A Phase 1B/2 Study of RP1 in Solid Organ Transplant Patients With Advanced Cutaneous Malignancies (ARTACUS)
Primary Purpose
Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma, Basal Cell Carcinoma
Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RP1, intra-tumoral injection, oncolytic virus
Sponsored by
About this trial
This is an interventional treatment trial for Cutaneous Squamous Cell Carcinoma
Eligibility Criteria
Key Inclusion Criteria:
- 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.
- Patients with histologically or cytologically confirmed recurrent, locally advanced or metastatic (to skin, soft tissue or lymph nodes) cutaneous malignancies, including CSCC, basal cell carcinoma, Merkel cell carcinoma, and melanoma
Patients must have progressed following local resection, prior radiation, topical or systemic therapies.
Documentation from the patient's transplant physician confirming that the patient's allograft is stable.
- Patients for whom surgical or radiation treatment of lesions is contraindicated.
- 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).
- Eastern Cooperative Oncology Group (ECOG) performance status ≤1.
- Anticipated life expectancy > 6 months
- Baseline ECG without evidence of acute ischemia.
- 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:
- Prior treatment with an oncolytic therapy.
- Patients with visceral metastases.
- Patients with active herpetic infections or prior complications of HSV-1 infection (e.g., herpetic keratitis or encephalitis).
- Patients with a history of organ graft rejection within 12 months.
- Had systemic infection requiring intravenous (IV) antibiotics or anti-virals, or other serious infection within 60 days prior to dosing.
- 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.
- Patients requiring CTLA-4-Ig medications.
- 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.
- Active infection with hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV).
- Any history of transplant-related viral infections, such as BKV, 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.
- Patients with a condition requiring an increase in the patient's usual immunosuppressive medications within 60 days of study treatment.
- Known active CNS metastases and/or carcinomatous meningitis.
Sites / Locations
- Medical Dermatology SpecialistsRecruiting
- University of California, San DiegoRecruiting
- University of California, Los AngelesRecruiting
- UCSF, Helen Diller Family Comprehensive Cancer CenterRecruiting
- University of Colorado Cancer Center School of MedicineRecruiting
- University of Miami Sylvester Comprehensive Cancer CenterRecruiting
- University of ChicagoRecruiting
- University of MichiganRecruiting
- Columbia University Medical Center
- Rochester Dermatologic SurgeryRecruiting
- Duke UniversityRecruiting
- University of CincinnatiRecruiting
- The Ohio State University Comprehensive Cancer CenterRecruiting
- University of Pittsburgh Medical CenterRecruiting
- MD Anderson Cancer Center
- VCU Massey Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
RP1, intra-tumoral injection, oncolytic virus
Arm Description
RP1 administered as an intra-tumoral injection every 2 weeks.
Outcomes
Primary Outcome Measures
Primary Safety Outcome Measure
Assess the safety and tolerability of single-agent RP1 in solid organ transplant patients with cutaneous malignancies by incidence of subjects with treatment-emergent adverse events
Primary Efficacy Outcome Measure
The objective response rate (ORR) according to investigator assessment using modified RECIST version 1.1.
Incidence of subjects with treatment-emergent adverse events greater than or equal to Grade 3
Incidence of subjects with Serious adverse events (SAEs)
Incidence of subjects with fatal adverse events
Treatment-emergent adverse events requiring withdrawal from IP and incidence of organ allograft rejection
Secondary Outcome Measures
Duration of response (DOR) by investigator among subjects who experience Complete Response (CR) or Progressive Disease (PD)
CR rate by investigator assessment
Disease control rate (DCR) by investigator review
Clinical benefit rate defined as the rate of Complete Response (CR), Partial Response (PR), or Stable Disease (SD)
Progression Free Survival (PFS) by investigator review Duration of clinical benefit (DOCB) during active treatment and for up to one year after last treatment by investigator review
Overall survival (OS) at one year and two years
3-year survival rate of subjects
Quality of life (QoL), as determined by patient-reported outcomes
Biologic activity as assessed by changes in individual tumor sizes, erythema, inflammation and necrosis
Percentage of patients with biopsy-proven clinical rejection and percentage of patients who require an increase in immune suppressive therapy, during active treatment and for up to 1 year after last treatment
Disease-free Survival
To asses the efficacy of RP1 as determined by ORR in all transplant recipients treated, by investigator review
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04349436
Brief Title
A Phase 1B/2 Study of RP1 in Solid Organ Transplant Patients With Advanced Cutaneous Malignancies
Acronym
ARTACUS
Official Title
An Open-Label, Multicenter, Phase 1B/2 Study of RP1 in Solid Organ and Hematopoietic Cell Transplant Recipients With Advanced Cutaneous Malignancies
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 15, 2020 (Actual)
Primary Completion Date
September 2027 (Anticipated)
Study Completion Date
January 2028 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Replimune Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This Phase 1B/2 study is a multicenter, open-label, study of RP1 to investigate the (a) objective response rate, in addition to (b) safety and tolerability of RP1 for the treatment of advanced cutaneous malignancies in up to 65 evaluable organ transplant recipients. This will include patients with either previous renal, hepatic, heart, lung, or other solid organ transplantation or hematopoietic cell transplant and experiencing subsequent documented locally advanced or metastatic cutaneous malignancies. The study will enroll a total of 65 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.
