Clinical Trials /

Nous-PEV: a Novel Immunotherapy for Lung Cancer and Melanoma

NCT04990479

Description:

This is an international, multicenter, open-label, multiple cohort, First in Human, phase 1b clinical study, designed to evaluate safety, tolerability, and immunogenicity, and to detect any preliminary evidence of anti-tumor activity of a personalized vaccine (PEV) based on GAd-PEV priming and MVA-PEV boosting, combined with SoC first-line immunotherapy using an anti-PD-1 checkpoint inhibitor in patients with unresectable stage III/IV cutaneous melanoma or with stage IV NSCLC (PDL1 ≥ 50%). The PEV vaccines will be prepared on an individual basis, following a tumor biopsy performed at the time of screening and subsequent NGS analysis, to identify patient-specific tumor mutations. Both neoantigen-encoding genetic vaccines are administered intramuscularly using 1 prime with GAd-PEV and 3 boosts with MVA-PEV in combination with the licensed programmed death receptor-1 (PD-1)-blocking antibody pembrolizumab in adult patients in patients with unresectable stage III/IV cutaneous melanoma (Cohort a) or with stage IV NSCLC (PDL1 ≥ 50%) (Cohort b).

Related Conditions:
  • Cutaneous Melanoma
  • Non-Squamous Non-Small Cell Lung Carcinoma
  • Squamous Cell Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Nous-PEV: a Novel Immunotherapy for Lung Cancer and Melanoma
  • Official Title: An Open-Label, Multicenter, Non-Randomized, Dose-Confirmation and Cohort-Expansion Phase 1b Study to Evaluate the Safety, Tolerability, and Anti-Tumor Activity of Nous-PEV, With Pembrolizumab, in Patients With Unresectable Stage III / IV Cutaneous Melanoma and With Stage IV NSCLC (PDL1≥ 50%)

Clinical Trial IDs

  • ORG STUDY ID: NOUS-PEV-01
  • SECONDARY ID: 2019-004759-35
  • NCT ID: NCT04990479

Conditions

  • Melanoma (Skin)
  • Non-Small-Cell Lung Carcinoma

Interventions

DrugSynonymsArms
GAd-PEVCohort 1a
MVA-PEVCohort 1a

Purpose

This is an international, multicenter, open-label, multiple cohort, First in Human, phase 1b clinical study, designed to evaluate safety, tolerability, and immunogenicity, and to detect any preliminary evidence of anti-tumor activity of a personalized vaccine (PEV) based on GAd-PEV priming and MVA-PEV boosting, combined with SoC first-line immunotherapy using an anti-PD-1 checkpoint inhibitor in patients with unresectable stage III/IV cutaneous melanoma or with stage IV NSCLC (PDL1 ≥ 50%). The PEV vaccines will be prepared on an individual basis, following a tumor biopsy performed at the time of screening and subsequent NGS analysis, to identify patient-specific tumor mutations. Both neoantigen-encoding genetic vaccines are administered intramuscularly using 1 prime with GAd-PEV and 3 boosts with MVA-PEV in combination with the licensed programmed death receptor-1 (PD-1)-blocking antibody pembrolizumab in adult patients in patients with unresectable stage III/IV cutaneous melanoma (Cohort a) or with stage IV NSCLC (PDL1 ≥ 50%) (Cohort b).

Detailed Description

      Overall Study Design:

      • This is an open-label, non-randomized, dose-confirmation and cohort expansion phase 1b
      first-in-human study, in which 28 patients, expandable up to 34 evaluable patients in case of
      DLT.

      Study IMPs:

      Nous-PEV vaccine is composed of 2 sets of IMPs:

        -  GAd-PEV

        -  MVA-PEV

      Treatment phases:

      A) Induction phase with pembrolizumab (cycles 1, 2 and 3). B) Priming phase including 1
      GAd-PEV administration with pembrolizumab (cycle 4).

      C) Boosting phase including 3 boosting administrations of MVA-PEV with pembrolizumab (cycles
      5, 6 and 7).
    

Trial Arms

NameTypeDescriptionInterventions
Cohort 1aExperimentalCohort 1a: 3 patients (expandable to 9) with unresectable stage III / IV Cutaneous Melanoma.
  • GAd-PEV
  • MVA-PEV
Cohort 2aExperimentalCohort 2a:13 patients with unresectable stage III / IV Cutaneous Melanoma.
  • GAd-PEV
  • MVA-PEV
Cohort 2bExperimentalCohort 2b: 12 patients with stage IV NSCLC (PDL1≥ 50%).
  • GAd-PEV
  • MVA-PEV

Eligibility Criteria

        Inclusion Criteria:

        Main Inclusion Criteria for Patients in Cohorts 1a and 2a:

          1. Age ≥ 18 years.

          2. Patients with histologically or cytologically confirmed unresectable stage III or
             stage IV Cutaneous Melanoma, as per American Joint Committee on Cancer (AJCC) staging
             system (8th edition).

          3. Participation in this trial will be dependent upon supplying tumor tissue from newly
             obtained specimen. Newly obtained biopsies of a tumor lesion, not previously
             irradiated, must be provided in the form of excisional biopsies, resected tissue or
             core needle biopsies.

