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T3011 in Combination With Cobimetinib in Patients With Advanced Melanoma

Primary Purpose

Melanoma, Malignant Melanoma

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
T3011 + Cobimetinib
Sponsored by
ImmVira Pharma Co. Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring intratumoral (IT) injection, Cobimetinib, advanced melanoma, RAS mutation-positive, BRAF V600E/V600K mutation-positive, stage IIIB to IV advanced malignant melanoma

Eligibility Criteria

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

Inclusion Criteria All patients must meet the following criteria for inclusion: Patient has provided informed consent prior to initiation of any study-specific activities/procedures. Male or female age ≥ 18 years at the time of informed consent. Willingness to provide pre-and post-treatment fresh tumor biopsy specimens as specified in the Schedule of Study Procedures and Assessments (Table 1). Histologically confirmed diagnosis of malignant melanoma (except for uveal melanoma). Patient with stage IIIB to IV advanced malignant melanoma (as defined by American Joint Committee on Cancer [AJCC] staging manual version 8.0) that is not surgically resectable, failed for standard of care (SOC) therapy or in the opinion of the investigator not suitable for SOC therapy. SOC may include, but not be limited to chemotherapy, targeted therapy or immunotherapy. BRAF V600E/V600K mutation-positive (applied to part 1 and part 2 cohort 1) or RAS mutation-positive (applied to part 1 and part 2 cohort 2). BRAF V600E/V600K and RAS mutation status result from diagnosis of tumor histopathology should be provided during Screening. If the patient is unable to provide, testing will be required during the Screening period in local laboratory. Measurable disease defined as one or both of the following: (1) At least 1 melanoma lesion that can be accurately and serially measured in at least 2 dimensions sand for which the longest diameter is ≥ 10 mm and with perpendicular diameter ≥ 5 mm as measured by contrast-enhanced or spiral CT scan for visceral or nodal/soft tissue disease. Lymph nodes must measure > 15 mm in their short axis to be considered measurable by CT scan. (2) At least 1 superficial cutaneous or subcutaneous melanoma lesion that can be accurately and serially measured in at least 2 dimensions and for which the short axis is ≥ 5 mm as measured by calipers. (3) Previously irradiated lesions can be considered as measurable disease only if progressive disease has been unequivocally documented at that lesion since radiation. 8. Injectable disease (i.e., suitable for direct injection or through the use of ultrasound [US] or CT guidance) defined as follows: At least 1 injectable melanoma lesion ≥ 5 mm in longest diameter, or in the opinion of the investigator the lesion can be injected. 9. Eastern Cooperative Oncology Group (ECOG) performance status 0-1. 10. Life expectancy ≥ 12 weeks. 11. Adequate bone marrow function defined by ANC of ≥ 1.5 × 109/L, platelet count of ≥ 100 × 109/L, and hemoglobin (Hb) of ≥ 8.5 g/dL. 12. Adequate hepatic function defined as AST/ALT ≤ 3 × ULN and total bilirubin ≤ 1.5 × ULN (except patients with Gilbert's Syndrome, wherein total bilirubin < 3.0 mg/dL is acceptable; patients with hepatic metastases: AST and/or ALT ≥ 5 × ULN is acceptable; patients with hepatic or bone metastases: ALP ≥ 5 × ULN is acceptable). 13. Adequate renal function defined as creatinine clearance > 50 mL/min as determined by the Cockcroft-Gault equation. 14. Adequate coagulation function defined as international normalization ratio (INR)/prothrombin time (PT) ≤ 1.5 × ULN, and partial thromboplastin time (PTT)/ activated PTT (aPTT) ≤ 1.5 × ULN, unless the patient is receiving anticoagulant therapy, in which case PT and PTT/aPTT must be within therapeutic range of intended use of anticoagulants. 15. Resolution of all prior anti-tumor therapy toxicities (except for alopecia) to ≤ NCI CTCAE version 5.0 Grade 1. Note: patients with immune-mediated endocrinopathies on replacement therapy are eligible. Patients with endocrine-related AE who can recover to ≤ NCI CTCAE version 5.0 Grade 1 after hormone replacement therapy, in the judgment of the investigator, have no impact on the safety and efficacy of this study can also be enrolled. Patients with toxicities attributed to the prior anti-tumor therapy and not expected to resolve, such as neuropathy or ototoxicity after platinum-based therapy, are permitted to enroll. Patients with other toxicities > NCI CTCAE version 5.0 Grade 1 may be enrolled with approval from the sponsor. 