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A Clinical Study of Intratumoral MVR-T3011 (T3011) Given as a Single Agent and in Combination With Intravenous Pembrolizumab in Participants With Advanced or Metastatic Solid Tumors

PHASE1PHASE2RECRUITING

This is a Phase 1/2a, open-label, study to evaluate the safety and preliminary efficacy of intratumoral T3011 given alone and in combination with intravenous pembrolizumab in partients with advanced or metastatic solid tumors.

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Study details:

This is a Phase 1/2a, open-label, first-in-human study of T3011 given via intratumoral (IT) injection as a single agent and in combination with IV pembrolizumab in participants with advanced or metastatic solid tumors. The Phase 1 portion of the study is a single agent dose escalation which will use a 3+3 design to evaluate escalating doses of T3011. Total enrollment will depend on the toxicities and/or activity observed, with approximately 15 to 30 evaluable participants enrolled.

Once the RP2D is established Phase 2a Part 1 will enroll approximately 10 participants with locally recurrent or metastatic melanoma (in Arm A) 23 to 53 participants with HNSCC in Arm B, 40 to 80 participants with sarcoma in Arm C and 10 participants with cSCC in Arm D. During Phase 2a Part 1 the safety, tolerability, and preliminary efficacy of T3011 as a single agent will be evaluated. Phase 2a Part 2 will enroll in parallel to Phase 2a Part 1 once the RP2D is established.

The safety, tolerability, and preliminary efficacy of IT T3011 given in combination with IV pembrolizumab will be evaluated in 15 participants with histologically or pathologically confirmed metastatic NSCLC (Arm E). A rollover arm is also included in this study to allow participants who have documented progression on T3011 alone to receive T3011 in combination with pembrolizumab if considered eligible.

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

  • Age 18 years or older.
  • Disease progression after standard of care (SOC) therapy or in the opinion of The Investigator unlikely to benefit from SOC therapy.
  • Inclusion Diagnosis Phase 1 - Histologically or pathologically confirmed locally recurrent or metastatic advanced malignancy.
  • Phase 2a Part 1 i. Arm A - locally recurrent or metastatic melanoma. Participants must have received no more than 3 prior regimens for advanced or metastatic disease.
  • ii. Arm B - locally recurrent or metastatic HNSCC. It must also meet the following criteria: 1) Disease progression to platinum-containing chemotherapy; 2) Failure to anti-PD-1/PDL1 blockade after receiving at least 2 doses alone or in combination.
  • iii. Arm C - Sarcoma. Participants must have received no more than three lines of prior anti-cancer therapies.
  • iv. Arm D - locally recurrent or metastatic cSCC. Participants must have received no more than 3 prior regimens for advanced or metastatic disease.
  • Phase 2a Part 2 i.v. Arm E - Histologically or pathologically confirmed NSCLC that is advanced or recurrent, without EGFR mutation or ALK rearrangement. Participants must have received at least one line but no more than three lines of prior anti-cancer therapies.
  • Measurable disease per RECIST version 1.1.
  • Must have at least 1 tumor lesion that is accessible for IT injection of T3011 in the opinion of the investigator.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
  • Life expectancy > 12 weeks.
  • Demonstrate adequate organ function as defined by acceptable laboratory testing results.
  • Women of child-bearing potential (WCBP) and men must agree to use adequate contraception prior to study entry, while on study treatment, and for six months after receiving last dose of T3011. WCBP must have a negative serum pregnancy test prior to W1D1.
  • Last dose of previous anticancer therapy ≥ 21 days, radiotherapy > 21 days, or surgical intervention > 21 days prior to the first dose of T3011.
  • Recovered from all prior anticancer therapy toxicities.
  • Willingness to provide fresh tumor biopsy specimens as specified in the Schedule of Assessments.
  • Capable of understanding and complying with protocol requirements.
  • Signed and dated institutional review board/independent ethics committee-approved informed consent form before any protocol-directed screening procedures are performed.
  • Exclusion criteria

