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A Single Arm Trial Evaluating the Efficacy and Safety of EVX-01 in Combination With Pembrolizumab in Adults With Unresectable or Metastatic Melanoma

Primary Purpose

Melanoma Stage III, Melanoma Stage IV

Status
Recruiting
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
EVX-01
Pembrolizumab 25 MG/ML
Sponsored by
Evaxion Biotech A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma Stage III

Eligibility Criteria

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

Inclusion Criteria:

  • Be at least 18 years of age on day of signing informed consent.
  • Histologically confirmed, and not amenable to local therapy, metastatic or unresectable melanoma Stage III or Stage IV, as per AJCC 8th ed. staging system.

    1. Patient may not have a diagnosis of uveal or ocular melanoma.
    2. Patients must be treatment naïve to checkpoint inhibitor (CPI) therapy
    3. Patients must have testing for a BRAF mutation prior to study entry.

Note: Patients with BRAF V600E mutant melanoma may have received prior BRAF inhibitor therapy as first-line systemic therapy and be eligible for this study as second line treatment. At the discretion of the investigator, patients with BRAF V600E mutant melanoma who have NOT received a BRAF inhibitor are also eligible for this study as first line treatment if they meet the following additional criteria:

i. LDH < local ULN, ii. No clinically significant tumor related symptoms in the judgment of the investigator, and iii. Absence of rapidly progressing metastatic melanoma in the judgment of the investigator

  • Have measurable disease per RECIST 1.1 as assessed by the local site investigator within 4 weeks prior to the first visit. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
  • Patients must be willing and able to provide fresh or frozen tumor tissue from an unresectable or metastatic site of disease for neoepitope and biomarker analyses. If a sufficient amount of tumor tissue from an unresectable or metastatic site is not available prior to the start of the screening phase, subjects must consent to allow the acquisition of additional tumor tissue. In addition, participants may provide additional biopsy at the time of discontinuation due to progression.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

Exclusion Criteria:

  • Has 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).
  • Has received prior systemic anti-cancer therapy including investigational agents within 4 weeks prior to treatment.
  • Has received prior radiotherapy within 2 weeks of start of study treatment. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease.
  • Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention. Note: Administration of killed vaccines are allowed.

Sites / Locations

  • Melanoma Institute AustraliaRecruiting
  • Ballarat Health Services (Grampians Health)Recruiting
  • One Clinical ResearchRecruiting
  • Sir Charles Gairdner HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EVX-01 in combination with pembrolizumab

Arm Description

EVX-01 is administered im. Pembrolizumab is administered according to label

Outcomes

Primary Outcome Measures

Change in the best overall response (BOR)
Composite of a BOR of complete response (CR) or PR for patients with SD at the time of first EVX-01 administration and a BOR of CR for patients with PR at the time of first EVX-01 administration, within 2 years of treatment with pembrolizumab, as per RECIST 1.1 criteria

Secondary Outcome Measures

Change in overall response rate
Overall response rate, defined as the proportion of the patients who have best response as CR or PR assessed 2 years after initiation of treatment with pembrolizumab, as per RECIST 1.1 criteria
Change in progression free survival (PFS)
PFS in patients with an assessment of SD, PR, or CR at the time of first EVX-01 administration, assessed 2 years after initiation of treatment with pembrolizumab and defined as the time from the first EVX-01 administration to the first documented disease progression per RECIST 1.1. criteria or death due to any causes, whichever occurs first
Change in overall survival (OS)
OS assessed 2 years after initiation of treatment with pembrolizumab and defined as the time from initiation of treatment of pembrolizumab to death due to any cause
Number, type and severity of adverse events (AEs) and serious adverse events (SAEs)
Number, type and severity of adverse events (AEs) and serious adverse events (SAEs) to evaluate the safety of EVX-01 in patients with metastatic or unresectable melanoma on pembrolizumab treatment
Immunologic response induced by EVX-01
Activation and level of neoepitope specific CD4+ and CD8+ T-cells before, during and after EVX-01 immunization
Percentage of patients in which EVX-01 is generated, produced, and administered
Percentage of patients in which EVX-01 is generated, produced, and administered to evaluate the manufacturing feasibility of EVX-01