16. Female patients must be surgically sterile (or have a monogamous partner who is surgically sterile), or be at least 2 years postmenopausal, or commit to using 2 acceptable forms of birth control (defined as the use of an intrauterine device, a barrier method with spermicide, condoms, any form of hormonal contraceptives, or abstinence) for the duration of the study and for 6 months following the last dose of study treatment. Male patients must be sterile (biologically or surgically) or commit to the use of a reliable method of birth control (condoms with spermicide) for the duration of the study and for 6 months following the last dose of study treatment. 17. Women of childbearing potential (WCBP) must have a negative serum pregnancy test at Screening within 14 days before the first dose of study treatment on W1D1 and a negative urine pregnancy test pre-dose on W1D1 (assessment not required at W1D1 if completed within the previous 7 days of W1D1). Note: A woman is considered to be of childbearing potential if she is postmenarchal, has not reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and is not permanently infertile due to surgery (i.e., removal of ovaries, fallopian tubes, and/or uterus) or another cause as determined by the investigator (e.g., Müllerian agenesis). Exclusion Criteria Patients are to be excluded from the study if they meet any of the following criteria: Prior treatment with other Oncolytic virus (OV) (including but not be limited to T-VEC), tumor vaccines, cellular therapy or gene therapy. Prior local anti-tumor therapy < 21 days prior to the first dose of study treatment; prior systemic targeted therapy (including but not be limited to MEK inhibitors) < 21 days or last dose of therapy with MEK inhibitors < 5 times the half-life prior to first dose of study treatment; prior other anti-tumor therapy (including but not be limited to PD-1/programmed cell death ligand 1[PD-L1]) < 21 days prior to the first dose of study treatment, prior major surgery < 21 days prior to the first dose of study treatment. Prior treatment with anti-PD-(L)1 monoclonal Ab in combination with IL-12. Previous intolerance to anti-PD-(L)1 monoclonal Ab or previous history of immunotherapy induced ≥ NCI CTCAE version 5.0 Grade 3 non-infectious pneumonitis/interstitial lung disease. The following foods/supplements are used within 7 days before the study treatment or the following foods/supplements are planned to be used during the study treatment: (1) St. John's wort or hyperforin (potent cytochrome P450 CYP3A4 enzyme inducer). (2) Grapefruit juice (potent cytochrome P450 CYP3A4 enzyme inhibitor). 6. Refractory nausea and vomiting, chronic gastrointestinal diseases or previous significant bowel resection that would interfere with absorption of study drugs, inability or unwillingness to swallow the formulated product. 7. A history of metastasis to the brain stem, midbrain, pons/medulla oblongata, or within 10 mm of optic nerve organs (optic nerve and optic chiasma); Or a history of leptomeningeal metastasis. 8. Patients with rapidly disease progression, defined as patients who cannot tolerate interruption of systemic anti-tumor therapy for at least 8 weeks, according to the investigator's judgment. 9. Primary or acquired immunodeficient status (leukemia, lymphoma, human immunodeficiency virus [HIV]/acquired immunodeficiency syndrome [AIDS]). 10. History or evidence of active autoimmune disease that requires systemic treatment (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs) within 4 weeks prior to first dose of study treatment. Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. 11. History or evidence of active primary immunodeficiency. 12. Current or prior use of immunosuppressive medication within 14 days before the first dose of study drug. The following are exceptions to this criterion: Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra-articular injection). Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent. Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication). 13. Requires continued concurrent systemic therapy with any drug active against herpes simplex virus (HSV) (acyclovir, valaciclovir, penciclovir, famciclovir, ganciclovir, foscarnet, cidofovir). Topical use of drugs against HSV are allowed. 