Immunotherapy With IFx-Hu2.0 Vaccine for Advanced Non-melanoma Skin Cancers
Merkel Cell Carcinoma, Cutaneous Squamous Cell Carcinoma, Non-Melanoma Skin Cancers
About this trial
This is an interventional treatment trial for Merkel Cell Carcinoma focused on measuring Advanced, MCC, cSCC, pDNA, plasmid DNA, pAc/emm55, Gene Therapy, Immuno-Oncology, Therapeutic Cancer Vaccine, Immunotherapy
Eligibility Criteria
Inclusion Criteria:
- Life expectancy ≥ 3 months at recruitment
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 at the time of study treatment initiation.
- Males or females with histologically confirmed diagnosis of advanced non-melanoma skin cancers.
- Patients must have progressed despite standard therapy(ies) or are intolerant to or refused standard therapy(ies).
- Clinically measurable disease with at least 1 injectable lesion ≥ 3 mm in longest diameter; an injectable lesion is defined as an easily palpable superficial lesion (cutaneous, subcutaneous or lymph nodal metastasis) that can be accurately localized, stabilized by palpation, and is superficial enough to enable intralesional injection.
- No known bleeding diathesis or coagulopathy that would make intratumoral injection or biopsy unsafe
The entry laboratory criteria for subject eligibility must be less than or equal to Grade 1 adverse event levels for the parameters tested as defined by CTCAE v5.0:
Bone Marrow Function:
- Hemoglobin (Hb) > LLN 10 g/dL
- White Blood Cell Count (WBC) > LLN 3,000 cells/mcL
- Platelet count (PLT) > LLN - 75,000 /mcL
Blood Coagulation Parameters
- PT, INR < 1.5 x institutional ULN unless patient is therapeutically anticoagulated. If on anticoagulation PT/INR need to be within appropriate anticoagulation limits for the clinical indication. Patients who are receiving anticoagulants may participate in the trial if their anticoagulation can be stopped safely for several days at the time of biopsy.
Renal Function
- Serum Creatinine (SCr) < 1 - 1.5 x baseline; < 1 1.5 x ULN
Hepatic Function:
- Blood bilirubin < 1 - 1.5 x ULN if baseline was normal; < 1 1.5 x baseline if baseline was abnormal
- Serum Alanine Aminotransferase (ALT) < 1 - 3 x ULN if baseline was normal; 1.5 3 x baseline if baseline was abnormal
- Serum Aspartate Aminotransferase (AST) < 1 - 3 x ULN if baseline was normal; 1.5 3 x baseline if baseline was abnormal
- Alkaline Phosphatase (ALP) < 1 - 2.5 x ULN if baseline was normal; 2 2.5 x baseline if baseline was abnormal
- Gamma Glutylamyltransferase (GGT) < 1 - 2.5 x ULN, if baseline was normal; 2 2.5 x baseline if baseline was abnormal
- Males and females of reproductive potential must agree to continuously use adequate contraception prior to study entry and for up to 6 months thereafter. A female is of childbearing potential unless she has had a surgical procedure that would accomplish sterility such a bilateral tubal ligation, hysterectomy or has not had menses for the past 12 months.
- Females of childbearing potential must have a negative urine or serum pregnancy test within one week prior to start of treatment
- Patient or legal representative must understand and sign a written informed consent form.
Exclusion Criteria:
- Concurrent use of any other investigational product or participation in another trial within 28 days before start of study treatment.
- Have received oncologic therapy within 2 weeks of planned IFx-Hu2.0 injection
- Presence or history of central nervous system metastasis [treated/stable brain metastasis are allowable when patients have received prior therapy for their brain metastases and their central nervous system (CNS) disease is radiographically stable (> 4 weeks)]
- Pregnant or breastfeeding females and females desiring to become pregnant or breastfeed within the timeframe of this study
- Concurrent steroid therapy (> 10 mg of daily prednisone equivalent) or other immunosuppressive therapies such as those needed for solid organ transplants and rheumatoid arthritis. Topical or inhaled steroids are allowable.
- History of organ allograft transplantation
- History of hemolytic anemia
- History of significant tumor bleeding, or coagulation or bleeding disorders.
- Patients with autoimmune disorder, with exception of patients with vitiligo or endocrine-related autoimmune conditions receiving appropriate hormonal supplementation who are eligible; systemic use of immunosuppressant drugs such as steroids (except as hormone replacement therapy or short-course supportive medication such as chemotherapy or drug allergy, etc.), azathioprine, tacrolimus, cyclosporine, etc. within 4 weeks before recruitment. Prior autoimmune toxicity resolved to Grade 1 or less no longer requiring immunosuppressive therapy is not an exclusion under this criterion.
- Major surgery within 14 days prior to starting study drug or has not recovered from major side effects (tumor biopsy is not considered major surgery) resulting from a prior surgery
- Leptomeningeal involvement regardless of treatment status
- Active, clinically serious uncontrolled medical conditions such as HIV, HBV, HCV, and EBV infection
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with protocol requirements
- Unwilling or unable to follow protocol requirements
Sites / Locations
- USC Norris Comprehensive Cancer CenterRecruiting
- H. Lee Moffitt Cancer Center and Research InstituteRecruiting
- Dana-Farber Cancer InstituteRecruiting
- Huntsman Cancer InstituteRecruiting
Arms of the Study
Arm 1
Experimental
IFx-Hu2.0 (plasmid DNA) 0.1 mg/lesion/time point
Exposure Escalation: The first 3 subjects enrolled will receive a fixed IFx-Hu2.0 (plasmid DNA) dose of 0.1 mg injected in up to 3 lesions at a single time point (28-day follow-up post last injection); 3/3 patients recruited. The second 3 subjects enrolled will receive a fixed IFx-Hu2.0 (plasmid DNA) dose of 0.1 mg injected in up to 3 lesions at 2 time points 7 days apart (28-day follow-up post last injection); 1/3 patients recruited. The third 3 subjects enrolled will receive a fixed IFx-Hu2.0 (plasmid DNA) dose of 0.1 mg injected in up to 3 lesions at 3 time points 7 days apart (28-day follow-up post last injection); recruitment pending. Cohort Expansion: The remaining 11 subjects enrolled will receive a fixed IFx-Hu2.0 (plasmid DNA) dose of 0.1 mg injected in up to 3 lesions at 3 time points 7 days apart (28-day follow-up post last injection); recruitment pending.