This is a phase 2 trial to assess the safety and tolerability of three schedules of CUE-101 administered in the neoadjuvant phase before standard of care (SOC) therapy to treatment naïve, HLA-A\*0201 positive patients with newly diagnosed, locally advanced HPV16+ oropharyngeal squamous-cell carcinoma (OPSCC). This is an exploratory trial of a limited sample size to confirm safety and to assess for pharmacodynamic signals of efficacy in each of three schedules of CUE-101. Safety assessments will be performed at baseline and after CUE-101 administration. To assess for efficacy, peripheral blood and tumor samples will be collected at baseline and after CUE-101 administration. Following CUE-101, patients will proceed with SOC therapy, as prescribed by the treating physician.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
CUE Biopharma will supply CUE-101, which will be provided free of charge to the patient.
Washington University School of Medicine
St Louis, Missouri, United States
RECRUITINGNumber of treatment-related adverse events
Time frame: From start of treatment through 12 months after the completion of standard of care treatment (estimated to be 15 months)
Number of adverse events
Time frame: From start of treatment through 12 months after the completion of standard of care treatment (estimated to be 15 months
Treatment-related delays in start of standard of care therapy
-Defined as \>7 days of treatment-related delay from the planned date of surgery or initiation of definitive-chemoradiation therapy.
Time frame: From start of treatment through start of standard of care therapy (estimated to be 2 weeks)
Change in frequency of HPV16 E711-20-specific CD8+ T cells in peripheral blood samples
* Determined by IFN γ ELISpot for detection of HPV16 E711-20-specific T cells * Baseline, prior to each CUE-101 infusion, 24 hours post-end of each CUE-101 infusion, prior to standard of care therapy, at day 28 post CUE-101, 2 month follow-up, 4 month follow-up, 8 month follow-up and 12 month follow-up
Time frame: Through 12 month follow-up
Change in frequency of HPV16 E711-20 tetramer-positive cytotoxic T cell lymphocytes
* Determined by multiparameter flow cytometry * Baseline, prior to each CUE-101 infusion, 24 hours post-end of each CUE-101 infusion, prior to standard of care therapy, at day 28 post CUE-101, 2 month follow-up, 4 month follow-up, 8 month follow-up and 12 month follow-up
Time frame: Through 12 month follow-up
Change in frequency of HPV16 E711-20-specific CD8+ T cells in tumor samples
Time frame: Baseline, day -2 or -1 before start of standard of care therapy
Activation markers of HPV16 E711-20 tetramer-positive cytotoxic T cell lymphocytes
Time frame: Through 12 month follow-up
Proliferative status of HPV16 E711-20 tetramer-positive cytotoxic T cell lymphocytes
Time frame: Through 12 month follow-up
Pathological tumor response
* Defined as rates of major and complete pathological response * A major pathologic response (mPR) will be defined as ≤ 10% residual viable tumor within the tumor sample collected after administration of CUE-101. A complete pathologic response (cPR) will be defined as no invasive cancer in the tumor sample collected. For surgical patients, the tumor sample will include the primary tumor specimen and all sampled regional lymph nodes at the time of resection. For def-chemoradiation therapy patients, the tumor sample will comprise the biopsy(s) submitted. Pathologic tumor response will be stratified based on if the patients underwent surgery or post-CUE-101 biopsy only.
Time frame: At the time of surgery or biopsy (Day 1 - approximately 7-14 days after start of CUE-101 treatment)
Objective response rate (ORR)
* Proportion of patients with a complete response + partial response * Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. * Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: Prior to surgery/definitive chemoradiation treatment (Day 1 - approximately 7-14 after start of CUE-101 treatment)
Change in area under the concentration-time curve (AUC) of serum PK parameters
-Prior to each CUE-101 infusion, end of each CUE-101 infusion, 1 hour post-end of each CUE-101 infusion, 5 hours post-end of each CUE-101 infusion, 24 hours post-end of each CUE-101 infusion, surgery day 1 or definitive chemoradiation day -2 or -1, 2 month follow-up, 4 month follow-up, 8 month follow-up and 12 month follow-up.
Time frame: Through 12 month follow-up
Change in Cmax of serum PK parameters
-Prior to each CUE-101 infusion, end of each CUE-101 infusion, 1 hour post-end of each CUE-101 infusion, 5 hours post-end of each CUE-101 infusion, 24 hours post-end of each CUE-101 infusion, surgery day 1 or definitive chemoradiation day -2 or -1, 2 month follow-up, 4 month follow-up, 8 month follow-up and 12 month follow-up.
Time frame: Through 12 month follow-up
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Change in Terminal elimination half-life(t1/2) of serum PK parameters
-Prior to each CUE-101 infusion, end of each CUE-101 infusion, 1 hour post-end of each CUE-101 infusion, 5 hours post-end of each CUE-101 infusion, 24 hours post-end of each CUE-101 infusion, surgery day 1 or definitive chemoradiation day -2 or -1, 2 month follow-up, 4 month follow-up, 8 month follow-up and 12 month follow-up.
Time frame: Through 12 month follow-up
Number of participants who relapse
Time frame: Through 12 month follow-up
Number of participants who die summarized by cause of death
Time frame: Through 12 month follow-up
Progression-free survival (PFS)
Time frame: Through 12 month follow-up
Overall survival (OS)
Time frame: Through 12 month follow-up