14. Live, attenuated vaccines within 4 weeks prior to initiation of study treatment (patients vaccinated with inactivated vaccines can be enrolled). 15. Active infection requiring systemic treatment. 16. Hepatic diseases known to be clinically significant include alcoholism, cirrhosis, fatty hepatic disease, and other hereditary hepatic diseases, or positive serological test of hepatitis B virus (HBV) or hepatitis C virus (HCV) at Screening. Patients who test positive for anti-hepatitis C Ab (anti-HCV) but negative for HCV ribonucleic acid (RNA) are considered eligible to participate in the study. Patients with infection of hepatitis B (positive hepatitis B surface antigen [HBsAg] result) will be excluded. Patients with a past or resolved HBV infection (defined as the presence of hepatitis B core Ab [HBcAb] and absence of HBsAg) are eligible. 17. Female patient is pregnant or breast-feeding, or planning to become pregnant during study treatment and through 6 months after the last dose of study treatment. 18. History of or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for neurosensory retinal detachment, central serous chorioretinopathy, retinal vein occlusion (RVO), or neovascular macular degeneration. Patients will be excluded from study participation if they currently are known to have any of the following risk factors for RVO: History of serous retinopathy; History of retinal vein occlusion; Evidence of ongoing serous retinopathy or RVO at baseline. 19. Patients with active central nervous system (CNS) lesions (i.e., those with radiographically unstable, symptomatic lesions, including but not limited to carcinomatous meningitis) and history of intracranial hemorrhage are excluded. However, patients are eligible if: Patients with all known CNS lesions have been treated with stereotactic therapy or surgery, whose disease is stable without using corticosteroids; AND There has been no evidence of clinical and radiographic disease progression in the CNS for ≥ 3 weeks after radiotherapy or surgery. 20. History of another primary malignant tumor, except the following: 1) the patient has undergone potentially curative therapy with no evidence of that disease and recurrence for 3 years prior to the first dose of study treatment; 2) Adequately treated non-melanoma skin cancer or lentigo with no evidence of malignancy; 3) Adequately treated carcinoma in situ without evidence of disease. 21. Patients with moderate to large amount of pleural effusion, ascites or pericardial effusion who need drug or medical intervention. Patient may be eligible to participate following discussion with investigator and approval from the sponsor. 22. Unexplained > 38.5℃ fever (If the fever is caused by the tumor according to the investigator's judgment, the patient can be enrolled) occurs during the Screening period or on the day of administration, which in the judgment of investigator, would interfere with patient participation in the study or evaluation of patient's efficacy. 23. History of seizure disorders within 6 months prior to Screening. 24. Active oral or skin herpes lesion at Screening. 25. Plan to receive any other anti-tumor therapy (including herbal therapy that has anti-tumor effects) during treatment with study drug. 26. History of congestive heart failure (> New York Heart Association Class II), active coronary artery disease, unevaluated new onset angina within 3 months or unstable angina (angina symptoms at rest), LVEF below institutional lower limit of normal or below 50%, whichever is lower, poorly controlled hypertension, defined as sustained, uncontrolled, nonepisodic baseline hypertension consistently above 159/99 mmHg despite optimal medical management, or clinically significant cardiac arrhythmias. 27. Uncontrolled diabetes or symptomatic hyperglycemia. 28. History of allergic reactions attributed to compounds of similar biological composition to HSV-1, IL-12, or anti-PD-1 monoclonal Ab or their excipients. 29. History of psychiatric disorders that would interfere with cooperation with the requirements of the trial or is still requiring for medication control. 30. History of substance abuse (including alcohol) within 6 months prior to signing informed consent. 31. Other systemic conditions or organ abnormalities that, in the opinion of the investigator, may interfere with the conduct and/or interpretation of the current study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Phase 2a

