This trial is active, not recruiting.

Conditions glioblastoma multiforme, anaplastic astrocytoma, anaplastic oligodendroglioma, anaplastic oligoastrocytoma
Treatment toca 511
Phase phase 1
Sponsor Tocagen Inc.
Start date October 2013
End date May 2016
Trial size 17 participants
Trial identifier NCT01985256, Tg 511-13-01


This is a multicenter study evaluating the safety and tolerability of Toca 511 administered intravenously to patients with recurrent or progressive Grade III or Grade IV Gliomas who have elected to undergo surgical removal of their tumor. Subjects meeting all of the inclusion and none of the exclusion criteria will receive a portion of the total dose of Toca 511 administered as an intravenous, bolus injection, followed approximately 11 days later by the remainder of the dose injected into the walls of the resection cavity at the time of planned tumor resection. Approximately 6 weeks later, subjects will begin treatment with oral Toca FC taken every 8 hours for 7 days, and repeated every 4 weeks. All subjects enrolled in this study will be encouraged to participate in a continuation protocol that enables additional 5-FC administration and the collection of long-term safety and response data.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Endpoint classification safety/efficacy study
Intervention model single group assignment
Masking open label
Primary purpose treatment
Toca 511 a retroviral replicating vector expressing the cytosine deaminase enzyme
toca 511 vocimagene amiretrorepvec
All subjects will receive Toca 511, a retroviral replicating vector that expresses the cytosine deaminase (CD) gene, intravenously and then intracranially. CD converts the antibiotic 5-fluorocytosine (5-FC) to the anti-cancer drug 5-fluorouracil (5-FU) in cells that have been infected by the Toca 511 vector. Beginning approximately 6 weeks after second administration of Toca 511, subjects will take a 7-day course of oral 5-FC. These 7-day courses of 5-FC are repeated every 4 weeks for the duration of the study.

Primary Outcomes

Determine maximum feasible, safe, and tolerated dose of Toca 511 as measured by dose limiting toxicities.
time frame: 32 weeks

Secondary Outcomes

Measure Toca 511 deposition in tumor at the time of resection by QT-PCR
time frame: At time of surgical resection
Measure how long Toca 511 stays in blood after IV administration by serum QT-PCR
time frame: 10 days
Safety and tolerability of Toca FC given at various doses and schedules as measured by dose limiting toxicities.
time frame: 32 weeks
Evaluate preliminary efficacy of Toca 511 and Toca FC by assessing overall survival, and tumor response rates.
time frame: Ongoing

Eligibility Criteria

Male or female participants from 18 years up to 80 years old.

Inclusion Criteria: - Has the subject given written informed consent? - Is the subject between 18 years old and 80 years old inclusive? - Has the subject had histologically proven HGG with recurrence or progression following initial definitive therapy(s) such as surgery with or without adjuvant radiation therapy and/or chemotherapy (confirmed by diagnostic biopsy or contrast-enhanced MRI and evaluable by Macdonald criteria)? Note, if first recurrence of HGG is documented by MRI, an interval of at least 12 weeks after the end of prior radiation therapy is required unless there is either: i) histopathologic confirmation of recurrent tumor, or ii) new enhancement on MRI outside of the radiotherapy treatment field. - Does the patient have either (1) a single, enhancing tumor recurrence/progression that is ≤ 8 cm in greatest dimension, or (2) multiple enhancing tumor recurrences/progressions within the same surgical field where the sum of their greatest dimensions is ≤ 8 cm? - Based on the pre-operative evaluation, is the tumor recurrence/progression a candidate for ≥ 80% resection? - Has the subject elected not to undergo treatment with the Gliadel® wafer? - Does the subject have a Karnofsky performance status ≥ 70? - Does the subject have an absolute neutrophil count (ANC) ≥ 1500/mm3? - Does the subject have an absolute lymphocyte count ≥ 500/mm3? - Does the subject have a platelet count ≥ 100,000/mm3? - Does the subject have a Hgb ≥ 10 g/dL? - Does the subject have a coagulation profile that would allow for the safe performance of surgery under general anesthesia? - Does the subject have an estimated glomerular filtration rate of at least 50 mL/min (inclusive) by the Cockcroft-Gault formula? - Does the subject have an ALT < 3 times the upper limit of the laboratory reference range and total bilirubin < 1.5 mg/dL? - If the subject is a female of childbearing potential, has she had a negative serum pregnancy test within the past 21 days? - Is the subject willing to use condoms for contraception for 6 months after receiving Toca 511 or until there is no evidence of the virus in his/her blood, whichever is longer. If the subject is a fertile female, is she willing to use contraception for at least 12 months? - Is the subject willing and able to abide by the protocol? - Does the subject have adequate venous access? Exclusion Criteria: - Has the subject received cytotoxic chemotherapy within the past 3 weeks (6 weeks for nitrosoureas) of the planned date of vector injection? - Does the subject have, or has the subject had, within the past 4 weeks any infection requiring antibiotic, antifungal or antiviral therapy? - Has the subject received Avastin® (bevacizumab) for this recurrence/progression, or within the 4 weeks prior to planned Visit 1? - Does the subject have any bleeding diathesis, or must the subject take any anticoagulants, or antiplatelet agents, including NSAIDs that cannot be stopped for surgery? - Does the subject have a history of allergy or intolerance to flucytosine? - Is the subject HIV positive? - Does the subject have any gastrointestinal disease that would prevent him or her from being able to swallow or absorb flucytosine? - Has the subject received any investigational treatment within the past 30 days? - Is the subject breastfeeding? - Does the patient have a history of prior malignancy, excluding basal or squamous cell carcinoma of the skin, with an expected survival of less than five years?

Additional Information

Official title A P1 Ascending Dose Trial of the Safety and Tolerability of Toca 511, a Retroviral Replicating Vector, Administered Intravenously Prior to, and Intracranially at the Time of, Subsequent Resection for Recurrent HGG & Followed by Treatment With Extended-Release 5-FC
Trial information was received from ClinicalTrials.gov and was last updated in February 2016.
Information provided to ClinicalTrials.gov by Tocagen Inc..
Location data was received from the National Cancer Institute and was last updated in March 2016.