducted at up to 10 clinical sites following institutional review board
      approval and completed informed consent.

      Subjects that meet the study eligibility criteria will undergo surgery associated with study
      drug administration. MDNA55 will be administered locally by convection-enhanced delivery
      (CED).

      Post-treatment follow-up assessment of safety and efficacy will be performed monthly for the
      first 6 months and bimonthly thereafter for approximately 1 year after study drug
      administrations. Subjects will continued to be followed for survival and post-study
      treatment(s) of GB after study completion or withdrawal.
    

Trial Arms

NameTypeDescriptionInterventions
MDNA55ExperimentalSingle infusion of MDNA55 via convection enhanced delivery (CED).* *Subjects may be eligible to receive a second administration of MDNA55.
  • MDNA55

Eligibility Criteria

        INCLUSION CRITERIA:

          1. Subjects must be ≥ 18 years old and have a life expectancy ≥ 12 weeks

          2. Histologically proven, primary (de novo) GB that has recurred or progressed (first or
             second recurrence, including this recurrence)

          3. Confirmation that archived tissue is available from first diagnosis of GB for
             biomarker analysis

          4. Recurrent tumor must be supratentorial, contrast-enhancing GB no smaller than 1 cm x 1
             cm (largest perpendicular dimensions) and no larger than 4 cm maximum in a single
             direction based on MRI taken within 14 days prior to catheter placement

          5. Karnofsky Performance Score (KPS) ≥ 70

          6. Subjects must be able and willing to undergo multiple brain MRI examinations

          7. Subjects must be able and willing to comply with all study procedures

          8. Any related toxicities following discontinuation of prior GB therapies must have
             resolved to CTCAE Grade 1 or lower prior to inclusion in this study

        EXCLUSION CRITERIA:

          1. Prior treatment with cytotoxic chemotherapy

               1. Temozolomide (standard induction and / or maintenance dosing) within the past 4
                  weeks prior to planned infusion

               2. "Metronomic" Temozolomide (low-dose, continuous administration) within the past 7
                  days prior to planned infusion

               3. Nitrosoureas within the past 6 weeks prior to planned infusion

               4. Treatment with any other cytotoxic agent within the past 4 weeks prior to planned
                  infusion

          2. Prior investigational treatment within the past 4 weeks or prior immunotherapy or
             antibody therapy within the past 4 weeks prior to planned infusion

          3. Prior treatment with bevacizumab (Avastin) or other vascular-endothelial growth factor
             (VEGF) inhibitors or VEGF-receptor signaling inhibitors within the past 4 weeks prior
             to planned infusion

          4. Prior therapy that included interstitial brachytherapy or Gliadel® Wafers (carmustine
             implants) within the past 12 weeks prior to planned infusion

          5. Prior surgery (including stereotactic radiosurgery and biopsy procedures) within the
             past 4 weeks prior to planned infusion

          6. Ongoing Optune© therapy within 5 days of planned infusion

          7. Secondary GB (i.e., GB that progressed from low-grade diffuse astrocytoma or AA)

          8. Known mutation in either the isocitrate dehydrogenase 1 (IDH1) or the IDH2 gene.

          9. Tumor in the brainstem (not including fluid-attenuated inversion recovery [FLAIR]
             changes), an infratentorial tumor, diagnosis of gliomatosis cerebri (highly
             infiltrative T2 hyperintense tumor with ill-defined margins encompassing at least
             three lobes of the brain.

         10. Tumor with a mass effect (e.g. 1-2 cm midline shift)

         11. Subjects with tumors for which the preponderance of tissue is not of the type in which
             convection would be possible (e.g. preponderance of cystic component)

         12. Tumor with geometric features that make them difficult to adequately cover the tumor
             volume with infusate by using CED catheters

         13. Clinical symptoms that are thought by the Investigator to be caused by uncontrolled
             increased intracranial pressure, hemorrhage, or edema of the brain

         14. Any condition that precludes the administration of anesthesia

         15. Known to be human immunodeficiency virus positive

         16. Concurrent or a history of any significant medical illnesses that in the
             Investigator's opinion cannot be adequately controlled with appropriate therapy or
             would compromise the subject's ability to tolerate the study drug therapy and/or put
             the subject at additional risk or interfere with the interpretation of the results of
             this trial

         17. Known history of allergy to gadolinium contrast agents

         18. Presence of another type of malignancy requiring treatment within < 3 years prior to
             the screening visit, except for adequately treated carcinoma in-situ of the cervix,
             prostate cancer not actively treated, and basal or squamous cell carcinoma of the skin
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Survival (OS)
Time Frame:12 months
Safety Issue:
Description:OS, time from treatment until death

Secondary Outcome Measures

Measure:Objective Response Rate (ORR)
Time Frame:12 months
Safety Issue:
Description:ORR, determined by independent central review (per RANO-based criteria)
Measure:Progression Free Survival (PFS)
Time Frame:12 months
Safety Issue:
Description:PFS, time from treatment until disease progression (per RANO-based criteria) or death

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Medicenna Therapeutics, Inc.

Trial Keywords

  • High grade glioma
  • malignant glioma
  • recurrent glioblastoma
  • recurrent GBM
  • recurrent GB
  • glioblastoma (GB)
  • glioblastoma multiforme (GBM)
  • progressive glioblastoma
  • Brain tumor
  • Brain cancer
  • immunotherapy
  • targeted
  • IL4R

Last Updated

January 15, 2021