<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04420975</url>
  </required_header>
  <id_info>
    <org_study_id>19-000419</org_study_id>
    <secondary_id>NCI-2019-08556</secondary_id>
    <secondary_id>1K08CA245181-01</secondary_id>
    <nct_id>NCT04420975</nct_id>
  </id_info>
  <brief_title>Nivolumab and BO-112 Before Surgery for the Treatment of Resectable Soft Tissue Sarcoma</brief_title>
  <official_title>A Phase I Study of Nivolumab and Intratumoral BO 112 for Resectable Soft Tissue Sarcoma</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Jonsson Comprehensive Cancer Center</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>National Cancer Institute (NCI)</agency>
      <agency_class>NIH</agency_class>
    </collaborator>
    <collaborator>
      <agency>Highlight Therapeutics</agency>
      <agency_class>Industry</agency_class>
    </collaborator>
  </sponsors>
  <source>Jonsson Comprehensive Cancer Center</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>Yes</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      This phase I trial studies the side effects of BO-112 when given together with nivolumab&#xD;
      before surgery in treating patients with soft tissue sarcoma that can be removed by surgery&#xD;
      (resectable). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the&#xD;
      body's immune system attack the cancer, and may interfere with the ability of tumor cells to&#xD;
      grow and spread. Immunotherapy with BO-112, may induce changes in body's immune system and&#xD;
      may interfere with the ability of tumor cells to grow and spread. Giving nivolumab and BO-112&#xD;
      before surgery may work better in treating patients with soft tissue sarcoma compared to&#xD;
      nivolumab alone.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      PRIMARY OBJECTIVE:&#xD;
&#xD;
      I. To determine the safety and tolerability of integrating BO-112, and BO-112 with nivolumab&#xD;
      in soft tissue sarcoma patients undergoing preoperative radiotherapy.&#xD;
&#xD;
      SECONDARY OBJECTIVES:&#xD;
&#xD;
      I. Determine the change in T cell infiltration at surgical resection from baseline as&#xD;
      measured by immunohistochemistry.&#xD;
&#xD;
      II. Assess treatment effect (necrosis score) of BO-112 and BO-112 in combination with&#xD;
      nivolumab in soft tissue sarcoma patients receiving preoperative hypofractionated&#xD;
      radiotherapy, compared to patients treated on a recently completed phase 2 study of&#xD;
      preoperative hypofractionated radiotherapy alone.&#xD;
&#xD;
      III. Evaluate the 2-year rate of local and distant metastasis of BO-112 and BO-112 in&#xD;
      combination with nivolumab in patients with localized resectable soft tissue sarcoma&#xD;
      receiving preoperative hypofractionated radiotherapy, as compared to historical patients&#xD;
      receiving preoperative radiotherapy alone.&#xD;
&#xD;
      EXPLORATORY OBJECTIVES:&#xD;
&#xD;
      I. Evaluate the dynamics of the intratumoral T cell phenotype. II. Assess the capacity to&#xD;
      grow ex vivo tumor infiltrating lymphocytes from patients treated with BO-112 and BO-112 in&#xD;
      combination with nivolumab.&#xD;
&#xD;
      III. Analyze changes in T-cell receptor (TCR) repertoire in tumor infiltrating lymphocytes&#xD;
      and peripheral blood mononuclear cells (PBMCs) between baseline, post-treatment, and ex vivo&#xD;
      cultured tumor infiltrating lymphocyte (TIL) samples.&#xD;
&#xD;
      IV. For patients with disease burden outside of the resected lesion, assess imaging response&#xD;
      to treatment using Response Evaluation Criteria in Solid Tumors (RECIST) criteria.&#xD;
&#xD;
      OUTLINE:&#xD;
&#xD;
      Patients receive BO-112 intratumorally on days 8 and 15 or 1, 8, and 15 and nivolumab&#xD;
      intravenously (IV) over 30-60 minutes on day 8 in the absence of disease progression or&#xD;
      unacceptable toxicity. Patients also undergo standard of care radiation therapy on days 8-12&#xD;
      for a total of 5 fractions. Patients then undergo standard of care definitive surgical&#xD;
      resection on day 26 to 50.&#xD;
&#xD;
      After completion of study treatment, patients are followed up at 2 weeks, 3 months, and&#xD;
      between 6-12, 12-18, and 18-24 months.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Active, not recruiting</overall_status>
