Phase 1 trial of vocimagene amiretrorepvec and 5-fluorocytosine for recurrent high-grade glioma

Timothy F. Cloughesy, Joseph Landolfi, Daniel J. Hogan, Stephen Bloomfield, Bob Carter, Clark C. Chen, J. Bradley Elder, Steven N. Kalkanis, Santosh Kesari, Albert Lai, Ian Y. Lee, Linda M. Liau, Tom Mikkelsen, Phioanh Leia Nghiemphu, David Piccioni, Tobias Walbert, Alice Chu, Asha Das, Oscar R. Diago, Dawn GammonHarry E. Gruber, Michelle Hanna, Douglas J. Jolly, Noriyuki Kasahara, David McCarthy, Leah Mitchell, Derek Ostertag, Joan M. Robbins, Maria Rodriguez-Aguirre, Michael A. Vogelbaum

Research output: Contribution to journalArticle

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Abstract

Toca 511 (vocimagene amiretrorepvec) is an investigational nonlytic, retroviral replicating vector (RRV) that delivers a yeast cytosine deaminase, which converts subsequently administered courses of the investigational prodrug Toca FC (extended-release 5-fluorocytosine) into the antimetabolite 5-fluorouracil. Forty-five subjects with recurrent or progressive high-grade glioma were treated. The end points of this phase 1, open-label, ascending dose, multicenter trial included safety, efficacy, and molecular profiling; survival was compared to a matching subgroup from an external control. Overall survival for recurrent high-grade glioma was 13.6 months (95% confidence interval, 10.8 to 20.0) and was statistically improved relative to an external control (hazard ratio, 0.45; P = 0.003). Tumor samples from subjects surviving more than 52 weeks after Toca 511 delivery disproportionately displayed a survival-related mRNA expression signature, identifying a potential molecular signature that may correlate with treatment-related survival rather than being prognostic. Toca 511 and Toca FC show excellent tolerability, with RRV persisting in the tumor and RRV control systemically. The favorable assessment of Toca 511 and Toca FC supports confirmation in a randomized phase 2/3 trial (NCT02414165).

Original languageEnglish (US)
Article number341ra75
JournalScience Translational Medicine
Volume8
Issue number341
DOIs
StatePublished - Jun 1 2016

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Flucytosine
Glioma
Cytosine Deaminase
Safety Management
Antimetabolites
Prodrugs
Fluorouracil
Multicenter Studies
Neoplasms
Yeasts
Confidence Intervals
Safety
Messenger RNA

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cloughesy, T. F., Landolfi, J., Hogan, D. J., Bloomfield, S., Carter, B., Chen, C. C., ... Vogelbaum, M. A. (2016). Phase 1 trial of vocimagene amiretrorepvec and 5-fluorocytosine for recurrent high-grade glioma. Science Translational Medicine, 8(341), [341ra75]. https://doi.org/10.1126/scitranslmed.aad9784

Phase 1 trial of vocimagene amiretrorepvec and 5-fluorocytosine for recurrent high-grade glioma. / Cloughesy, Timothy F.; Landolfi, Joseph; Hogan, Daniel J.; Bloomfield, Stephen; Carter, Bob; Chen, Clark C.; Elder, J. Bradley; Kalkanis, Steven N.; Kesari, Santosh; Lai, Albert; Lee, Ian Y.; Liau, Linda M.; Mikkelsen, Tom; Nghiemphu, Phioanh Leia; Piccioni, David; Walbert, Tobias; Chu, Alice; Das, Asha; Diago, Oscar R.; Gammon, Dawn; Gruber, Harry E.; Hanna, Michelle; Jolly, Douglas J.; Kasahara, Noriyuki; McCarthy, David; Mitchell, Leah; Ostertag, Derek; Robbins, Joan M.; Rodriguez-Aguirre, Maria; Vogelbaum, Michael A.

In: Science Translational Medicine, Vol. 8, No. 341, 341ra75, 01.06.2016.

