Condition category
Date applied
Date assigned
Last edited
Prospectively registered
Overall trial status
Recruitment status
No longer recruiting

Contact information



Primary contact

Dr Ann Pope


Contact details

Cancer Research UK Clinical Trials Unit
Institute for Cancer Studies
B15 2TT
United Kingdom

Additional identifiers

EudraCT number

2007-700341-13 number

Protocol/serial number


Study information

Scientific title

AdUP: A Phase I Clinical Trial of a replication defective type 5 adenovirus vector expressing nitroreductase and GMCSF (AdNRGM) given via trans-perineal, template-guided, intra-prostatic injection, followed by intravenous CB1954, in patients with locally relapsed hormone-refractory Prostate Cancer



Study hypothesis

The main purpose of this trial is to determine the safety and tolerability of a gene therapy strategy for the treatment of locally relapsed prostate cancer. The gene therapy is based on the intraprostatic injection of a viral vector (AdNRGM) carrying a gene called GMCSF which is able to induce a strong immune response against the prostate cancer, and a gene called NTR which is able to convert an inactive compound called CB1954 (prodrug) to a powerful anti-cancer drug. To ensure coverage of the whole prostate the vector will be administered by multiple stereotactically-guided intraprostatic injections. 48 hours after the injection of the viral vector, the prodrug CB1954 will be administered intravenously. It is expected that the combination of the immune response induced by the GMCSF and the activation of the prodrug C1954 operated by NTR within the tumour tissue will result in the death of a significant number of prostate cancer cells.

Ethics approval

Oxford A, 07/12/2012, ref: 12_SC_0660

Study design

Non-randomised interventional; Design type: Treatment

Primary study design


Secondary study design

Non randomised study

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Prostate cancer


Current interventions as of 12/07/2016:
This is an open-label, non-randomised, phase I, sequential group trial which will explore the safety and tolerability of ascending doses of replication defective adenovirus type 5 vector expressing nitroreductase and GMCSF (AdNRGM), in combination with CB1954. Five groups of three patients each will be treated with escalating doses of AdNRGM (1010, 3x1010, 1011, 3x1011, 1012 vp) followed 2 days later by intravenous CB1954 at a fixed dose (24mg/m2). The AdNRGM is given via trans-perineal, template-guided, intra-prostatic injection. Patients will be monitored on days 1, 2 and 5-7 following AdNRGM administration, with telephone contact on days 3 and 4; then seen at weeks 2, 3 and 4, then monthly for 12 months or until PSA progression.

Previous interventions:
AdNRGM Administration, Template-guided prostate brachytherapy
CB1954 Infusion, Infusion of 24 mg/m2

Intervention type



Phase I

Drug names

Intraprostatic injection of a viral vector (AdNRGM)

Primary outcome measure

Current primary outcome measures as of 26/07/2016:
1. Safety and tolerability of escalating doses of AdNRGM, followed by iv CB1954 determined by assessing local effects on tumour etc. and number of participants with treatment related adverse events by CTCAE v4.0 (Time Frame: 12 months)
1.1. Safety will be assessed in terms of local effects on the tumour, the prostate gland and the lower urinary tract as well as in terms of systemic effects. The data will be summarised descriptively
1.2. Adverse events and side effects will be determined as changes of the relevant clinical parameters as well as changes of haematological and clinical biochemistry data

Previous primary outcome measures:
Toxicity; timepoint(s): up to end of Month 11 visit

Secondary outcome measures

Current secondary outcome measures as of 26/07/2016:
1. PSA levels and PSA kinetics following treatment with AdNRGM and CB1954 (time frame: 12 months). Changes in the level and kinetics of the serum PSA will be measured to provide an indication of changes in tumour burden, growth rate and possible anti-tumour activity of the treatment.

