A Phase I, Open-label, Dose-escalating Study of the Safety or Percutaneous Intra-tumoral Injection of TG4023 (MVA-FCU1) Combined With Systemic Administration of 5-fluorocytosine in Patients With Primary or Secondary Hepatic Tumors.
Inclusion Criteria:
- Patients with advanced disease without any other standard of care treatment options:
- hepatic metastases of colorectal cancer (CRC) or of other cancers
- Hepatocellular carcinoma (HCC)
- At least one unresectable target tumor located in the liver, measuring 2-5 cm and
accessible to IT administration of TG4023 and amenable to radiological measurement
using RECIST,
- Weight ≤ 100 kg,
- Patients with stable disease, who have to discontinue chemotherapy because of
intolerance,
- ECOG performance status ≤ 2,
- Life expectancy ≥ 3 months,
- Hematology:
- Absolute neutrophil count > 1,500/mm3,
- Hemoglobin > 9g/dL,
- Platelet count > 100,000/mm3,
- Prothrombin time international normalized ratio (INR) ≤ 2; partial
thromboplastin time ≤ 1.66 times upper limit of normal (ULN),
- Biochemistry:
- Total bilirubin ≤ 3 x ULN,
- Aspartate amino-transferase (AST), alanine amino-transferase (ALT), alkaline
phosphatase
- 5.0 x ULN,
- Creatinin clearance ≥ 40 mL/min,
- Total albumin ≥ 30 g/L,
- Anti-vitamin K anticoagulants should have been switched for low-molecular weight
heparin prior to TG4023 injection,
- Signed, written Independent Ethics Committee (IEC)-approved informed consent.
Exclusion Criteria:
- Child-Pugh stage C hepatic insufficiency,
- Impaired renal function (creatinin clearance < 40 mL/min),
- Known deficiency in dihydropyrimidine dehydrogenase (DPD) or total DPD deficiency
diagnosed at baseline in those patients not previously treated with 5-FU-related
compounds,
- Ascites,
- Brain metastases,
- Significant impairment of gastro-intestinal (GI) tract absorption capacity, such as
total gastrectomy, gastric mucosal atrophy, extensive intestinal resections or
malabsorption disease will not be treated by oral 5-FC,
- History of bleeding disorders,
- Pregnant or breast-feeding women,
- Human Immunodeficiency Virus (HIV) positive,
- Chronic use of immunodepressants within 4 weeks prior to TG4023 injection or
immune-depressed patients,
- Hypersensitivity to 5-FC,
- Hypersensitivity to egg proteins,
- Concomitant or previous chemotherapy or targeted therapy within 4 weeks prior to
TG4023 injection and last treatment with bevacizumab (Avastin®) within 2 months prior
to TG4023 injection,
- Concomitant treatment with anti-inflammatory drugs: systemic cortico-steroids and
non-steroidal anti-inflammatory drugs (NSAIDs),
- Prior gene therapy,
- Prior participation in any other research protocol involving an IMP within 2 months
prior to TG4023 injection,
- Major surgery within 6 weeks of TG4023 injection,