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A Phase 1B Study of RP1 in Transplant Patients With Advanced Cutaneous Squamous Cell Carcinoma (ARTACUS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT04349436
Recruitment Status : Recruiting
First Posted : April 16, 2020
Last Update Posted : September 14, 2021
Information provided by (Responsible Party):
Replimune Inc.

Brief Summary:
This Phase 1B study is a multicenter, open-label, study of RP1 to investigate the safety and tolerability of RP1 for the treatment of advanced CSCC in up to 30 evaluable organ transplant recipients. This will include patients with either previous renal or hepatic allograft transplantation and experiencing subsequent documented locally advanced or metastatic CSCC. The study will enroll a total of 30 evaluable patients. Patients will participate up to approximately 3 years including a 28-day screening period, up to approximately 1 year treatment period, and a 2-year follow-up period.

Condition or disease Intervention/treatment Phase
Cutaneous Squamous Cell Carcinoma Biological: RP1, intra-tumoral injection, oncolytic virus Phase 1

Detailed Description:
RP1 is a genetically modified herpes simplex type 1 virus that is designed to directly destroy tumors and to generate an anti-tumor immune response. This is a Phase 1B, open label, multicenter, trial evaluating the safety and tolerability, biodistribution, shedding, and preliminary efficacy of RP1 in adult hepatic and renal transplant recipients who subsequently experienced advanced or metastatic CSCC. Patients will be dosed with RP1 by direct or ultrasound guided intra-tumoral injection into superficial, subcutaneous or nodal tumors. No transplanted organs will be injected.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: RP1 injection
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-Label, Multicenter, Phase 1B Study of RP1 in Organ Transplant Recipients With Advanced Cutaneous Squamous Cell Carcinoma (CSCC)
Actual Study Start Date : May 15, 2020
Estimated Primary Completion Date : February 2024
Estimated Study Completion Date : June 2024

Arm Intervention/treatment
Experimental: RP1, intra-tumoral injection, oncolytic virus
RP1 administered as an intra-tumoral injection every 2 weeks.
Biological: RP1, intra-tumoral injection, oncolytic virus
Genetically modified herpes simplex type 1 virus

Primary Outcome Measures :
  1. Percentage of subjects with treatment-emergent adverse events greater than or equal to Grade 3 [ Time Frame: 36 months ]
  2. Percentage of subjects with Serious adverse events (SAEs) [ Time Frame: 36 months ]
  3. Percentage of subjects with Treatment-emergent adverse events [ Time Frame: 36 months ]
  4. Percentage of subjects experiencing organ allograft rejection [ Time Frame: 36 months ]

Secondary Outcome Measures :
  1. Overall response rate (ORR) [ Time Frame: 36 months ]
  2. Median Duration of response (DOR) of subjects [ Time Frame: 36 months ]
  3. Percentage of subjects with Complete response (CR) [ Time Frame: 36 months ]
  4. Percentage of subjects who receive a clinical benefit rate defined as the rate of Complete Response (CR), Progressive Disease (PR), or Stable Disease (SD) [ Time Frame: 36 months ]
  5. Median duration of clinical benefit of subjects [ Time Frame: 36 months ]
  6. Median disease-free survival of subjects [ Time Frame: 36 months ]
  7. 3-year survival rate of subjects [ Time Frame: 36 months ]
  8. Change in subject reported quality of life [ Time Frame: 36 months ]
  9. Changes subjects experience in individual tumor sizes, erythema, inflammation and necrosis [ Time Frame: 36 months ]
    Changes in tumor size will be evaluated using radiologic scans and calipers for externally visible lesions

  10. To assess the incidence and severity of graft rejection, and the need for increase in immune suppressive therapy,during active treatment and for up to 1 year after last treatment [ Time Frame: 24 months ]
    Graft rejection will be assessed by clinical presentation and using the standard measures of kidney/liver function (BUN/Creatinine in the former, AST/ALT/bilirubin in the latter) to ensure that there is no evidence of allograft failure.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Key Inclusion Criteria:

  1. Voluntary agreement to provide written informed consent prior to any study procedures and the willingness and ability to comply with all aspects of the protocol and understand the risk to their organ allograft.
  2. Patients with histologically or cytologically confirmed recurrent, locally advanced or metastatic (to skin, soft tissue or lymph nodes) cutaneous squamous cell carcinoma, who have progressed following local resection or one local (i.e., topical) medical therapy.
  3. Patients who are renal or hepatic organ allograft recipients on a stable immunosuppressive regimen for at least 12 months prior to study participation with stable renal and/or hepatic function. NOTE: Patients who require CTLA-4-Ig medications are excluded.
  4. Patients for whom surgical or radiation treatment of lesions is contraindicated.
  5. At least 1 lesion that is measurable and injectable by study criteria (tumor of ≥1cm in longest diameter or ≥1.5 cm in shortest diameter for lymph nodes).
  6. Eastern Cooperative Oncology Group (ECOG) performance status ≤1.
  7. Anticipated life expectancy > 6 months
  8. Baseline ECG without evidence of acute ischemia.
  9. All patients must consent to provide archived or newly obtained tumor material (either formalin-fixed, paraffin-embedded [FFPE] block or 20 unstained slides).

