A Phase II-a, Open-Label, Randomized Study of JX-594 (Thymidine Kinase-deleted Vaccinia Virus Plus GM-CSF) Administered by Intratumoral Injection in Patients With Unresectable Primary Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is estimated to be the third most common cause of
cancer-related deaths world-wide, and the fifth most common cancer diagnosis. According to
the National Cancer Institute (NCI), approximately 17,000 new cases of HCC are diagnosed
annually in the U.S. In Canada, the predicted incidence for 2007 is 1,350 new cases. In
addition, approximately 10,000 new cases are diagnosed per year in S. Korea, 35,000 in the
E.U. and 45,000 in Japan.
The five-year survival rate is estimated to be <10% for all HCC patients. Given the poor
prognosis of these patients there is a desperate need for new therapies.
Surgical resection and liver transplant are the only curative treatment for HCC. Small HCC
tumor(s) (less than 3 cm in diameter) can be resected by hepatectomy, the most effective
treatment. Surgery was associated with a reported 50-60% five-year survival rate, but
unfortunately was possible in only 10-15% of cases. Liver transplant is considered for
patients with tumors that are unresectable but that are still limited exclusively to the
liver, have no extracapsular or vascular invasion within the liver, and for whom there are
no medical contraindications to transplantation. Patients with unresectable HCC that cannot
receive liver transplantation, and who do not require systemic therapy, may be administered
percutaneous ethanol injection therapy (PEIT), radiofrequency ablation (RFA), transarterial
chemoembolization (TACE), and/or radioembolization, depending on the size of the
intrahepatic tumors and the underlying liver function.
HCC may be a good target for IT injection with JX-594 because of the relatively high rate of
accessible tumors for injection, the positive response seen in a patient with HCC in a
recently completed Phase I study of JX-594 intratumoral injection within the liver,
excellent tumor responses in multiple preclinical cancer models, and the lack of effective,
tolerable therapy for most patients with HCC who cannot receive curative surgery or
immediate liver transplantation. Furthermore, it is speculated that JX-594 replication
targets the EGFR pathway, and that it's spread within and between tumors is dependent upon
the intratumoral vasculature; HCC has highly activated angiogenesis and EGFR pathways in the
majority of cases.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
To assess whether one of two dose levels of JX-594 is superior in preventing tumor progression in patients with unresectable primary hepatocellular carcinoma
Initial progression status and response assessment at 8 weeks from first dose
No
David Kirn, MD
Study Director
Jennerex Biotherapeutics
United States: Food and Drug Administration
JX594-IT-HEP007
NCT00554372
August 2008
February 2013
Name | Location |
---|---|
Mayo Clinic | Rochester, Minnesota 55905 |
Moores UCSD Cancer Center | La Jolla, California 92093-0658 |
Billings Clinic Cancer Center | Billings, Montana 59107-5100 |
The Ohio State University | Columbus, Ohio 43210 |
University of Pittsburgh Medical Center - Liver Cancer Center | Pittsburgh, Pennsylvania 15213 |