Trial of pIL-12 Electroporation in Squamous Cell Carcinoma of the Head and Neck (IL12HNSCC)

• ClinicalTrials.gov Identifier: NCT02345330
• Recruitment Status: Terminated
• First Posted: January 26, 2015
• Results First Posted: January 3, 2018
• Last Update Posted: January 3, 2018
• Sponsor: OncoSec Medical Incorporated
• Information provided by (Responsible Party): OncoSec Medical Incorporated

Study Description

Brief Summary:

This study will assess the safety and effectiveness of ImmunoPulse IL-12® in treatment-refractory metastatic and unresectable squamous cell carcinoma of the head and neck (HNSCC). ImmunPulseIL12® is the combination of intrtumoral interleukin-12 gene (also known as tavokinogene telseplasmid [tavo]) and in vivo electroporation-mediated plasmid deoxyribonucleic acid [DNA] vaccine therapy (tavo-EP) administered using the OncoSec Medical System (OMS). Intratumoral tavo is a gene therapy approach to directly induce a pro-inflammatory response within a tumor to initiate and/or enhance anti-tumor immunity.

Condition or disease	Intervention/treatment	Phase
Head and Neck Squamous Cell Carcinoma	Biological: Tavokinogene Telseplasmid (tavo); Device: OncoSec Medical System (OMS)	Phase 2

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 4 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Multicenter Phase II Trial of Intratumoral pIL-12 Electroporation in Treatment-Refractory Metastatic and Unresectable SCC of the Head and Neck
• Actual Study Start Date: May 21, 2015
• Actual Primary Completion Date: November 14, 2016
• Actual Study Completion Date: November 14, 2016

Arms and Interventions

Arm

Intervention/treatment

Experimental: Tavokinogene Telseplasmid (tavo) Electroporation (EP); Participants received tavo intratumorally followed immediately by electroporation (EP) on Days 1, 8, and 15 in a 6-week cycle for up to 9 cycles.

Biological: Tavokinogene Telseplasmid (tavo); Patients received intratumoral injection(s) of tavo.; Other Names: pIL-12; IL-12 gene; plasmid DNA encoding human interleukin-12; plasmid IL-12; interleukin-12 gene; Device: OncoSec Medical System (OMS); Electroporation via OMS was performed immediately following intratumoral injection of tavo. A sterile applicator containing 6 stainless steel electrodes arranged in a circle were placed around the tumor. The applicator was connected to the OMS power supply and six pulses were administered to each tumor lesion at the approximate point of tavo injection.; Other Name: MedPulser

Outcome Measures

Primary Outcome Measures :

1. Best Overall Response Rate (BORR) by RECIST v1.1 [ Time Frame: Every 6 weeks until disease progression, death, withdrawal of consent or study termination (up to 14.5 months) ]
   BORR is defined as the percentage of participants with evaluable lesions that achieved a complete response (CR) or partial response (PR) as assessed by the investigator using Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. CR: Disappearance of all target lesions, non-target lesions, no new lesions, and normalization of tumor marker level. PR: At least a 30% decrease in the sum of diameters of target lesions, no progression in non-target lesion, and no new lesions.

Secondary Outcome Measures :

1. Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) [ Time Frame: From first study treatment to 30 days after the last study treatment (up to 14.5 months) ]
   An AE was any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product, medical treatment or procedure and which did not necessarily have to have had a causal relationship with this treatment. An adverse event could have, therefore, been any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product, medical treatment or procedure whether or not considered related to the medicinal product. An SAE was defined an any untoward medical occurrence that at any dosage resulted in one or more of the following: death, A life-threatening adverse event (real risk of dying), inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability/incapacity, congenital anomaly, required intervention to prevent permanent impairment of damage.
2. Best Overall Response Rate (BORR) by Immune-related Response Criteria (irRC) [ Time Frame: Every 6 weeks until disease progression, death, withdrawal of consent or study termination (up to 14.5 months) ]
   BORR is defined as the percentage of participants with evaluable lesions that achieved a complete response (CR) or partial response (PR) as assessed by the investigator using irRC criteria. CR: complete disappearance of all lesions (whether measurable or not) and the absence of new lesions for at least 4 weeks duration, confirmed by additional scan and visit 4 to 6 weeks after first documentation of CR. PR: ≥50% decrease in the product of the diameters from baseline.
3. Regression Rate of Treated and Untreated Lesions [ Time Frame: Every 6 weeks until disease progression, death, withdrawal of consent or study termination (up to 14.5 months) ]
   The treated (injected, electroporated) lesion regression rate is defined as the percentage of patients who had at least one treated lesion that decreased in longest dimension by ≥ 30%. The untreated (non-injected, non-electroporated) lesion regression rate is defined as the percentage of patients who had at least one untreated lesion that decreased in longest dimension by ≥ 30%.
4. Median Progression Free Survival (PFS) [ Time Frame: From start of study treatment weeks until disease progression, death, withdrawal of consent or study termination (up to 14.5 months) ]
   Progression free survival (PFS) time is defined as the duration between the date of treatment initiation (Study Day 1) to the first date of either disease progression at either local or any distant sites, or death from any cause. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Patients were censored at their date of last assessment, if they were alive and without evidence of disease progression.
5. Median Time to Progression (TTP) [ Time Frame: From start of study treatment weeks until disease progression, death, withdrawal of consent or study termination (up to 14.5 months) ]
   TTP is defined as the number of days between the treatment initiation date (Study Day 1) and the earliest date of documented disease progression as defined by RECIST 1.1 or death that is not associated with prior disease progression. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
6. Median Overall Survival (OS) [ Time Frame: From the start of study treatment until death ]
   Overall survival is defined as the time in days from the date of first study drug administration to the date of death.

