Malignant GliomaPhase 1NCT02507583
Antisense102: Pilot Immunotherapy for Newly Diagnosed Malignant Glioma
A Phase 1 study testing IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours. in people with Malignant Glioma and Neoplasms, run by david andrews at 1 site in United States.
Trial summary
This human Phase 1 trial is a continuation of a Phase 1 trial which enrolled patients with recurrent gliomas (#TJU-14379-101) and which was designed after a previously conducted Phase 1 human trial at our institution. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Malignant Glioma, Neoplasms
- What is being tested?
- IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours.
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 33 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Sep 2015to 17 Aug 2020
- Phase
- Phase 1
- Are there results?
- None posted in the registry
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
- Documentation by MR of a gadolinium-enhancing intraparenchymal mass consistent with malignant glioma.
- Frozen section diagnosis of WHO Grade IV glioma, confirmed with permanent section and immunopositive for IGF-1R.
- An Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 or a Karnofsky Performance Score (KPS) of at least 60.
- Must be 18 years of age or older.
- Must sign an approved informed consent.
- Hemodynamically stable, consistent with Standard of Care values for patients undergoing elective tumor resection.
Who cannot join
- Females who are pregnant, nursing, or not inclined to use adequate contraceptive methods if necessary to prevent pregnancy during the study.
- An active second primary malignancy with the exception of basal cell or squamous cell skin carcinoma.
- Major concomitant medical illness inclusive of severe chronic obstructive pulmonary disease, multiple sclerosis, symptomatic coronary artery disease, heart failure, recent major cerebrovascular accident, brittle diabetes, renal dialysis, end stage liver disease, labile hypertension, or any autoimmune disorder.
- A history of heparin-induced thrombocytopenia or hypersensitivity to heparin, enoxaparin, or pork products.
- An abnormal International Normalized Ratio (INR) of greater than 1.3, if repeatable and refractory to correction by routine methods.
- Documented deep venous thrombosis
Trial locations and contacts
1 site in 1 country.
United States1 site
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
About this study
Official title: Phase I Study in Humans Evaluating the Safety of Rectus Sheath Implantation of Diffusion Chambers Encapsulating Autologous Malignant Glioma Cells Treated With Insulin-like Growth Factor Receptor-1 Antisense Oligodeoxynucleotide (IGF-1R/AS ODN) in 32 Patients With Newly Diagnosed Malignant Glioma
This human Phase 1 trial is a continuation of a Phase 1 trial which enrolled patients with recurrent gliomas (#TJU-14379-101) and which was designed after a previously conducted Phase 1 human trial at our institution. With certain modifications, it is intended to reproduce the safety results of the recurrent glioma previous trials as well as explore any objective clinical responses in newly diagnosed patients. Protocol 14379-101 is closed to accrual and Abbreviated Clinical Report is prepared for FDA submission. The safety profile for this protocol was quite favorable.
This treatment involves taking the patient's own tumor cells at surgery, treating them with an investigational new drug (an antisense molecule) designed to shut down a targeted surface receptor protein, and re-implanting the cells, now encapsulated in small diffusion chambers the size of a nickel in the patient's abdomen within 24 hours after the surgery. Loss of the surface receptor causes the tumor cells to die in a process called apoptosis. As the tumor cells die, they release small particles called exosomes, each full of tumor antigens. The investigators believe that these exosomes as well as the presence of the antisense molecule work together to activate the immune system against the tumor as they slowly diffuse out of the chamber. Immune cells are immediately available for activation outside of the chamber because a wound was created to implant these tumor cells and a foreign body (the chamber) is present in the wound. In this trial, a dose escalation of the therapeutic agent will involve an increase in both biodiffusion chamber number as well as the time the biodiffusion chambers remain implanted. The wound and the chamber fortify the initial immune response which eventually leads to the activation of immune system T cells that attack and eliminate the tumor. By training the immune system to recognize the tumor, the patient is also protected through immune surveillance from later tumor growth should the tumor recur. Compared to treatment alternatives for tumor recurrence, including a boost of further radiation and more chemotherapy, this treatment represents potentially greater benefit with fewer risks.
