Phase 3 Randomized, Double-blind, Controlled Study of ICT-107 in Glioblastoma

Status: temporarily closed to accrual

ICT-107 consists of dendritic cells, prepared from autologous mononuclear cells that are pulsed with six synthetic peptides that were derived from tumor associated antigens (TAA) present on glioblastoma tumor cells. This is a Phase 3 study to evaluate ICT-107 in patients with newly diagnosed glioblastoma. Subjects will be randomized to receive standard of care chemoradiation (temozolomide (TMZ) with either ICT-107 or a blinded control. Reinfusion with the pulsed dendritic cells should stimulate cytotoxic T cells to specifically target glioblastoma tumour cells.

Inclusion Criteria

Subjects must understand and sign the study specific informed consent
Subjects must be in primary remission
Subjects should have < 1 cm3 disease by MRI within the previous 4 weeks (by central read)
Subjects must be HLA-A2 positive by central lab
Subjects must have adequate renal, hepatic and bone marrow function based on screening laboratory assessments. Baseline hematologic studies and chemistry and coagulation profiles must meet the following criteria:
Hemoglobin (Hgb) > 8 g/dL
Absolute Neutrophil Count (ANC) > 1000/mm3
Platelet count > 100,000/mm3
Blood Urea Nitrogen (BUN) < 30 mg/dL
Creatinine < 2 mg/dL
Alkaline Phosphatase (ALP), Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) < 2 x upper limit of normal (ULN)
Prothrombin Time (PT) and activated partial thromboplastin time (PTT) ≤ 1.6x unless therapeutically warranted
Subjects must use effective contraceptive methods during the study and for three months following the last dose of study product, if of reproductive age and still retain fertility potential.
Subjects must have at least one positive DTH skin response (more than 5 mm) to test item challenge prior to randomization.

Exclusion Criteria

Subjects receiving investigational study drug for any indication or immunological-based treatment for any reason (Filgrastim may be used for prevention of severe neutropenia).
Subjects with glioblastoma mutated IDH by Immunohistochemistry (IHC)
Subjects with concurrent conditions that would jeopardize the safety of the subject or compliance with the protocol.
Subjects with a history of chronic or acute hepatitis C or B infection.
Subjects require or are likely to require more than a 2-week course of corticosteroids for intercurrent illness. Subjects must have completed the course of corticosteroids at the time of apheresis to meet eligibility.
Subjects have any acute infection that requires specific therapy. Acute therapy must have been completed within seven days prior to study enrollment.
Subjects with active other malignancy diagnosed in the past 3 years (excepting in situ tumors)
Subjects known to be pregnant or nursing.

This is a double blind Phase III study where eligible subjects are randomized into two

treatment arms following the SOC primary treatment with chemoradiation: Arm 1 will

receive ICT-107 in combination with the standard of care, temozolomide (TMZ), Arm 2 will

receive TMZ with a blinded control. A 1:1 randomization will be employed, where ARM 1

will receive ICT-107 and Arm 2 will receive placebo control. All subjects must be

HLA-A2+. All subjects must have glioblastoma tissue that has tumor assessment for MGMT

methylation status prior to randomization (for stratification). Subjects will have had

tumor resection and magnetic resonance imaging (MRI) prior to enrollment into the study.

After signing of written informed consent and any required privacy compliance forms and

screening, enrolled subjects will undergo large volume apheresis at the study site for

collection of PBMCs. Apheresis product will be sent to the manufacturing site where both

active therapy (ICT-107) and control will be prepared for each subject prior to

randomization The study period consists of 4 time periods; a 6-week Post-Surgery Standard

of Care Treatment Phase where subjects receive radiotherapy and TMZ; TMZ and radiation to

be initiated no more than 8 weeks after surgical resection of glioblastoma; a Rest Period

of no more than 14 days where subjects are reassessed for eligibility, and then

randomized; a 4 week Induction Phase where study therapy (ICT-107 or Control) is given

weekly; followed by a Maintenance Phase where study therapy is given monthly for 11

months, and then every 6 months until either progression, withdrawal from the study,

death, or the supply of autologous study therapy is exhausted. Randomized subjects will

receive 4 weekly administrations of subject-specific study therapy (ICT-107 or Control)

during the Induction Phase. No TMZ will be given during the 4 week Induction Phase. Each

study therapy injection will be delivered intradermally (axilla).

The Maintenance Phase will consist of administration of subject-specific study therapy

monthly for 11 months after the Induction Phase (for a total of 15 injections over 12

months during the Induction and Maintenance Phases), and then every 6 mos. thereafter

until depletion or confirmation of progressive disease (PD). During the Maintenance Phase

(where ICT-107 or control are given monthly), the administration of TMZ and subject

specific study therapy or control will be separated in time by approximately 2 weeks (see

Section 9.1.4). Pre-treatment, treatment and assessment schedules will be the same for

all subjects.

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Phase 3 Randomized, Double-blind, Controlled Study of ICT-107 in Glioblastoma

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