  <start_date type="Actual">October 29, 2020</start_date>
  <completion_date type="Anticipated">January 31, 2025</completion_date>
  <primary_completion_date type="Anticipated">January 31, 2024</primary_completion_date>
  <phase>Phase 1</phase>
  <study_type>Interventional</study_type>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Incidence of adverse events (AEs)</measure>
    <time_frame>study enrollment through 100 days after the last dose of study drug</time_frame>
    <description>AEs will be tabulated by type, severity, and the proportion of subject experiencing the event.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Immune-oncologic impact of the BO-112 or the combined regimen of nivolumab and BO-112</measure>
    <time_frame>from the date of study drug initiation until 50 days after study drug initiation (or the date of surgery, whichever comes first)</time_frame>
    <description>Statistical analysis of immune-oncologic changes will be performed by comparing results from surgical specimens with baseline biopsy specimens. For immunohistochemical parameters, the percentage of CD4+ (cluster of differentiation 4) or CD8+((cluster of differentiation 8) cells will be compared between biopsy and surgical specimens using a paired two-tailed ratio T-test comparing means.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Pathologic treatment effect</measure>
    <time_frame>At time of surgery</time_frame>
    <description>Will be compared to historical samples receiving preoperative radiotherapy alone. Will use a two-sample paired T-test comparing means.</description>
  </secondary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Actual">14</enrollment>
  <condition>Leiomyosarcoma</condition>
  <condition>Malignant Peripheral Nerve Sheath Tumor</condition>
  <condition>Myxofibrosarcoma</condition>
  <condition>Pleomorphic Rhabdomyosarcoma</condition>
  <condition>Resectable Dedifferentiated Liposarcoma</condition>
  <condition>Resectable Soft Tissue Sarcoma</condition>
  <condition>Resectable Undifferentiated Pleomorphic Sarcoma</condition>
  <condition>Soft Tissue Fibrosarcoma</condition>
  <condition>Spindle Cell Sarcoma</condition>
  <condition>Stage I Retroperitoneal Sarcoma AJCC (American Joint Committee on Cancer) v8</condition>
  <condition>Stage I Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Stage IA Retroperitoneal Sarcoma AJCC v8</condition>
  <condition>Stage IA Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Stage IB Retroperitoneal Sarcoma AJCC v8</condition>
  <condition>Stage IB Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Stage II Retroperitoneal Sarcoma AJCC v8</condition>
  <condition>Stage II Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Stage III Retroperitoneal Sarcoma AJCC v8</condition>
  <condition>Stage III Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Stage IIIA Retroperitoneal Sarcoma AJCC v8</condition>
  <condition>Stage IIIA Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Stage IIIB Retroperitoneal Sarcoma AJCC v8</condition>
  <condition>Stage IIIB Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8</condition>
  <condition>Storiform-Pleomorphic Malignant Fibrous Histiocytoma</condition>
  <condition>Synovial Sarcoma</condition>
  <condition>Undifferentiated High Grade Pleomorphic Sarcoma of Bone</condition>
  <condition>Undifferentiated Pleomorphic Sarcoma</condition>
  <condition>Undifferentiated Pleomorphic Sarcoma With Osteoclast-Like Giant Cells</condition>
  <condition>Undifferentiated Pleomorphic Sarcoma, Inflammatory Variant</condition>
  <condition>Undifferentiated Spindle Cell Sarcoma</condition>
  <arm_group>
    <arm_group_label>Treatment (BO-112, nivolumab)</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Patients receive BO-112 intratumorally on days 8 and 15 or 1, 8, and 15 and nivolumab IV over 30-60 minutes on day 8 in the absence of disease progression or unacceptable toxicity. Patients also undergo standard of care radiation therapy on days 8-12 for a total of 5 fractions. Patients then undergo standard of care definitive surgical resection on day 26 to 50.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Definitive Surgical Resection</intervention_name>
    <description>Undergo definitive surgical resection</description>