Read the detailed description
This trial will be an adaptation of Protocol 101 which recently closed after rapid and complete accrual, now with an escalation of the induction vaccination in four cohorts. For practical purposes, a standard dose-escalation study is not possible with the current paradigm. Although the investigators may have identified a distinct bioactive byproduct of Insulin-like growth factor receptor-1 Antisense Oligodeoxynucleotide (IGF-1R/AS ODN)-induced tumor cell apoptosis (exosomes), it is difficult to perform a dose escalation in a typical fashion. Also, antigen concentration can affect immune response in a biphasic manner: too little or too much can dampen an immune response, so even if the antigen or antigens were known, a typical pharmacologic dose escalation would not follow typical pharmacokinetics. For these reasons, in Protocol 102, 32 patients will have therapy at initial surgery followed by implantation of 20 chambers for a duration of 48 hours. There was a documented increase in tumor infiltrating lymphocytes after treatment in our original trial, this observation provided preliminary supporting evidence that this therapeutic vaccine will elicit an adaptive immune response. Protocol 102 has been designed to further elucidate an immune response with a quantitative assessment of tumor specific T cells as well as circulating M2 macrophages before and after treatment. The design of the Phase 1 trial will allow a statistical analysis of both antigen dose (number of chambers) and time of exposure (chamber dwell time) as either variable may relate to any toxicity or treatment response.
A summary of the treatment paradigm includes: Pre-operative plasma leukopheresis, then surgery with tissue harvest and implantation of 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN as previously reported within 24 hours of craniotomy, implanted for 48 hours. All patients who meet the eligibility criteria and agree to participate in this study will be potential candidates for therapy.
- Conditions
- Malignant Glioma, Neoplasms
- Being tested
- IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours.
- Keywords
- Brain Tumor, Glioma, Newly Diagnosed
- Medical subject headings
- Glioma, Neoplasms, Brain Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours.Drug
Also called Insulin-like growth factor receptor-1 antisense oligodeoxynucleotide
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1 | Experimental | After protocol amendment dated 11 May 2017, all subjects enrolled into the trial will receive 20 chambers for 48 hours. Receives: Drug: IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Collect adverse events as a measure of safety and tolerability of IG-1R/ AS ODN
Adverse events and survival outcomes will be captured as a measure of safety and tolerability of IG-1R/AS ODN administered as a treatment 4 to 6 weeks before initiation of standard of care treatment. Blood (equivalent of 8 units of mononuclear cells by plasma leukopheresis) will be collected within 3 days of craniotomy and 7 tbsp of blood on days 14, 28, 42, 56, followed by every 3 months after vaccination to measure the degree of anti-glioma Cytotoxic T lymphoctye immunity achieved.
Measured: 36 months
Secondary outcomes (3)
Document any T-1 weighted MRI-based radiographic responses to treatment.
T-1 weighted abnormalities include: (1) size of the enhancing area utilizing the broadest unambiguous diameter in any orthogonal plane; (2) characteristics of the enhancement (e.g. progression from linearity to nodularity or regression from nodularity to linearity) and (3) intensity of enhancing area
Measured: Evaluated 3 days pre surgery, and again at day 28, day 56, and then every 3 months up to 24 months.
Document any T-2 weighted MRI-based radiographic abnormalities or responses to treatment.
T-2 weighted abnormalities include: (1) local mass effect; (2) size of T-2 weighted abnormality (e.g. edema, tumor, radiation change); (3) invasion of the deep white matter tracts; and (4) distal progression.
Measured: Evaluated 3 days pre surgery, and again at day 28, day 56, and then every 3 months up to 24 months.
MRI measure of tumor response
Each imaging characteristic will be rated as increased, decreased, or without change. Since distal progression including invasion of the contralateral hemisphere will either be present or absent, this criterion will be scored as either absent (stable) or present utilizing FLAIR sequence. Comparisons will be made between an MRI study performed within 48 hours of craniotomy documenting residual contrast-enhancing tumor.
Measured: Evaluated 3 days pre surgery, and again at day 28, day 56, and then every 3 months up to 24 months.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2015 (estimated)
- Study start1 Sep 2015
- Primary completion6 Mar 2018
- Study completion17 Aug 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Malignant GliomaStudies 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
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 33 participants (actual)
Sponsor and investigators
- Lead sponsor
- david andrews
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, david andrews, Thomas Jefferson University
- Investigators
- Kevin Judy, MD, Principal investigator, Thomas Jefferson University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02507583
- Sponsor's protocol ID
- 14G.96
- Other IDs
- JT 5979
- Status last verified
- Oct 2020
- First submitted
- 29 Jun 2015
- Last updated
- 7 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Andrews DW, Resnicoff M, Flanders AE, Kenyon L, Curtis M, Merli G, Baserga R, Iliakis G, Aiken RD. Results of a pilot study involving the use of an antisense oligodeoxynucleotide directed against the insulin-like growth factor type I receptor in malignant astrocytomas. J Clin Oncol. 2001 Apr 15;19(8):2189-200. doi: 10.1200/JCO.2001.19.8.2189.
