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Bladder CancerPhase 1/2NCT02010203

A Phase 1/2 Study of HS-410 in Patients With Non-Muscle Invasive Bladder Cancer After TURBT

A Phase 1/2 study testing HS-410 and BCG in people with Bladder Cancer, run by Heat Biologics at 19 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Phase I/II study: Phase 1 is an open-label, safety study, patients who previously received 3-6 instillations of weekly intravesical Bacillus Calmette-Guerin (BCG) induction therapy (as standard of care) followed by low dose intradermal (1*10^6 cells) HS-410 monotherapy. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bladder Cancer
What is being tested?
HS-410 and BCG
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
104 participants
Where
19 sitesUnited States
Study dates
Dec 2013to Apr 2018
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically confirmed non-muscle invasive bladder cancer [Ta, T1 or Tis (CIS)] that has been removed by transurethral resection
  • Either: (i) high-risk disease, defined as T1 and/or high-grade and/or CIS or (ii) intermediate-risk disease, defined as Ta low-grade with at least 3 of the following 4 risk factors: multiple tumors, tumor size > 3cm, early recurrence (<1 year from previous staging procedure), or recurrence with a frequency of more than once in any 12 month period
  • Not have received bacillus Calmette-Guérin (BCG) or have completed previous BCG treatment > 12 months prior to the baseline staging procedure.
  • Phase 2 Arms 1-3: Suitable to receive a 6-week course of BCG in the adjuvant setting within 6 weeks following TURBT. Phase 2 Arm 4: Suitable for monotherapy vaccine administration post-TURBT. For Phase 1 only: Has previously received 3-6 weekly doses of BCG.
  • Adequate laboratory parameters

Who cannot join

  • Human immunodeficiency virus (HIV) infection or immunodeficiency disorders, either primary or acquired
  • Infections or intercurrent illness requiring active therapy
  • Any condition requiring active steroid or other immunosuppressive therapy
  • Active malignancies within the past 12 months except negligible risk of metastasis or death treated with expected curative outcome.
  • Prostate pelvic radiation within the past 12 months
  • Significant cardiac impairment
Show all 14Show fewer
  • Current alcohol or chemical abuse, or mental or psychiatric condition precluding protocol compliance
  • Pregnant or nursing
  • Allergy to soy, egg, or peanut products
  • Receiving another investigational agent (30 day wash-out required prior to first dose)
  • Neo-adjuvant therapy prior to baseline staging procedures for the current occurrence of non-muscle invasive bladder cancer
  • Prior treatment with a cancer vaccine for this indication
  • Prior vaccination with BCG for tuberculosis disease
  • Prior splenectomy

Trial locations and contacts

19 sites in 1 country.

19 sites in 1 country

United States19 sites
  • Johns Hopkins University

    Baltimore, Maryland, 21287

  • University of North Carolina Chapel Hill

    Chapel Hill, North Carolina, 27599

  • University of Chicago

    Chicago, Illinois, 60637

  • Urology of North Texas

    Dallas, Texas, 75231

  • Urology Center of Colorado

    Denver, Colorado, 80211

  • MD Anderson Cancer Center

    Houston, Texas, 77030

  • First Urology

    Jeffersonville, Indiana, 47130

  • Horizon Oncology Research

    Lafayette, Indiana, 47905

  • University of California at Los Angeles

    Los Angeles, California, 90095

  • University of Minnesota

    Minneapolis, Minnesota, 55455

  • Carolina Urologic Research Center

    Myrtle Beach, South Carolina, 29572

  • Thomas Jefferson University

    Philadelphia, Pennsylvania, 19107

  • Skyline Urology

    Sherman Oaks, California, 91411

  • Washington University School of Medicine

    St Louis, Missouri, 63110

  • Montefiore Medical Center

    The Bronx, New York, 10471

  • Skyline Urology

    Torrance, California, 90505

  • Urology of Virginia

    Virginia Beach, Virginia, 23462

  • University of Kansas Cancer Center

    Westwood, Kansas, 66205

  • University of Massachusetts

    Worcester, Massachusetts, 01655

Other trials in United States

About this study

Official title: Phase 1/2, Placebo-Controlled, Randomized Study to Evaluate the Safety, Immune Response & Clinical Activity of HS-410 in Patients With Non-Muscle Invasive Bladder Cancer Who Have Undergone Transurethral Resection of Bladder Tumor (TURBT)