    <arm_group_label>Treatment (BO-112, nivolumab)</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Biological</intervention_type>
    <intervention_name>Nanoplexed Poly I:C BO-112</intervention_name>
    <description>Given intratumorally</description>
    <arm_group_label>Treatment (BO-112, nivolumab)</arm_group_label>
    <other_name>BO 112</other_name>
    <other_name>BO-112</other_name>
    <other_name>BO112</other_name>
    <other_name>Nanoplexed Poly IC BO-112</other_name>
    <other_name>Nanoplexed Polyinosinic:Polycytidylic Acid BO-112</other_name>
  </intervention>
  <intervention>
    <intervention_type>Biological</intervention_type>
    <intervention_name>Nivolumab</intervention_name>
    <description>Given IV</description>
    <arm_group_label>Treatment (BO-112, nivolumab)</arm_group_label>
    <other_name>BMS-936558</other_name>
    <other_name>CMAB819</other_name>
    <other_name>MDX-1106</other_name>
    <other_name>NIVO</other_name>
    <other_name>Nivolumab Biosimilar CMAB819</other_name>
    <other_name>ONO-4538</other_name>
    <other_name>Opdivo</other_name>
  </intervention>
  <intervention>
    <intervention_type>Radiation</intervention_type>
    <intervention_name>Radiation Therapy</intervention_name>
    <description>Undergo radiation therapy</description>
    <arm_group_label>Treatment (BO-112, nivolumab)</arm_group_label>
    <other_name>Cancer Radiotherapy</other_name>
    <other_name>ENERGY_TYPE</other_name>
    <other_name>Irradiate</other_name>
    <other_name>Irradiated</other_name>
    <other_name>Irradiation</other_name>
    <other_name>Radiation</other_name>
    <other_name>Radiation Therapy, NOS</other_name>
    <other_name>Radiotherapeutics</other_name>
    <other_name>Radiotherapy</other_name>
    <other_name>RT</other_name>
    <other_name>Therapy, Radiation</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Written informed consent, and assent where appropriate, must be obtained from the&#xD;
             subject prior to performing any protocol-related procedures, including screening&#xD;
             evaluations&#xD;
&#xD;
          -  Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1&#xD;
&#xD;
          -  Biopsy proven soft tissue sarcoma of the extremity, trunk or retroperitoneum including&#xD;
             undifferentiated pleomorphic sarcoma, myxofibrosarcoma, leiomyosarcoma,&#xD;
             dedifferentiated liposarcoma, synovial sarcoma, malignant peripheral nerve sheath&#xD;
             tumor, or pleomorphic rhabdomyosarcoma. Undifferentiated pleomorphic sarcoma&#xD;
             encompasses any of the following histologies:&#xD;
&#xD;
               -  Pleomorphic undifferentiated sarcoma&#xD;
&#xD;
               -  Unclassified spindle cell sarcoma&#xD;
&#xD;
               -  Spindle cell sarcoma not otherwise specified&#xD;
&#xD;
               -  Pleomorphic spindle cell sarcoma&#xD;
&#xD;
               -  Pleomorphic fibroblastic sarcoma&#xD;
&#xD;
               -  Undifferentiated high-grade pleomorphic sarcoma&#xD;
&#xD;
               -  Pleomorphic sarcoma with prominent inflammation&#xD;
&#xD;
               -  Pleomorphic sarcoma with giant cells&#xD;
&#xD;
               -  Malignant fibrous histiocytoma (including storiform-pleomorphic and inflammatory&#xD;
                  subtypes)&#xD;
&#xD;
               -  Fibrosarcoma&#xD;
&#xD;
          -  Tumor that is injectable&#xD;
&#xD;
          -  Hemoglobin &gt;= 9 g/dL&#xD;
&#xD;
          -  Absolute neutrophil count &gt;= 1,000/mm^3&#xD;
&#xD;
          -  Platelet count &gt;= 100,000/mm^3 and transfusion independent&#xD;
&#xD;
          -  Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =&lt; 2.5 x&#xD;
             institutional upper limit of normal (ULN)&#xD;
&#xD;
          -  Serum creatinine &lt; 1.5 x ULN or creatinine clearance &gt; 60 mL/min for patients with&#xD;
             creatinine levels above ULN (as determined by Cockcroft-Gault equation)&#xD;
&#xD;
          -  Bilirubin =&lt; 1.5 x ULN; for subjects with documented/suspected Gilbert's disease,&#xD;
             bilirubin =&lt; 3 x ULN&#xD;
&#xD;
          -  Prothrombin time (PT)/international normalized ratio (INR) and partial thromboplastin&#xD;
             time (PTT) =&lt; 1.5 x institutional upper limit of normal unless the patient is on&#xD;
             anticoagulant therapy within 28 days prior to enrollment (if the patient is receiving&#xD;
