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).
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
Drug | Synonyms | Arms |
---|
GAd-PEV | | Cohort 1a |
MVA-PEV | | Cohort 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
Name | Type | Description | Interventions |
---|
Cohort 1a | Experimental | Cohort 1a: 3 patients (expandable to 9) with unresectable stage III / IV Cutaneous Melanoma. | |
Cohort 2a | Experimental | Cohort 2a:13 patients with unresectable stage III / IV Cutaneous Melanoma. | |
Cohort 2b | Experimental | Cohort 2b: 12 patients with stage IV NSCLC (PDL1≥ 50%). | |
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