          4. Presence of at least 1 measurable lesion by computed tomography or magnetic resonance
             imaging per RECIST v1.1 by the local site Investigator / radiologist assessment

          5. Presence of at least one lesion amenable to repeated biopsy, ideally not the one being
             used for measuring.

          6. Willingness to undergo a minimum of two fresh lesion biopsies (pre-treatment and
             on-treatment).

          7. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1.

          8. Life expectancy of at least 12 months.

          9. Adequate renal, hepatic, and hematologic functions.

         10. A female patient is eligible to participate if she is not pregnant, not breastfeeding,
             and woman of childbearing potential willing to use adequate contraception.

         11. A male patient must agree to use adequate contraception.

        Main Inclusion Criteria for Patients in Cohort 2b:

          1. Age ≥ 18 years.

          2. Histologically or cytologically confirmed stage IV squamous or non-squamous NSCLC
             without EGFR or ALK /ROS1/RET genomic alteration.

          3. Tumor expression with PD-L1 ≥50% tumor proportion score (TPS).

          4. First-line treatment-naïve patients.

          5. Participation in this trial will be dependent upon supplying tumor tissue from a newly
             obtained specimen. Newly obtained biopsies of a tumor lesion, not previously
             irradiated, must be provided in the form of excisional biopsies, resected tissue or
             core needle biopsies.

          6. Presence of at least 1 measurable lesion by computed tomography (CT) or magnetic
             resonance imaging (MRI) per RECIST v1.1 as determined by the local site Investigator /
             radiologist assessment.

          7. Presence of at least one tumor lesion amenable to repeated biopsy, if possible,
             ideally not the one being used for measuring.

          8. Willingness to undergo a minimum of two fresh tumor biopsies (pre-treatment and
             on-treatment).

          9. ECOG performance status 0 to 1.

         10. Life expectancy of at least 6 months.

         11. Adequate renal, hepatic, and hematologic functions.

         12. A female patient is eligible to participate if she is not pregnant, not breastfeeding,
             and woman of childbearing potential willing to use adequate contraception.

         13. A male patient must agree to use adequate contraception.

        Main Exclusion Criteria for patients in all Cohorts:

          1. Currently receiving treatment with another investigational medicinal product.

          2. Prior therapy with immune checkpoint inhibitors. Patients must not have received any
             investigational immunotherapy either.

          3. Prior radiotherapy within 2 weeks of enrolment, or within 4 weeks of enrolment in the
             case of radiation to central nervous system (CNS), which requires ≥ 4-week washout.

          4. Prior allogenic tissue or solid organ transplant.

          5. Active interstitial lung disease (ILD)/pneumonitis or a history of ILD/pneumonitis
             requiring treatment with systemic steroids and/or whose pulse oxymetry is less than
             92% "on room air".

          6. Major surgery within 12 weeks before enrolment.

          7. Known additional malignancy that is progressing or requires active treatment, or
             history of other malignancy within 2 years of study entry.

          8. Immunosuppression including the continued use of systemic (at prednisone dose
             equivalent of > 10 mg) or topical steroids at or near the planned i.m. injection site
             or the use of immunosuppressive agents for any concurrent condition in the 4 weeks
             prior to first study treatment administration. Inhaled and eye drop-containing
             corticosteroids are permitted.

          9. Previous vaccination (either therapeutic and/or prophylactic) against cancer.

         10. History of autoimmune disease in the last 5 years, including any active autoimmune
             disease except vitiligo or childhood asthma.

         11. Chronic or concurrent active infectious disease requiring systemic antibodies,
             antifungal, or antiviral treatment.

         12. Known Medical History of human immunodeficiency virus (HIV) infection or known Medical
             History of acquired immunodeficiency syndrome (AIDS). HIV testing is not required
             unless mandated by the local health authority.

         13. Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection that requires
             treatment, or at risk for HBV reactivation.

         14. Known CNS metastasis and/or carcinomatous meningitis.

         15. Known cerebral edema.

         16. Live vaccine received within 30 days before treatment initiation.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Safety and tolerability: incidence of treatment- emerging adverse events. AEs characterized by type, severity (graded by CTCAE v.5.0), Timing, seriousness and relationship to study treatments.
Time Frame:Up to 110 weeks
Safety Issue:
Description:Frequency, duration, and severity of adverse events (AEs) and serious adverse events (SAEs) using CTCAE v5.0 criteria. Changes in vital signs and clinical evaluations. Changes in clinical laboratory blood samples. Dose-limiting toxicity (DLT)

Secondary Outcome Measures

Measure:RP2D confirmation 2. Clinical efficacy:
Time Frame:Up to 110 weeks
Safety Issue:
Description:RP2D confirmation based on safety and tolerability
Measure:Clinical efficacy
Time Frame:Up to 110 weeks
Safety Issue:
Description:Clinical efficacy based on Overall response rate (ORR); Best overall response (BOR); Duration of response (DoR); Progression-free survival (PFS); Overall survival (OS), all as defined in tumor imaging, RECIST 1.1

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Nouscom SRL

Last Updated

August 4, 2021