             anticoagulant therapy, PT, and a PTT must be within therapeutic range of intended use&#xD;
             of anticoagulants)&#xD;
&#xD;
          -  Patients must be willing to submit blood and tissue specimens for translational&#xD;
             medicine studies&#xD;
&#xD;
          -  Patients must be offered the opportunity to participate in specimen banking for future&#xD;
             research&#xD;
&#xD;
          -  Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy&#xD;
             test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin&#xD;
             [HCG]) within 24 hours prior to the start of study drug&#xD;
&#xD;
          -  Women must not be breastfeeding&#xD;
&#xD;
          -  Women of childbearing potential (WOCBP) must be willing to use either two adequate&#xD;
             barrier methods or a barrier method plus a hormonal method of contraception to prevent&#xD;
             pregnancy, or to abstain from heterosexual activity (complete abstinence) throughout&#xD;
             the study, starting with visit 1 through 5 months after the last dose of study&#xD;
             therapy. Approved contraceptive methods include intrauterine device, diaphragm with&#xD;
             spermicide, cervical cap with spermicide, male condoms, female condoms with&#xD;
             spermicide, or oral contraceptives. Spermicides alone are not an acceptable method of&#xD;
             contraception. Should a woman become pregnant or suspect she is pregnant while she or&#xD;
             her partner is participating in this study, she should inform her treating physician&#xD;
             immediately&#xD;
&#xD;
          -  Men receiving nivolumab and who are sexually active with WOCBP will be instructed to&#xD;
             adhere to highly effective contraception during active participation in study&#xD;
             treatment and for a period of 7 months after the last dose of nivolumab&#xD;
&#xD;
          -  HIGHLY EFFECTIVE METHODS OF CONTRACEPTION&#xD;
&#xD;
        Highly effective methods of contraception have a failure rate of &lt; 1% when used&#xD;
        consistently and correctly. WOCBP and female partners of male subjects, who are WOCBP, are&#xD;
        expected to use one of the highly effective methods of contraception listed below. Male&#xD;
        subjects must inform their female partners who are WOCBP of the contraceptive requirements&#xD;
        of the protocol and are expected to adhere to using contraception with their partner.&#xD;
        Contraception methods are as follows:&#xD;
&#xD;
          -  Progestogen only hormonal contraception associated with inhibition of ovulation&#xD;
&#xD;
          -  Hormonal methods of contraception including oral contraceptive pills containing&#xD;
             combined estrogen + progesterone, vaginal ring, injectables, implants and intrauterine&#xD;
             devices (IUDs) such as Mirena&#xD;
&#xD;
          -  Nonhormonal IUDs, such as ParaGard&#xD;
&#xD;
          -  Bilateral tubal occlusion&#xD;
&#xD;
          -  Vasectomized partner with documented azoospermia 90 days after procedure&#xD;
&#xD;
               -  Vasectomized partner is a highly effective birth control method provided that&#xD;
                  partner is the sole sexual partner of the WOCBP trial participant and that the&#xD;
                  vasectomized partner has received medical assessment of the surgical success&#xD;
&#xD;
          -  Intrauterine hormone-releasing system (IUS)&#xD;
&#xD;
          -  Complete abstinence&#xD;
&#xD;
               -  Complete abstinence is defined as the complete avoidance of heterosexual&#xD;
                  intercourse&#xD;
&#xD;
               -  Complete abstinence is an acceptable form of contraception for all study drugs&#xD;
                  and must be used throughout the duration of the study treatment (plus 5&#xD;
                  half-lives of the investigational drug plus 30 days)&#xD;
&#xD;
               -  It is not necessary to use any other method of contraception when complete&#xD;
                  abstinence is elected&#xD;
&#xD;
               -  Subjects who choose complete abstinence must continue to have pregnancy tests, as&#xD;
                  specified&#xD;
&#xD;
