Title

A Study of ICT-107 Immunotherapy in Glioblastoma Multiforme (GBM)
A Randomized, Double-blind, Controlled Phase IIb Study of the Safety and Efficacy of ICT-107 in Newly Diagnosed Patients With Glioblastoma Multiforme (GBM) Following Resection and Chemoradiation
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    ict-107 ...
  • Study Participants

    124
This is a phase 2, multicenter study to determine the safety and efficacy of ICT-107 in treating a type of brain tumor called Glioblastoma Multiforme (GBM). ICT-107 is an immunotherapy in which the patient's immune response will be stimulated to kill the tumor cells. Patients must be newly diagnosed with GBM and not yet received chemoradiation. Some of the patient's white blood cells (WBC) will be removed and cultured in a laboratory with purified antigens, similar to those on GBM cells. The patient's own WBC/DC that have been exposed to the tumor antigens will then be given back to the patient as a vaccine over several months. The goal is for the ICT-107 vaccine to stimulate the patient's immune response to kill the remaining GBM tumor cells after surgery and chemotherapy.
The proposed phase 2 study is a randomized, double blind, controlled study of the safety and efficacy of ICT-107 in newly diagnosed patients with glioblastoma multiforme (GBM) following resection and chemoradiation. The phase 1 clinical trial demonstrated safety and promising efficacy in a small, open-label study. The purpose of this study is to provide information from a larger, controlled clinical trial. Patients must be newly diagnosed with GBM and not yet received chemoradiation. Patients will have had tumor resection, magnetic resonance imaging (MRI) and tumor assessment prior to enrollment into the study. Post surgical treatment consists of 6 weeks of chemotherapy (TMZ) and radiation followed by a washout period. After Screening and informed consent, patients will undergo apheresis at the study site for collection of peripheral blood mononuclear cells (PBMCs). Apheresis product will be sent to a central site where monocytes will be purified and cultured into dendritic cells (DC). DC will be pulsed with synthetic peptides that correspond to immunogenic epitopes of tumor antigens. The pulsed dendritic cells will then be aliquoted and frozen before shipping back to the site. Patients will have the autologous DCs reinfused intradermally. A control group will receive unpulsed autologous DC. Patients will be randomized by age in a 2:1 ratio to ICT-107 or control.Patients will receive at least four intradermal injections of the ICT-107 vaccine and additional vaccine during a maintenance phase. The primary objective is to compare overall survival (OS) and progression free survival (PFS) in patients when treated with ICT-107 versus Control.
Study Started
Jan 31
2011
Primary Completion
Dec 31
2013
Study Completion
Dec 31
2015
Results Posted
Oct 07
2014
Estimate
Last Update
Mar 20
2017

Biological ICT-107

Autologous dendritic cells pulsed with immunogenic antigens

Biological Placebo DC

Autologous dendritic cells (DC) that have not been pulsed with antigens

ICT-107 Experimental

Autologous dendritic cells pulsed with immunogenic peptides from tumor antigens

Control Placebo Comparator

Autologous dendritic cells that have not been pulsed with antigens

Criteria

Inclusion Criteria:

Confirmed, initial diagnosis of GBM. Patients must be newly diagnosed with GBM and not yet received chemoradiation.
≥ 18 years of age
HLA-A1 or HLA-A2 positive
KPS score of ≥ 70%

Baseline hematologic studies and chemistry profiles must meet the following criteria:

Hemoglobin (Hgb) > 9.9 g/dL total granulocyte count > than 1000/mm3 platelet count > 100,000/mm3 blood urea nitrogen (BUN) < 30 mg/dL creatinine < 2 mg/dL alkaline phosphatase (ALP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 4x upper limit of normal (ULN) prothrombin time (PT) and activated partial thromboplastin time (PTT) ≤ 1.6x control unless therapeutically warranted

Female patients of child-bearing potential must have negative serum pregnancy test
If not surgically sterile, male and female patients of childbearing age must use double barrier contraception (hormonal; intrauterine device; barrier)
Sufficient paraffin embedded tumor sample for analysis MGMT methylation status
Written informed consent, Release of Medical Records Form and Health Insurance Portability and Accountability Act (HIPAA) reviewed and signed by patient or legally authorized representatives

Exclusion Criteria:

Recurrent disease
Radiosurgery including Gamma Knife, linear accelerator based radiosurgery, CyberKnife and placement of Gliadel wafer
Presence of any other active malignancy or prior history of malignancy (except for basal cell carcinoma of the skin)
Severe pulmonary, cardiac or other systemic disease
Congestive heart failure Class III or IV according to New York Heart Association (NYHA)
Presence of an acute infection requiring active treatment with antibiotics/antivirals; prophylactic administration is allowed
Known history of an autoimmune disorder
Known human immunodeficiency virus (HIV) positivity or acquired immunodeficiency syndrome (AIDS) related illness or other serious medical illness
Breastfeeding
Received any other therapeutic investigational agent within 30 days of enrollment
Reduction of steroids (dexamethasone) to a maximum of 2 mg twice a day (BID) prior to the first administration of study vaccine

Summary

ICT-107

Placebo

All Events

Event Type Organ System Event Term ICT-107 Placebo

Overall Survival (OS)

The objective is to compare overall survival (OS) in patients when treated with ICT 107 versus Control. OS defined as the time from randomization until date of death or the last date patient known alive (if death is not observed) All randomized patients are included in Intent to Treat analysis

ICT-107

18.3
months of survival (Median)
95% Confidence Interval: 14.9 to 21.2

Control Dendritic Cells

16.7
months of survival (Median)
95% Confidence Interval: 12.3 to 23.0

Overall Survival in HLA-A2 Patients

Overall survival in a predefined subpopulation. All randomized patients are included in intent to treat analysis.

ICT-107

18.3
months of survival (Median)
95% Confidence Interval: 13.2 to 21.1

Control

12.9
months of survival (Median)
95% Confidence Interval: 10.2 to 19.1

PFS

Secondary Endpoints PFS is defined as the time from randomization until the date of documented progressive disease (PD) or death, whichever occurs first, or last date known alive and progression free if progression or death is not observed. Population is all randomized patients ITT.

ICT-107

11.2
months of progression free survival (Median)
95% Confidence Interval: 8.2 to 13.0

Placebo

9.0
months of progression free survival (Median)
95% Confidence Interval: 5.5 to 10.3

Progression Free Survival in HLA- A2 Patients

Progression Free Survival in a prespecified subpopulation of patients with HLA-A2 haplotype. Intent to treat population includes all randomized patients. PFS is defined as the time from randomization until the date of documented progressive disease (PD) or death, whichever occurs first, or last date known alive and progression free if progression or death is not observed

ICT-107

11.2
months of progression free survival (Median)
95% Confidence Interval: 6.5 to 14.0

Placebo

7.2
months of progression free survival (Median)
95% Confidence Interval: 4.6 to 10.2

Total

124
Participants

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

ICT-107

Placebo