Phase I/II study: Phase 1 is an open-label, safety study, patients who previously received 3-6 instillations of weekly intravesical Bacillus Calmette-Guerin (BCG) induction therapy (as standard of care) followed by low dose intradermal (1*10^6 cells) HS-410 monotherapy. Phase 2, patients will be randomized to one of three blinded (physician-patient), placebo-controlled groups and receive either intradermal placebo or low dose (1*10^6 cells) or high dose (1*10^7 cells) vesigenurtacel-L in combination with induction and maintenance intravesical BCG. Patients who do not receive BCG will be enrolled into an open-label, non-randomized group receiving high dose (1*10^7 cells) intradermal HS-410 monotherapy.

Read the detailed description

This study is a two part study: Phase I and Phase II. The Phase 1 portion is an open-label, safety study. Patients will have previously received 3-6 instillations of weekly intravesical Bacillus Calmette-Guerin (BCG) induction therapy (as standard of care) followed by low dose intradermal (1*10^6 cells) HS-410 monotherapy. In Phase 2, patients will be assigned to treatment groups based on whether they will receive induction BCG in the typical post-TURBT window. If the investigator plans to administer BCG, patients will be randomized to one of three blinded (physician-patient), placebo-controlled groups and receive either intradermal placebo or low dose (1*10^6 cells) or high dose (1*10^7 cells) vesigenurtacel-L in combination with induction and maintenance intravesical BCG. If patients will not receive BCG, they will be enrolled into an open-label, non-randomized group and receive high dose (1*10^7 cells) intradermal HS-410 monotherapy.

Conditions
Bladder Cancer
Being tested
HS-410, Placebo, BCG
Keywords
TURBT, Bladder, Cancer, GP96, Vaccine, Immunotherapy, Heat Biologics, BCG, Bacillus Calmette-Guerin, Bacillus Calmette-Guérin
Medical subject headings
Urinary Bladder Neoplasms, Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • HS-410Biological

    Vaccine derived from irradiated cancer cells genetically engineered to continually secrete gp96

  • PlaceboBiological

    Injection containing sterile solution but no cells

  • BCGBiological

    Also called Bacillus Calmette-Guerin

    Vaccine derived from a live bacterium

Study groups in NCT02010203
Study groupRoleWhat they receive
Phase I: HS-410 Low DoseExperimentalIn the open label Phase 1 portion, HS-410 is given as 1*10^6 cells per dose for 12 weekly injections followed by 3 monthly injections.
Receives: Biological: HS-410
Phase II: HS-410 Low-Dose Plus BCGExperimentalIn the Phase 2 portion, HS-410 is given as 1*10^6 cells per dose weekly for 6 weeks in combination with BCG, followed by 6 weeks of HS-410 alone, and then 3 courses of three once-weekly doses of HS-410 in combination with BCG.
Receives: Biological: HS-410; Biological: BCG
Phase II: High-Dose HS-410 Plus BCGExperimentalIn the Phase 2 portion, HS-410 is given as 1*10^7 cells per dose weekly for 6 weeks in combination with BCG, followed by 6 weeks of HS-410 alone, and then 3 courses of three once-weekly doses of HS-410 in combination with BCG.
Receives: Biological: HS-410; Biological: BCG
Phase II: Placebo Plus BCGPlacebo comparatorIn the Phase 2 portion, a placebo is given weekly for 6 weeks in combination with BCG, followed by 6 weeks of placebo alone, and then 3 courses of three once-weekly doses of placebo in combination with BCG.
Receives: Biological: Placebo; Biological: BCG
Phase II: High-Dose HS-410ExperimentalIn the Phase II portion, if patients will not receive BCG, HS-410 is given as 1*10^7 cells per dose weekly for 12 weeks, and then 3 courses of three once-weekly doses of HS-410.
Receives: Biological: HS-410

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase 1: Safety and Tolerability

    To evaluate the safety and tolerability of vesigenurtacel-L

    Measured: Up to 3 years.

