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The Combination of GX-188E Vaccination and Pembrolizumab in Patients With HPV 16 and/or 18+ Advanced Cervical Cancer

Primary Purpose

Cervical Cancer

Status
Active
Phase
Phase 1
Locations
Korea, Republic of
Study Type
Interventional
Intervention
GX-188E
Keytruda
Sponsored by
Genexine, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Cancer focused on measuring keytruda, pembrolizumab, GX-188E, TDS-IM device, KEYNOTE-567

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients must be female and age ≥ 18 years (19 years for Korean sites)
  2. Patients with histologically confirmed advanced or metastatic HPV-positive (HPV-16 or HPV-18) cervical cancer, who have disease progression after treatment with all available therapies for metastatic disease that are known to confer clinical benefit, or are intolerant to treatment, or refuse standard treatment.
  3. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1
  4. Life Expectancy of at least 6 months
  5. Patients must agree to provide either an archival tumor tissue sample or fresh biopsy sample for baseline biomarker tissue analyses, including staining for PD-L1. If archival tissue is not available and the patient does not have biopsy-accessible tumor lesions, the patient will be excluded.

Exclusion Criteria:

  1. Patient has disease that is suitable for local therapy administered with curative intent.
  2. Patient has a known additional malignancy that is progressing or has required active treatment within the past 3 years.
  3. Patient is expected to require any other form of antineoplastic therapy while on study; including systemic chemotherapy, radiation therapy (except for palliative purposes) biological therapy, or immunotherapy not specified in this protocol.
  4. Patient has a history of active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  5. Patients have received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137) and was discontinued from that treatment due to a Grade 3 or higher immune-related Adverse Event (irAE)
  6. Patients with active autoimmune disease requiring systemic immunosuppressive treatment within the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment and is allowed.
  7. Patients has had an allogeneic solid organ or allogeneic bone marrow transplant

Sites / Locations

  • Keimyung University Dongsan Medical Center
  • National Cancer Center
  • Seoul National University Bundang Hospital
  • Severance Hospital, Yonsei University Health System
  • Asan Medical Center
  • Samsung Medical Center
  • The Catholic University of Korea Seoul St. Mary's Hospital
  • Korea University Guro Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GX-188E, Keytruda

Arm Description

GX-188E: 1st day of week 1,2,4,7,13,19, 46/ 2mg Keytruda:Day 1 q3 weeks/ 200mg

Outcomes

Primary Outcome Measures

DLT evaluation for safety and tolerability(part A)
Patient will be evaluated for the first 21 days for dose-limiting toxicities.
ORR for efficacy(part B&C)
ORR within 24 weeks (ORR24) evaluated by RECIST v1.1

Secondary Outcome Measures

ORR for efficacy(part A)
Overall Response Rate within 24 weeks (ORR24) by RECIST v1.1 and immune-related Response Criteria (irRC)
BORR (part B&C)
Best Overall Response Rate(BORR24) by RECIST v1.1
Time-to-Best Response
Time-to-Best Response by RECIST v1.1 and iRECIST
Duration of Response (DOR)
Duration of Response (DOR) by RECIST v1.1 and iRECIST
Progression-Free Survival (PFS)
6month- PFS by RECIST v1.1 and iRECIST
Overall Survival (OS)
Overall Survival (OS) by RECIST v1.1 and iRECIST

Full Information

First Posted
January 25, 2018
Last Updated
April 4, 2022
Sponsor
Genexine, Inc.
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03444376
Brief Title
The Combination of GX-188E Vaccination and Pembrolizumab in Patients With HPV 16 and/or 18+ Advanced Cervical Cancer
Official Title
A Multi-Center, Open-label Phase Ib-II Trial of the Combination of GX-188E Vaccination and Pembrolizumab in Patients With Advanced, Non-Resectable HPV Type 16 and/or 18 Positive Cervical Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 23, 2018 (Actual)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genexine, Inc.
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A Multi-Center, Open-label Phase Ib-II Trial of the Combination of GX-188E Vaccination and Pembrolizumab in Patients with Advanced, Non-Resectable HPV-Positive Cervical Cancer
Detailed Description
This is an open-label Phase Ib-II trial to evaluate the safety and efficacy of GX-188E (IM administration using Ichor TDS-IM device) + pembrolizumab (P) in patients with advanced HPV-16+ or HPV-18+ cervical cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Cancer
Keywords
keytruda, pembrolizumab, GX-188E, TDS-IM device, KEYNOTE-567