Key Exclusion Criteria:

  1. Prior treatment with an oncolytic therapy or more than one prior CSCC-directed local/topical therapy.
  2. Prior systemic anti-cancer treatment for CSCC.
  3. Patients with visceral metastases.
  4. Patients with active herpetic infections or prior complications of HSV-1 infection (e.g. herpetic keratitis or encephalitis).
  5. Patients with a history of organ graft rejection within 12 months.
  6. Patients with an ANC < 1.0 x 109/L at any point within 3 months of starting therapy.
  7. Had systemic infection requiring intravenous (IV) antibiotics or anti-virals, or other serious infection within 60 days prior to dosing.
  8. Patients who require intermittent or chronic use of systemic (oral or intravenous) anti-virals with known anti-herpetic activity (e.g. acyclovir) unless for organ allograft preservation.
  9. Patients requiring CTLA-4-Ig medications.
  10. Ongoing or recent (within 5 years) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments beyond that required for maintenance allograft rejection prevention. The following are not exclusionary: vitiligo, childhood asthma that has resolved, type 1 diabetes, residual hypothyroidism that requires only hormone replacement, or psoriasis that does not require systemic treatment.
  11. Active infection with hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV).
  12. Any history of transplant-related viral infections, such as BK, EBV or CMV, within 3 months of study entry. Patients with a history of hepatitis B or C virus must have undetectable viral load within 3 months of study entry.
  13. Patients with a condition requiring an increase in the patient's usual immunosuppressive medications within 60 days of study treatment.
  14. Known active CNS metastases and/or carcinomatous meningitis.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04349436

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Contact: Clinical Trials at Replimune 1-781-222-9570

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United States, California
University of California, San Diego Recruiting
La Jolla, California, United States, 92093
Principal Investigator: Gregory Daniels, MD         
University of California, Los Angeles Recruiting
Los Angeles, California, United States, 90024
Principal Investigator: Wanxing Chai-Ho, MD         
UCSF, Helen Diller Family Comprehensive Cancer Center Recruiting
San Francisco, California, United States, 94143
Principal Investigator: Katy Tsai, MD         
United States, Colorado
University of Colorado Cancer Center School of Medicine Recruiting
Aurora, Colorado, United States, 80045
Principal Investigator: Theresa Medina, MD         
United States, Florida
University of Miami Sylvester Comprehensive Cancer Center Not yet recruiting
Miami, Florida, United States, 33136
Principal Investigator: Jose Lutzky, MD         
United States, Illinois
University of Chicago Recruiting
Chicago, Illinois, United States, 60637
Contact    773-702-7696   
Principal Investigator: Diana Bolotin, MD         
United States, North Carolina
Duke University Recruiting
Durham, North Carolina, United States, 27708
Principal Investigator: Meenal Kheterpal, MD         
United States, Ohio
University of Cincinnati Recruiting
Cincinnati, Ohio, United States, 45267
Principal Investigator: Trisha Wise-Draper, MD         
The Ohio State University Comprehensive Cancer Center Recruiting
Columbus, Ohio, United States, 43210
Principal Investigator: Clarie Verschraegen, MD         
United States, Pennsylvania
University of Pittsburgh Medical Center Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Principal Investigator: Jason Luke, MD         
United States, Texas
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Principal Investigator: Michael Migden, MD         
United States, Virginia
VCU Massey Cancer Center Recruiting
Richmond, Virginia, United States, 23298
Principal Investigator: Andrew Poklepovic, MD         
Sponsors and Collaborators
Replimune Inc.
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Study Director: Henry Castro, MD Replimune Inc.
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Responsible Party: Replimune Inc. Identifier: NCT04349436    
Other Study ID Numbers: RPL-003-19
First Posted: April 16, 2020    Key Record Dates
Last Update Posted: September 14, 2021
Last Verified: September 2021

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Carcinoma, Squamous Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Squamous Cell