  2. Phase 2: 1-year Disease-Free Survival

    Arm 1, 2, 3: 1-year DFS in patients with NMIBC treated with BCG in combination with blinded study product (one of two doses of vesigenurtacel-L or placebo) Arm 4: 1-year DFS in patients with NMIBC treat1fv 9 with high dose vesigenurtacel-L monotherapy

    One-year disease-free survival will be defined as the proportion of patients who are free from recurrent disease, progressive disease, and alive one year after the date of randomization/treatment assignment

    Measured: One year

Secondary outcomes (15)
  1. Proportion of Patients With Recurrence at 3, 6, 12, 18, and 24 Months

    Evaluate the proportion of patients with recurrence at 3, 6, 12, 18, and 24 months

    Measured: Up to 2 years

  2. Proportion of Patients With Progressive Disease at 3, 6, 12, 18, and 24 Months

    Evaluate the proportion of patients with progressive disease at 3, 6, 12, 18, and 24

    Measured: Up to 2 years

  3. Disease-free Survival at 3, 6, 18, and 24 Months

    Evaluate Disease Free Survival at 3, 6, 18 and 24 months

    Measured: Up to 2 years

  4. Overall Disease-free Survival

    Evaluate overall Disease Free Survival

    Measured: Up to 3 years

  5. Overall Survival, Expressed as the Number of Participants Alive

    Evaluate overall survival (OS)

    Measured: Up to 3 years

  6. Proportion of Patients Undergoing Repeat Transurethral Resection of Bladder Tumor (TURBT) by 12 and 24 Months

    Measured: Up to 2 years

  7. Proportion of Patients Undergoing Cystectomy by 12 and 24 Months

    Evaluate the proportion of patients undergoing cystectomy by 12 and 24 months from randomization

    Measured: Up to 2 years

  8. Immunologic Response of PBMCs Via Intracellular Cytokine Staining (ICS) by Flow Cytometry and/or Enzyme-linked Immunosorbent Spot (ELISPOT) on CD8+ Cells After HS-410 Vaccination as Compared to Baseline.

    Evaluate the proportion of patients with immunologic response of peripheral blood mononuclear cells (PBMCs) via intracellular cytokine staining (ICS) by flow cytometry and/or ELISPOT on CD8+ cells following vesigenurtacel-L vaccination

    Measured: Up to 2 years

  9. Immunologic Response of Peripheral Blood Mononuclear Cells (PBMCs) and Stimulation Analysis Via ICS in Baseline and Post-treatment Biopsies, if Clinically Indicated

    Evaluate immunologic response of PBMCs (analysis of surface markers, CD3, CD4, CD8, CD19, CD25, CD45, CD56, FoxP3, and degranulation) and stimulation analysis via ICS of interferon gamma (IFNγ) and granzyme B (gzB)

    Measured: Up to 3 years

  10. Total PBMC Counts by Flow Cytometry

    Evaluate total PBMC counts by flow cytometry, including lymphocyte subsets (B cells, helper T-cells, cytotoxic T-cells, natural killer (NK) cells and T-reg)

    Measured: Up to 3 years

  11. Tumor Antigen Expression

    Evaluation of pre-treatment tumor tissue for antigen expression

    Measured: At screening

  12. Tumor Infiltrating Lymphocytes (TILs)

    Evaluation of tumor tissue obtained from repeat biopsy, if clinically indicated, for presence of TILs

    Measured: Up to 3 years

  13. T Cell Receptor Sequencing of Peripheral Blood T Cells Before and During Treatment

    Evaluation of tumor tissue obtained from repeat biopsy, if clinically indicated, for presence of TILs, T cell receptor sequencing of peripheral blood T cells before and during the course of treatment.

    Measured: Up to 2 years

  14. Safety of the Combination of the HS-410 and BCG

    Phase 2 only Evaluate the safety of the combination of vesigenurtacel-L and BCG

    Measured: Up to 1 year

  15. Safety of the High Dose HS-410 Monotherapy

    Phase 2 only Evaluate the safety of high dose vesigenurtacel-L monotherapy

    Measured: Up to 3 years.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Dec 2013 (estimated)
  2. Study startDec 2013
  3. Primary completionDec 2017
  4. Study completionApr 2018

Why it stopped: Inability to accrue due to changing treatment landscape (PD-1 approvals)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
104 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02010203
Sponsor's protocol ID
HS410-101
Status last verified
Feb 2020
First submitted
5 Dec 2013
Last updated
17 Feb 2020
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing HS-410 and BCG in people with Bladder Cancer, run by Heat Biologics at 19 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 17 Feb 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 17 Feb 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1: Safety and Tolerability (time frame: Up to 3 years.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2020.

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