    Arm Description

    T3011 given via intratumoral (IT) injection in combination with Cobimetinib via oral administration in patients with advanced melanoma.

    Outcomes

    Primary Outcome Measures

    ORR
    defined as the proportion of patients with a CR or PR on two consecutive occasions ≥ 4 weeks apart, as determined by the investigator according to RECIST version 1.1
    Characterize the safety and tolerability of T3011 in combination with Cobimetinib.
    Incidence and severity of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), dose-limiting toxicities (DLTs) (part 1 only), adverse event of special interest (AESIs), abnormal clinically significant vital signs, physical examination, and laboratory tests, with severity determined according to national cancer institute (NCI) common terminology criteria for adverse events (CTCAE) version 5.0.

    Secondary Outcome Measures

    Overall Survival (OS)
    defined as the time from initiation of study treatment to death from any cause
    Progression-free survival (PFS)
    defined as the time from initiation of study treatment to the first occurrence of disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST version 1.1
    Disease control rate (DCR)
    defined as the proportion of patients who have a best overall response of CR or PR or SD, as determined by the investigator according to RECIST version 1.1.
    Duration of response (DOR)
    defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST version 1.1.
    European Organization for Research and Treatment of Cancer Questionnaire Core 30 (EORTC QLQ-C30)
    Change from baseline in the European Organization for Research and Treatment of Cancer Questionnaire Core 30 (EORTC QLQ-C30) (version 3.0) at subsequent visits protocol required.

    Full Information

    First Posted
    December 23, 2022
    Last Updated
    June 13, 2023
    Sponsor
    ImmVira Pharma Co. Ltd
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05756556
    Brief Title
    T3011 in Combination With Cobimetinib in Patients With Advanced Melanoma
    Official Title
    A Phase 2a, Open-label Study of T3011 in Combination With Cobimetinib in Patients With Advanced Melanoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 30, 2023 (Anticipated)
    Primary Completion Date
    December 31, 2025 (Anticipated)
    Study Completion Date
    January 1, 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    ImmVira Pharma Co. Ltd