               -  Acceptable alternate methods of highly effective contraception must be discussed&#xD;
                  in the event that the subject chooses to forego complete abstinence&#xD;
&#xD;
               -  The reliability of sexual abstinence needs to be evaluated in relation to the&#xD;
                  duration of the clinical trial and the preferred and usual lifestyle of the&#xD;
                  subject&#xD;
&#xD;
                    -  LESS EFFECTIVE METHODS OF CONTRACEPTION&#xD;
&#xD;
          -  Diaphragm with spermicide&#xD;
&#xD;
          -  Cervical cap with spermicide&#xD;
&#xD;
          -  Vaginal sponge with spermicide&#xD;
&#xD;
          -  Male or female condom with or without spermicide&#xD;
&#xD;
               -  A male and a female condom must not be used together&#xD;
&#xD;
          -  Progestogen-only oral hormonal contraception, where inhibition of ovulation is not the&#xD;
             primary mode of action&#xD;
&#xD;
               -  UNACCEPTABLE METHODS OF CONTRACEPTION&#xD;
&#xD;
          -  Periodic abstinence (calendar, symptothermal, post-ovulation methods)&#xD;
&#xD;
          -  Withdrawal (coitus interruptus)&#xD;
&#xD;
          -  Spermicide only&#xD;
&#xD;
          -  Lactation amenorrhea method (LAM)&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Contraindications to tumor biopsy and injections (coagulopathy, known history of&#xD;
             keloid formation, etc.)&#xD;
&#xD;
          -  Women who are pregnant or breastfeeding&#xD;
&#xD;
          -  Inability to give informed consent&#xD;
&#xD;
          -  History of other malignancy that can interfere with interpretation of the results&#xD;
&#xD;
          -  Prior irradiation in the area to be treated with preoperative radiation such that the&#xD;
             risk of re-irradiation outweighs its benefit, according to the treating radiation&#xD;
             oncologist&#xD;
&#xD;
          -  Any condition that might interfere with the subject's participation in the study,&#xD;
             safety, or in the evaluation of the study results&#xD;
&#xD;
          -  Concurrent enrollment in another clinical study, unless it is an observational&#xD;
             (non-interventional) clinical study or the follow-up period of an interventional study&#xD;
&#xD;
          -  Patients must not have received any live vaccine within 30 days prior to registration.&#xD;
             Seasonal flu vaccines and other vaccines that do not contain live virus are permitted&#xD;
&#xD;
          -  Any concurrent chemotherapy, immunotherapy, or biologic therapy for cancer treatment.&#xD;
             Concurrent use of hormones is acceptable&#xD;
&#xD;
          -  Patient must not have evidence of any clinically significant immunosuppression such as&#xD;
             the following: primary immunodeficiency state such as severe combined immunodeficiency&#xD;
             disease; concurrent opportunistic infection; receiving systemic immunosuppressive&#xD;
             therapy within 28 days before enrollment with the exceptions of intranasal, topical,&#xD;
             and inhaled corticosteroids or oral corticosteroids at physiologic doses not to exceed&#xD;
             10 mg/day of prednisone or equivalent&#xD;
&#xD;
          -  Active or prior documented autoimmune disease within the past 3 years&#xD;
&#xD;
               -  NOTE: Subjects with active, known or suspected autoimmune disease such as&#xD;
                  vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune&#xD;
                  condition only requiring hormone replacement, psoriasis not requiring systemic&#xD;
                  treatment, or conditions not expected to recur in the absence of an external&#xD;
                  trigger are permitted to enroll&#xD;
&#xD;
          -  Active or prior documented inflammatory bowel disease&#xD;
&#xD;
          -  History of (non-infectious) interstitial lung disease (ILD)/pneumonitis that required&#xD;
             steroids or has current ILD/pneumonitis or where suspected ILD/pneumonitis cannot be&#xD;
             ruled out by imaging at screening&#xD;
&#xD;
          -  Current or history of fibromyalgia, myositis, myocarditis or myasthenia gravis&#xD;
&#xD;
          -  Exposure to any investigational drug within 7 days prior to screening visit or for&#xD;
             which 5 half-lives have not elapsed&#xD;
&#xD;
