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).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
8
Adenovirus vaccine expressing mutant HPV E6 and E7
MG1 Maraba oncolytic virus expressing mutant HPV E6 and E7
monoclonal antibody; checkpoint inhibitor
University of Miami
Miami, Florida, United States
Billings Clinic
Billings, Montana, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
University of Toledo-The Eleanor N. Dana Cancer Center
Toledo, Ohio, United States
University of Texas-MD Anderson Cancer Center
Houston, Texas, United States
Juravinski Cancer Centre
Hamilton, Ontario, Canada
Ottawa Hospital Research Institute
Ottawa, Ontario, Canada
Princess Margaret Hospital
Toronto, Ontario, Canada
Safety of Ad/MG1-E6E7 administration in HPV associated cancers
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.
Time frame: 8 months
Determine the maximum tolerated dose (MTD)/ maximum feasible dose (MFD) of Ad/MG1-E6E7 in HPV associated cancers
MTD/MFD of Ad/MG1-E6E7 administered by IV infusion alone and IV infusion followed by direct injection of tumor (IT injection) in HPV associated cancers
Time frame: 4 to 6 weeks after first treatment with Ad/MG1-E6E7
Concentration of Ad/MG1-E6E7 in blood
Change over time in the number of MG1-E6E7 genomes (qPCR) and MG1-E6E7 infectious units (PFU) in blood
Time frame: 4 to 6 weeks after first treatment with Ad/MG1-E6E7
Assess for the biodistribution and shedding of Ad/MG1-E6E7
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
Time frame: 6 weeks after first treatment with Ad/MG1-E6E7
Measure the differences in pre- and post treatment levels of T cell subsets and T cell activation status
Analyze the change over time in the the frequencies, absolute numbers and subsets of T cells (including regulatory T cells)
Time frame: Before and after each dose of Ad/MG1-E6E7 and then every 3 weeks until treatment discontinuation
Anti-tumor activity
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
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
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