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This is a Trial of MG1-E6E7 With Ad-E6E7 and Atezolizumab in Patients With HPV Associated Cancers

NCT03618953

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).

Related Conditions:
  • Anal Carcinoma
  • Cervical Carcinoma
  • Oropharyngeal Carcinoma
  • Penile Carcinoma
  • Vaginal Carcinoma
  • Vulvar Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 1

Trial Eligibility

Document

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

  • HPV-Associated Cancers

Interventions

DrugSynonymsArms
Ad-E6E7Arm 1 (Intravenous dosing)
MG1-E6E7Arm 1 (Intravenous dosing)
AtezolizumabTecentriqArm 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

NameTypeDescriptionInterventions
Arm 1 (Intravenous dosing)ExperimentalFixed 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)ExperimentalFixed 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