PubMed 11304771Andrews DW, Judy KD, Scott CB, Garcia S, Harshyne LA, Kenyon L, Talekar K, Flanders A, Atsina KB, Kim L, Martinez N, Shi W, Werner-Wasik M, Liu H, Prosniak M, Curtis M, Kean R, Ye DY, Bongiorno E, Sauma S, Exley MA, Pigott K, Hooper DC. Phase Ib Clinical Trial of IGV-001 for Patients with Newly Diagnosed Glioblastoma. Clin Cancer Res. 2021 Apr 1;27(7):1912-1922. doi: 10.1158/1078-0432.CCR-20-3805. Epub 2021 Jan 26.
PubMed 33500356
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase I Study in Humans Evaluating the Safety of Rectus Sheath Implantation of Diffusion Chambers Encapsulating Autologous Malignant Glioma Cells Treated With Insulin-like Growth Factor Receptor-1 Antisense Oligodeoxynucleotide (IGF-1R/AS ODN) in 32 Patients With Newly Diagnosed Malignant Glioma
- ClinicalTrials.gov ID
- NCT02507583
- Acronym / sponsor ID
- 14G.96
- Conditions
- Malignant Glioma, Neoplasms
- Keywords
- Brain Tumor, Glioma, Newly Diagnosed
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 33 participants (actual)
- Lead sponsor
- david andrewsUniversity, hospital or other
- Study start
- 1 Sep 2015 (actual)
- Primary completion
- 6 Mar 2018 (actual)
- Study completion
- 17 Aug 2020 (actual)
- First posted
- 24 Jul 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This human Phase 1 trial is a continuation of a Phase 1 trial which enrolled patients with recurrent gliomas (#TJU-14379-101) and which was designed after a previously conducted Phase 1 human trial at our institution. With certain modifications, it is intended to reproduce the safety results of the recurrent glioma previous trials as well as explore any objective clinical responses in newly diagnosed patients. Protocol 14379-101 is closed to accrual and Abbreviated Clinical Report is prepared for FDA submission. The safety profile for this protocol was quite favorable.
This treatment involves taking the patient's own tumor cells at surgery, treating them with an investigational new drug (an antisense molecule) designed to shut down a targeted surface receptor protein, and re-implanting the cells, now encapsulated in small diffusion chambers the size of a nickel in the patient's abdomen within 24 hours after the surgery. Loss of the surface receptor causes the tumor cells to die in a process called apoptosis. As the tumor cells die, they release small particles called exosomes, each full of tumor antigens. The investigators believe that these exosomes as well as the presence of the antisense molecule work together to activate the immune system against the tumor as they slowly diffuse out of the chamber. Immune cells are immediately available for activation outside of the chamber because a wound was created to implant these tumor cells and a foreign body (the chamber) is present in the wound. In this trial, a dose escalation of the therapeutic agent will involve an increase in both biodiffusion chamber number as well as the time the biodiffusion chambers remain implanted. The wound and the chamber fortify the initial immune response which eventually leads to the activation of immune system T cells that attack and eliminate the tumor. By training the immune system to recognize the tumor, the patient is also protected through immune surveillance from later tumor growth should the tumor recur. Compared to treatment alternatives for tumor recurrence, including a boost of further radiation and more chemotherapy, this treatment represents potentially greater benefit with fewer risks.
Detailed description
This trial will be an adaptation of Protocol 101 which recently closed after rapid and complete accrual, now with an escalation of the induction vaccination in four cohorts. For practical purposes, a standard dose-escalation study is not possible with the current paradigm. Although the investigators may have identified a distinct bioactive byproduct of Insulin-like growth factor receptor-1 Antisense Oligodeoxynucleotide (IGF-1R/AS ODN)-induced tumor cell apoptosis (exosomes), it is difficult to perform a dose escalation in a typical fashion. Also, antigen concentration can affect immune response in a biphasic manner: too little or too much can dampen an immune response, so even if the antigen or antigens were known, a typical pharmacologic dose escalation would not follow typical pharmacokinetics. For these reasons, in Protocol 102, 32 patients will have therapy at initial surgery followed by implantation of 20 chambers for a duration of 48 hours. There was a documented increase in tumor infiltrating lymphocytes after treatment in our original trial, this observation provided preliminary supporting evidence that this therapeutic vaccine will elicit an adaptive immune response. Protocol 102 has been designed to further elucidate an immune response with a quantitative assessment of tumor specific T cells as well as circulating M2 macrophages before and after treatment. The design of the Phase 1 trial will allow a statistical analysis of both antigen dose (number of chambers) and time of exposure (chamber dwell time) as either variable may relate to any toxicity or treatment response.