    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 study will evaluate the efficacy and safety of T3011 in combination with Cobimetinib in patients with advanced melanoma.
    Detailed Description
    This is a phase 2a, open-label study of T3011 given via intratumoral (IT) injection in combination with Cobimetinib given via oral administration in patients with advanced melanoma. This study is planned to enroll approximately 62~68 patients with BRAF V600E/V600K mutation-positive or RAS mutation-positive, which will be conducted in 2 parts (part 1 and part 2).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Melanoma, Malignant Melanoma
    Keywords
    intratumoral (IT) injection, Cobimetinib, advanced melanoma, RAS mutation-positive, BRAF V600E/V600K mutation-positive, stage IIIB to IV advanced malignant melanoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Model Description
    This is a phase 2a, open-label study of T3011 given via intratumoral (IT) injection in combination with Cobimetinib given via oral administration in patients with advanced melanoma. This study is planned to enroll approximately 62~68 patients with BRAF V600E/V600K mutation-positive or RAS mutation-positive, which will be conducted in 2 parts (part 1 and part 2)
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    68 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Phase 2a
    Arm Type
    Experimental
    Arm Description
    T3011 given via intratumoral (IT) injection in combination with Cobimetinib via oral administration in patients with advanced melanoma.
    Intervention Type
    Combination Product
    Intervention Name(s)
    T3011 + Cobimetinib
    Intervention Description
    1e8 plaque-forming units (PFU)/mL (up to 10 mL, every 2 weeks [Q2W], 28 days/cycle) T3011 will be administered in combination with 60 mg Cobimetinib (once daily [QD] for the first 21 days of each 28-day cycle)
    Primary Outcome Measure Information:
    Title
    ORR
    Description
    defined as the proportion of patients with a CR or PR on two consecutive occasions ≥ 4 weeks apart, as determined by the investigator according to RECIST version 1.1
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.
    Title
    Characterize the safety and tolerability of T3011 in combination with Cobimetinib.
    Description
    Incidence and severity of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), dose-limiting toxicities (DLTs) (part 1 only), adverse event of special interest (AESIs), abnormal clinically significant vital signs, physical examination, and laboratory tests, with severity determined according to national cancer institute (NCI) common terminology criteria for adverse events (CTCAE) version 5.0.
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.
    Secondary Outcome Measure Information:
    Title
    Overall Survival (OS)
    Description
    defined as the time from initiation of study treatment to death from any cause
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.
    Title
    Progression-free survival (PFS)
    Description
    defined as the time from initiation of study treatment to the first occurrence of disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST version 1.1
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.
    Title
    Disease control rate (DCR)
    Description
    defined as the proportion of patients who have a best overall response of CR or PR or SD, as determined by the investigator according to RECIST version 1.1.
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.
    Title
    Duration of response (DOR)
    Description
    defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST version 1.1.
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.
    Title
    European Organization for Research and Treatment of Cancer Questionnaire Core 30 (EORTC QLQ-C30)
    Description
    Change from baseline in the European Organization for Research and Treatment of Cancer Questionnaire Core 30 (EORTC QLQ-C30) (version 3.0) at subsequent visits protocol required.
    Time Frame
    up to 5 years after the first dose of the last patient, depending on the actual situation.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria All patients must meet the following criteria for inclusion: Patient has provided informed consent prior to initiation of any study-specific activities/procedures. Male or female age ≥ 18 years at the time of informed consent. Willingness to provide pre-and post-treatment fresh tumor biopsy specimens as specified in the Schedule of Study Procedures and Assessments (Table 1). Histologically confirmed diagnosis of malignant melanoma (except for uveal melanoma). Patient with stage IIIB to IV advanced malignant melanoma (as defined by American Joint Committee on Cancer [AJCC] staging manual version 8.0) that is not surgically resectable, failed for standard of care (SOC) therapy or in the opinion of the investigator not suitable for SOC therapy. SOC may include, but not be limited to chemotherapy, targeted therapy or immunotherapy. BRAF V600E/V600K mutation-positive (applied to part 1 and part 2 cohort 1) or RAS mutation-positive (applied to part 1 and part 2 cohort 2). BRAF V600E/V600K and RAS mutation status result from diagnosis of tumor histopathology should be provided during Screening. If the patient is unable to provide, testing will be required during the Screening period in local laboratory. Measurable disease defined as one or both of the following: (1) At least 1 melanoma lesion that can be accurately and serially measured in at least 2 dimensions sand for which the longest diameter is ≥ 10 mm and with perpendicular diameter ≥ 5 mm as measured by contrast-enhanced or spiral CT scan for visceral or nodal/soft tissue disease. Lymph nodes must measure > 15 mm in their short axis to be considered measurable by CT scan. (2) At least 1 superficial cutaneous or subcutaneous melanoma lesion that can be accurately and serially measured in at least 2 dimensions and for which the short axis is ≥ 5 mm as measured by calipers. (3) Previously irradiated lesions can be considered as measurable disease only if progressive disease has been unequivocally documented at that lesion since radiation. 