Description:
This is a Phase 1/1b open-label dose escalation trial of Ad/MG1-E6E7 and sequential treatment
with atezolizumab in patients with HPV associated cancers. This study will consist of two
arms. Both arms will dose escalate (MG1-E6E7) using a 3 + 3 design in Phase 1 to establish
initial safety and the maximum tolerated dose (MTD) / maximum feasible dose (MFD).
- Arm 1 - intravenous (IV) administration of MG1-E6E7 following intramuscular (IM) AD-E6E7
priming and subsequent treatment with IV atezolizumab.
- Arm 2 - intratumoral (IT) and IV injection of MG1-E6E7 following (IM) Ad-E6E7 priming
and subsequent treatment with IV atezolizumab.
In the Phase 1b expansion for each arm, additional patients will be enrolled at the MTD as
determined in Phase 1 in order to more thoroughly explore immune response,
pharmacokinetics/dynamics, and safety for the patient populations with Cervical cancer, HPV
positive (HPV+) Oropharyngeal cancer (Phase 1B, Arm 1, Cohorts A and B respectively) and HPV+
tumors with injectable lesions (Phase 1B, Arm 2, Cohort 3).
Title
- Brief Title: This is a Trial of MG1-E6E7 With Ad-E6E7 and Atezolizumab in Patients With HPV Associated Cancers
- Official Title: Phase 1/1b, Multicenter, Open-label Trial of Oncolytic MG1 Virus (MG1-E6E7) With Adenovirus Vaccine (Ad-E6E7) Both Expressing Mutant Human Papilloma Virus (HPV) E6 and E7 and Atezolizumab in Pts With HPV Assoc. Cancers
Clinical Trial IDs
- ORG STUDY ID:
Ad-MG1-E6E7-002
- NCT ID:
NCT03618953
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Ad-E6E7 | | Arm 1 (Intravenous dosing) |
MG1-E6E7 | | Arm 1 (Intravenous dosing) |
Atezolizumab | Tecentriq | Arm 1 (Intravenous dosing) |
Purpose
This is a Phase 1/1b open-label dose escalation trial of Ad/MG1-E6E7 and sequential treatment
with atezolizumab in patients with HPV associated cancers. This study will consist of two
arms. Both arms will dose escalate (MG1-E6E7) using a 3 + 3 design in Phase 1 to establish
initial safety and the maximum tolerated dose (MTD) / maximum feasible dose (MFD).
- Arm 1 - intravenous (IV) administration of MG1-E6E7 following intramuscular (IM) AD-E6E7
priming and subsequent treatment with IV atezolizumab.
- Arm 2 - intratumoral (IT) and IV injection of MG1-E6E7 following (IM) Ad-E6E7 priming
and subsequent treatment with IV atezolizumab.
In the Phase 1b expansion for each arm, additional patients will be enrolled at the MTD as
determined in Phase 1 in order to more thoroughly explore immune response,
pharmacokinetics/dynamics, and safety for the patient populations with Cervical cancer, HPV
positive (HPV+) Oropharyngeal cancer (Phase 1B, Arm 1, Cohorts A and B respectively) and HPV+
tumors with injectable lesions (Phase 1B, Arm 2, Cohort 3).
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1 (Intravenous dosing) | Experimental | Fixed dose of Ad-E6E7 administered IM on study Day 1. Followed by one of 3 dose levels (escalation) of MG1-E6E7 administered as 4 infusion (IV) doses over 2 weeks starting at study day 15.
Fixed dose of atezolizumab administered IV every 3weeks starting at study day 43. | - Ad-E6E7
- MG1-E6E7
- Atezolizumab
|
Arm 2 (Intravenous and Intra-tumoral injection dosing) | Experimental | Fixed dose of Ad-E6E7 administered IM on study Day 1. Followed by one of 2 dose levels (escalation) of MG1-E6E7 administered as 1 IV dose, starting at study day 15, followed by 2 intratumoral (IT) doses administered on study days 18 & 29.
Fixed dose of atezolizumab administered IV every 3weeks starting at study day 43. | - Ad-E6E7
- MG1-E6E7
- Atezolizumab
|
Eligibility Criteria
Key Inclusion Criteria:
- Histologically or cytologically confirmed recurrent or metastatic HPV associated tumor
(cervical, oropharyngeal, vulvar, vaginal, anal, or penile) with documented disease
progression.
