Carcinoma, HepatocellularPhase 2NCT01171651
A Study of Pexa-Vec (JX-594) Prior to Sorafenib to Treat Unresectable Primary Hepatocellular Carcinoma
A Phase 2 study testing JX-594 and Sorafenib in people with Carcinoma, Hepatocellular, run by Jennerex Biotherapeutics at 2 sites in South Korea.
Trial summary
The purpose of this pilot safety study is to evaluate the safety and tolerability of JX-594 (Pexa-Vec) administered intravenously and intratumorally prior to standard sorafenib therapy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Carcinoma, Hepatocellular
- What is being tested?
- JX-594 and Sorafenib
- Type of treatment
- Vaccines, Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 25 participants
- Where
- 2 sitesSouth Korea
- Study dates
- 26 May 2009to 27 Sep 2012
- Phase
- Phase 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
- Histological confirmation or clinical/laboratory diagnosis of primary hepatocellular carcinoma (HCC)
- Cancer is not surgically resectable for cure
- Child Pugh A or B
- Performance Score: KPS score of ≥ 70
- Platelet count ≥ 50,000 plts/mm3
- Total bilirubin ≤ 2.5 x ULN
Show all 10Show fewer
- AST, ALT < 5.0 x ULN
- Acceptable coagulation status: INR ≤ 1.5 x ULN
- Acceptable kidney function: Serum creatinine < 2.0 mg/dL
- Sorafenib naive or refractory to sorafenib therapy Tumor Status: At least one intrahepatic tumor, and at least ≥50% of the total intrahepatic viable tumor mass, measurable by CT and injectable under imaging-guidance (note: injected and/or viable tumors must be previously untreated or ≥20% increase in size since preceding local-regional treatment).
Who cannot join
- Known contraindications to sorafenib
- Pregnant or nursing an infant
- Significant immunodeficiency due to underlying illness (e.g. hematological malignancies, congenital immunodeficiencies and/or HIV infection/AIDS) and/or medication (e.g. high-dose systemic corticosteroids)
- History of exfoliative skin condition (e.g. severe eczema, ectopic dermatitis, or similar skin disorder) that at some stage has required systemic therapy
- Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions
- Severe or unstable cardiac disease
Show all 14Show fewer
- Current, known CNS malignancy
- Use of anti-platelet or anti-coagulation medication
- Use of the following anti-viral agents: ribavirin, adefovir, cidofovir (within 7 days prior to the first treatment), and PEG-IFN (within 14 days prior to the first treatment).
- Patients with household contacts who meet any of these criteria unless alternate living arrangements can be made during the patient's active dosing period and for 7 days following the last dose of study medication:
- Pregnant or nursing an infant
- Children < 12 months old
- History of exfoliative skin condition that at some stage has required systemic therapy
- Significant immunodeficiency due to underlying illness (e.g. HIV/AIDS) and/or medication
Trial locations and contacts
2 sites in 1 country.
South Korea2 sites
Pusan National University Hospital
Busan
Pusan National University Yangsan Hospital
Yangsan
About this study
Official title: A Phase 2 Open-Label Pilot Safety Study of JX-594 Administered by IV Infusion Followed by Intratumoral Injection Prior to Standard Sorafenib Treatment in Patients With Unresectable Primary Hepatocellular Carcinoma
The purpose of this pilot safety study is to evaluate the safety and tolerability of JX-594 (Pexa-Vec) administered intravenously and intratumorally prior to standard sorafenib therapy.
Read the detailed description
This is a Phase 2, open-label, pilot safety study designed to evaluate the safety and tolerability of sequential therapy consisting of Pexa-Vec (JX-594) followed by standard sorafenib in patients with advanced, unresectable primary hepatocellular carcinoma (HCC).