8. Injectable disease (i.e., suitable for direct injection or through the use of ultrasound [US] or CT guidance) defined as follows: At least 1 injectable melanoma lesion ≥ 5 mm in longest diameter, or in the opinion of the investigator the lesion can be injected. 9. Eastern Cooperative Oncology Group (ECOG) performance status 0-1. 10. Life expectancy ≥ 12 weeks. 11. Adequate bone marrow function defined by ANC of ≥ 1.5 × 109/L, platelet count of ≥ 100 × 109/L, and hemoglobin (Hb) of ≥ 8.5 g/dL. 12. Adequate hepatic function defined as AST/ALT ≤ 3 × ULN and total bilirubin ≤ 1.5 × ULN (except patients with Gilbert's Syndrome, wherein total bilirubin < 3.0 mg/dL is acceptable; patients with hepatic metastases: AST and/or ALT ≥ 5 × ULN is acceptable; patients with hepatic or bone metastases: ALP ≥ 5 × ULN is acceptable). 13. Adequate renal function defined as creatinine clearance > 50 mL/min as determined by the Cockcroft-Gault equation. 14. Adequate coagulation function defined as international normalization ratio (INR)/prothrombin time (PT) ≤ 1.5 × ULN, and partial thromboplastin time (PTT)/ activated PTT (aPTT) ≤ 1.5 × ULN, unless the patient is receiving anticoagulant therapy, in which case PT and PTT/aPTT must be within therapeutic range of intended use of anticoagulants. 15. Resolution of all prior anti-tumor therapy toxicities (except for alopecia) to ≤ NCI CTCAE version 5.0 Grade 1. Note: patients with immune-mediated endocrinopathies on replacement therapy are eligible. Patients with endocrine-related AE who can recover to ≤ NCI CTCAE version 5.0 Grade 1 after hormone replacement therapy, in the judgment of the investigator, have no impact on the safety and efficacy of this study can also be enrolled. Patients with toxicities attributed to the prior anti-tumor therapy and not expected to resolve, such as neuropathy or ototoxicity after platinum-based therapy, are permitted to enroll. Patients with other toxicities > NCI CTCAE version 5.0 Grade 1 may be enrolled with approval from the sponsor. 16. Female patients must be surgically sterile (or have a monogamous partner who is surgically sterile), or be at least 2 years postmenopausal, or commit to using 2 acceptable forms of birth control (defined as the use of an intrauterine device, a barrier method with spermicide, condoms, any form of hormonal contraceptives, or abstinence) for the duration of the study and for 6 months following the last dose of study treatment. Male patients must be sterile (biologically or surgically) or commit to the use of a reliable method of birth control (condoms with spermicide) for the duration of the study and for 6 months following the last dose of study treatment. 17. Women of childbearing potential (WCBP) must have a negative serum pregnancy test at Screening within 14 days before the first dose of study treatment on W1D1 and a negative urine pregnancy test pre-dose on W1D1 (assessment not required at W1D1 if completed within the previous 7 days of W1D1). Note: A woman is considered to be of childbearing potential if she is postmenarchal, has not reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and is not permanently infertile due to surgery (i.e., removal of ovaries, fallopian tubes, and/or uterus) or another cause as determined by the investigator (e.g., Müllerian agenesis). Exclusion Criteria Patients are to be excluded from the study if they meet any of the following criteria: Prior treatment with other Oncolytic virus (OV) (including but not be limited to T-VEC), tumor vaccines, cellular therapy or gene therapy. Prior local anti-tumor therapy < 21 days prior to the first dose of study treatment; prior systemic targeted therapy (including but not be limited to MEK inhibitors) < 21 days or last dose of therapy with MEK inhibitors < 5 times the half-life prior to first dose of study treatment; prior other anti-tumor therapy (including but not be limited to PD-1/programmed cell death ligand 1[PD-L1]) < 21 days prior to the first dose of study treatment, prior major surgery < 21 days prior to the first dose of study treatment. Prior treatment with anti-PD-(L)1 monoclonal Ab in combination with IL-12. Previous intolerance to anti-PD-(L)1 monoclonal Ab or previous history of immunotherapy induced ≥ NCI CTCAE version 5.0 Grade 3 non-infectious pneumonitis/interstitial lung disease. The following foods/supplements are used within 7 days before the study treatment or the following foods/supplements are planned to be used during the study treatment: (1) St. John's wort or hyperforin (potent cytochrome P450 CYP3A4 enzyme inducer). (2) Grapefruit juice (potent cytochrome P450 CYP3A4 enzyme inhibitor). 6. Refractory nausea and vomiting, chronic gastrointestinal diseases or previous significant bowel resection that would interfere with absorption of study drugs, inability or unwillingness to swallow the formulated product. 7. A history of metastasis to the brain stem, midbrain, pons/medulla oblongata, or within 10 mm of optic nerve organs (optic nerve and optic chiasma); Or a history of leptomeningeal metastasis. 8. Patients with rapidly disease progression, defined as patients who cannot tolerate interruption of systemic anti-tumor therapy for at least 8 weeks, according to the investigator's judgment. 