This is a 2-part, open-label, multicenter, dose-escalation, proof-of-concept study with a safety run-in designed to assess the safety, tolerability, MTD, and objective antitumor efficacy of ascending dose strengths of VP-315 when administered intratumorally to adults with biopsy proven basal cell carcinoma (BCC). The study is expected to enroll approximately 86 subjects with a histological diagnosis of BCC in at least 1 eligible target lesion (confirmed by punch or shave biopsy).
This is a 2-part, open-label, multicenter, dose-escalation, proof-of-concept study with a safety run-in designed to assess the safety, tolerability, maximum tolerated dose (MTD), and objective antitumor efficacy of ascending dose strengths of VP-315 when administered intratumorally to adults with biopsy proven BCC. The study is expected to enroll approximately 86 subjects with a histological diagnosis of BCC in at least 1 eligible target lesion (confirmed by punch or shave biopsy). All enrolled subjects will receive VP-315 intradermal injection on an outpatient basis into up to 2 target lesions. In all Parts of the study (1 or 2, as below), each 7-day treatment week comprises up to 3 consecutive treatment days followed by a no-treatment period of at least 4 days. Dosing will commence in a single target lesion. Once a lesion is observed to be fully necrotic (Part 1, Part 2; Cohorts 1-2 only), treatment of that lesion stops, and treatment of subsequent target lesions (up to 2 total) may continue on Day 1 of the following week. In Part 2, Cohorts 4 and 5, treatment of a second target lesion begins on W2D1 (not based on status of necrosis of target lesion 1).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
92
2-8 mg of VP-315 administered via intratumor injection into a single target lesion on W1D1. Each 500-μL dose will be divided into 2 injections given at least 15 minutes and no more than 30 minutes apart, with 30% (150 μL) administered in the first injection and the remaining 70% (350 μL) with the second injection. In all parts of the study, the targeted total volume of delivery is 500 μL daily.
4mg (halt the target dose) loading dose on W1D1 administered via intratumor injection into a single target lesion, followed by total daily doses at the full target dose of 8 mg on the remaining days of treatment.
8 mg of VP-315 administered daily via intratumor injection into a single target lesion up to 3 consecutive daily doses/week for up to 2 weeks (W1D1, W1D2, W1D3 and W2D1, W2D2, W2D3 - up to 6 total doses).
8 mg of VP-315 administered daily via intratumor injection into a single target lesion up to 2 consecutive daily doses/week for up to 2 weeks (W1D1, W1D2, W1D3 and W2D1, W2D2, W2D3 - up to 6 total doses).
8 mg of VP-315 administered daily via intratumor injection into a single target lesion up to 3 consecutive daily doses/week for up to 2 weeks (W1D1, W1D2, W1D3 and W2D1, W2D2, W2D3 - up to 6 total doses).
Therapeutics Clinical Research
San Diego, California, United States
ClearlyDerm
Boca Raton, Florida, United States
Life Clinical Trials
Coral Springs, Florida, United States
Florida Center for Dermatology
Saint Augustine, Florida, United States
Gwinnett Dermatology
Snellville, Georgia, United States
Affinity Health
Oakbrook Terrace, Illinois, United States
DermAssociates
Rockville, Maryland, United States
Lawrence J Green, MD LLC
Rockville, Maryland, United States
ActivMed Research - Borthwick
Portsmouth, New Hampshire, United States
UPMC St. Margaret
Pittsburgh, Pennsylvania, United States
...and 3 more locations
Part 1: Percentage of Subjects With Discontinuations Due to Adverse Events
Part 1: Percentage of subjects that discontinued the study due to adverse event
Time frame: Up to 9 weeks
Part 1: Percentage of Subjects With Dose-limiting Toxicities (DLTs)
Subjects with pre-determined dose-limiting toxicities such as hypotension (specific criteria); significant elevation of serum tryptase; Grade 2 or higher adverse event (with specific criteria)
Time frame: Day 4 (Safety Assessment)
Part 1: Percentage of Subjects With Cutaneous Reaction by Maximum Severity
Cutaneous injection site reactions are defined as the following preferred terms: Injection site erythema, Injection site induration, Injection site swelling, Injection site vesicles, Injection site exfoliation, Injection site erosion, Injection site ulcer, Injection site necrosis. The intended scale for cutaneous injection site reactions is mild, moderate, severe from CRA. Subjects having more than one event may appear in more than one System Organ Class or Preferred Term but are counted at most once per each SOC and PT at the maximum severity. Cutaneous injection site reactions are types of reactions that can be expected to occur.
Time frame: Up to 9 weeks
Part 2: Percent of Subjects With Adverse Events
Part 2: Percent of subjects with adverse events, treatment-related AEs
Time frame: Up to 15 weeks
Part 2: Percentage of Subjects With Study Discontinuations Due to Adverse Events
Part 2: Percentage of subjects with study discontinuations due to adverse events.
Time frame: Up to 15 weeks
Part 2: Percent of Subjects With Treatment Related Adverse Events of Special Interest (TRAEs SI)
Subjects with pre-determined TRAEs of SI such as hypotension (specific criteria); significant elevation of serum tryptase; Grade 2 or higher adverse event (with specific criteria)
Time frame: Treatment Days up to 2 weeks
Part 2: Percentage of Subjects With Cutaneous Reaction by Maximum Severity
Evaluation of the tissue condition at the treatment site for the presence and severity of each of the following cutaneous reactions; Erythema, Induration, Swelling, Blister Formation, Desquamation, Erosion, Ulceration, Necrosis by a scale of None; Mild; Moderate; Severe. Subjects having more than one event may appear in more than one SOC or PT but are counted at most once per each SOC and PT at the maximum severity. Cutaneous injection site reactions are types of reactions that can be expected to occur. The intended scale for cutaneous injection site reactions is mild, moderate, severe from CRA
Time frame: Up to 105 days
Part 2: Percentage of Subjects With Clinical Clearance of Treated Lesion(s) at Excision
Clinical clearance of Target Lesion at excision as determined by visual assessment (no residual tumor seen on visual inspection). Clinical assessment using Physician Global Assessment (PGA). PGA scale: 100% Improvement, no visible tumor; 75% to less than 100% improvement, 50% to less than 75% improvement, 25% to less than 50% improvement, Up to 25% improvement, No change, Worse.
Time frame: Day 84-91
Part 2: Percentage of Subjects With Histological Clearance of Treated Lesion(s) at Excision
Percentage of Subjects with histological clearance of treated lesion(s) at excision. Histologic clearance confirmed by central dermatopathologist. Percentage is calculated using the number of subjects with non-missing responses within lesion as the denominator. \*Scar indicates complete histologic clearance
Time frame: Day 84-91
Part 2: Mean Estimated Remaining Tumor Volume at Excision
Estimate of remaining tumor volume (necrotic cells:tumor cells) at excision by central dermatopathologist Scale: 0 = None Remaining to 100 = All Remaining.
Time frame: Day 84-91
Part 2 (Cohorts 4 and 5 Expansion Groups): Plasma Concentrations of VP-315
Pharmacokinetics (PK) of an 8 mg dose of VP-315 administered with the optimal dosing regimen
Time frame: Day 1-2
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