          -  Prisoners or subjects who are involuntarily incarcerated&#xD;
&#xD;
               -  Note: under certain specific circumstances a person who has been imprisoned may&#xD;
                  be included or permitted to continue as a subject&#xD;
&#xD;
          -  Subjects who are compulsorily detained for treatment of either a psychiatric or&#xD;
             physical (e.g., infectious disease) illness&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Vishruth Reddy, MD, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>UCLA / Jonsson Comprehensive Cancer Center</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>UCLA / Jonsson Comprehensive Cancer Center</name>
      <address>
        <city>Los Angeles</city>
        <state>California</state>
        <zip>90095</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <verification_date>November 2022</verification_date>
  <study_first_submitted>June 4, 2020</study_first_submitted>
  <study_first_submitted_qc>June 4, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">June 9, 2020</study_first_posted>
  <last_update_submitted>November 18, 2022</last_update_submitted>
  <last_update_submitted_qc>November 18, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">November 21, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Sarcoma</mesh_term>
    <mesh_term>Rhabdomyosarcoma</mesh_term>
    <mesh_term>Leiomyosarcoma</mesh_term>
    <mesh_term>Liposarcoma</mesh_term>
    <mesh_term>Sarcoma, Synovial</mesh_term>
    <mesh_term>Nerve Sheath Neoplasms</mesh_term>
    <mesh_term>Neurofibrosarcoma</mesh_term>
    <mesh_term>Fibrosarcoma</mesh_term>
    <mesh_term>Histiocytoma</mesh_term>
    <mesh_term>Histiocytoma, Malignant Fibrous</mesh_term>
    <mesh_term>Histiocytoma, Benign Fibrous</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Nivolumab</mesh_term>
  </intervention_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04420975
org study id: 19-000419
secondary id: NCI-2019-08556
secondary id: 1K08CA245181-01
nct id: NCT04420975
lead sponsor: 
collaborator: 
collaborator: 
has dmc: Yes
is fda regulated drug: Yes
is fda regulated device: No
is us export: No
This phase I trial studies the side effects of BO-112 when given together with nivolumab
      before surgery in treating patients with soft tissue sarcoma that can be removed by surgery
      (resectable). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the
      body's immune system attack the cancer, and may interfere with the ability of tumor cells to
      grow and spread. Immunotherapy with BO-112, may induce changes in body's immune system and
      may interfere with the ability of tumor cells to grow and spread. Giving nivolumab and BO-112
      before surgery may work better in treating patients with soft tissue sarcoma compared to
      nivolumab alone.
PRIMARY OBJECTIVE:

      I. To determine the safety and tolerability of integrating BO-112, and BO-112 with nivolumab
      in soft tissue sarcoma patients undergoing preoperative radiotherapy.

      SECONDARY OBJECTIVES:

      I. Determine the change in T cell infiltration at surgical resection from baseline as
      measured by immunohistochemistry.

      II. Assess treatment effect (necrosis score) of BO-112 and BO-112 in combination with
      nivolumab in soft tissue sarcoma patients receiving preoperative hypofractionated
      radiotherapy, compared to patients treated on a recently completed phase 2 study of
      preoperative hypofractionated radiotherapy alone.

      III. Evaluate the 2-year rate of local and distant metastasis of BO-112 and BO-112 in
      combination with nivolumab in patients with localized resectable soft tissue sarcoma
      receiving preoperative hypofractionated radiotherapy, as compared to historical patients
      receiving preoperative radiotherapy alone.

      EXPLORATORY OBJECTIVES:

      I. Evaluate the dynamics of the intratumoral T cell phenotype. II. Assess the capacity to
      grow ex vivo tumor infiltrating lymphocytes from patients treated with BO-112 and BO-112 in
      combination with nivolumab.

      III. Analyze changes in T-cell receptor (TCR) repertoire in tumor infiltrating lymphocytes
      and peripheral blood mononuclear cells (PBMCs) between baseline, post-treatment, and ex vivo
      cultured tumor infiltrating lymphocyte (TIL) samples.

