RECRUITING

Intra-tumoral (IT) Injection of vvDD-hIL2-2-RG-1 for Metastatic Gastrointestinal and Peritoneal Tumors

Conditions

Gastric Neoplasms Esophageal Cancer Liver Cancer Liver Metastasis MSS-CRC MSS Gastric Adenocarcinoma Peritoneal Cancer Peritoneal Carcinoma Peritoneal Metastases MSI-H Gastric Cancer Oncolytic virus vaccinia immunotherapy intra-tumoral intra-peritoneal

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This research study aims to evaluate the safety and determine the optimal dose of a new experimental drug, vvDD-hIL2 (vaccinia virus double-deleted human interleukin 2), in patients with advanced abdominal cancer. The study will involve three dose levels, with three to six patients enrolled at each level. vvDD-hIL2 is a genetically modified vaccinia virus, derived from the virus previously used for smallpox vaccination. The modification is intended to target and destroy tumors while minimizing harm to healthy tissues by stimulating the body's immune response. Participants will receive an injection of vvDD-hIL2 directly into their abdominal tumors at AHN West Penn. The study team will monitor for side effects and assess tumor response to the treatment. Active participation will last up to two months, involving seven clinic visits and approximately four lab visits at AHN West Penn Hospital. Visits will include standard of care procedures as well as study-specific tests and exams. Most visits will last one to two hours, with some extending to two to three hours. The drug administration day will require a twelve-hour visit. Effectiveness and side effects will be evaluated through blood draws, oral swabs, urinalysis and tissue biopsies. Tissue samples will be used for genomic analysis and stored for potential future research. Data collected may also be used for future research purposes. Previous human trials of vvDD-hIL2 have reported side effects such as pain, rash or inflammation at the injection site, low-grade fevers, flu-like symptoms, and fatigue. There is a rare risk of rash transmission to close contacts with skin openings, and information on limiting contact and managing rash development will be provided.

Official Title

A Phase I Dose-Escalation Trial of vvDD-hIL2-2-RG-1 (Vaccina Virus Double Deleted) Administered by Intra-tumoral (IT) Injection for Metastatic Gastrointestinal and Peritoneal Tumors

Quick Facts

Study Start:2025-05-06

Study Completion:2028-05

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT07001592

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 69 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Males or females age, 18 to \< 70 years at the time of consent 2. Histologically confirmed metastases from gastrointestinal tumors with molecular determinants for MSI and KRAS. 3. For microsatellite stable (MSS) tumors, subjects must have failed (or be ineligible for) standard 1st and 2nd line chemotherapy. For microsatellite instability-high (MSI-H) tumors, subjects must also have failed (or be ineligible for) systemic immunotherapy. 4. Karnofsky Performance Status (KPS) of \> 70 5. Anticipated survival of at least 12 weeks. 6. Written informed consent in accordance with national, local, and institutional guidelines obtained prior to any study procedures (subject or subject's legally authorized representative (LAR) must have the ability to understand and willingness to sign a written informed consent). 7. Adequate bone marrow function: WBC \> 2,000 and \<50,000 cells/mm3, ANC \> 1,000 cells/mm3, hemoglobin \>8 g/dL, and platelet count \>100,000 cells/mm3. 8. Adequate renal function: serum creatinine level ≤ 2xULN 9. Adequate liver function: Serum bilirubin \< 1.5 x ULN 10. Acceptable coagulation status: INR \< ULN +15%. All patients must be able to suspend anticoagulant therapy for study specific biopsies and intra-tumoral injection. 11. Women of childbearing potential (defined as all women physiologically capable of becoming pregnant) must have negative serum or urine pregnancy test. 12. If sexually active, to prevent pregnancy and to prevent the spread of virus, subject must use an acceptable method of contraception as well as barrier contraception from screening through 6 weeks following study treatment with vvDD-hIL-2-RG-1. 13. Subjects must be willing to comply with all study procedures, requirements, adhere to post-treatment care instructions and follow-up examinations. 14. Have measurable disease based on RECIST 1.1 criteria. 15. Have at least one tumor at least 1 cm in diameter amenable to safe intra-tumoral injection.	1. Pregnant or nursing an infant. 2. Systemic corticosteroid or other immunosuppressive medication use within 2 weeks of the study treatment. 3. Significant immunodeficiency (e.g. due to underlying illness and/or medication) in subject or household contacts (must be able to avoid household contact with immunodeficient person for 3 weeks). 4. Clinically significant active infection or uncontrolled medical condition (e.g., pulmonary, neurological, cardiovascular, gastrointestinal, genitourinary) considered high risk for investigational new drug treatment, per investigator discretion. 5. Active eczema or psoriasis or other inflammatory skin conditions 6. Unstable cardiac disease which includes but is not limited to any of the following within 6 months prior to study entry: myocardial infarction (MI), unstable angina, congestive heart failure, myocarditis, ventricular arrhythmias diagnosed and requiring medication. * New York Heart Association functional class III-IV heart failure on active treatment * Pulse oximetry of \< 90% in room air at rest 7. Subjects who have received radiation, chemotherapy or other potentially immunosuppressive therapy within 2 weeks prior to study screening and within 4 weeks prior to anticipated vvDD-hIL-2-RG-1 treatment. 8. Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination. 9. Subjects who, in the opinion of the Investigator, have a medical condition that would subject the subject to prohibitive risk by participation in this study, or who may be unable to safely complete the required tumor biopsies. 10. Subjects with household contacts who are children \< 5 years old, have active eczema, psoriasis or other inflammatory skin conditions or have a significant immunodeficiency due to underlying illness (e.g. human immunodeficiency virus) and/or medication (e.g. systemic corticosteroids) will be excluded unless alternate living arrangements can be made during the subject's active dosing period and for three weeks following the study medication. 11. Vaccination with a live virus in the previous 60 days prior to Day 0. 12. Inability or unwillingness to give informed consent. 13. Is unable or unwilling to comply with protocol follow-up requirements. -

