Journal article
An open label, single-arm, phase II multicenter study of the safety and efficacy of CG0070 oncolytic vector regimen in patients with BCG-unresponsive non–muscle-invasive bladder cancer: Interim results
Urologic oncology, Vol.36(10), pp.440-447
10/2018
DOI: 10.1016/j.urolonc.2017.07.005
PMID: 28755959
Abstract
CG0070 is a replication-competent oncolytic adenovirus that targets bladder tumor cells through their defective retinoblastoma pathway. Prior reports of intravesical CG0070 have shown promising activity in patients with high-grade non–muscle invasive bladder cancer (NMIBC) who previously did not respond to bacillus Calmette-Guérin (BCG). However, limited accrual has hindered analysis of efficacy, particularly for pathologic subsets. We evaluated interim results of a phase II trial for intravesical CG0070 in patients with BCG-unresponsive NMIBC who refused cystectomy.
At interim analysis (April 2017), 45 patients with residual high-grade Ta, T1, or carcinoma-in-situ (CIS) ± Ta/T1 had evaluable 6-month follow-up in this phase II single-arm multicenter trial (NCT02365818). All patients received at least 2 prior courses of intravesical therapy for CIS, with at least 1 being a course of BCG. Patients had either failed BCG induction therapy within 6 months or had been successfully treated with BCG with subsequent recurrence. Complete response (CR) at 6 months was defined as absence of disease on cytology, cystoscopy, and random biopsies.
Of 45 patients, there were 24 pure CIS, 8 CIS + Ta, 4 CIS + T1, 6 Ta, 3 T1. Overall 6-month CR (95% CI) was 47% (32%–62%). Considering 6-month CR for pathologic subsets, pure CIS was 58% (37%–78%), CIS ± Ta/T1 50% (33%–67%), and pure Ta/T1 33% (8%–70%). At 6 months, the single patient that progressed to muscle-invasive disease had Ta and T1 tumors at baseline. No patients with pure T1 had 6-month CR. Treatment–related adverse events (AEs) at 6 months were most commonly urinary bladder spasms (36%), hematuria (28%), dysuria (25%), and urgency (22%). Immunologic treatment–related AEs included flu-like symptoms (12%) and fatigue (6%). Grade III treatment–related AEs included dysuria (3%) and hypotension (1.5%). There were no Grade IV/V treatment–related AEs.
This phase II study demonstrates that intravesical CG0070 yielded an overall 47% CR rate at 6 months for all patients and 50% for patients with CIS, with an acceptable level of toxicity for patients with high-risk BCG-unresponsive NMIBC. There is a particularly strong response and limited progression in patients with pure CIS.
•Overall 6-month complete response rate of 47% in patients with high-risk BCG-unresponsive NMIBC.•A 58% 6-month complete response in patients with pure CIS; 50% 6-month complete response for patients with CIS-containing tumors.•Overall toxicity was acceptably low.
Details
- Title: Subtitle
- An open label, single-arm, phase II multicenter study of the safety and efficacy of CG0070 oncolytic vector regimen in patients with BCG-unresponsive non–muscle-invasive bladder cancer: Interim results
- Creators
- Vignesh T. Packiam - University of ChicagoDonald L. Lamm - NRG OncologyDaniel A. Barocas - Vanderbilt UniversityAndrew Trainer - Adult and Pediatric DermatologyBenjamin FandRonald L. Davis III - Wake Forest UniversityWilliam ClarkMichael Kroeger - University of Nebraska Medical CenterIgor Dumbadze - Tri State Urologic Services, Cincinnati, OHKarim Chamie - University of California, Los AngelesA. Karim Kader - University of California, San DiegoDominic Curran - GenesysJohn Gutheil - SciQuus Oncology, La Jolla, CAArthur Kuan - GenesysAlex W. Yeung - GenesysGary D. Steinberg - University of Chicago
- Resource Type
- Journal article
- Publication Details
- Urologic oncology, Vol.36(10), pp.440-447
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.urolonc.2017.07.005
- PMID
- 28755959
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Language
- English
- Date published
- 10/2018
- Academic Unit
- Urology
- Record Identifier
- 9984320850902771
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