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A phase I clinical trial of a bevacizumab-expressing oncolytic herpesvirus T-BV in patients with malignant glioma

A phase I clinical trial of a bevacizumab-expressing oncolytic herpesvirus T-BV in patients with malignant glioma

Todo Tomoki

The Institute of Medical Science ,The University of Tokyo

4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan

toudou-nsu@umin.ac.jp

Ito Hirotaka

The Institute of Medical Science ,The University of Tokyo

4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan

+81-3-3443-8111

uitohiro@g.ecc.u-tokyo.ac.jp

Recruiting

Dec. 01, 2025

Interventional

single arm study

open(masking not used)

no treatment control/standard of care control

single assignment

treatment purpose

Patients who have experienced tumor progression or recurrence following standard initial treatment for glioblastoma (IDH-wildtype) or grade 4 astrocytoma (IDH-mutant), and who meet all of the following criteria, will be eligible for inclusion in this study.
1) A confirmed histopathological diagnosis of glioblastoma (IDH-wildtype) or grade 4 astrocytoma (IDH-mutant) based on the WHO 2021 classification is required.
2) Patients who have experienced tumor progression or recurrence following standard initial treatment.
3) Patients with a confirmed lesion measuring >=1.0 cm on magnetic resonance imaging (MRI) performed within 14 days prior to the eligibility assessment date.
4) Patients with a Karnofsky Performance Status (KPS) of >=60% (or >=50% if the reduction is due to surgery-related paralysis).
5) The patient must be at least 18 years old at the time informed consent is obtained.
6) Patients who are capable of providing written informed consent themselves.
7) Maintain a constant steroid dosage for at least one week prior to Eligibility Determination Date.
8) Willing to use effective barrier birth control for at least 6 months after T-BV administration.
9) Expected survival >= 3 months.
10) Laboratory test results meet the following criteria
- White blood cell count>2000/mm3, Absolute neutrophil count (ANC)>1000 /mm3, Platelets>100,000 /mm3, Hemoglobin>9.0 g/dL
- Prothrombin time-international normalized ratio <= 1.3 times the upper limit of facility reference value
- Serum creatinine<1.7mg/dL
- AST and ALT <= 4 times the upper limit of facility reference value
- Total bilirubin<=1.5 mg/dL

1) Patients with a medical history or current condition of any of the following:
- A history of encephalitis, multiple sclerosis, or other central nervous system infections
- Known HIV seropositivity
- Any contraindication for undergoing gadolinium contrast enhanced MRI such as: individuals with pacemakers, infusion pumps, or allergy to MRI contrast media
2) Patients in whom any of the following tumor conditions have been confirmed:
- Extracranial metastasis of the tumor
- Multiple (two or more) intracranial malignant glioma lesions
- Tumors located in the ventricles, brainstem, or posterior fossa, or tumors requiring administration of the investigational drug via the ventricular route
- Subependymal and subarachnoid dissemination
3) Patients with any of the following comorbidities:
- Active herpesvirus infection
- Herpesvirus infection requiring treatment with antiviral agents such as acyclovir, valacyclovir, famciclovir, vidarabine, or amenamevir
- Active, uncontrolled infection that would interfere with the performance of surgery
- Uncontrolled or severe medical condition such as heart failure, diabetes mellitus, hypertension, interstitial pneumonia, renal failure, and autoimmune disease
- History of alcohol or other drug dependency
- Other active cancer
4) Allergy to anti-HSV drug
5) Patients who have received any of the following treatments:
- Administration of other clinical study drugs or research treatments within 30 days of T-BV administration
- Surgical resection of a brain tumor within 30 days of T-BV administration
- Bevacizumab within 30 days of T-BV administration
-Prior gene therapy or oncolytic virus therapy other than T-BV
6) Pregnant or nursing females
7) Conditions considered inadequate for the subject to be enrolled in the study

Both

malignant glioma

T-BV is administered at a dose of 1 billion pfu per injection. A total volume of 1 mL, diluted with saline to a concentration of 1 billion pfu/mL, is slowly injected in divided portions into up to two target sites. Administer the second dose within 5 to 14 days.

Safety
-Spectrum and frequency of adverse events

Efficacy
-Overall survival
-Progression free survival
-Tumor changes on MRI images

+81-3-5449-5462

Aug. 14, 2025

No

none