Eligibility Criteria

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

Criteria

Inclusion Criteria:

1. Histological or cytological diagnosis of squamous cell carcinoma (SCC) of head and neck with American Joint Committee on Cancer (AJCC) Stage III, IVA or IVB and not amenable to surgical resection or locoregional radiation therapy with curative intent.
2. Patients must have measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1).
3. Patients must have at least one tumor accessible for intratumoral injection and EP on investigator's assessment.
4. Patients must have at least one additional lesion (measurable by RECIST v1.1 or non-target) identified as a control untreated lesion to be left untreated and followed for response.
5. Patients may have had prior chemotherapy or immunotherapy or radiation therapy. Any drug-related adverse events (AEs) identified during prior therapy must have been well-controlled (typically resolution to ≤ Grade 2), or resolved upon investigator review prior to initiation of the study therapy.
6. Patients must have platinum-refractory disease defined as disease progression within 12 months platinum-based chemoradiation with curative intent or any disease progression on platinum-based chemotherapy in the absence of radiation.
7. Age ≥ 18 years old.
8. Patients must have agreed to a new biopsy of tumor (deemed accessible and safe for biopsy by the investigator's assessment) and allowing acquired tissue to be used for biomarker analysis. If the biopsied lesions were previously irradiated, they must demonstrate either radiographic or pathological evidence of recurrent or residual disease.
9. No systemic antineoplastic therapy may have been received between the time of biopsy and the first administration of study treatment.
10. Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
11. Life expectancy of at least 3 months.
12. Adequate organ function.
13. Female patient of childbearing potential has a negative pregnancy test within 14 days prior to the start of study drug.
14. Women of child-bearing potential and men must agree to use adequate contraception.
15. Able to give informed consent.

Exclusion Criteria:

1. Prior therapy with IL-12 or prior gene therapy.
2. Concurrent ongoing administration of systemic therapy (e.g. chemotherapy), or radiation therapy.
3. Evidence of significant active infection (e.g., pneumonia, cellulitis, wound abscess, etc.) at time of study entry.
4. Pregnant or breast-feeding women are excluded.
5. Patients with electronic pacemakers or defibrillators are excluded.
6. Significant disease or uncontrolled disease, i.e. cardiovascular renal, hepatic, endocrine, metabolic, neurologic; or other significant disease that would limit the patients ability to participate in the study as determined by the investigator or medical monitor.

Contacts and Locations

Locations

United States, California

UCSF Helen Diller Family Comprehensive Cancer Center

San Francisco, California, United States, 94115

United States, Illinois

University of Chicago Medical Center

Chicago, Illinois, United States, 60637

Sponsors and Collaborators

OncoSec Medical Incorporated

More Information

• Responsible Party: OncoSec Medical Incorporated
• ClinicalTrials.gov Identifier: NCT02345330
• Other Study ID Numbers: OMS-I130
• First Posted: January 26, 2015
• Results First Posted: January 3, 2018
• Last Update Posted: January 3, 2018
• Last Verified: December 2017

Additional relevant MeSH terms:

Carcinoma; Carcinoma, Squamous Cell; Squamous Cell Carcinoma of Head and Neck; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Squamous Cell; Head and Neck Neoplasms; Neoplasms by Site; Interleukin-12; Adjuvants, Immunologic; Immunologic Factors; Physiological Effects of Drugs; Angiogenesis Inhibitors; Angiogenesis Modulating Agents; Growth Substances; Growth Inhibitors; Antineoplastic Agents