Patients will receive an initial intravenous (IV) infusion of Pexa-Vec at a dose of 1 x 10^9 plaque-forming units (pfu) on Day 1. This is followed by two intratumoral (IT) injections of Pexa-Vec on Day 8 and Day 22, each at a total dose of 1 x 10^9 pfu divided among 1 to 5 hepatic tumors. Starting on Day 25 (approximately 3 days after the final regular dose of Pexa-Vec), patients will initiate standard oral sorafenib therapy twice daily. For patients with viable hepatic tumor tissue at Week 12, an optional additional IT dose of Pexa-Vec may be administered.
The primary objective of this study is to assess the safety and toxicity of this sequential regimen, determined by the incidence of treatment-related Grade 3 and Grade 4 adverse events (AEs) and treatment-related serious adverse events (SAEs). Secondary objectives include evaluating the disease control rate (DCR) at 12 weeks, overall survival (OS) time, and radiographic response rate based on modified RECIST (mRECIST 1.0) and/or Choi criteria.
- Conditions
- Carcinoma, Hepatocellular
- Being tested
- JX-594, Sorafenib
- Keywords
- Vaccinia, Vaccinia Virus, JX-594, Jennerex, Primary Hepatocellular Carcinoma, Primary Liver Cancer, Liver Cancer, Sorafenib, Nexavar, Pexa-Vec
- Medical subject headings
- Carcinoma, Hepatocellular, Vaccinia, Liver Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
JX-594Biological
Also called Pexa-Vec, Pexastimogene Devacirepvec, VACC-6.25.1, Recombinant Vaccinia GM-CSF
Patients will receive a total dose of 1e9 pfu per treatment starting with one IV dose on Day 1 and injected intratumorally in 1-5 intrahepatic tumors on Day 8 and 22. An optional maintenance JX-594 dose may be given intratumorally at Week 12.
SorafenibDrug
Also called Nexavar
Starting on Day 25 (3 days after the final JX-594 dose), patients will initiate oral sorafenib therapy twice daily according to standard approved guidelines. Sorafenib therapy is briefly interrupted if an optional Week 12 JX-594 dose is given.
| Study group | Role | What they receive |
|---|---|---|
| JX-594 followed by sorafenib | Experimental | 1e9 pfu (plaque-forming units) total JX-594 dose on each of up to four (4) JX-594 treatment days. Sorafenib is initiated after 3 JX-594 treatments and briefly interrupted if an optional 4th JX-594 treatment is given. Receives: Biological: JX-594; Drug: Sorafenib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Treatment-Related Grade 3 and Grade 4 Adverse Events (AEs) and Serious Adverse Events (SAEs)
Safety and toxicity will be determined by the incidence of treatment-related Grade 3 and Grade 4 AEs and treatment-related SAEs. Adverse events will be collected and assessed through 28 days after the last dose of JX-594 (or until all events considered probably or possibly related to JX-594 have resolved, stabilized, or returned to baseline status).
Measured: Safety evaluations through 28 days after last dose of JX-594
Secondary outcomes (3)
Number of Participants Achieving Disease Control (DCR) at 12 Weeks
Disease Control Rate (DCR) is defined as the percentage of participants achieving a confirmed complete response (CR), partial response (PR), or stable disease (SD), with tumor responses assessed based on modified RECIST (mRECIST 1.0) and/or Choi criteria. Per mRECIST 1.0 for target tumors, CR indicates the disappearance of all tumor(s), PR indicates a >=30% decrease in the sum of the longest diameters (LD) of tumor(s) referenced to Baseline, and SD represents any case that does not qualify for either PR or progressive disease (PD, which is a >=20% increase in the sum of LDs). Additionally, per Choi criteria, a response is defined as a >=10% decrease in the LD of the tumor and/or a >=15% decrease in the average tumor density measured in Hounsfield Units on a CT scan.
Measured: 12 weeks from first JX-594 dose
Determine Radiographic Response Rate
Response rate evaluation based on modified RECIST and/or Choi response criteria
Measured: Periodically throughout study participation (average of up to 1 year)
Overall Survival (OS)
Overall survival (OS) is defined as the time from the first dose of Pexa-Vec treatment until death from any cause. For patients not known to have died at the time of the analysis, OS was censored on the date they were last known to be alive. Data were summarized using the Kaplan-Meier method.