      IV. For patients with disease burden outside of the resected lesion, assess imaging response
      to treatment using Response Evaluation Criteria in Solid Tumors (RECIST) criteria.

      OUTLINE:

      Patients receive BO-112 intratumorally on days 8 and 15 or 1, 8, and 15 and nivolumab
      intravenously (IV) over 30-60 minutes on day 8 in the absence of disease progression or
      unacceptable toxicity. Patients also undergo standard of care radiation therapy on days 8-12
      for a total of 5 fractions. Patients then undergo standard of care definitive surgical
      resection on day 26 to 50.

      After completion of study treatment, patients are followed up at 2 weeks, 3 months, and
      between 6-12, 12-18, and 18-24 months.
allocation: N/A
intervention model: Single Group Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Incidence of adverse events (AEs)
time frame: study enrollment through 100 days after the last dose of study drug
description: AEs will be tabulated by type, severity, and the proportion of subject experiencing the event.
measure: Immune-oncologic impact of the BO-112 or the combined regimen of nivolumab and BO-112
time frame: from the date of study drug initiation until 50 days after study drug initiation (or the date of surgery, whichever comes first)
description: Statistical analysis of immune-oncologic changes will be performed by comparing results from surgical specimens with baseline biopsy specimens. For immunohistochemical parameters, the percentage of CD4+ (cluster of differentiation 4) or CD8+((cluster of differentiation 8) cells will be compared between biopsy and surgical specimens using a paired two-tailed ratio T-test comparing means.
measure: Pathologic treatment effect
time frame: At time of surgery
description: Will be compared to historical samples receiving preoperative radiotherapy alone. Will use a two-sample paired T-test comparing means.
arm group label: Treatment (BO-112, nivolumab)
arm group type: Experimental
description: Patients receive BO-112 intratumorally on days 8 and 15 or 1, 8, and 15 and nivolumab IV over 30-60 minutes on day 8 in the absence of disease progression or unacceptable toxicity. Patients also undergo standard of care radiation therapy on days 8-12 for a total of 5 fractions. Patients then undergo standard of care definitive surgical resection on day 26 to 50.
intervention type: Procedure
intervention name: Definitive Surgical Resection
description: Undergo definitive surgical resection
arm group label: Treatment (BO-112, nivolumab)
intervention type: Biological
intervention name: Nanoplexed Poly I:C BO-112
description: Given intratumorally
arm group label: Treatment (BO-112, nivolumab)
other name: BO 112
other name: BO-112
other name: BO112
other name: Nanoplexed Poly IC BO-112
other name: Nanoplexed Polyinosinic:Polycytidylic Acid BO-112
intervention type: Biological
intervention name: Nivolumab
description: Given IV
arm group label: Treatment (BO-112, nivolumab)
other name: BMS-936558
other name: CMAB819
other name: MDX-1106
other name: NIVO
other name: Nivolumab Biosimilar CMAB819
other name: ONO-4538
other name: Opdivo
intervention type: Radiation
intervention name: Radiation Therapy
description: Undergo radiation therapy
arm group label: Treatment (BO-112, nivolumab)
other name: Cancer Radiotherapy
other name: ENERGY_TYPE
other name: Irradiate
other name: Irradiated
other name: Irradiation
other name: Radiation
other name: Radiation Therapy, NOS
other name: Radiotherapeutics
other name: Radiotherapy
other name: RT
other name: Therapy, Radiation
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Vishruth Reddy, MD, PhD
role: Principal Investigator
affiliation: UCLA / Jonsson Comprehensive Cancer Center
facility: 
country: United States
responsible party type: Sponsor
mesh term: Sarcoma
mesh term: Rhabdomyosarcoma
mesh term: Leiomyosarcoma
mesh term: Liposarcoma
mesh term: Sarcoma, Synovial
mesh term: Nerve Sheath Neoplasms
mesh term: Neurofibrosarcoma
mesh term: Fibrosarcoma
mesh term: Histiocytoma
mesh term: Histiocytoma, Malignant Fibrous
mesh term: Histiocytoma, Benign Fibrous
mesh term: Nivolumab