Overview

A Study to Evaluate Safety and Efficacy of ACT001 and Anti-PD-1 in Patients With Surgically Accessible Recurrent Glioblastoma Multiforme

Status:
Recruiting
Trial end date:
2023-11-01
Target enrollment:
0
Participant gender:
All
Summary
The current design provides a window to analyze the impact of the ACT001+Pembrolizumab combination on the tumor microenvironment and disease outcomes.
Phase:
Phase 1/Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Accendatech USA Inc.
Collaborators:
Avance Clinical Pty Ltd.
C3 Research Associates
Treatments:
Pembrolizumab
Criteria
Inclusion Criteria:

1. Patient has provided written informed consent.

2. ≥ 18 years old at time of screening visit.

3. Histologically confirmed GBM at the time of diagnosis.

4. First or second relapse by the time of consenting.

5. Tumor progression (magnetic resonance imaging [MRI], defined by RANO) post prior
treatments.

6. Feasibility for re-surgery.

7. Karnofsky Performance Status ≥ 70% (requires occasional assistance, but able to care
for most of their needs, equivalent to < ECOG 2).

8. Must be ≥ 4 weeks from administration of last dose of cancer therapy (including
radiation therapy or chemotherapy). The patient must have recovered from all
treatment-related toxicities to less than grade 2 per Common Terminology Criteria for
Adverse Events (CTCAE) version 5.0.

9. Life expectancy of ≥ 3 months.

10. Adequate organ function (absolute neutrophil count ≥1.5 x 109 /L, lymphocytes ≥ 0.5 x
109 /L, platelets ≥ 75 x 109 /L, hemoglobin ≥ 10 g/dl; total bilirubin ≤ 1.5 x
institutional upper limit of normal (ULN); alanine aminotransferase (ALT) and
aspartate aminotransferase (AST) ≤ 2.5 x ULN (≤ 5.0 x ULN if liver metastasis); plasma
creatinine ≤ 1.5 x ULN; QTc < 450 ms (male), < 470 ms (female).

11. Female patients are eligible if they are of:

1. Non-childbearing potential, defined as

- Previous hysterectomy or bilateral oophorectomy

- Previous bilateral tubal ligation

- Post-menopausal (total cessation of menses for ≥ 1 year)

2. Childbearing potential with a negative serum pregnancy test at screening (within
7 days of the first investigational product administration) and uses a highly
effective method contraception before study entry and throughout the study until
28 days after the last investigational product administration. Highly effective
contraception (<1% failure rate per year), when used consistently and in
accordance with both the product label and the instructions of the physician, are
defined as follows:

- Vasectomized partner who is sterile prior to the female patient's enrolment
and is her sole sexual partner

- An intrauterine device with a documented failure rate of less than 1% per
year

- Double barrier contraception defined as condom with a female diaphragm

12. Male patients, if sexually active, must agree to use a highly effective method of
contraception (< 1% failure rate per year) with their female partners from screening
until 28 days following the last study drug administration.

13. Absence of deteriorating neurological symptoms, new onset of seizures and the need for
increasing doses of corticosteroids.

14. Absence of toxicity from prior therapy (excluding alopecia) that has not resolved to ≤
Grade 1 unless otherwise specified.

15. Absence of other clinically significant concomitant active medical disorder, based on
the investigator's judgement

Exclusion Criteria:

1. The patient has uncontrolled infection.

2. The patient has serious diseases such as unstable angina pectoris, myocardial
infarction in the past 6 months, heart failure (New York Heart Association class > II)
or stroke within 6 months prior to the enrollment.

3. A gastrointestinal absorption disorder that would limit the bioavailability of oral
drugs or if patient cannot take oral drugs.

4. Uncontrolled brain metastases or spinal cord compression. Patients who were treated
with surgical resection or radiation therapy completing at least 4 weeks earlier are
eligible if they are neurologically stable, not taking glucocorticoids and have a
follow-up. MRI scan performed within the previous 4 weeks showing no tumor
progression.

5. Pre-existing allergy to ACT001 or related compounds.

6. A patient has active autoimmune disease managed by systemic treatments in the past 2
years (i.e. the use of corticosteroids, immunosuppressive drugs or other disease
modifying agents). Of note, a replacement therapy, e.g. thyroxine, insulin, or
physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency,
is not considered a form of systemic treatment.

7. A known history of, or any evidence of an active non-infectious pneumonitis.

8. Treatment with cancer therapies such as chemotherapy or radiation therapy either
currently or within 4 weeks of ACT001 dosing. An exception is focal radiation for
symptomatic bone metastases, which must not be within 2 weeks of ACT001 dosing.

9. History of treatment with immune CPB and Avastin (or other antiangiogenic or
anti-vascular endothelial growth factor agents).

10. High dose of corticosteroids (> 4mg/day of dexamethasone or equivalent for at least 3
consecutive days) within two weeks of enrolment for GBM treatment.

11. A patient has received other systemic immunosuppressive treatments such as mTOR
inhibitor everolimus four weeks prior to registration.

12. A patient has a diagnosis of ongoing immunodeficiency due to other diseases such as
human immunodeficiency virus (HIV) infection.

13. Unresolved toxicity from prior antitumor therapy, defined as toxicities (excluding
alopecia) that have not resolved to < Grade 2 as scored using the CTCAE current
version. Exceptions may be allowed for stable toxicities after discussion with the
investigator and sponsor.

14. Major surgery within 30 days of commencing first study therapy.

15. Pregnant or breast-feeding females.

16. A history of infection with HIV or hepatitis B or C viruses.

17. The patient has participated in other drug clinical studies < 4 weeks prior to
obtaining the informed consent.

18. The patient is, in the opinion of the investigator, unsuitable for any other reason.