The purpose of this study is to assess the safety, tolerability, and immunogenicity of
mRNA-4157 alone in participants with resected solid tumors and in combination with
pembrolizumab in participants with unresectable solid tumors.
This is a multi-part, dose-escalation study of mRNA-4157 monotherapy in participants with
resected solid tumors (Part A) and of mRNA-4157 in combination with pembrolizumab in
participants with both unresectable (locally advanced or metastatic) solid tumors (Parts B
and C) and resected cutaneous melanoma (Part D). Parts A and B will include a dose escalation
phase of the study to identify doses of mRNA-4157 for the expansion phase of the study. Doses
of mRNA-4157 will be administered to participants in a dose escalation regimen. Participants
in Parts B, C, and D dose expansion phase will receive mRNA-4157 at a recommended dose for
expansion.
Inclusion Criteria:
- Male or female, ≥18 years old with the ability to understand and provide signed and
witnessed informed consent, and agree to comply with protocol requirements
- Part A: Participants must have one of the histologically-confirmed solid malignancies
listed below, must be clinically disease-free at study entry (that is, participants in
the adjuvant setting). Participants will be permitted to complete any standard of care
adjuvant therapy prior to study entry, and those not eligible for any standard of care
adjuvant treatment or who decline such treatment are permitted to consent to this
study, as long as all treatment options have been transparently disclosed and
documented in the participant's medical record.
- Part B: Participants must have one of the histologically- or cytologically-confirmed
unresectable (locally advanced or metastatic) solid malignancies listed below, have
measurable disease at study entry defined by Response Evaluation Criteria in Solid
Tumors (RECIST) Version 1.1., and be considered suitable for treatment with
pembrolizumab; in this study pembrolizumab will be considered an investigational study
drug.
Participants with any of the following solid malignancies:
a. Non-small cell lung cancer (participants in Part B must either lack epidermal growth
factor receptor (EGFR) sensitizing mutation or anaplastic lymphoma kinase (ALK)
translocation per local test results or must have progressed on approved standard of care
treatment for EGFR or ALK positive non-small cell lung cancer [NSCLC]) b. Small cell lung
cancer c. Melanoma d. Bladder urothelial carcinoma e. Human papillomavirus-negative head
and neck squamous cell carcinoma (HPV-ve HNSCC) f. Any solid malignancy known to be
microsatellite instable (MSI) high/mismatch repair (MMR) deficient g. Any solid malignancy
known to have a high tumor mutational load/burden
- Part C: Participants must have one of the histologically- or cytologically confirmed
unresectable (locally advanced or metastatic) solid malignancies listed below, must
not have received prior anti-programmed cell death protein 1 (PD-1)/programmed death
-ligand 1 (PD-L1) therapy, and must have measurable disease at study entry defined by
RECIST 1.1.
1. Microsatellite stable (MSS)-CRC
2. HPV-ve metastatic or recurrent HPV-ve HNSCC of the oral cavity, oropharynx,
hypopharynx, or larynx
3. Bladder urothelial carcinoma
- Part D: Participants must have completed resected adjuvant melanoma and must be
clinically disease-free at study entry. Participants will be permitted to complete any
standard of care adjuvant therapy prior to study entry, and those not eligible for any
standard of care adjuvant treatment or who decline such treatment are permitted to
consent to this study, as long as all treatment options have been transparently
disclosed and documented in the participant's medical record.
- Parts A and D: Participants must have a formalin-fixed paraffin embedded (FFPE) tumor
sample available (for example, from their prior surgery) that is suitable for the next
generation sequencing (NGS) required for this study.
- Parts B and C: Participants must have at least 1 lesion amenable to the mandatory
fresh tumor biopsy at study entry and provide a biopsy suitable for the next
generation sequencing (NGS) required for this study. An existing (archival) FFPE tumor
sample may instead be used for NGS after discussing with medical monitor.
- Participants must have resolution of toxic effect(s) from prior therapy to Grade 1 or
less. Participants with Grade ≤2 neuropathy or alopecia are an exception to this
criterion. If a participant received major surgery or radiation therapy of >30 gray
(Gy), they must have recovered from the toxicity and/or complications from the
intervention to Grade 1 or less.
- Participant is willing to use an adequate method of contraception for the course of
the study through 120 days after the last dose of study drug (male and female
participants of childbearing potential).
- Participants with Performance Scale (PS) of 0 or 1 on the Eastern Cooperative Oncology
Group (ECOG) PS
- Life expectancy >12 weeks at Screening
- Participants with adequate organ and marrow function
- Parts A and D: Participant must consent to required apheresis procedure and meet
additional inclusion criteria per local institutional apheresis procedure.
Exclusion Criteria:
- Treatment with any of the following:
1. Any investigational agents, anti-cancer monoclonal antibody, anti-cancer
therapeutic vaccine, immunostimulant (for example, IL-2), or study drugs from a
previous clinical study within 4 weeks of the first dose of mRNA-4157 or
pembrolizumab (note only a 2 week wash out is required from prior pembrolizumab
treatment)
2. Any chemotherapy, targeted small molecule therapy, or radiation therapy within 2
weeks of the first dose of mRNA-4157 or pembrolizumab
3. Live-virus vaccination within 30 days of the first dose of mRNA-4157 or
pembrolizumab. Seasonal flu vaccines that do not contain live virus are
permitted.
4. Any systemic steroid therapy or other form of immunosuppressive therapy within 7
days of the first dose of mRNA-4157 or pembrolizumab
5. Transfusion of blood products (including platelets or red blood cells [RBCs]) or
administration of colony stimulating factors (including granulocyte colony
stimulating factor [G-CSF], granulocyte/macrophage colony stimulating factor
[GM-CSF], or recombinant erythropoietin) within 1 week of the NGS blood sample
during screening, and 4 weeks of the first dose of mRNA-4157 or pembrolizumab
- Prior PD-1/PD-L1 treatment is permitted for participants in Parts A, B, and D of this
study, but only participants who have progressed on their prior PD-1/PD-L1 treatment
without a partial or complete response, and without discontinuing for drug-related
toxicity are eligible.
- Active central nervous system metastases and/or carcinomatous meningitis
- Active autoimmune disease that has required systemic treatment in past 2 years
- Has a history of (noninfectious) pneumonitis that required steroids or has current
pneumonitis
- Has a diagnosis of immunodeficiency
- Any clinically-significant cardiac disease defined as New York Heart Association Class
III or IV within the past 6 months of Screening, unless, in the opinion of the
Investigator, the disease is well-controlled
- A history or current evidence of any condition, therapy, or laboratory abnormality
that might confound the results of the study, interfere with participation for the
full duration of the study, or is not in the best interest of the participant to
participate, in the opinion of the treating Investigator
- Known psychiatric or substance abuse disorders that would interfere with cooperation
with the requirements of the trial
- Previously identified hypersensitivity to components of the formulations used in this
study
- Had a solid organ or allogeneic bone marrow transplant
- Participants with a history of interstitial lung disease
- An active infection requiring systemic therapy
- A known history of human immunodeficiency virus (HIV)
- Known active Hepatitis B or Hepatitis C
- Known additional malignancy that is progressing or requires active treatment,
exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the
skin that has undergone curative therapy, or in situ cervical cancer
- Participants participating in apheresis; mandatory in the Part A apheresis expansion
phase cohort and Part D (optional for other study parts), must not meet any of the
exclusion criteria on any day when apheresis is performed, either protocol specific
apheresis criteria, or per local institutional apheresis protocol.