Gene therapy combined with radiotherapy for brain tumors
Phase I Study of Replication-Competent Adenovirus-Mediated Double Suicide Gene Therapy With Stereotactic Radiosurgery in Patients With Recurrent or Progressive High Grade Astrocytomas
This study is testing a new gene therapy combined with targeted radiation to see if it can safely help people with recurrent high-grade brain tumors.
Quick facts
| Phase | Phase 1 |
|---|---|
| Study type | Interventional |
| Enrollment | 18 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Henry Ford Health System Academic / other |
| Drugs / interventions | chemotherapy, immunotherapy, radiation |
| Locations | 1 site (Detroit, Michigan) |
| Trial ID | NCT05686798 on ClinicalTrials.gov |
What this trial studies
This Phase I study aims to determine the maximum tolerated dose of an oncolytic adenovirus combined with fractionated stereotactic radiosurgery in patients with recurrent high-grade astrocytoma. Eligible patients will undergo tumor resection, followed by injection of the modified adenovirus into the resection cavity and any remaining tumor tissue. The treatment is further supplemented with oral prodrug therapy and monitored for 30 days before the next line of anti-cancer therapy begins. The study focuses on assessing safety and tolerability of this innovative approach.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older with recurrent high-grade astrocytoma who are scheduled for surgical resection.
Not a fit: Patients with low-grade tumors or those who have not recovered from prior therapy toxicity may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with recurrent high-grade astrocytoma, potentially improving survival outcomes.
How similar studies have performed: While this approach is innovative, similar studies using gene therapy in combination with radiotherapy have shown promise in other contexts, suggesting potential for success.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Subjects with radiologic evidence of intracranial recurrence or progression of a previously diagnosed high-grade astrocytoma. To be eligible for this trial, the subjects must have: * Histologically documented glioblastomas or anaplastic astrocytoma prior to the debulking surgery that is suspicious to have progressed on imaging. An interval of at least 3 months must have elapsed since the completion of the most recent course of radiation while at least 4 weeks must have elapsed since the completion of a non-nitrosourea containing chemotherapy regimen and at least 6 weeks since the completion of a nitrosourea containing chemotherapy regimen. * Patients must be ≥ 18 years of age, able to provide informed consent and express a willingness to meet all the expected requirements of the protocol for the duration of the study. * Must have recovered from toxicity (grade 2 or less) of prior therapy. * Eligible for partial or total resection of the recurrent tumor * No anticipated physical connection between post-resection tumor cavity and cerebral ventricle * Karnofsky performance status (KPS) ≥ 60 at time of surgery * No prior treatment of the tumor with gene or virus therapy, immunotherapy, brachytherapy, or implants of polymers containing chemotherapeutic agents (e.g. Gliadel Wafer) * No immunosuppressive or immune disorder * Baseline organ function testing intact * Patients who are candidates for surgical debulking (re-resection) following recurrence of diseases based on multidisciplinary evaluation by neurosurgeons, radiation oncologists, neuro-radiologists, and neuro-oncologists. 2. Subjects must have adequate baseline organ function, as assessed by the following laboratory values, within 30 days before initiating the study therapy: * Adequate renal function with creatinine clearance ≥ 50 mL/min/m2 * Platelet count ≥ 100,000/μL * Absolute neutrophil count ≥ 1,000/μL * Hemoglobin \> 10.0 g/dL * Bilirubin \< 1.5 mg/dL; SGOT and SGPT \< 2.5 times upper limit of normal (ULN). 3. Women of child-bearing potential will be required to practice birth control for the duration of the treatment and for at least 90 days after surgery with intratumor virus inoculation. Men must use barrier protection for the duration of treatment and for at least 90 days after surgery with intratumor virus inoculation treatment. Exclusion Criteria: * Acute infection. Acute infection is defined by any viral, bacterial, or fungal infection that has required active treatment and caused oral temperature \>38.5oC and/or clinically significant leukocytosis * Serum antibodies to human immunodeficiency virus (HIV) * Previous history of liver disease including autoimmune or viral hepatitis * Positive serologic test for Hepatitis B or C at baseline * Immunosuppressive therapy except for corticosteroid use * Serious medical or psychiatric illness or concomitant medication, which, in the judgment of the investigator, might interfere with the subject's ability to respond to or tolerate the treatment or complete the trial * Impaired immunity or susceptibility to serious viral infections * Pregnant or lactating females * Allergy to any product used on the protocol * Patient is not able to undergo a brain MRI. * Patients who are not eligible for debulking surgery or resection of recurrent disease will be considered ineligible.
Where this trial is running
Detroit, Michigan
- Henry Ford Health System — Detroit, Michigan, United States (Recruiting)
Study contacts
- Principal investigator: Tobias Walbert, MD, PhD — Henry Ford Health System
- Study coordinator: Tobias Walbert, MD, PhD
- Email: twalber1@hfhs.org
- Phone: 3139162723
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.