This is a multi-center study in patients with un-resectable Recurrent or Metastatic HPV16-positive oropharyngeal Head and Neck Squamous Cell Carcinoma (HNSCC). The trial is designed to investigate VB10.16, an investigational therapeutic DNA vaccine in combination with another medicine, pembrolizumab, which is the standard of care for patients with previously untreated metastatic or resectable recurrent PD-L1 positive HNSCC. The study is divided in 2 parts: * Phase 1: Dose escalation to evaluate safety and determine the recommended phase 2 dose (RP2D) of VB10.16 * Phase 2: Randomized comparison of VB10.16 in combination with pembrolizumab versus pembrolizumab monotherapy The goal of Phase 1 is to evaluate the safety and tolerability of the combined treatment and to decide on the dose of VB10.16 to be used in the second part of the trial. The randomized Phase 2 will consist of 2 parallel arms exploring VB10.16 at the selected RP2D from the escalation phase in combination with pembrolizumab SoC (experimental arm, Arm A), versus pembrolizumab alone (control arm, Arm B).
This Phase 1/2, open-label, dose-escalation and randomized trial is designed to evaluate the safety, tolerability, anti-tumor activity and immunogenicity of VB10.16 in combination with pembrolizumab in patients with HPV16-positive, PD-L1-positive unresectable recurrent or metastatic (r/m) oropharyngeal HNSCC, who are eligible for pembrolizumab monotherapy as standard of care (SoC) in the first-line setting. The trial consists of 2 consecutive phases with separate patient groups and is designed to determine the RP2D of VB10.16 in combination with pembrolizumab through dose-escalation of 3 mg, 6 mg, and 9 mg VB10.16, and to evaluate efficacy of the RP2D of VB10.16 when combined with pembrolizumab compared to pembrolizumab alone in Phase 2. Phase 1: The dose escalation Phase 1 will consist of 3 dosing cohorts to evaluate VB10.16 at 3 mg (Cohort 1), 6 mg (Cohort 2), and 9 mg (Cohort 3). The 3 mg cohort will utilize a partial accelerated titration approach with a single patient41. The 6 mg cohort will follow a standard titration with 3 patients, and the 9 mg cohort will include a minimum of 6 patients to safety-clear the dose as a potential RP2D in the randomized phase. Phase 2: The randomized Phase 2 will consist of 2 parallel arms exploring VB10.16 at the selected RP2D from the escalation phase in combination with pembrolizumab SoC (experimental arm, Arm A), versus pembrolizumab alone (control arm, Arm B). Allocation will be 1:1 by centralized block randomization, stratified by PD-L1 expression (CPS 1-19 versus ≥20) and ECOG PS (0 versus 1) Treatment duration is up to 2 years or until disease progression, unacceptable toxicity, withdrawal of consent, or death.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
110
Intramuscular injection using a PharmaJet needle-free injection system
Intravenous infusion.
CRLC Val d'Aurelle - Institut de Recherche en Cancerologie de Montpellier (IRCM)
Montpellier, France
RECRUITINGInstitut Gustave Roussy
Paris, France
RECRUITINGUniversitaetsklinikum Giessen und Marburg GmbH - Klinik fuer Hals, Nasen- und Ohrenheilkunde
Giessen, Germany
RECRUITINGNational Institute of Oncology
Budapest, Hungary
RECRUITINGUniversity of Bergen, Haukeland University Hospital
Bergen, Norway
RECRUITINGOslo Universitetssykehus
Oslo, Norway
RECRUITINGUniwersyteckie Cetrum Kliniczne
Gdansk, Poland
RECRUITINGNarodowy Instytut Onkologii-im Marii Sklodowskiej-Curie Panstwowy Instytut
Gliwice, Poland
RECRUITINGHospital del Mar
Barcelona, Spain
RECRUITINGICO Hospitalet (Hospital Duran i Reynals)
Barcelona, Spain
RECRUITING...and 2 more locations
Phase 1: Dose Escalation: Dose Limiting Toxicities (DLT)
Proportion of patient with Dose Limiting Toxicities (DLTs).
Time frame: 42 days
Phase 2: Dose expansion: Objective Response Rate (ORR)
Objective Response Rate (ORR), defined as the proportion of patients who have either confirmed CR or confirmed PR as best overall response per RECIST 1.1.
Time frame: Up to 2 years
Phase 2: Dose Expansion: Progression-Free Survival (PFS)
PFS defined as the time from randomization to the first documented disease progression according to RECIST 1.1 or death from any cause, whichever occurs first.
Time frame: Up to 2 years
Phase 2: Dose Expansion: Disease Control Rate (DCR)
Disease control rate (DCR), defined as the proportion of patients who have either confirmed CR, confirmed PR, or SD as BOR according to RECIST 1.1.
Time frame: Up to 2 years
Phase 2: Dose Expansion: Duration of response (DOR)
Duration of response (DOR), defined as time from the date of first documented response of CR or PR to the date of the first documented progression or death due to any cause.
Time frame: Up to 2 years
Phase 2: Dose Expansion: Duration of complete response (DOCR)
Duration of complete response (DOCR), defined as time from the date of first documented response of CR to the date of the first documented progression or death due to any cause.
Time frame: Up to 2 years
Phase 2: Dose Expansion: Duration of Disease Control (DODC)
Duration of Disease Control (DODC), defined as time from the date of first documented response of CR, PR or SD to the date of the first documented progression or death due to any cause.
Time frame: Up to 2 years
Phase 2: Dose Expansion: Time to Response (TTR)
Time to Response (TTR), s defined as the time from VB10.16 treatment start date to the date of first documented response of either confirmed CR or confirmed PR.
Time frame: Up to 2 years
Phase 1+2: Incidence of Treatment-Emergent and Treatment-Related Adverse Events (TEAEs) and (TRAEs)
Number and percentage of participants experiencing treatment-emergent/Treatment related adverse events, including Grade ≥3 adverse events, serious adverse events (SAEs), adverse events leading to treatment discontinuation, and adverse events of special interest.
Time frame: Up to 2 years
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