A Phase I Dose Escalation Study of JX-594 (Thymidine Kinase-deleted Vaccinia Virus Plus GM-CSF) Administered by Intravenous Infusion in Patients With Refractory Solid Tumors
Inclusion Criteria:
- Histologically-confirmed, advanced/metastatic solid tumor refractory to standard
therapy or the patient has refused or does not tolerate the standard therapy; tumors
may include malignant melanoma, non-small cell lung cancer, renal cell carcinoma, and
squamous cell carcinoma of the head and neck
- At least one measurable tumor mass by CT/MRI (i.e. lesion that can accurately be
measured in at least one dimension with longest diameter > 1 cm)
- At least one tumor mass amenable to biopsy and/or FNA
- Expected survival for approximately 16 weeks or longer
- Karnofsky Performance Score (KPS) ≥ 70
- Age ≥18 years
- WBC ≥ 3,500 cells/mm3 and ≤ 50,000 cells/mm3
- ANC ≥ 1,500 cells/mm3
- Hemoglobin ≥ 10 g/dL
- Platelet count ≥ 100,000 plts/mm3
- Total bilirubin ≤ 1.5 x ULN
- AST, ALT ≤ 2.5 x ULN
- Serum chemistries within normal limits (WNL) or Grade 1 - If patients are diabetic or
have a screening random glucose > 160 mg/dL, a fasting glucose must be done and
patients must be WNL or Grade 1 in order to be eligible for the study.
- Acceptable coagulation status: INR ≤ (ULN + 10%)
- CD4 count ≥ 500/mm3
Exclusion Criteria:
- Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or
medication (e.g. systemic corticosteroids)
- Known myeloproliferative disorders requiring systemic therapy
- History of exfoliative skin condition (e.g. eczema or ectopic dermatitis) requiring
systemic therapy
- Tumor(s) invading a major vascular structure (e.g. carotid artery)
- Tumor(s) in location that would potentially result in significant clinical adverse
effects if post-treatment tumor swelling were to occur (e.g. tumors impinging on the
upper airway or affecting biliary tract drainage, etc.)
- Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or
pleural effusions
- Severe or unstable cardiac disease
- Current, known CNS malignancy (history of completely resected or irradiated brain
metastases allowed)
- Received anti-cancer therapy within 4 weeks prior to first treatment (6 weeks in case
of mitomycin C or nitrosoureas)
- Use of anti-viral, anti-platelet, or anti-coagulation medication [Patients who
discontinue such medications within 7 days prior to first treatment may be eligible
for this study.]
- Pulse oximetry O2 saturation <90% at rest
- Experienced a severe systemic reaction or side-effect as a result of a previous
smallpox vaccination
Household contact exclusions:
- Women who are pregnant or nursing an infant
- Children < 5 years old
- History of exfoliative skin condition (e.g. eczema) that at some stage has required
systemic therapy
- Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or
medication (e.g. systemic corticosteroids)