Full Information

First Posted
March 22, 2022
Last Updated
September 26, 2023
Sponsor
Evaxion Biotech A/S
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05309421
Brief Title
A Single Arm Trial Evaluating the Efficacy and Safety of EVX-01 in Combination With Pembrolizumab in Adults With Unresectable or Metastatic Melanoma
Official Title
An Open Label, Single Arm Trial Evaluating the Efficacy and Safety of EVX-01 in Combination With Pembrolizumab in Checkpoint Inhibitor Treatment naïve Adults With Unresectable or Metastatic Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 30, 2022 (Actual)
Primary Completion Date
June 28, 2025 (Anticipated)
Study Completion Date
July 25, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Evaxion Biotech A/S
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this single arm, multi-national clinical trial in patients with metastatic or unresectable melanoma is to evaluate the BOR and compare it to historical data on patients on anti-PD1 treatment with pembrolizumab alone.
Detailed Description
Patients will initiate treatment with pembrolizumab at the start of the trial and receive up to 18 treatment cycles (approximately 2 years). Immunization with the EVX-01 will be initiated at Week 12. In total, 10 doses of EVX-01 will be administered intramuscularly, with 6 doses given two weeks apart and 4 booster doses at later time points.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma Stage III, Melanoma Stage IV

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
EVX-01 in combination with pembrolizumab
Arm Type
Experimental
Arm Description
EVX-01 is administered im. Pembrolizumab is administered according to label
Intervention Type
Drug
Intervention Name(s)
EVX-01
Intervention Description
Investigational drug given in combination with standard of care
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab 25 MG/ML
Other Intervention Name(s)
Keytruda
Intervention Description
Standard of care
Primary Outcome Measure Information:
Title
Change in the best overall response (BOR)
Description
Composite of a BOR of complete response (CR) or PR for patients with SD at the time of first EVX-01 administration and a BOR of CR for patients with PR at the time of first EVX-01 administration, within 2 years of treatment with pembrolizumab, as per RECIST 1.1 criteria
Time Frame
Measurements at Baseline through study completion (up to 102 weeks)
Secondary Outcome Measure Information:
Title
Change in overall response rate
Description
Overall response rate, defined as the proportion of the patients who have best response as CR or PR assessed 2 years after initiation of treatment with pembrolizumab, as per RECIST 1.1 criteria
Time Frame
Measurements at Baseline through study completion (up to 102 weeks)
Title
Change in progression free survival (PFS)
Description
PFS in patients with an assessment of SD, PR, or CR at the time of first EVX-01 administration, assessed 2 years after initiation of treatment with pembrolizumab and defined as the time from the first EVX-01 administration to the first documented disease progression per RECIST 1.1. criteria or death due to any causes, whichever occurs first
Time Frame
Measurements at Baseline through study completion (up to 102 weeks)
Title
Change in overall survival (OS)
Description
OS assessed 2 years after initiation of treatment with pembrolizumab and defined as the time from initiation of treatment of pembrolizumab to death due to any cause
Time Frame
Measurements at Baseline through study completion (up to 102 weeks)
Title
Number, type and severity of adverse events (AEs) and serious adverse events (SAEs)
Description
Number, type and severity of adverse events (AEs) and serious adverse events (SAEs) to evaluate the safety of EVX-01 in patients with metastatic or unresectable melanoma on pembrolizumab treatment
Time Frame
Measurements at Baseline through study completion (up to 102 weeks)
Title
Immunologic response induced by EVX-01
Description
Activation and level of neoepitope specific CD4+ and CD8+ T-cells before, during and after EVX-01 immunization
Time Frame
Measurements at Baseline through study completion (up to 102 weeks)
Title
Percentage of patients in which EVX-01 is generated, produced, and administered
Description
Percentage of patients in which EVX-01 is generated, produced, and administered to evaluate the manufacturing feasibility of EVX-01