Research output: Contribution to journalArticle

Cloughesy, TF, Landolfi, J, Hogan, DJ, Bloomfield, S, Carter, B, Chen, CC, Elder, JB, Kalkanis, SN, Kesari, S, Lai, A, Lee, IY, Liau, LM, Mikkelsen, T, Nghiemphu, PL, Piccioni, D, Walbert, T, Chu, A, Das, A, Diago, OR, Gammon, D, Gruber, HE, Hanna, M, Jolly, DJ, Kasahara, N, McCarthy, D, Mitchell, L, Ostertag, D, Robbins, JM, Rodriguez-Aguirre, M & Vogelbaum, MA 2016, 'Phase 1 trial of vocimagene amiretrorepvec and 5-fluorocytosine for recurrent high-grade glioma', Science Translational Medicine, vol. 8, no. 341, 341ra75. https://doi.org/10.1126/scitranslmed.aad9784
Cloughesy, Timothy F. ; Landolfi, Joseph ; Hogan, Daniel J. ; Bloomfield, Stephen ; Carter, Bob ; Chen, Clark C. ; Elder, J. Bradley ; Kalkanis, Steven N. ; Kesari, Santosh ; Lai, Albert ; Lee, Ian Y. ; Liau, Linda M. ; Mikkelsen, Tom ; Nghiemphu, Phioanh Leia ; Piccioni, David ; Walbert, Tobias ; Chu, Alice ; Das, Asha ; Diago, Oscar R. ; Gammon, Dawn ; Gruber, Harry E. ; Hanna, Michelle ; Jolly, Douglas J. ; Kasahara, Noriyuki ; McCarthy, David ; Mitchell, Leah ; Ostertag, Derek ; Robbins, Joan M. ; Rodriguez-Aguirre, Maria ; Vogelbaum, Michael A. / Phase 1 trial of vocimagene amiretrorepvec and 5-fluorocytosine for recurrent high-grade glioma. In: Science Translational Medicine. 2016 ; Vol. 8, No. 341.
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abstract = "Toca 511 (vocimagene amiretrorepvec) is an investigational nonlytic, retroviral replicating vector (RRV) that delivers a yeast cytosine deaminase, which converts subsequently administered courses of the investigational prodrug Toca FC (extended-release 5-fluorocytosine) into the antimetabolite 5-fluorouracil. Forty-five subjects with recurrent or progressive high-grade glioma were treated. The end points of this phase 1, open-label, ascending dose, multicenter trial included safety, efficacy, and molecular profiling; survival was compared to a matching subgroup from an external control. Overall survival for recurrent high-grade glioma was 13.6 months (95{\%} confidence interval, 10.8 to 20.0) and was statistically improved relative to an external control (hazard ratio, 0.45; P = 0.003). Tumor samples from subjects surviving more than 52 weeks after Toca 511 delivery disproportionately displayed a survival-related mRNA expression signature, identifying a potential molecular signature that may correlate with treatment-related survival rather than being prognostic. Toca 511 and Toca FC show excellent tolerability, with RRV persisting in the tumor and RRV control systemically. The favorable assessment of Toca 511 and Toca FC supports confirmation in a randomized phase 2/3 trial (NCT02414165).",
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T1 - Phase 1 trial of vocimagene amiretrorepvec and 5-fluorocytosine for recurrent high-grade glioma

AU - Cloughesy, Timothy F.

AU - Landolfi, Joseph

AU - Hogan, Daniel J.

AU - Bloomfield, Stephen

AU - Carter, Bob

AU - Chen, Clark C.

AU - Elder, J. Bradley

AU - Kalkanis, Steven N.

AU - Kesari, Santosh

AU - Lai, Albert

AU - Lee, Ian Y.

AU - Liau, Linda M.

AU - Mikkelsen, Tom

AU - Nghiemphu, Phioanh Leia

AU - Piccioni, David

AU - Walbert, Tobias

AU - Chu, Alice

AU - Das, Asha

AU - Diago, Oscar R.

AU - Gammon, Dawn

AU - Gruber, Harry E.

AU - Hanna, Michelle

AU - Jolly, Douglas J.

AU - Kasahara, Noriyuki

AU - McCarthy, David

AU - Mitchell, Leah

AU - Ostertag, Derek

AU - Robbins, Joan M.

AU - Rodriguez-Aguirre, Maria

AU - Vogelbaum, Michael A.

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