A Study of Safety, Tolerability and Immunogenicity of HPV-L2 Vaccine in Healthy Adult Male and Female Subjects

A First-in-Human, Phase 1, Randomized, Placebo-Controlled, Double-Blind Study to Assess the Safety and Tolerability, and to Explore Immunological Effects of I.M. Administered AAVLP-HPV Vaccine in Healthy Adult Male and Female Subjects

The purpose of this study is to evaluate the safety, tolerability, and the immunological effects of adeno-associated virus-like particle human papillomavirus (AAVLP-HPV) vaccine in healthy adults.

2A Pharma's AAVLP-HPV vaccine candidate is based on AAVLPs with insertion of sequences of the L2 minor HPV capsid protein. The vaccine's intended clinical use is as a vaccine for prophylaxis against HPV infection in adolescents and adults.

This is a 12 month single-center, randomized, placebo-controlled, double-blind, repeated dose, safety, tolerability, and immunological effect study. Twenty (20) healthy, adult male and female subjects will be enrolled with a minimum of 40% of each gender. Sixteen (16) subjects will be randomized to receive the active drug and 4 subjects to receive the placebo. At least 1 subject of each gender will be randomized to receive the placebo.

Subjects will receive a total of 3 doses of AAVLP-HPV or placebo: a prime on Day 1, and two boosts, one on Day 57 (±2 days) and one on Day 180 (±1 week). The volunteers will be followed until day 365 (±1 week) when they return for the final safety and serum-based immunogenicity and neutralising antibodies assessment.

Inclusion Criteria:

Subjects must fulfill all of the following inclusion criteria to be eligible for participation in the study:

1. Healthy, adult, male or female aged between 18 and 45 years, inclusive, at screening.

2. Body Mass Index (BMI) ≥ 18 and ≤ 32.0 kg/m2 at screening.

3. Medically healthy with no clinically significant medical history, physical examination, laboratory profiles, vital signs or ECGs, as deemed by the PI or designee.

4. For a female of childbearing potential: either be sexually inactive (abstinent as a lifestyle*) for 28 days prior to the first dosing and throughout the study or be using one of the following acceptable birth control methods:

   • hormonal oral contraceptives, vaginal ring, transdermal patch, or hormone releasing intrauterine device for at least 3 months prior to the first dosing with either a physical (e.g., condom, diaphragm, or other) or a chemical (e.g., spermicide) barrier method from the time of screening and throughout the study.
   • depot/implantable hormone (e.g., Depo-provera®, Implanon) for at least 3 months prior to the first dosing and throughout the study.

   In addition, female subjects of childbearing potential will be advised to remain sexually inactive or to keep the same birth control method for at least 28 days following the last dose.

   * True abstinence is defined as refraining from heterosexual intercourse in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), declaration of abstinence for the duration of exposure to study drug, and withdrawal are not acceptable methods of contraception.

5. For a female of non-childbearing potential: must have undergone one of the following sterilization procedures at least 6 months prior to the first dosing:

   • hysteroscopic sterilization;
   • bilateral tubal ligation or bilateral salpingectomy;
   • hysterectomy;
   • bilateral oophorectomy; or be postmenopausal with amenorrhea for at least 1 year prior to the first dosing and follicle-stimulating hormone (FSH) serum levels consistent with postmenopausal status.

6. Understands the study procedures in the informed consent form (ICF), and be willing and able to comply with the protocol.

Exclusion Criteria:

Subjects must not be enrolled in the study if they meet any of the following criteria:

1. Is mentally or legally incapacitated or has significant emotional problems at the time of the screening visit or expected during the conduct of the study.
2. History or presence of clinically significant medical or psychiatric condition or disease in the opinion of the PI or designee.
3. History of any illness that, in the opinion of the PI or designee, might confound the results of the study or poses an additional risk to the subject by their participation in the study.
4. History or presence of alcoholism or drug abuse within the past 2 years prior to the first dosing.
5. History or presence of hypersensitivity or idiosyncratic reaction to the study drugs or related compounds.
6. Prior vaccination against HPV.
7. Positive for HPV antibodies against HPV types 6, 11, 16, and 18.
8. Have received an investigational vaccination within 90 days before screening.
9. Have received any licensed vaccination within 30 days before screening.
10. Any condition that may interfere with the intended administration of the study drug.
11. Suffered from febrile or infectious illness within 7 days prior to Day 1.
12. Subjects who plan to become pregnant/start a family during the study.
13. Female subjects with a positive pregnancy test or who are lactating.
14. Drink alcohol in excess of 21 glasses/units (425 g) per week for males or 14 glasses/units (284 g) per week for females, with one unit = 150 mL of wine or 360 mL of beer or 45 mL of 45% alcohol.
15. Positive urine drug or alcohol results at screening or Day -1.
16. Positive results at screening for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV).
17. Seated blood pressure is less than 90/40 mmHg or greater than 140/90 mmHg at screening.
18. Seated heart rate is lower than 40 bpm or higher than 99 bpm at screening.
19. QTcF interval is >460 msec (males) or >470 msec (females) or has ECG findings deemed abnormal with clinical significance by the PI or designee at screening.
20. Unable to refrain from or anticipates the use of any drug, including prescription and non-prescription medications, herbal remedies, or vitamin supplements that could adversely affect the immune system during 3 months prior to vaccination and throughout the study. Inhaled and topical corticosteroids will be allowed. Medication listed as part of acceptable birth control methods and hormone replacement therapy will be allowed. After randomization, acetaminophen (up to 2 g per 24 hours) may be administered at the discretion of the PI or designee. Appropriate sources will be consulted by the PI or designee to confirm interaction with study drugs. Subjects may not initiate new prescription medication within 1 month prior to screening, with exceptions, or must be on a stable dose for at least 90 days prior to vaccination as approved in advance by the PI or designee.
21. Donation of blood or plasma within 90 days prior to the first dosing.
22. Donation of bone marrow within the last 6 months prior to the first dosing.
23. Participation in another clinical study with an investigational agent within the 90 days prior to first dosing. The 90-day window will be derived from the date of the last dosing, whichever is later, in the previous study to Day 1 of the current study.
24. Has tattoo(s) or scarring at or near the site of vaccine administration or any other condition which may interfere with injection site examination, in the opinion of the PI.