A summary of the treatment paradigm includes: Pre-operative plasma leukopheresis, then surgery with tissue harvest and implantation of 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN as previously reported within 24 hours of craniotomy, implanted for 48 hours. All patients who meet the eligibility criteria and agree to participate in this study will be potential candidates for therapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Cohort 1 | Experimental | Drug: IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours.After protocol amendment dated 11 May 2017, all subjects enrolled into the trial will receive 20 chambers for 48 hours. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Documentation by MR of a gadolinium-enhancing intraparenchymal mass consistent with malignant glioma.
- Frozen section diagnosis of WHO Grade IV glioma, confirmed with permanent section and immunopositive for IGF-1R.
- An Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 or a Karnofsky Performance Score (KPS) of at least 60.
- Must be 18 years of age or older.
- Must sign an approved informed consent.
Key exclusion criteria (6 listed)
- Females who are pregnant, nursing, or not inclined to use adequate contraceptive methods if necessary to prevent pregnancy during the study.
- An active second primary malignancy with the exception of basal cell or squamous cell skin carcinoma.
- Major concomitant medical illness inclusive of severe chronic obstructive pulmonary disease, multiple sclerosis, symptomatic coronary artery disease, heart failure, recent major cerebrovascular accident, brittle diabetes, renal dialysis, end stage liver disease, labile hypertension, or any autoimmune disorder.
- A history of heparin-induced thrombocytopenia or hypersensitivity to heparin, enoxaparin, or pork products.
- An abnormal International Normalized Ratio (INR) of greater than 1.3, if repeatable and refractory to correction by routine methods.
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 |
|---|---|---|
| IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours.Also: Insulin-like growth factor receptor-1 antisense oligodeoxynucleotide | Drug | Cohort 1 |
Primary outcome
Collect adverse events as a measure of safety and tolerability of IG-1R/ AS ODN
Time frame: 36 months
Adverse events and survival outcomes will be captured as a measure of safety and tolerability of IG-1R/AS ODN administered as a treatment 4 to 6 weeks before initiation of standard of care treatment. Blood (equivalent of 8 units of mononuclear cells by plasma leukopheresis) will be collected within 3 days of craniotomy and 7 tbsp of blood on days 14, 28, 42, 56, followed by every 3 months after vaccination to measure the degree of anti-glioma Cytotoxic T lymphoctye immunity achieved.
3 secondary outcomes
Document any T-1 weighted MRI-based radiographic responses to treatment.
Time frame: Evaluated 3 days pre surgery, and again at day 28, day 56, and then every 3 months up to 24 months.
Document any T-2 weighted MRI-based radiographic abnormalities or responses to treatment.
Time frame: Evaluated 3 days pre surgery, and again at day 28, day 56, and then every 3 months up to 24 months.
MRI measure of tumor response
Time frame: Evaluated 3 days pre surgery, and again at day 28, day 56, and then every 3 months up to 24 months.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2025.
- Background: PubMed 11304771Andrews DW, Resnicoff M, Flanders AE, Kenyon L, Curtis M, Merli G, Baserga R, Iliakis G, Aiken RD. Results of a pilot study involving the use of an antisense oligodeoxynucleotide directed against the insulin-like growth factor type I receptor in malignant astrocytomas. J Clin Oncol. 2001 Apr 15;19(8):2189-200. doi: 10.1200/JCO.2001.19.8.2189.
- Derived from this study: PubMed 33500356Andrews DW, Judy KD, Scott CB, Garcia S, Harshyne LA, Kenyon L, Talekar K, Flanders A, Atsina KB, Kim L, Martinez N, Shi W, Werner-Wasik M, Liu H, Prosniak M, Curtis M, Kean R, Ye DY, Bongiorno E, Sauma S, Exley MA, Pigott K, Hooper DC. Phase Ib Clinical Trial of IGV-001 for Patients with Newly Diagnosed Glioblastoma. Clin Cancer Res. 2021 Apr 1;27(7):1912-1922. doi: 10.1158/1078-0432.CCR-20-3805. Epub 2021 Jan 26.
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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.
Kevin Judy, MD principal investigator
Thomas Jefferson University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing IGF-1R/AS ODN; Surgery with tissue harvest and implantation 20 diffusion chambers in the rectus sheath with IGF-1R/AS ODN within 24 hours of craniotomy, implanted for 48 hours. in people with Malignant Glioma and Neoplasms, run by david andrews at 1 site 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 6 inclusion and 6 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 7 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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. 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 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.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Collect adverse events as a measure of safety and tolerability of IG-1R/ AS ODN (time frame: 36 months). 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 NCT02507583, which also lists 2 linked publications.
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 7 May 2025.