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Virus potency titer of drug product as determined by an improved potency assay was lower than originally determined by the assay described in the IND.
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This is a Phase 1/1b open-label dose escalation trial of Ad/MG1-E6E7 and sequential treatment with atezolizumab in patients with HPV associated cancers. This study will consist of two arms. Both arms will dose escalate (MG1-E6E7) using a 3 + 3 design in Phase 1 to establish initial safety and the maximum tolerated dose (MTD) / maximum feasible dose (MFD).
In the Phase 1b expansion for each arm, additional patients will be enrolled at the MTD as determined in Phase 1 in order to more thoroughly explore immune response, pharmacokinetics/dynamics, and safety for the patient populations with Cervical cancer, HPV positive (HPV+) Oropharyngeal cancer (Phase 1B, Arm 1, Cohorts A and B respectively) and HPV+ tumors with injectable lesions (Phase 1B, Arm 2, Cohort 3).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 (Intravenous dosing) | Experimental | Fixed dose of Ad-E6E7 administered IM on study Day 1. Followed by one of 3 dose levels (escalation) of MG1-E6E7 administered as 4 infusion (IV) doses over 2 weeks starting at study day 15. Fixed dose of atezolizumab administered IV every 3weeks starting at study day 43. |
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| Arm 2 (Intravenous and Intra-tumoral injection dosing) | Experimental | Fixed dose of Ad-E6E7 administered IM on study Day 1. Followed by one of 2 dose levels (escalation) of MG1-E6E7 administered as 1 IV dose, starting at study day 15, followed by 2 intratumoral (IT) doses administered on study days 18 & 29. Fixed dose of atezolizumab administered IV every 3weeks starting at study day 43. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ad-E6E7 | Biological | Adenovirus vaccine expressing mutant HPV E6 and E7 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety of Ad/MG1-E6E7 administration in HPV associated cancers | Safety will be determined by assessing the severity and frequency of treatment emergent Adverse Events and clinical laboratory toxicity using NCI CTCAE v 4.03. | 8 months |
| Determine the maximum tolerated dose (MTD)/ maximum feasible dose (MFD) of Ad/MG1-E6E7 in HPV associated cancers | MTD/MFD of Ad/MG1-E6E7 administered by IV infusion alone and IV infusion followed by direct injection of tumor (IT injection) in HPV associated cancers | 4 to 6 weeks after first treatment with Ad/MG1-E6E7 |
| Measure | Description | Time Frame |
|---|---|---|
| Concentration of Ad/MG1-E6E7 in blood | Change over time in the number of MG1-E6E7 genomes (qPCR) and MG1-E6E7 infectious units (PFU) in blood | 4 to 6 weeks after first treatment with Ad/MG1-E6E7 |
| Assess for the biodistribution and shedding of Ad/MG1-E6E7 |
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Key Inclusion Criteria:
Key Exclusion Criteria:
Exclusion Criteria Household Contacts:
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| Name | Affiliation | Role |
|---|---|---|
| Steve Bernstein, MD | Turnstone Biologics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Miami | Miami | Florida | 33136 | United States | ||
| Billings Clinic |
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| MG1-E6E7 | Biological | MG1 Maraba oncolytic virus expressing mutant HPV E6 and E7 |
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| Atezolizumab | Biological | monoclonal antibody; checkpoint inhibitor |
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Determine if there is any shedding of Ad/MG1-E6E7 into the environment by detecting the presence of viral plaque forming units (PFUs) in urine samples, cheek swabs, and rectal swabs after Ad/MG1-E6E7 treatment |
| 6 weeks after first treatment with Ad/MG1-E6E7 |
| Measure the differences in pre- and post treatment levels of T cell subsets and T cell activation status | Analyze the change over time in the the frequencies, absolute numbers and subsets of T cells (including regulatory T cells) | Before and after each dose of Ad/MG1-E6E7 and then every 3 weeks until treatment discontinuation |
| Anti-tumor activity | Evaluate tumor response by CT scan using RECIST v1.1 and irRECIST criteria in the overall patient population and the HPV16/18 positive patient population | Every 6 weeks for the first course of treatment and then every 9 weeks until date of documented progression by irRECIST, up to 2 years |
| Billings |
| Montana |
| 59101 |
| United States |
| Memorial Sloan Kettering Cancer Center | New York | New York | 10065 | United States |
| University of Toledo-The Eleanor N. Dana Cancer Center | Toledo | Ohio | 43614 | United States |
| University of Texas-MD Anderson Cancer Center | Houston | Texas | 77030 | United States |
| Juravinski Cancer Centre | Hamilton | Ontario | L8V 5C2 | Canada |
| Ottawa Hospital Research Institute | Ottawa | Ontario | K1H 8L6 | Canada |
| Princess Margaret Hospital | Toronto | Ontario | M5G 1X6 | Canada |
| ID | Term |
|---|---|
| C000594389 | atezolizumab |
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