Measured: From the date of first treatment until death from any cause, assessed up to approximately 40 months.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jul 2010 (estimated)
- Study start26 May 2009
- Primary completion27 Sep 2012
- Study completion27 Sep 2012
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.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Carcinoma, HepatocellularStudies 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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 25 participants (actual)
Sponsor and investigators
- Lead sponsor
- Jennerex Biotherapeutics
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- David H Kirn, MD, Study director, Jennerex Biotherapeutics
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01171651
- Sponsor's protocol ID
- JX594-HEP016
- Status last verified
- Jul 2026
- First submitted
- 26 Jul 2010
- Last updated
- 14 Jul 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Breitbach CJ, Arulanandam R, De Silva N, Thorne SH, Patt R, Daneshmand M, Moon A, Ilkow C, Burke J, Hwang TH, Heo J, Cho M, Chen H, Angarita FA, Addison C, McCart JA, Bell JC, Kirn DH. Oncolytic vaccinia virus disrupts tumor-associated vasculature in humans. Cancer Res. 2013 Feb 15;73(4):1265-75. doi: 10.1158/0008-5472.CAN-12-2687. Epub 2013 Feb 7.
PubMed 23393196
Study at a glance
From the registry record, last updated by the sponsor on 14 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2 Open-Label Pilot Safety Study of JX-594 Administered by IV Infusion Followed by Intratumoral Injection Prior to Standard Sorafenib Treatment in Patients With Unresectable Primary Hepatocellular Carcinoma
- ClinicalTrials.gov ID
- NCT01171651
- Acronym / sponsor ID
- JX594-HEP016
- Conditions
- Carcinoma, Hepatocellular
- Keywords
- Vaccinia, Vaccinia Virus, JX-594, Jennerex, Primary Hepatocellular Carcinoma, Primary Liver Cancer, Liver Cancer, Sorafenib
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 25 participants (actual)
- Lead sponsor
- Jennerex BiotherapeuticsIndustry (pharma, biotech, devices)
- Study start
- 26 May 2009 (actual)
- Primary completion
- 27 Sep 2012 (actual)
- Study completion
- 27 Sep 2012 (actual)
- First posted
- 28 Jul 2010 (estimated)
- Results
- Posted 14 Jul 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this pilot safety study is to evaluate the safety and tolerability of JX-594 (Pexa-Vec) administered intravenously and intratumorally prior to standard sorafenib therapy.
Detailed description
This is a Phase 2, open-label, pilot safety study designed to evaluate the safety and tolerability of sequential therapy consisting of Pexa-Vec (JX-594) followed by standard sorafenib in patients with advanced, unresectable primary hepatocellular carcinoma (HCC).
Patients will receive an initial intravenous (IV) infusion of Pexa-Vec at a dose of 1 x 10^9 plaque-forming units (pfu) on Day 1. This is followed by two intratumoral (IT) injections of Pexa-Vec on Day 8 and Day 22, each at a total dose of 1 x 10^9 pfu divided among 1 to 5 hepatic tumors. Starting on Day 25 (approximately 3 days after the final regular dose of Pexa-Vec), patients will initiate standard oral sorafenib therapy twice daily. For patients with viable hepatic tumor tissue at Week 12, an optional additional IT dose of Pexa-Vec may be administered.
