A phase 1b, open-label, multicenter, dose-escalation study designed to evaluate the safety,
tolerability, antigen-specific immune response and preliminary antitumor activity associated
with VB10.NEO administered in combination with atezolizumab, and to identify a RP2D for
VB10.NEO in combination with atezolizumab, in patients with locally advanced and metastatic
tumors that have progressed after at least 1 available standard therapy; or for whom standard
therapy has proven to be ineffective or intolerable, or is considered inappropriate; or for
whom a clinical trial of an investigational agent is a recognized standard of care (SOC).
Inclusion Criteria:
Signed Informed Consent Form
Age ≥18 years at time of signing the Informed Consent Form
Life expectancy ≥ 6 months
Ability to comply with the trial protocol
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
Adequate hematologic and end-organ function, defined by the following laboratory test
results, obtained within 14 days prior to initiation of trial treatment:
ANC ≥1.5 × 109/L (1500/µL) without granulocyte colony-stimulating factor support
Lymphocyte count ≥0.5 × 109/L (500/µL)
Platelet count ≥100 × 109/L (100,000/µL) without transfusion
Hemoglobin ≥90 g/L (9 g/dL)
Subjects may be transfused to meet this criterion.
AST and ALT ≤3 × ULN
Alkaline phosphatase (ALP) ≤2.5 × ULN, with the following exceptions:
Subjects with documented liver or bone metastases: ALP ≤5 × ULN
Total bilirubin ≤1.5 × ULN with the following exception:
Subjects with known Gilbert disease: total bilirubin ≤3 × ULN
Measured or calculated creatinine clearance ≥50 mL/min (according to the Cockcroft-Gault
formula)
Albumin ≥25 g/L (2.5 g/dL)
For subjects not receiving therapeutic anticoagulation: International Normalized Ratio
(INR) and activated partial thromboplastin time (aPTT) ≤1.5 × ULN
For subjects receiving therapeutic anticoagulation: stable anticoagulant regimen
Female subjects of childbearing potential must have a negative serum pregnancy test result
within 14 days prior to initiation of trial treatment.
Female subjects of childbearing potential must agree to use a highly effective form of
contraception during treatment and for at least 90 days after the final dose of VB10.NEO,
and for 5 months after the final dose of atezolizumab, whichever occurs later. Highly
effective forms of contraception include:
combined (estrogen and progestogen containing) hormonal contraception associated with
inhibition of ovulation: oral, intravaginal, transdermal
progestogen-only hormonal contraception associated with inhibition of ovulation: oral,
injectable, implantable
intrauterine device
intrauterine hormone-releasing system
bilateral tubal occlusion
vasectomized partner
sexual abstinence (defined as refraining from heterosexual intercourse during the entire
period of risk associated with the trial treatments. The reliability of sexual abstinence
needs to be evaluated in relation to the duration of the clinical trial and the preferred
and usual lifestyle of the subject. Periodic abstinence [calendar, symptothermal,
post-ovulation methods], withdrawal [coitus interruptus], spermicides only, and the
lactational amenorrhea method are not acceptable methods of contraception).
For men with a female partner of childbearing potential or pregnant female partner:
agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom
during the treatment period and for at least 28 days after the final dose of trial
treatment to avoid exposing the embryo, and agreement to refrain from donating sperm.
Histologic documentation of locally advanced, recurrent, or metastatic incurable malignancy
that has progressed after at least 1 available standard therapy; or for whom standard
therapy has proven to be ineffective or intolerable or is considered inappropriate; or for
whom a clinical trial of an investigational agent is a recognized SOC.
Exclusion Criteria:
Pregnant or breastfeeding, or intending to become pregnant during the trial or within 90
days after the last dose of VB10.NEO or 5 months after the last dose of atezolizumab,
whichever occurs later
Significant cardiovascular disease such as, but not limited to, New York Heart Association
Class III or IV cardiac disease, myocardial infarction within the last 6 months, unstable
arrhythmias, or unstable angina
QT interval corrected through use of Fridericia's formula (QTcF) >470ms demonstrated by at
least 2 electrocardiograms (ECGs) >30 minutes apart
Clinically significant liver disease including active viral, alcoholic, or other hepatitis,
cirrhosis, and inherited liver disease or current alcohol abuse
Positive hepatitis B surface antigen (HBsAg) test at screening
Subjects with past or resolved hepatitis B infection (defined as having a negative HBsAg
test and a positive IgG antibody to hepatitis B core antigen) are eligible.