9. Primary or acquired immunodeficient status (leukemia, lymphoma, human immunodeficiency virus [HIV]/acquired immunodeficiency syndrome [AIDS]). 10. History or evidence of active autoimmune disease that requires systemic treatment (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs) within 4 weeks prior to first dose of study treatment. Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. 11. History or evidence of active primary immunodeficiency. 12. Current or prior use of immunosuppressive medication within 14 days before the first dose of study drug. The following are exceptions to this criterion: Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra-articular injection). Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent. Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication). 13. Requires continued concurrent systemic therapy with any drug active against herpes simplex virus (HSV) (acyclovir, valaciclovir, penciclovir, famciclovir, ganciclovir, foscarnet, cidofovir). Topical use of drugs against HSV are allowed. 14. Live, attenuated vaccines within 4 weeks prior to initiation of study treatment (patients vaccinated with inactivated vaccines can be enrolled). 15. Active infection requiring systemic treatment. 16. Hepatic diseases known to be clinically significant include alcoholism, cirrhosis, fatty hepatic disease, and other hereditary hepatic diseases, or positive serological test of hepatitis B virus (HBV) or hepatitis C virus (HCV) at Screening. Patients who test positive for anti-hepatitis C Ab (anti-HCV) but negative for HCV ribonucleic acid (RNA) are considered eligible to participate in the study. Patients with infection of hepatitis B (positive hepatitis B surface antigen [HBsAg] result) will be excluded. Patients with a past or resolved HBV infection (defined as the presence of hepatitis B core Ab [HBcAb] and absence of HBsAg) are eligible. 17. Female patient is pregnant or breast-feeding, or planning to become pregnant during study treatment and through 6 months after the last dose of study treatment. 18. History of or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for neurosensory retinal detachment, central serous chorioretinopathy, retinal vein occlusion (RVO), or neovascular macular degeneration. Patients will be excluded from study participation if they currently are known to have any of the following risk factors for RVO: History of serous retinopathy; History of retinal vein occlusion; Evidence of ongoing serous retinopathy or RVO at baseline. 19. Patients with active central nervous system (CNS) lesions (i.e., those with radiographically unstable, symptomatic lesions, including but not limited to carcinomatous meningitis) and history of intracranial hemorrhage are excluded. However, patients are eligible if: Patients with all known CNS lesions have been treated with stereotactic therapy or surgery, whose disease is stable without using corticosteroids; AND There has been no evidence of clinical and radiographic disease progression in the CNS for ≥ 3 weeks after radiotherapy or surgery. 20. History of another primary malignant tumor, except the following: 1) the patient has undergone potentially curative therapy with no evidence of that disease and recurrence for 3 years prior to the first dose of study treatment; 2) Adequately treated non-melanoma skin cancer or lentigo with no evidence of malignancy; 3) Adequately treated carcinoma in situ without evidence of disease. 21. Patients with moderate to large amount of pleural effusion, ascites or pericardial effusion who need drug or medical intervention. Patient may be eligible to participate following discussion with investigator and approval from the sponsor. 22. Unexplained > 38.5℃ fever (If the fever is caused by the tumor according to the investigator's judgment, the patient can be enrolled) occurs during the Screening period or on the day of administration, which in the judgment of investigator, would interfere with patient participation in the study or evaluation of patient's efficacy. 23. History of seizure disorders within 6 months prior to Screening. 24. Active oral or skin herpes lesion at Screening. 25. Plan to receive any other anti-tumor therapy (including herbal therapy that has anti-tumor effects) during treatment with study drug. 26. History of congestive heart failure (> New York Heart Association Class II), active coronary artery disease, unevaluated new onset angina within 3 months or unstable angina (angina symptoms at rest), LVEF below institutional lower limit of normal or below 50%, whichever is lower, poorly controlled hypertension, defined as sustained, uncontrolled, nonepisodic baseline hypertension consistently above 159/99 mmHg despite optimal medical management, or clinically significant cardiac arrhythmias. 27. Uncontrolled diabetes or symptomatic hyperglycemia. 28. History of allergic reactions attributed to compounds of similar biological composition to HSV-1, IL-12, or anti-PD-1 monoclonal Ab or their excipients. 29. History of psychiatric disorders that would interfere with cooperation with the requirements of the trial or is still requiring for medication control. 30. History of substance abuse (including alcohol) within 6 months prior to signing informed consent. 31. Other systemic conditions or organ abnormalities that, in the opinion of the investigator, may interfere with the conduct and/or interpretation of the current study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    ImmVira Pharma Co., LTD
    Phone
    0755-28291816
    Email
    clinicaltrials@immviragroup.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    T3011 in Combination With Cobimetinib in Patients With Advanced Melanoma

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