The primary objective of this study is to assess the safety and toxicity of this sequential regimen, determined by the incidence of treatment-related Grade 3 and Grade 4 adverse events (AEs) and treatment-related serious adverse events (SAEs). Secondary objectives include evaluating the disease control rate (DCR) at 12 weeks, overall survival (OS) time, and radiographic response rate based on modified RECIST (mRECIST 1.0) and/or Choi criteria.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| JX-594 followed by sorafenib | Experimental | Biological: JX-594, Drug: Sorafenib1e9 pfu (plaque-forming units) total JX-594 dose on each of up to four (4) JX-594 treatment days. Sorafenib is initiated after 3 JX-594 treatments and briefly interrupted if an optional 4th JX-594 treatment is given. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Histological confirmation or clinical/laboratory diagnosis of primary hepatocellular carcinoma (HCC)
- Cancer is not surgically resectable for cure
- Child Pugh A or B
- Performance Score: KPS score of ≥ 70
- Platelet count ≥ 50,000 plts/mm3
Key exclusion criteria (14 listed)
- Known contraindications to sorafenib
- Pregnant or nursing an infant
- Significant immunodeficiency due to underlying illness (e.g. hematological malignancies, congenital immunodeficiencies and/or HIV infection/AIDS) and/or medication (e.g. high-dose systemic corticosteroids)
- History of exfoliative skin condition (e.g. severe eczema, ectopic dermatitis, or similar skin disorder) that at some stage has required systemic therapy
- Clinically significant and/or rapidly accumulating ascites, peri-cardial and/or pleural effusions
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| JX-594Also: Pexa-Vec, Pexastimogene Devacirepvec, VACC-6.25.1, Recombinant Vaccinia GM-CSFPatients will receive a total dose of 1e9 pfu per treatment starting with one IV dose on Day 1 and injected intratumorally in 1-5 intrahepatic tumors on Day 8 and 22. An optional maintenance JX-594 dose may be given intratumorally at Week 12. | Biological | JX-594 followed by sorafenib |
| SorafenibAlso: NexavarStarting on Day 25 (3 days after the final JX-594 dose), patients will initiate oral sorafenib therapy twice daily according to standard approved guidelines. Sorafenib therapy is briefly interrupted if an optional Week 12 JX-594 dose is given. | Drug | JX-594 followed by sorafenib |
Primary outcome
Number of Participants With Treatment-Related Grade 3 and Grade 4 Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: Safety evaluations through 28 days after last dose of JX-594
Safety and toxicity will be determined by the incidence of treatment-related Grade 3 and Grade 4 AEs and treatment-related SAEs. Adverse events will be collected and assessed through 28 days after the last dose of JX-594 (or until all events considered probably or possibly related to JX-594 have resolved, stabilized, or returned to baseline status).
3 secondary outcomes
Number of Participants Achieving Disease Control (DCR) at 12 Weeks
Time frame: 12 weeks from first JX-594 dose
Determine Radiographic Response Rate
Time frame: Periodically throughout study participation (average of up to 1 year)
Overall Survival (OS)
Time frame: From the date of first treatment until death from any cause, assessed up to approximately 40 months.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jul 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 23393196Breitbach CJ, Arulanandam R, De Silva N, Thorne SH, Patt R, Daneshmand M, Moon A, Ilkow C, Burke J, Hwang TH, Heo J, Cho M, Chen H, Angarita FA, Addison C, McCart JA, Bell JC, Kirn DH. Oncolytic vaccinia virus disrupts tumor-associated vasculature in humans. Cancer Res. 2013 Feb 15;73(4):1265-75. doi: 10.1158/0008-5472.CAN-12-2687. Epub 2013 Feb 7.
- Sponsor Company WebsiteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David H Kirn, MD study director
Jennerex Biotherapeutics
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing JX-594 and Sorafenib in people with Carcinoma, Hepatocellular, run by Jennerex Biotherapeutics at 2 sites in South Korea.
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 10 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: finished, as of the sponsor's last update on 14 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in South Korea. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
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 14 Jul 2026). 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?
Number of Participants With Treatment-Related Grade 3 and Grade 4 Adverse Events (AEs) and Serious Adverse Events (SAEs) (time frame: Safety evaluations through 28 days after last dose of JX-594). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01171651, which also lists 1 linked publication.
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 14 Jul 2026.