- Arm 1, Phase 1 dose escalation: Cervical, HPV+ oropharyngeal, vulvar, vaginal, anal,
or penile
- Arm 1, Cohort A: Cervical cancer
- Arm 1, Cohort B: HPV+ Oropharyngeal cancer
- Arm 2 Phase 1 dose escalation and Cohort C: Cervical, oropharyngeal, vulvar, vaginal,
anal, or penile
- Failed, refused or intolerant to systemic therapy
- Measurable disease based on RECIST 1.1
- At least one tumor mass amenable to core needle biopsy
- Arm 2 only: At least one tumor judged as being safely injectable
- ECOG performance status 0 or 1
- Demonstrate adequate organ function
- Additional Inclusion criteria exist
Key Exclusion Criteria:
- Prior systemic therapy within 4 weeks.
- Patients receiving prior XRT must have recovered from any acute toxicity.
- Currently receiving/received experimental therapy within 4 weeks.
- Prior treatment with any HPV vaccine therapy for cancer.
- Requires use of anti-platelet or anti-coagulant therapy that cannot be safely
suspended for per protocol biopsies or intra-tumoral injections.
- Known active CNS metastases and/or carcinomatous meningitis.
- Clinically significant tumor invasion/ rapidly accumulating ascites, pericardial or
pleural effusions.
- Active infection requiring systemic therapy.
- Active autoimmune disease that has required systemic therapy in the past 2 years.
- Conditions likely to have resulted in splenic dysfunction.
- Known HIV/AIDS, active HBV or HCV infection.
- Received prior treatment with vesicular stomatitis (VSV) viral vector.
- Received immunosuppressive medication within 4 weeks. (>10mg/day prednisone)
- ≥ Grade 2 dyspnea and/or require supplemental oxygen
- Known intolerance to anti-PD-1 or anti-PD-L1 antibody therapy
- Additional Exclusion criteria exist
Exclusion Criteria Household Contacts:
- Patients with household contacts meeting any of the following criteria are ineligible
for study entry unless alternate living arrangements can be made, while under contact
precautions.
- Women who are pregnant or nursing an infant
- Children < 1 year old
- Individuals who are severely immunocompromised
- Contact precautions are from initial treatment with MG1-E6E7 to 7 days after the last
dose of MG1-E6E7
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety of Ad/MG1-E6E7 administration in HPV associated cancers |
Time Frame: | 8 months |
Safety Issue: | |
Description: | Safety will be determined by assessing the severity and frequency of treatment emergent Adverse Events and clinical laboratory toxicity using NCI CTCAE v 4.03. |
Secondary Outcome Measures
Measure: | Concentration of Ad/MG1-E6E7 in blood |
Time Frame: | 4 to 6 weeks after first treatment with Ad/MG1-E6E7 |
Safety Issue: | |
Description: | Change over time in the number of MG1-E6E7 genomes (qPCR) and MG1-E6E7 infectious units (PFU) in blood |
Measure: | Assess for the biodistribution and shedding of Ad/MG1-E6E7 |
Time Frame: | 6 weeks after first treatment with Ad/MG1-E6E7 |
Safety Issue: | |
Description: | Determine if there is any shedding of Ad/MG1-E6E7 into the environment by detecting the presence of viral plaque forming units (PFUs) in urine samples, cheek swabs, and rectal swabs after Ad/MG1-E6E7 treatment |
Measure: | Measure the differences in pre- and post treatment levels of T cell subsets and T cell activation status |
Time Frame: | Before and after each dose of Ad/MG1-E6E7 and then every 3 weeks until treatment discontinuation |
Safety Issue: | |
Description: | Analyze the change over time in the the frequencies, absolute numbers and subsets of T cells (including regulatory T cells) |
Measure: | Anti-tumor activity |
Time Frame: | Every 6 weeks for the first course of treatment and then every 9 weeks until date of documented progression by irRECIST, up to 2 years |
Safety Issue: | |
Description: | Evaluate tumor response by CT scan using RECIST v1.1 and irRECIST criteria in the overall patient population and the HPV16/18 positive patient population |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Turnstone Biologics, Corp. |
Last Updated
April 2, 2021