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GX-188E, Keytruda
Arm Type
Experimental
Arm Description
GX-188E: 1st day of week 1,2,4,7,13,19, 46/ 2mg Keytruda:Day 1 q3 weeks/ 200mg
Intervention Type
Drug
Intervention Name(s)
GX-188E
Other Intervention Name(s)
Ichor Tri-Grid Delivery System
Intervention Description
GX-188E (1.0mg/0.5ml/vial), Intramuscular administration using electroporator, Ichor TDS-IM device
Intervention Type
Drug
Intervention Name(s)
Keytruda
Other Intervention Name(s)
Pembrolizumab
Intervention Description
pembrolizumab(100mg/4mL/vial), Intravenous administration
Primary Outcome Measure Information:
Title
DLT evaluation for safety and tolerability(part A)
Description
Patient will be evaluated for the first 21 days for dose-limiting toxicities.
Time Frame
within 21days
Title
ORR for efficacy(part B&C)
Description
ORR within 24 weeks (ORR24) evaluated by RECIST v1.1
Time Frame
within 24 weeks
Secondary Outcome Measure Information:
Title
ORR for efficacy(part A)
Description
Overall Response Rate within 24 weeks (ORR24) by RECIST v1.1 and immune-related Response Criteria (irRC)
Time Frame
up to 1 year
Title
BORR (part B&C)
Description
Best Overall Response Rate(BORR24) by RECIST v1.1
Time Frame
up to 1 year
Title
Time-to-Best Response
Description
Time-to-Best Response by RECIST v1.1 and iRECIST
Time Frame
up to 1 year
Title
Duration of Response (DOR)
Description
Duration of Response (DOR) by RECIST v1.1 and iRECIST
Time Frame
up to 1 year
Title
Progression-Free Survival (PFS)
Description
6month- PFS by RECIST v1.1 and iRECIST
Time Frame
up to 6 months
Title
Overall Survival (OS)
Description
Overall Survival (OS) by RECIST v1.1 and iRECIST
Time Frame
up to 1 year

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must be female and age ≥ 18 years (19 years for Korean sites) Patients with histologically confirmed advanced or metastatic HPV-positive (HPV-16 or HPV-18) cervical cancer, who have disease progression after treatment with all available therapies for metastatic disease that are known to confer clinical benefit, or are intolerant to treatment, or refuse standard treatment. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1 Life Expectancy of at least 6 months Patients must agree to provide either an archival tumor tissue sample or fresh biopsy sample for baseline biomarker tissue analyses, including staining for PD-L1. If archival tissue is not available and the patient does not have biopsy-accessible tumor lesions, the patient will be excluded. Exclusion Criteria: Patient has disease that is suitable for local therapy administered with curative intent. Patient has a known additional malignancy that is progressing or has required active treatment within the past 3 years. Patient is expected to require any other form of antineoplastic therapy while on study; including systemic chemotherapy, radiation therapy (except for palliative purposes) biological therapy, or immunotherapy not specified in this protocol. Patient has a history of active central nervous system (CNS) metastases and/or carcinomatous meningitis. Patients have received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137) and was discontinued from that treatment due to a Grade 3 or higher immune-related Adverse Event (irAE) Patients with active autoimmune disease requiring systemic immunosuppressive treatment within the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment and is allowed. Patients has had an allogeneic solid organ or allogeneic bone marrow transplant
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Soo-Young Hur, M.D
Organizational Affiliation
The Catholic University of Korea
Official's Role
Principal Investigator
Facility Information:
Facility Name
Keimyung University Dongsan Medical Center
City
Daegu
ZIP/Postal Code
42601
Country
Korea, Republic of
Facility Name
National Cancer Center
City
Gyeonggi-do
ZIP/Postal Code
10408
Country
Korea, Republic of
Facility Name
Seoul National University Bundang Hospital
City
Gyeonggi-do
ZIP/Postal Code
13620
Country
Korea, Republic of
Facility Name
Severance Hospital, Yonsei University Health System
City
Seoul
ZIP/Postal Code
03722
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
05505
Country
Korea, Republic of
Facility Name
Samsung Medical Center
City
Seoul
ZIP/Postal Code
06351
Country
Korea, Republic of
Facility Name
The Catholic University of Korea Seoul St. Mary's Hospital
City
Seoul
ZIP/Postal Code
06591
Country
Korea, Republic of
Facility Name
Korea University Guro Hospital
City
Seoul
ZIP/Postal Code
152-703
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33271094
Citation
Youn JW, Hur SY, Woo JW, Kim YM, Lim MC, Park SY, Seo SS, No JH, Kim BG, Lee JK, Shin SJ, Kim K, Chaney MF, Choi YJ, Suh YS, Park JS, Sung YC. Pembrolizumab plus GX-188E therapeutic DNA vaccine in patients with HPV-16-positive or HPV-18-positive advanced cervical cancer: interim results of a single-arm, phase 2 trial. Lancet Oncol. 2020 Dec;21(12):1653-1660. doi: 10.1016/S1470-2045(20)30486-1.
Results Reference
derived

Learn more about this trial

The Combination of GX-188E Vaccination and Pembrolizumab in Patients With HPV 16 and/or 18+ Advanced Cervical Cancer

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