The goal of this clinical trial is to assess the safety and tolerability of a virus replicon particle (VRP) encapsulated saRNA encoding IL-12 when injected into in head and neck cancer patients. The main questions being addressed are: The safety and tolerability of intratumoral (IT) injections of VRP-encapsulated saRNA encoding IL-12 (VLPONC-01) The tumor response to IT injections of VLPONC-01 The tumor response due to the combination of IT injections of VLPONC-01 and system IV administration of neoadjuvant pembrolizumab (anti-PD-1) treatment Researchers will compare neoadjuvant pembrolizumab alone to the combination therapy to see if the combination enhances tumor responses.
The study is an Open label, Phase I study to determine the safety of IT injected VLPONC-01 as a therapeutic agent in subjects with non-resectable and resectable Head and Neck Cancer Squamous Cell Carcinomas (HCSCC), and secondarily to assess pathologic response and radiological response (assessed by RECIST 1.1 criteria) in the primary tumor and regional lymph nodes. Researchers also will explore tumor microenvironment changes in cytokine levels and cellular responses. There will be three distinct cohorts enrolling sequentially: Cohort A: Researchers will enroll unresectable or recurrent/metastatic head and neck cancer with at least 1 injectable tumor not scheduled for tumor resection surgery who will receive four doses of VLPONC-01. Cohort C: Researchers will enroll HCSCC patients scheduled for tumor resection surgery who will receive four doses of VLPONC-1 and two doses of neoadjuvant pembrolizumab or only two doses of neoadjuvant pembrolizumab prior to tumor resection surgery.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
41
Weekly IT injections of 1 x 10\^9 viral particles of VLPONC-01
200mg twice 3 weeks apart IV
Weekly IT injections of 3 x 10\^8 viral particles of VLPONC-01
Stanford University
Stanford, California, United States
RECRUITINGSafety and tolerability
To assess the safety and tolerability of VLPONC-01. Safety will be based on the occurrence of any grade 3 or higher drug-related adverse events from the VLPONC-01 injections for non-surgery patients and any grade 3 or higher drug-related adverse events that result in a delay to tumor resection surgery.
Time frame: First injection to 90-day follow-up visit post-final injection (Cohort A) or post-surgery (Cohort B and Cohort C)
Levels of circulating IL-12
To assess the circulating blood levels of IL-12 after VLPONC-01 treatment compared to baseline to determine the occurrence and safety profile of potential systemic inflammatory responses.
Time frame: First injection to 30-day follow-up visit post-final injection (Cohort A) or post-surgery (Cohort B and Cohort C)
VLPONC-01 levels in tumor tissue
To detect levels of VLPONC-01 RNA in surgically resected tissue.
Time frame: First injection to tumor resection surgery
Tumor response
To assess the primary tumor response by radiological imaging and pathological analysis.
Time frame: First injection to tumor resection surgery
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