Inclusion Criteria

Exclusion Criteria

1. Males or females age, 18 to \< 70 years at the time of consent
2. Histologically confirmed metastases from gastrointestinal tumors with molecular determinants for MSI and KRAS.
3. For microsatellite stable (MSS) tumors, subjects must have failed (or be ineligible for) standard 1st and 2nd line chemotherapy. For microsatellite instability-high (MSI-H) tumors, subjects must also have failed (or be ineligible for) systemic immunotherapy.
4. Karnofsky Performance Status (KPS) of \> 70
5. Anticipated survival of at least 12 weeks.
6. Written informed consent in accordance with national, local, and institutional guidelines obtained prior to any study procedures (subject or subject's legally authorized representative (LAR) must have the ability to understand and willingness to sign a written informed consent).
7. Adequate bone marrow function: WBC \> 2,000 and \<50,000 cells/mm3, ANC \> 1,000 cells/mm3, hemoglobin \>8 g/dL, and platelet count \>100,000 cells/mm3.
8. Adequate renal function: serum creatinine level ≤ 2xULN
9. Adequate liver function: Serum bilirubin \< 1.5 x ULN
10. Acceptable coagulation status: INR \< ULN +15%. All patients must be able to suspend anticoagulant therapy for study specific biopsies and intra-tumoral injection.
11. Women of childbearing potential (defined as all women physiologically capable of becoming pregnant) must have negative serum or urine pregnancy test.
12. If sexually active, to prevent pregnancy and to prevent the spread of virus, subject must use an acceptable method of contraception as well as barrier contraception from screening through 6 weeks following study treatment with vvDD-hIL-2-RG-1.
13. Subjects must be willing to comply with all study procedures, requirements, adhere to post-treatment care instructions and follow-up examinations.
14. Have measurable disease based on RECIST 1.1 criteria.
15. Have at least one tumor at least 1 cm in diameter amenable to safe intra-tumoral injection.

1. Pregnant or nursing an infant.
2. Systemic corticosteroid or other immunosuppressive medication use within 2 weeks of the study treatment.
3. Significant immunodeficiency (e.g. due to underlying illness and/or medication) in subject or household contacts (must be able to avoid household contact with immunodeficient person for 3 weeks).
4. Clinically significant active infection or uncontrolled medical condition (e.g., pulmonary, neurological, cardiovascular, gastrointestinal, genitourinary) considered high risk for investigational new drug treatment, per investigator discretion.
5. Active eczema or psoriasis or other inflammatory skin conditions
6. Unstable cardiac disease which includes but is not limited to any of the following within 6 months prior to study entry: myocardial infarction (MI), unstable angina, congestive heart failure, myocarditis, ventricular arrhythmias diagnosed and requiring medication.
* New York Heart Association functional class III-IV heart failure on active treatment
* Pulse oximetry of \< 90% in room air at rest
7. Subjects who have received radiation, chemotherapy or other potentially immunosuppressive therapy within 2 weeks prior to study screening and within 4 weeks prior to anticipated vvDD-hIL-2-RG-1 treatment.
8. Experienced a severe systemic reaction or side-effect as a result of a previous smallpox vaccination.
9. Subjects who, in the opinion of the Investigator, have a medical condition that would subject the subject to prohibitive risk by participation in this study, or who may be unable to safely complete the required tumor biopsies.
10. Subjects with household contacts who are children \< 5 years old, have active eczema, psoriasis or other inflammatory skin conditions or have a significant immunodeficiency due to underlying illness (e.g. human immunodeficiency virus) and/or medication (e.g. systemic corticosteroids) will be excluded unless alternate living arrangements can be made during the subject's active dosing period and for three weeks following the study medication.
11. Vaccination with a live virus in the previous 60 days prior to Day 0.
12. Inability or unwillingness to give informed consent.
13. Is unable or unwilling to comply with protocol follow-up requirements. -

Contacts and Locations

Study Contact

Patrick Wagner, MD

CONTACT

412-359-3731

patrick.wagner@ahn.org

AHN Clinical Trial Contact

CONTACT

412-359-3731

clinicaltrials@ahn.org

Principal Investigator

Patrick Wagner, MD

PRINCIPAL_INVESTIGATOR

Allegheny Health Network

Study Locations (Sites)

AHN West Penn Hospital

Pittsburgh, Pennsylvania, 15224

United States

Collaborators and Investigators

Sponsor: Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)

Patrick Wagner, MD, PRINCIPAL_INVESTIGATOR, Allegheny Health Network

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2025-05-06

Study Completion Date2028-05

Study Record Updates

Study Start Date2025-05-06

Study Completion Date2028-05

Terms related to this study

Keywords Provided by Researchers

Oncolytic virus
vaccinia
immunotherapy
intra-tumoral
intra-peritoneal

Additional Relevant MeSH Terms

Gastric Neoplasms
Esophageal Cancer
Liver Cancer
Liver Metastasis
MSS-CRC
MSS
Gastric Adenocarcinoma
Peritoneal Cancer
Peritoneal Carcinoma
Peritoneal Metastases
MSI-H
Gastric Cancer