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Tolerability and Efficacy of UV1 Vaccine in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma Planned for First-line Treatment With Pembrolizumab (FOCUS)

Primary Purpose

Head and Neck Squamous Cell Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
UV1
Sargramostim for Injection
Pembrolizumab injection
Sponsored by
Martin-Luther-Universität Halle-Wittenberg
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Squamous Cell Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed diagnosis of a non-resectable recurrent or metastatic head and neck squamous cell carcinoma (not necessarily reconfirmed at time of enrolment)
  • At least one measurable tumor lesion as per RECIST v1.1, (Scan not older than 4 weeks before randomization)
  • Eligible for pembrolizumab monotherapy (PD-L1 CPS >/= 1% and adequate laboratory parameters for pembrolizumab monotherapy as assessed by the investigator)
  • ECOG-performance score 0-2
  • Written informed consent obtained according to international guidelines and local laws
  • Ability to understand and give informed consent.
  • Safe contraception measures for males and females. Procedures with a pearl index of less than 1% apply as safe pregnancy prevention measures.

Exclusion Criteria:

  • Patients for whom a combination therapy of a checkpoint inhibitor and a chemotherapy is deemed necessary in the opinion of the investigator
  • Participation in another interventional study simultaneously and within the last 30 days prior to inclusion (registries or observational studies allowed)
  • Concurrent malignancies other than disease under study within 5 years prior to inclusion, with the exception of those with a negligible risk of metastasis or death (e.g., expected 5-year OS > 90%) treated with expected curative outcome
  • Active, known, or suspected autoimmune disease requiring systemic treatment.
  • A concomitant therapy with systemic immune suppression: use of chronic systemic steroid medication (up to 5 mg/day prednisolone equivalent is allowed; patients using physiological replacement doses of prednisone for adrenal or pituitary insufficiency are eligible)
  • History of severe autoimmune disorder or history of organ transplant
  • Any serious or uncontrolled medical disorder or active infection that, in the opinion of the investigator, may increase the risk associated with study participation, study drug administration, or would impair the ability of the subject to receive study drug.
  • Significant acute or chronic infections including, among others (test not older than 4 weeks prior to randomization): Any positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS), Any positive test result for hepatitis B virus or hepatitis C virus indicating acute or chronic infection.
  • Pregnancy or lactation
  • (Bacterial) infections requiring systemic antibiotic treatment within 2 weeks prior to first dose of study treatment (depending on group assignment: either prior to first UV1 or prior to first pembrolizumab administration).
  • History of allergy or hypersensitivity to study drug or human granulocyte-macrophage colony stimulating factor, yeast-derived products or any constituent of the products
  • Receipt of a live vaccine within 30 days prior to start of therapy
  • Patient who has been incarcerated or involuntarily institutionalized by court order or by the authorities.
  • Patients who are unable to consent because they do not understand the nature, significance and implications of the clinical study and therefore cannot form a rational intention in the light of the facts.

Sites / Locations

  • Universitätsklinikum Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie
  • Charité Universitätsmedizin, Comprehensive Cancer Center, Medizinische Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie
  • Universitätsklinikum Greifswald, Klinik für Hals-, Nasen-, Ohrenkrankheiten, Kopf- und Halschirurgie
  • Universitätsklinikum Halle (Saale), Klinik und Poliklinik für Innere Medizin IVRecruiting
  • Universitätsklinikum Hamburg, Universitäres Cancer Center Hamburg UCCH, Hubertus Wald Tumorzentrum
  • Klinikum St. Georg gGmbH
  • Universitätsklinikum Leipzig, Klinik und Poliklinik für HNO HeilkundeRecruiting
  • Universitätsklinikum Mainz, III. Medizinische Klinik und PoliklinikRecruiting
  • Klinikum Stuttgart, Klinik für Hämatologie, Onkologie und PalliativmedizinRecruiting
  • Universitätsklinikum Würzburg, Comprehensive Cancer Center Mainfranken

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Vaccination arm

Calibration arm

Arm Description

Pembrolizumab flat dose iv every 3 weeks + UV1 vaccination (UV1 plus GM-CSF/Sargramostim as adjuvant per vaccination)

Pembrolizumab flat dose iv every 3 weeks

Outcomes

Primary Outcome Measures

Progression free survival rate
according to iRECIST

Secondary Outcome Measures

Progression free survival
according to iRECIST
Overall survival
Objective Response Rate
Complete Remission (CR) + Partial Remission (PR) according to iRECIST
Duration of Response
according to iRECIST
Rate of immune responses against hTERT peptides
measured by 3H-Thymidine proliferation and IFNgamma ELISPOT assays
Rate of clearance of ctDNA from blood on treatment
Adverse Events
according to NCI CTC AE v5.0