Time Frame
From tumor biopsy sampling to first dose of EVX-01 (up to 16 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be at least 18 years of age on day of signing informed consent. Histologically confirmed, and not amenable to local therapy, metastatic or unresectable melanoma Stage III or Stage IV, as per AJCC 8th ed. staging system. Patient may not have a diagnosis of uveal or ocular melanoma. Patients must be treatment naïve to checkpoint inhibitor (CPI) therapy Patients must have testing for a BRAF mutation prior to study entry. Note: Patients with BRAF V600E mutant melanoma may have received prior BRAF inhibitor therapy as first-line systemic therapy and be eligible for this study as second line treatment. At the discretion of the investigator, patients with BRAF V600E mutant melanoma who have NOT received a BRAF inhibitor are also eligible for this study as first line treatment if they meet the following additional criteria: i. LDH < local ULN, ii. No clinically significant tumor related symptoms in the judgment of the investigator, and iii. Absence of rapidly progressing metastatic melanoma in the judgment of the investigator Have measurable disease per RECIST 1.1 as assessed by the local site investigator within 4 weeks prior to the first visit. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. Patients must be willing and able to provide fresh or frozen tumor tissue from an unresectable or metastatic site of disease for neoepitope and biomarker analyses. If a sufficient amount of tumor tissue from an unresectable or metastatic site is not available prior to the start of the screening phase, subjects must consent to allow the acquisition of additional tumor tissue. In addition, participants may provide additional biopsy at the time of discontinuation due to progression. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Exclusion Criteria: Has 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). Has received prior systemic anti-cancer therapy including investigational agents within 4 weeks prior to treatment. Has received prior radiotherapy within 2 weeks of start of study treatment. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease. Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention. Note: Administration of killed vaccines are allowed.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anders Jespersen, MD, PhD
Phone
+45 28 93 12 38
Email
clinicaltrials@evaxion-biotech.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jeanette Vollerup, MSc.
Phone
+45 31 31 47 03
Email
clinicaltrials@evaxion-biotech.com
Facility Information:
Facility Name
Melanoma Institute Australia
City
Wollstonecraft
State/Province
New South Wales
ZIP/Postal Code
2065
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Georgina Long
Phone
+61 (0) 2-9911-7200
Email
georgina.long@sydney.edu.au
First Name & Middle Initial & Last Name & Degree
Georgina Long, MD
Facility Name
Ballarat Health Services (Grampians Health)
City
Ballarat Central
State/Province
Victoria
ZIP/Postal Code
3350
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sharad Sharma, MD
Phone
+61 (0) 3-5320-8500
Email
sharad.sharma@bhs.org.au
First Name & Middle Initial & Last Name & Degree
Sharad Sharma, MD
Facility Name
One Clinical Research
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Adnan Khattak, Prof
Phone
+61 (08) 6279 9466
Email
muhammad.khattak@health.wa.gov.au
First Name & Middle Initial & Last Name & Degree
Adnan Khattak, Prof
Facility Name
Sir Charles Gairdner Hospital
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tarek Meniawy
Phone
+61 (08) 6457 333
Email
SCGH.MedOncCTM@health.wa.gov.au
First Name & Middle Initial & Last Name & Degree
Tarek Meniawy, MD

12. IPD Sharing Statement

Citations:
PubMed Identifier
36047545
Citation
Long GV, Ferrucci PF, Khattak A, Meniawy TM, Ott PA, Chisamore M, Trolle T, Hyseni A, Heegaard E. KEYNOTE - D36: personalized immunotherapy with a neoepitope vaccine, EVX-01 and pembrolizumab in advanced melanoma. Future Oncol. 2022 Oct;18(31):3473-3480. doi: 10.2217/fon-2022-0694. Epub 2022 Sep 1.
Results Reference
derived

Learn more about this trial

A Single Arm Trial Evaluating the Efficacy and Safety of EVX-01 in Combination With Pembrolizumab in Adults With Unresectable or Metastatic Melanoma

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