Other pre-specified outcome measures:
2. Evidence for local tumour destruction, and immune infiltration, in tumour biopsies taken after the treatment (time frame: 12 months). Treatment-induced immune responses will be assessed by measurement of T cell responses to prostate cancer antigens in blood samples collected at baseline and at intervals (2, 3, 4, and 8 weeks) following treatment.
3. Changes in cellular immune response to prostate cancer antigens following treatment with AdNRGM and CB1954 (time frame: 12 months). Evidence of tumour destruction and immune infiltration will be assessed by looking at patterns of tissue damage, residual tumour tissue and immune cell infiltrates detected by immunohistochemistry in post-treatment prostate biopsies

Previous secondary outcome measures:
PSA level and kinetics; timepoint(s): Up to end of Month 11

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Patients who present with biopsy proven local recurrence of prostate cancer following radical radiotherapy and a rising PSA while on androgen suppression with LHRH agonist therapy or after bilateral orchidectomy. A rising PSA is defined as 3 consecutive increases (measured by the same laboratory) over a minimum period of 6 weeks, with timepoints separated by at least 15 days. If the patient is on LHRH agonist therapy, this therapy should be continued.
2. Life expectancy greater than 3 months
3. Aged at least 18 years
4. Written informed consent
5. WHO performance status of 0-1 (Appendix 2)
6. PSA value = 4 and = 25 ng/ml at study entry
7. Adequate hepatic function (i.e. bilirubin, AST, ALT all < 1.5 x upper limit of normal for Institution)
8. Normal renal function (<1.25 x upper normal limit for the Institution)
9. Adequate haematological function (i.e. haemoglobin > 10g/dl, WCC > 3x109/l, platelets > 150x109/l) and normal clotting (INR and APTT <1.2)
10. Patients must agree not to father a child within 12 months following AdNRGM administration, and must practice a barrier method of contraception starting from the time of AdNRGM administration for at least 12 months
11. No known immunoincompetence

Participant type


Age group




Target number of participants

UK Sample Size: 15

Total final enrolment


Participant exclusion criteria

1. Patients with a prostate or tumour which is deemed clinically unsuitable for transperineal templateguided injection
2. Patients who have previously been treated with prostate brachytherapy
3. Patients who have received chemotherapy, radiotherapy or immunotherapy within 28 days of study entry
4. Acute active infection (viral, bacterial, or fungal) which requires specific therapy
5. Chronic hepatitis B or C infection, HIV positive patients (patients will be tested for HBV/HCV, but not HIV)
6. Concurrent severe medical illnesses incompatible with the treatment including psychiatric pathology likely to affect protocol compliance
7. Tumours of other organs or tissues still active or treated radically less that 3 years before (except that successfully treated, nonmetastatic skin cancers are not an exclusion criterion)
8. Concurrent corticosteroids, or any medication known to have significant immunosuppressive action
9. Patients unable to travel for regular hospital assessments
10. Evidence of adenovirus infection and/or shedding at prescreening

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Institute for Cancer Studies
B15 2TT
United Kingdom

Sponsor information


University of Birmingham (UK)

Sponsor details

B15 2TT
United Kingdom

Sponsor type




Funder type


Funder name

Cancer Research UK (UK); Grant Codes: C198/A9699

Alternative name(s)

Funding Body Type


Funding Body Subtype


Funder name

Medical Research Council (MRC) (UK)

Alternative name(s)


Funding Body Type


Funding Body Subtype


Results and Publications

Publication and dissemination plan

Publish protocol & planned publication of results in a high-impact peer-reviewed journal.

Intention to publish date


Participant level data

Available on request

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes

10/09/2019: The following changes were made to the trial record: 1. The total final enrolment was added. 2. The recruitment end date was changed from 20/08/2019 to 05/08/2019. 13/06/2019: The following changes were made to the trial record: 1. The recruitment end date was changed from 01/02/2019 to 20/08/2019. 2. The overall end date was changed from 01/02/2019 to 31/12/2020. 3. The intention to publish date was added. 4. The publication and dissemination plan was added. 06/12/2017: Dr Ann Pope replaced Dr Laura Crack as the primary study contact. 12/07/2016: the overall trial end date and recruitment end date were changed from 31/01/2014 to 01/02/2019.