Full Information

First Posted
July 21, 2021
Last Updated
March 8, 2022
Sponsor
Martin-Luther-Universität Halle-Wittenberg
Collaborators
Ultimovacs ASA, Apotheke der Universitätsmedizin der Johannes Gutenberg-Universität Mainz (Germany), Axel Hinke. CCRC Cancer Clinical Research Consulting (Düsseldorf, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT05075122
Brief Title
Tolerability and Efficacy of UV1 Vaccine in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma Planned for First-line Treatment With Pembrolizumab
Acronym
FOCUS
Official Title
Phase 2 Multicenter Study Investigating the Tolerability and Efficacy of UV1 Vaccine in Patients With Recurrent or Metastatic PD-L1 Positive (CPS≥1) Head and Neck Squamous Cell Carcinoma Planned for First-line Treatment With Pembrolizumab
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 2, 2021 (Actual)
Primary Completion Date
August 2024 (Anticipated)
Study Completion Date
February 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Martin-Luther-Universität Halle-Wittenberg
Collaborators
Ultimovacs ASA, Apotheke der Universitätsmedizin der Johannes Gutenberg-Universität Mainz (Germany), Axel Hinke. CCRC Cancer Clinical Research Consulting (Düsseldorf, Germany

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
The primary objective of this study is to determine the clinical performance of UV1 vaccination as add on to standard pembrolizumab treatment in patients with recurrent or metastatic PD-L1 positive (CPS >=1) head and neck squamous cell carcinoma. Secondary objectives are to determine the efficacy in terms of overall survival ,objective response rate and duration of response. Moreover, this study will explore patient subgroups most likely deriving benefit from a targeted immunotherapy approach combining a checkpoint inhibitor with a cancer vaccine and help to establish liquid biopsy tumor monitoring in HNSCC.
Detailed Description
Overall survival of patients with metastatic or recurrent HNSCC has improved over the past decade but remains poor overall. Median overall survival is limited to less than 15 months, with the current standard of care (immune checkpoint blockade with or without chemotherapy). Many patients with HNSCC are frail and therefore cannot tolerate chemotherapy, reducing their treatment options to checkpoint inhibitor. Therefore, the development of effective and tolerable combination regimens is urgently needed, especially in first-line therapy. The FOCUS study will evaluate such a combination regimen in patients with metastatic or recurrent HNSCC. The experimental regimen evaluated in this study will test the first-line standard drug pembrolizumab in combination with the novel UV1 cancer vaccine. In the comparator arm, patients receive pembrolizumab as the standard of care. The aim is to assess whether the addition of UVI can increase the efficacy of the checkpoint inhibitor. Based on currently available data, a decrease in efficacy due to the combination of standard first-line therapy with pembrolizumab is unlikely. The FOCUS study could therefore establish a new 1st-line regimen with increased efficacy and acceptable tolerability, which would need to be compared with the standard of care in a larger phase III trial. Based on the biomarker data from the FOCUS study, a subsequent Phase 3 study would potentially test the regimen only in subpopulations with increased response probability. From the perspective of the individual patient, participants may benefit from the experimental combination through improved efficacy. On the other hand, this is a novel combination study for HNSCC, and there is a risk that efficacy may not improve.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Squamous Cell Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Vaccination arm
Arm Type
Experimental
Arm Description
Pembrolizumab flat dose iv every 3 weeks + UV1 vaccination (UV1 plus GM-CSF/Sargramostim as adjuvant per vaccination)
Arm Title
Calibration arm
Arm Type
Other
Arm Description
Pembrolizumab flat dose iv every 3 weeks
Intervention Type
Biological
Intervention Name(s)
UV1
Intervention Description
UV1 vaccination (300 μg) UV1 vaccination will be applied in a dense schedule with three vaccinations during one week before initiation of pembrolizumab, followed by 5 additional vaccinations every 3 weeks on d1 of each cycle (5 cycles in total, duration of treatment will be 13 weeks in total, regular EOT at week 14)
Intervention Type
Drug
Intervention Name(s)
Sargramostim for Injection
Intervention Description
75 μg GM-CSF as adjuvant per vaccination. Applied in a dense schedule with three injections during one week before initiation of pembrolizumab, followed by 5 additional injections every 3 weeks on d1 of each cycle (5 cycles in total, duration of treatment will be 13 weeks in total, regular EOT at week 14).
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab injection
Intervention Description
200mg flat dose iv every 3 weeks. Pembrolizumab will be administered beyond the EOT visit at physician discretion until disease progression and up to a maximum of two years (standard of care)
Primary Outcome Measure Information:
Title
Progression free survival rate
Description
according to iRECIST
Time Frame
6 months after first administration of study medication
Secondary Outcome Measure Information:
Title
Progression free survival
Description
according to iRECIST
Time Frame
every three months, until progression of disease, maximum 12 months from the date of LPI (last patient in)
Title
Overall survival
Time Frame
every three months, until death, maximum 12 months from the date of LPI (last patient in)
Title
Objective Response Rate
Description
Complete Remission (CR) + Partial Remission (PR) according to iRECIST
Time Frame
every three months, until death, maximum 12 months from the date of LPI (last patient in)
Title
Duration of Response
Description
according to iRECIST
Time Frame