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/2, open label, multicenter, trial evaluating the objective response rate and the safety and tolerability, biodistribution, shedding, and preliminary efficacy of RP1 in adult hepatic, renal, heart, lung, other solid organs, or hematopoietic cell transplant recipients who subsequently experienced advanced or metastatic cutaneous malignancies. 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.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma, Basal Cell Carcinoma, Melanoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
RP1 injection
Masking
None (Open Label)
Allocation
N/A
Enrollment
65 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
RP1, intra-tumoral injection, oncolytic virus
Arm Type
Experimental
Arm Description
RP1 administered as an intra-tumoral injection every 2 weeks.
Intervention Type
Biological
Intervention Name(s)
RP1, intra-tumoral injection, oncolytic virus
Intervention Description
Genetically modified herpes simplex type 1 virus
Primary Outcome Measure Information:
Title
Primary Safety Outcome Measure
Description
Assess the safety and tolerability of single-agent RP1 in solid organ transplant patients with cutaneous malignancies by incidence of subjects with treatment-emergent adverse events
Time Frame
36 months
Title
Primary Efficacy Outcome Measure
Description
The objective response rate (ORR) according to investigator assessment using modified RECIST version 1.1.
Time Frame
36 months
Title
Incidence of subjects with treatment-emergent adverse events greater than or equal to Grade 3
Time Frame
36 months
Title
Incidence of subjects with Serious adverse events (SAEs)
Time Frame
36 months
Title
Incidence of subjects with fatal adverse events
Time Frame
36 months
Title
Treatment-emergent adverse events requiring withdrawal from IP and incidence of organ allograft rejection
Time Frame
36 months
Secondary Outcome Measure Information:
Title
Duration of response (DOR) by investigator among subjects who experience Complete Response (CR) or Progressive Disease (PD)
Time Frame
36 months
Title
CR rate by investigator assessment
Time Frame
36 months
Title
Disease control rate (DCR) by investigator review
Time Frame
36 months
Title
Clinical benefit rate defined as the rate of Complete Response (CR), Partial Response (PR), or Stable Disease (SD)
Time Frame
36 months
Title
Progression Free Survival (PFS) by investigator review Duration of clinical benefit (DOCB) during active treatment and for up to one year after last treatment by investigator review
Time Frame
36 months
Title
Overall survival (OS) at one year and two years
Time Frame
36 months
Title
3-year survival rate of subjects
Time Frame
36 months
Title
Quality of life (QoL), as determined by patient-reported outcomes
Time Frame
36 months
Title
Biologic activity as assessed by changes in individual tumor sizes, erythema, inflammation and necrosis
Description
Percentage of patients with biopsy-proven clinical rejection and percentage of patients who require an increase in immune suppressive therapy, during active treatment and for up to 1 year after last treatment
Time Frame
36 months
Title
Disease-free Survival
Time Frame
36 months
Title
To asses the efficacy of RP1 as determined by ORR in all transplant recipients treated, by investigator review
Time Frame
36 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria:
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.
Patients with histologically or cytologically confirmed recurrent, locally advanced or metastatic (to skin, soft tissue or lymph nodes) cutaneous malignancies, including CSCC, basal cell carcinoma, Merkel cell carcinoma, and melanoma
Patients must have progressed following local resection, prior radiation, topical or systemic therapies.
Documentation from the patient's transplant physician confirming that the patient's allograft is stable.
Patients for whom surgical or radiation treatment of lesions is contraindicated.
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).
Eastern Cooperative Oncology Group (ECOG) performance status ≤1.
Anticipated life expectancy > 6 months
Baseline ECG without evidence of acute ischemia.
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:
Prior treatment with an oncolytic therapy.
Patients with visceral metastases.
Patients with active herpetic infections or prior complications of HSV-1 infection (e.g., herpetic keratitis or encephalitis).
Patients with a history of organ graft rejection within 12 months.
Had systemic infection requiring intravenous (IV) antibiotics or anti-virals, or other serious infection within 60 days prior to dosing.
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.
Patients requiring CTLA-4-Ig medications.
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.
Active infection with hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV).
Any history of transplant-related viral infections, such as BKV, 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.
Patients with a condition requiring an increase in the patient's usual immunosuppressive medications within 60 days of study treatment.
Known active CNS metastases and/or carcinomatous meningitis.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Clinical Trials at Replimune
Phone
1-781-222-9570
Email
Clinicaltrials@replimune.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeannie Hou, MD
Organizational Affiliation
Replimune Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Medical Dermatology Specialists
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nathalie Zeitouni, MD
Facility Name
University of California, San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gregory Daniels, MD
Facility Name
University of California, Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90024
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wanxing Chai-Ho, MD
Facility Name
UCSF, Helen Diller Family Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Katy Tsai, MD
Facility Name
University of Colorado Cancer Center School of Medicine
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Theresa Medina, MD
Facility Name
University of Miami Sylvester Comprehensive Cancer Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jennifer Tang, MD
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diana Bolotin, MD
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Swiecicki, MD
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Individual Site Status
Withdrawn
Facility Name
Rochester Dermatologic Surgery
City
New York
State/Province
New York
ZIP/Postal Code
14564
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ibrahim Sherrif, MD, PhD
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27708
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Meenal Kheterpal, MD
Facility Name
University of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Trisha Wise-Draper, MD
Facility Name
The Ohio State University Comprehensive Cancer Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Claire Verschraegen, MD
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diwakar Davar, MD
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
VCU Massey Cancer Center
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrew Poklepovic, MD
12. IPD Sharing Statement
Learn more about this trial
A Phase 1B/2 Study of RP1 in Solid Organ Transplant Patients With Advanced Cutaneous Malignancies
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