Positive hepatitis C virus (HCV) antibody test at screening
Subjects positive for HCV antibody are eligible only if polymerase chain reaction is
negative for HCV ribonucleic acid (RNA)
Positive human immunodeficiency virus (HIV)-1 test at screening
Active tuberculosis
Any other diseases, metabolic dysfunction, physical examination finding, and/or clinical
laboratory finding giving reasonable suspicion of a disease or condition that
contraindicates the use of an investigational drug or that may affect the interpretation of
the results or may render the subject at high risk from treatment complications
Known primary immunodeficiencies
Active, or history of, autoimmune disease or immune deficiency, including, but not limited
to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus,
rheumatoid arthritis, inflammatory bowel disease, antiphospholipid antibody syndrome,
Wegener granulomatosis, Sjögren syndrome, Guillain-Barré syndrome, or multiple sclerosis,
with the following exceptions:
Subjects with a history of autoimmune-related hypothyroidism who are on thyroid replacement
hormone are eligible for the trial.
Subjects with controlled Type 1 diabetes mellitus who are on an insulin regimen are
eligible for the trial.
Subjects with eczema, psoriasis, lichen simplex chronicus, or vitiligo with dermatologic
manifestations only (e.g., subjects with psoriatic arthritis are excluded) are eligible for
the trial provided all of the following conditions are met:
Rash must cover <10% of body surface area
Disease is well controlled at baseline and requires only lowpotency topical corticosteroids
No occurrence of acute exacerbations of the underlying condition requiring psoralen plus
ultraviolet A radiation, methotrexate, retinoids, biologic agents, oral calcineurin
inhibitors, or high potency or oral corticosteroids within the previous 12 months
History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or
fusion proteins.
Known hypersensitivity to Chinese hamster ovary cell products or to any component of the
atezolizumab formulation.
Known allergy or hypersensitivity to any component of the VB10.NEO formulation.
History of idiopathic pulmonary fibrosis, pneumonitis (including drug-induced), organizing
pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or
evidence of active pneumonitis on imaging conducted for tumor assessment at screening
History of radiation pneumonitis in the radiation field (fibrosis) is permitted
History of drug-induced pneumonitis that was asymptomatic (defined by radiographic findings
only) and reversible (without any anti-inflammatory therapies) is permitted.
Severe infection within 28 days prior to Cycle 1, Day 1, including, but not limited to,
hospitalization for complications of infection, bacteremia, or severe pneumonia
Subjects receiving prophylactic antibiotics (e.g., to prevent a urinary tract infection or
chronic obstructive pulmonary disease [COPD] exacerbation) are eligible for the trial.
Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent
drainage procedures (once monthly or more frequently)
Subjects with indwelling catheters (e.g., PleurX) are allowed.
Uncontrolled or symptomatic hypercalcemia (ionized calcium >1.5 mmol/L, calcium >12 mg/dL,
or corrected calcium >ULN)
Major surgical procedure within 28 days prior to Cycle 1, Day 1, or anticipation of need
for a major surgical procedure during the course of the trial
Prior allogeneic stem cell or solid organ transplantation
Treatment with systemic immunostimulatory agents (including, but not limited to, interferon
and IL-2) within 28 days or 5 drug-elimination half-lives (whichever is longer) prior to
Cycle 1, Day 1
Treatment with systemic immunosuppressive medications (including, but not limited to,
prednisone >7.5 mg/day, cyclophosphamide, azathioprine, methotrexate, thalidomide, and
tumor necrosis factor-alpha [TNF-α] antagonists) within 2 weeks prior to Cycle 1, Day 1
with the following exceptions:
Subjects who received acute, low-dose systemic immunosuppressant medication or a one-time
pulse dose of systemic immunosuppressant medication (e.g., 48 hours of corticosteroids for
a contrast allergy) are eligible for the trial after medical monitor confirmation has been
obtained
Subjects who received mineralocorticoids (e.g., fludrocortisone), corticosteroids for COPD
or asthma, or low-dose corticosteroids for orthostatic hypotension or adrenal insufficiency
are eligible for the trial.
Treatment with investigational therapy within 28 days prior to Cycle 1, Day 1
Live, attenuated vaccines are prohibited within 28 days prior to Cycle 1, Day 1, during
atezolizumab treatment, and for 5 months after the final dose of atezolizumab
Vaccination with an approved COVID-19 vaccine that does not contain live, attenuated virus
is permitted