  • Have only uninjectable tumors.
  • Patients with injectable tumors impinging upon major airways or blood vessels.
  • HNSCC only: Prior re-irradiation field containing carotid artery.
  • Greater than 3 distant metastatic lymph node regions and/or metastatic lesions or the largest distant metastases with a diameter of more than 3 cm (non-sarcoma)/5 cm (sarcoma) unless the lesion is to be injected.
  • Prior treatment with another OV (including T-VEC), tumor vaccines, cellular therapy or gene therapy.
  • Prior intolerance to anti-PD-(L)1 monoclonal antibody or history of immunotherapy related non-infectious pneumonitis/interstitial lung disease.
  • Prior treatment with anti-PD-(L)1 monoclonal antibody in combination with IL-12.
  • Requires continued concurrent therapy with any drug active against HSV.
  • Live vaccines, attenuated vaccines within 4 weeks prior to initiation of study treatment (participants vaccinated with inactivated vaccines can be enrolled).
  • Primary or acquired immunodeficient states.
  • Pregnant or lactating.
  • Prior organ transplantation.
  • Active hepatitis B virus, hepatitis C virus, and HIV infection or a positive serological test at Screening within 14 days of dosing with T3011.
  • Active autoimmune disease or medical conditions requiring chronic steroid or immunosuppressive therapy within 4 weeks prior to first administration of study treatment.
  • History of or current central nervous system metastases.
  • History of seizure disorders within 6 months of Screening.
  • Active oral or skin herpes lesion at Screening.
  • Active interstitial lung disease (ILD)/pneumonitis or a history of ILD/pneumonitis requiring treatment with systemic steroids.
  • Congestive heart failure, active coronary artery disease, unevaluated new onset angina within 3 months or unstable angina, or clinically significant cardiac arrhythmias.
  • History of allergic reactions attributed to compounds of similar biological composition to HSV-1, IL-12, or anti-PD-1 monoclonal antibody.
  • Active infection with SARS-CoV-2 virus.
  • Participants with moderate to large amount of pleural effusion, ascites or pericardial effusion who need drug or medical intervention.
  • Other systemic conditions or organ abnormalities that, in the opinion of the investigator, may interfere with the conduct and/or interpretation of the current study.
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    Eligibility

    Age eligible for study : 18 and older

    Healthy volunteers accepted : No

    Gender eligible for study: All

    Things to know

    Study dates

    Study start: 2020-09-17

    Primary completion: 2023-10-31

    Study completion finish: 2025-10-31

    study type

    Study type

    TREATMENT

    phase

    Phase

      PHASE1

      PHASE2

    trial

    Trial ID

    NCT04370587

    Intervention or treatment

    BIOLOGICAL: T3011

    COMBINATION_PRODUCT: T3011 + pembrolizumab

    Conditions

    • Solid Tumor
    • Melanoma
    • NSCLC
    • HNSCC
    • Sarcoma
    • Squamous Cell Carcinoma

    Find a site

    Closest Location:

    Southern Oncology

    Research sites nearby

    Select from list below to view details:

    • Southern Oncology

      Bedford Park, Not Specified, Australia

    • Peninsula & South Eastern Haematology and Oncology Group

      Frankston, Not Specified, Australia

    • The Alfred

      Melbourne, Not Specified, Australia

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    Study Plan

    This section provides details of the study plan, including how the study is designed and what the study is measuring.

    How is the study designed?

