Hematopoietic and Lymphoid Cell NeoplasmPhase 1/2NCT04379518
Rintatolimod and IFN Alpha-2b for the Treatment of COVID-19 in Cancer Patients
A Phase 1/2 study testing Recombinant Interferon Alfa-2b and Rintatolimod in people with Hematopoietic and Lymphoid Cell Neoplasm and Malignant Solid Neoplasm, run by Roswell Park Cancer Institute at 1 site in United States.
Trial summary
This phase I/IIa trial studies the best dose and side effects of rintatolimod and interferon (IFN) alpha-2b in treating cancer patients with COVID-19 infection. Interferon alpha is a protein important for defense against viruses. It activates immune responses that help to clear viral infection. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hematopoietic and Lymphoid Cell Neoplasm, Malignant Solid Neoplasm, Symptomatic COVID-19 Infection Laboratory-Confirmed
- What is being tested?
- Recombinant Interferon Alfa-2b and Rintatolimod
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4 participants
- Where
- 1 siteUnited States
- Study dates
- 17 Nov 2020to 15 Mar 2023
- Phase
- Phase 1/2
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
- Patients with cancer, with the exception of patients with active acute leukemia and allogeneic hematopoietic stem cell transplant recipients. Patients may be on active therapy or received therapy (e.g., chemotherapy, radiation or surgery) within 7 years. Patients with active cancer who have not yet been treated (e.g. newly diagnosed cancer or early stage myelodysplastic syndrome [MDS] or chronic lymphocytic leukemia [CLL]) are eligible. Basal cell cancer and carcinoma in situ treated with local excision alone do not qualify for inclusion
- Presence of symptomatic infection, defined by fever (temperature [T] >= 38 degrees Celsius [C]) OR respiratory symptoms (cough, nasal congestion, or shortness of breath) OR lung infilitrates on chest X-ray or CT imaging. Diagnosis of COVID-19 is based on polymerase chain reaction (PCR) testing of respiratory samples.
- Age equal to >= 18 years or older (children are excluded because COVID-19 typically has a milder course in children, and lack of safety data of this regimen in children)
- Platelet >= 75,000/uL
- Hemoglobin >= 9 g/dL
- Hematocrit >= 27%
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- Absolute neutrophil count (ANC) >= 1000/uL
- Creatinine clearance >= 50 mL/min (Cockcroft-Gault Equation-note: plasma creatine instead of serum is used at Roswell Park)
- Total bilirubin =< 2 X institutional upper limit of normal (ULN)
- Aspartate transaminase (AST) (plasma) and alanine transferase (ALT) (plasma) =< 2 X institutional ULN
- Plasma amylase and lipase =< 2 X institutional ULN
- In the absence of COVID-19, a life expectancy of 6 months is expected
- Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure
- NOTE: For blood chemistry labs, Roswell Park clinical blood chemistries are performed on plasma unless otherwise indicated
- EXPANSION COHORT: Patients with cancer or allogeneic stem cell transplant recipients with and without a cancer diagnosis
- Patients with cancer may be on active therapy or received therapy (e.g., chemotherapy, radiation or surgery) within 7 years
- Patients with active cancer who have not yet been treated (e.g. newly diagnosed cancer or early stage MDS or CLL) are eligible
- Basal cell cancer and carcinoma in situ treated with local excision alone do not qualify for inclusion
- Presence of symptomatic infection, defined by fever (T >= 38.0 degrees C ) OR respiratory symptoms (cough, nasal congestion, or shortness of breath) OR lung infiltrates by chest X-ray or CT imaging. Diagnosis of COVID-19 is based on PCR testing of respiratory samples. Severe infection is excluded
- Age equal to >= 18 years or older (children are excluded because COVID-19 typically has a milder course in children, and lack of safety data of this regimen in children). In the absence of COVID-19, a life expectancy of 6 months is expected
- Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure. There may be specific instances when the patient can't provide informed consent, e.g. they require mechanical ventilation and are sedated, in which case a health care proxy will be able to provide informed consent. Patients with temporary cognitive impairment will be consented once their capacity has returned. Patients with chronic cognitive impairment, e.g. dementia, that precludes informed consent will not be enrolled.