every three months, until death, maximum 12 months from the date of LPI (last patient in)
Title
Rate of immune responses against hTERT peptides
Description
measured by 3H-Thymidine proliferation and IFNgamma ELISPOT assays
Time Frame
Baseline, up to 8 weeks, time of progression (max. 12 months after LPI)
Title
Rate of clearance of ctDNA from blood on treatment
Time Frame
Baseline, week 5, week 8 and 1, 3, 6 months after EOT (max. 14 weeks), time of progression (max. 12 months after LPI)
Title
Adverse Events
Description
according to NCI CTC AE v5.0
Time Frame
3 months after EOT (maximum 25 weeks after start of treatment)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed diagnosis of a non-resectable recurrent or metastatic head and neck squamous cell carcinoma (not necessarily reconfirmed at time of enrolment) At least one measurable tumor lesion as per RECIST v1.1, (Scan not older than 4 weeks before randomization) Eligible for pembrolizumab monotherapy (PD-L1 CPS >/= 1% and adequate laboratory parameters for pembrolizumab monotherapy as assessed by the investigator) ECOG-performance score 0-2 Written informed consent obtained according to international guidelines and local laws Ability to understand and give informed consent. Safe contraception measures for males and females. Procedures with a pearl index of less than 1% apply as safe pregnancy prevention measures. Exclusion Criteria: Patients for whom a combination therapy of a checkpoint inhibitor and a chemotherapy is deemed necessary in the opinion of the investigator Participation in another interventional study simultaneously and within the last 30 days prior to inclusion (registries or observational studies allowed) Concurrent malignancies other than disease under study within 5 years prior to inclusion, with the exception of those with a negligible risk of metastasis or death (e.g., expected 5-year OS > 90%) treated with expected curative outcome Active, known, or suspected autoimmune disease requiring systemic treatment. A concomitant therapy with systemic immune suppression: use of chronic systemic steroid medication (up to 5 mg/day prednisolone equivalent is allowed; patients using physiological replacement doses of prednisone for adrenal or pituitary insufficiency are eligible) History of severe autoimmune disorder or history of organ transplant Any serious or uncontrolled medical disorder or active infection that, in the opinion of the investigator, may increase the risk associated with study participation, study drug administration, or would impair the ability of the subject to receive study drug. Significant acute or chronic infections including, among others (test not older than 4 weeks prior to randomization): Any positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS), Any positive test result for hepatitis B virus or hepatitis C virus indicating acute or chronic infection. Pregnancy or lactation (Bacterial) infections requiring systemic antibiotic treatment within 2 weeks prior to first dose of study treatment (depending on group assignment: either prior to first UV1 or prior to first pembrolizumab administration). History of allergy or hypersensitivity to study drug or human granulocyte-macrophage colony stimulating factor, yeast-derived products or any constituent of the products Receipt of a live vaccine within 30 days prior to start of therapy Patient who has been incarcerated or involuntarily institutionalized by court order or by the authorities. Patients who are unable to consent because they do not understand the nature, significance and implications of the clinical study and therefore cannot form a rational intention in the light of the facts.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mascha Binder, MD
Phone
0049 345 557
Ext
2054
Email
mascha.binder@uk-halle.de
First Name & Middle Initial & Last Name or Official Title & Degree
Christine Dierks, MD
Phone
0049 345 557
Ext
2590
Email
christine.dierks@uk-halle.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mascha Binder, MD
Organizational Affiliation
University Medical Center Halle, Department of Hematology and Oncology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinikum Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie
City
Aachen
Country
Germany
Individual Site Status
Not yet recruiting
Facility Name
Charité Universitätsmedizin, Comprehensive Cancer Center, Medizinische Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie
City
Berlin
Country
Germany
Individual Site Status
Not yet recruiting
Facility Name
Universitätsklinikum Greifswald, Klinik für Hals-, Nasen-, Ohrenkrankheiten, Kopf- und Halschirurgie
City
Greifswald
Country
Germany
Individual Site Status
Not yet recruiting
Facility Name
Universitätsklinikum Halle (Saale), Klinik und Poliklinik für Innere Medizin IV
City
Halle (Saale)
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitätsklinikum Hamburg, Universitäres Cancer Center Hamburg UCCH, Hubertus Wald Tumorzentrum
City
Hamburg
Country
Germany
Individual Site Status
Not yet recruiting
Facility Name
Klinikum St. Georg gGmbH
City
Leipzig
Country
Germany
Individual Site Status
Not yet recruiting
Facility Name
Universitätsklinikum Leipzig, Klinik und Poliklinik für HNO Heilkunde
City
Leipzig
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitätsklinikum Mainz, III. Medizinische Klinik und Poliklinik
City
Mainz
Country
Germany
Individual Site Status
Recruiting
Facility Name
Klinikum Stuttgart, Klinik für Hämatologie, Onkologie und Palliativmedizin
City
Stuttgart
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitätsklinikum Würzburg, Comprehensive Cancer Center Mainfranken
City
Würzburg
Country
Germany
Individual Site Status
Not yet recruiting

12. IPD Sharing Statement

Learn more about this trial

Tolerability and Efficacy of UV1 Vaccine in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma Planned for First-line Treatment With Pembrolizumab

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