    Participant Group/ArmIntervention/Treatment
    EXPERIMENTAL: Phase 1
    • T3011 single agent dose escalation in participants with solid tumors
    BIOLOGICAL: T3011
    • T3011 will be administered up to 4mL as an intratumoral injection given Q2W.
    EXPERIMENTAL: Phase 2a Part 1 Arm A
    • RP2D T3011 single agent in participants with melanoma
    BIOLOGICAL: T3011
    • T3011 will be administered up to 4mL as an intratumoral injection given Q2W.
    EXPERIMENTAL: Phase 2a Part 1 Arm B
    • RP2D T3011 single agent in participants with other solid tumors
    BIOLOGICAL: T3011
    • T3011 will be administered up to 4mL as an intratumoral injection given Q2W.
    EXPERIMENTAL: Phase 2a Part 2 Arm C
    • RP2D T3011 + pembrolizumab in participants with NSCLC
    COMBINATION_PRODUCT: T3011 + pembrolizumab
    • T3011 will be administered up to 4mL as an intratumoral injection in combination with intravenous pembrolizumab given Q3W.
    EXPERIMENTAL: Rollover Arm
    • RP2D T3011 + pembrolizumab in participants who have progressed on T3011 single agent
    COMBINATION_PRODUCT: T3011 + pembrolizumab
    • T3011 will be administered up to 4mL as an intratumoral injection in combination with intravenous pembrolizumab given Q3W.

    What is the study measuring?

    Primary outcome

    Primary Outcome MeasurePrimary Outcome DescriptionPrimary Outcome Time Frame
    Safety and tolerability of escalating doses T3011Number of participants in dose escalating cohorts with dose limiting toxicities (DLTs), treatment-emergent adverse events (TEAEs), and/or changes in clinical laboratory abnormalities.Up to 2 years from first dose of T3011
    To determine the dose(s) of T3011 to be examined in Phase 2aIncidence of DLTsThrough the first two T3011 injections (approximately 28 days)
    Safety and tolerability of T3011 dose(s) selected from Phase 1 in disease specific cohortsNumber of participants with treatment-emergent adverse events (TEAEs), and/or changes in clinical laboratory abnormalities.Up to 2 years from first dose of T3011
    Characterize the safety and tolerability of T3011 in combination with pembrolizumabNumber of participants with treatment-emergent adverse events (TEAEs), and/or changes in clinical laboratory abnormalities.Up to 2 years from first dose of T3011
    Characterize the safety and tolerability of T3011 in combination with pembrolizumab in participants who progress on T3011 aloneNumber of participants with treatment-emergent adverse events (TEAEs), and/or changes in clinical laboratory abnormalities.Up to 2 years from first dose of T3011

    Secondary outcome

    Secondary Outcome MeasureSecondary Outcome DescriptionSecondary Outcome Time Frame
    Overall response rate (ORR)ORR is defined as the proportion of participants who have a partial response (PR) or complete response (CR) to intervention, based on assessments by RECIST v1.1 and iRECIST.Up to 2 years from first dose of T3011
    Disease control rate (DCR)DCR is defined as the percentage of participants who have achieved CR, PR, or stable disease (SD) based on assessments by RECIST v1.1 and iRECIST.Up to 2 years from first dose of T3011
    Duration of response (DOR)DOR is defined as the time from the first met CR or PR until disease progression or death due to any cause, whichever occurs first.Up to 2 years from first dose of T3011
    Durable response (DR)DR is defined as objective response (CR or PR) according to RECIST v1.1 and iRECIST.Up to 2 years from first dose of T3011
    Progression-free survival (PFS)PFS is defined as the time from enrollment to the first documentation of progressive disease (PD) or death from any cause, whichever occurs first per RECIST v1.1 and iRECIST.Up to 2 years from first dose of T3011
    Overall Survival (OS)OS is defined as the time from enrollment to death from any cause.Up to 1 year after last dose of T3011
    Presence of neutralizing antibodies of anti-PD-1 antibody for antidrug antibodies (ADAs) developmentTo evaluate the immunogenicity of anti-PD-1 antibody expressed by T3011 given as single agent and in combination with pembrolizumab post injection.Up to 2 years from first dose of T3011
    Presence and frequency of T3011 in injection site swab, saliva, and urineTo evaluate the virus shedding of T3011 following intratumoral injectionUp to 2 years from first dose of T3011

    Frequently Asked Questions

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    References

    Clinical Trials Gov: A Clinical Study of Intratumoral MVR-T3011 (T3011) Given as a Single Agent and in Combination With Intravenous Pembrolizumab in Participants With Advanced or Metastatic Solid Tumors

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