Who cannot join
- Patients with severe COVID-19 infection defined by pulmonary infiltrates on chest x-ray or computed tomography (CT) imaging plus one of the following: room air oxygen saturation (SaO2) =< 92%, room air partial pressure of oxygen (PaO2) < 70 mm Hg, or partial pressure of oxygen in arterial blood (PaO2)-PaO2 (alveolar gas) >= 35 mm Hg
- Contraindication to recombinant (r)-INFalpha based on prior hypersensitivity, autoimmune hepatitis, decompensated liver disease
- Patients who have active acute myeloid leukemia or acute lymphoid leukemia or are allogeneic hematopoietic stem transplant recipients. Acute leukemia in remission and chronic leukemias are not exclusion criteria
- Cardiac events:
- Acute coronary syndrome, myocardial infarction, or ischemia within past 3 months
- New York Heart Association classification of III or IV congestive heart failure
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- Unwilling or unable to follow protocol requirements
- Patients with known serious mood disorders
- Any additional condition, such as pre-existing inflammatory lung disease, which in the investigator's opinion deems the participant an unsuitable candidate to receive the study drugs
- Concurrent infections, e.g. bacterial pneumonia or sepsis, that would make it difficult to evaluate clinical response to therapy or study drug toxicities
- Therapies known to cause cytokine release syndrome (CRS), e.g. engineered T cells, within 30 days
- Patients at high risk for tumor lysis syndrome
- Concurrent active pneumonitis predating COVID-19, such as from checkpoint inhibitor therapy, chemotherapy-associated toxicity, or radiation pneumonitis
- Autoimmune disease that requires systemic immunosuppression
- Protocol-defined baseline abnormalities in cell counts, renal, or hepatic function
- Any additional condition which in the investigator's opinion deems the participant an unsuitable candidate to receive the study drugs
- Patients with respiratory failure requiring mechanical ventilation with FIO2 of > 60%.
- Allogeneic hematopoietic stem cell transplant recipients with active pulmonary graft versus host disease (GvHD) (any grade)
- Cardiac events:
- Acute coronary syndrome, myocardial infarction, or ischemia within past 3 months,
- New York Heart Association classification of III or IV congestive heart failure
- Unwilling or unable to follow protocol requirements
- Any additional condition which in the investigator's opinion deems the participant an unsuitable candidate to receive the study drugs
- Cognitively impaired adults/adults with impaired decision-making capacity
- Individuals who are not yet adults (infants, children, teenagers)
- Pregnant women
- Prisoners
Trial locations and contacts
1 site in 1 country.
United States1 site
Roswell Park Cancer Institute
Buffalo, New York, 14263
About this study
Official title: Phase 1/2A Study of Rintatolimod and IFN Alpha Regimen in Cancer Patients With COVID-19
This phase I/IIa trial studies the best dose and side effects of rintatolimod and interferon (IFN) alpha-2b in treating cancer patients with COVID-19 infection. Interferon alpha is a protein important for defense against viruses. It activates immune responses that help to clear viral infection. Rintatolimod is double stranded ribonucleic acid (RNA) designed to mimic viral infection by stimulating immune pathways that are normally activated during viral infection. Giving rintatolimod and interferon alpha-2b may activate the immune system to limit the replication and spread of the virus.
Read the detailed description
PRIMARY OBJECTIVES:
- To determine the safety of the combination of intravenous (i.v.) rintatolimod administered with or without i.v. IFN alpha (recombinant interferon alfa-2b [Intron A]) in patients with cancer with coronavirus disease 2019 (COVID-19).
II. Determine the kinetics of viral load in nasopharyngeal swabs in the course of treatment and Days 7 and 14.
SECONDARY OBJECTIVES:
- To assess the efficacy of the treatment combination in patients with cancer with COVID-19.
II. Determine the kinetics of viral load in the peripheral blood in the course of treatment and Days 7 and 14.
III. Determine the kinetics of changes of the immune subsets and circulating inflammatory mediators (including C-reactive protein [CRP], cytokines, chemokines, interferons) in peripheral blood in the course of treatment and Days 7 and 14.
IV. Determine the induction of known mediators of antiviral immunity that include (myxovirus resistance gene, MxA; protein Kinase R (PKR); oligoadenylate synthetase-2 (OAS2); RNAse-L, IFN-stimulated gene-15 (ISG15); IFN-induced proteins with tetratricopeptide repeats (IFIT1) and IFN-inducible transmembrane protein 3 (IFITM3), TLR3, RIG-I, MDA5, IRF3, IRF7, in nasopharyngeal swabs material and blood cells of patients on all tiers of treatment.
OUTLINE: This is a phase I, dose-escalation study of recombinant interferon alfa-2b followed by a phase II study.
LEAD-IN PHASE: Patients receive rintatolimod IV over 2.5-3 hours on day 1 and day 3 (or 4).
ARM I: Patients receive rintatolimod IV over 2.5-3 hours and recombinant interferon alfa-2b IV over 20 minutes on day 1 and on day 3 or 4 in the absence of disease progression or unacceptable toxicity.
EXPANSION COHORT:
ARM III: Patients receive rintatolimod IV over 2.5-3 hours along with standard of care.
Patients are followed up at days 7, 14 and 30 after initiation of the study regimen.
- Conditions
- Hematopoietic and Lymphoid Cell Neoplasm, Malignant Solid Neoplasm, Symptomatic COVID-19 Infection Laboratory-Confirmed
- Being tested
- Recombinant Interferon Alfa-2b, Rintatolimod
- Medical subject headings
- Hematologic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Recombinant Interferon Alfa-2bBiological
Also called Alfatronol, Glucoferon, Heberon Alfa, IFN alpha-2B
Given IV
RintatolimodDrug
Also called Ampligen, Atvogen
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Rintatolimod, recombinant interferon alfa-2b 0 MU/M^2 | Experimental | Dose level 1:Patients receive rintatolimod IV over 2.5-3 hours plus recombinant interferon alfa-2b IV 0 over 20 minutes on day 1 and on day 3 (or 4) in the absence of disease progression or unacceptable toxicity. Receives: Biological: Recombinant Interferon Alfa-2b; Drug: Rintatolimod |
| Rintatolimod, recombinant interferon alfa-2b 5 MU/M^2 | Experimental | Dose level 2 :Patients receive rintatolimod IV over 2.5-3 hours plus recombinant interferon alfa-2b IV 5 MU/M^2 over 20 minutes on day 1 and on day 3 (or 4) in the absence of disease progression or unacceptable toxicity. Receives: Biological: Recombinant Interferon Alfa-2b; Drug: Rintatolimod |
| Rrintatolimod plus Standard of Care) | Experimental | Patients receive rintatolimod IV over 2.5-3 hours once plus standard of care. Receives: Drug: Rintatolimod |
| Rintatolimod, recombinant interferon alfa-2b 10 MU/M^2 | Experimental | Dose level 3: Patients receive rintatolimod IV over 2.5-3 hours plus recombinant interferon alfa-2b IV 10 MU/M^2 over 20 minutes on day 1 and on day 3 (or 4) in the absence of disease progression or unacceptable toxicity. Receives: Biological: Recombinant Interferon Alfa-2b; Drug: Rintatolimod |
| Rintatolimod, recombinant interferon alfa-2b 20 MU/M^2 | Experimental | Dose level 4: Patients receive rintatolimod IV over 2.5-3 hours plus recombinant interferon alfa-2b IV 20 MU/M^2 over 20 minutes on day 1 and on day 3 (or 4) in the absence of disease progression or unacceptable toxicity. Receives: Biological: Recombinant Interferon Alfa-2b; Drug: Rintatolimod |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Adverse Events (AEs)
This refers to the frequency of grade 3 or 4 AEs considered to be probably or definitely related to the treatment regimen. Toxicity will be assessed according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE version [v] 5.0).
Measured: Up to 30 days post treatment initiation, On average, the timeframe is 25 days
Kinetics of Viral Load
Will be assessed as cycle threshold values in nasopharyngeal swabs based on quantitative polymerase chain reaction (PCR) in the course of treatment and days 1, 3/4, 7, and 11.
Measured: Treatment and days 1, 3/4, 7 and 11
Secondary outcomes (22)
Number of Participants With Selected Clinical Efficacy Complications
Will be assessed by the frequency of these complications: (i) progression of infection requiring hospitalization; (ii) respiratory failure requiring mechanical ventilation (primary efficacy endpoint); and (iii) death within 30 days. If present, acute respiratory distress syndrome will be graded by Berlin criteria.
Measured: Up to 30 days post treatment initiation
Kinetics of Viral Load
Will be assessed as cycle threshold values in the peripheral blood and nasopharyngeal swab based on quantitative PCR in the course of treatment and days 1, 3, 7, and 14.
Data entered are values that were measured, no "placeholders" were entered, zero is a valid measurement.
Measured: Days 1, 3, 7, 14 post treatment initiation
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (COX2)
Gene expresssion measured by qPCR
Measured: Days 1, 4 , 7, 14 and 30 post treatment initiation
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (CCL5)
Gene expression measured by QPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (CXCL10)
Gene expression measured by qPCR
Measured: Days 1, 4, 7, 14, and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (CCL22)
Gene expression measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (CXCL12)
Gene expression measured by qPCR
Measured: Days 1, 4, 7, and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (IL-10)
gene expression measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (IDO1)
Gene expression measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (IFNB1)
Gene expression measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Kinetics of Changes of the Immune Subsets and Circulating Inflammatory Mediators in Peripheral Blood (IFNa)
Gene expression measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (RIG-1)
Induction of known mediator RIG-1 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (TLR-3)
Induction of known mediator TLR-3 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (ISG-15)
Induction of known mediator ISG-15 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (RNAseL)
Induction of known mediator RNAseL of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (OAS2)
Induction of known mediator OAS2 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (ACE2)
Induction of known mediator ACE2 of antiviral immunity measured by qPCR
Measured: Days 1, and 14 post treatment
Known Mediators of Antiviral Immunity (Mx1)
Induction of known mediator Mx1 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (IFIT1)
Induction of known mediator IFIT1 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (IFITM3)
Induction of known mediator IFITM3 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (IRF3)
Induction of known mediator IRF3 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Known Mediators of Antiviral Immunity (IRF7)
Induction of known mediator IRF7 of antiviral immunity measured by qPCR
Measured: Days 1, 4, 7, 14 and 30 post treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2020
- Study start17 Nov 2020
- Primary completion15 Mar 2023
- Study completion15 Mar 2023
Why it stopped: Low accrual
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Hematopoietic and Lymphoid Cell NeoplasmStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 4 participants (actual)
Sponsor and investigators
- Lead sponsor
- Roswell Park Cancer Institute
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI), AIM ImmunoTech Inc.
- Responsible party
- Sponsor
- Investigators
- Igor Puzanov, Principal investigator, Roswell Park Cancer Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04379518
- Sponsor's protocol ID
- I 659920
- Other IDs
- NCI-2020-02317, I 659920, P30CA016056
- Status last verified
- Jan 2026
- First submitted
- 6 May 2020
- Last updated
- 13 Jan 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No