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Study of RP3 Monotherapy and RP3 in Combination With Nivolumab in Patients With Solid Tumors

Phase 1
Recruiting
Conditions
Advanced solid tumors
Interventions
Registration Number
2024-512710-17-00
Lead Sponsor
Replimune Group Inc.
Brief Summary

RP2-001-18 is a Phase 1, multicenter, open label, single agent dose escalation and combination treatment study of RP2 in adult subjects with advanced solid tumors, to determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D), as well as to evaluate preliminary efficacy.

Detailed Description

RP2 is a genetically modified herpes simplex type 1 virus (HSV-1) that expresses an anti-CTLA-4 antibody and is designed to directly destroy tumors and to generate an anti-tumor immune response. This is a Phase 1, multicenter, open label, dose escalation and expansion, first-in-human (FIH) clinical study to evaluate the safety and tolerability, biodistribution, shedding, and preliminary efficacy of RP2 alone and in combination with nivolumab in adult subjects with advanced solid tumors.

The study will be conducted in two parts. The first part of the study is an open-label, dose escalation FIH Phase 1 study to assess the safety and tolerability of RP2 and to determine the recommended Phase 2 dose (RP2D) to be used in the second part of the study. The second part of the study is an open label design to further investigate safety of RP2 in combination with nivolumab. It will also assess the biological activity of multiple doses of RP2 in combination with nivolumab. An expansion to the second part of the study will include enrolment of a further 30 patients on RP2 in combination with nivolumab.

Following completion of the expansion in part 2, part 3 will enroll a further 15 patients on RP3 monotherapy.

The expansion to part 2 and part 3 will focus on patients with advanced or metastatic uveal melanoma, lung cancer, breast cancer or GI cancers and patients with liver metastasis.

Recruitment & Eligibility

Status
RECRUITING
Sex
Not specified
Target Recruitment
36
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Dose escalation of RP2 - superficial tumorsRP2Dose escalation of RP2 alone in 3 cohorts with IT injections in superficial tumors.
Dose escalation of RP2 - deep/visceral tumorsRP2Dose escalation of RP2 alone in 3 cohorts with imaging guided IT injections in deep/visceral tumors.
Dose expansion of RP2 and nivolumab - superficial tumorsRP2Doses of RP2 (IT) in superficial tumors with nivolumab (IV).
Dose expansion of RP2 and nivolumab - superficial tumorsnivolumabDoses of RP2 (IT) in superficial tumors with nivolumab (IV).
Dose expansion of RP2 and nivolumab - deep/visceral tumorsRP2Imaging guided doses of RP2 (IT) in deep/visceral tumors.
Dose expansion of RP2 and nivolumab - deep/visceral tumorsnivolumabImaging guided doses of RP2 (IT) in deep/visceral tumors.
Seronegative cohortRP2Doses of RP2 (IT) in HSV seronegative participants.
Primary Outcome Measures
NameTimeMethod
Percentage of dose limiting toxicities (DLTs)From Day 1 up to 30 days after last dose.

Percentage of subjects with DLTs

Percentage of TEAEs ≥ Grade 3From Day 1 up to 60 days after last dose.

Percentage of subjects with TEAEs ≥ Grade 3

Maximum tolerated dose (MTD) of RP27 months

MTD on the safety and response data collected during the dose escalation phase (Part 1).

Percentage of adverse events (AEs)From Day 1 up to 60 days after last dose

Percentage of subjects with AEs

Percentage of serious adverse events (SAEs)From Day 1 up to 60 days after last dose

Percentage of subjects with SAEs

Recommended Phase 2 dose (RP2D) of RP27 months

RP2D of RP2 based on the safety and response data collected during the dose escalation phase (Part 1).

Percentage of treatment emergent adverse events (TEAEs)From Day 1 up to 60 days after last dose.

Percentage of subjects with TEAEs

Percentage of events requiring withdrawalFrom Day 1 up to last dose (up to 8 weeks for dose escalation phase and up to 2 years for expansion phase)).

Percentage of subjects experiencing events requiring withdrawal from treatment.

Secondary Outcome Measures
NameTimeMethod
Percentage of biologic activity20 weeks

Percentage of subjects with biological activity determined by tumor biopsies and biomarker data

Change in HSV-1 antibody levelsFrom Day 1 up to last dose (up to 4 months for dose escalation phase and up to 5.5 months for expansion phase)).

Change in HSV-1 antibody levels during treatment compared to baseline

Median duration of response3 years

Median duration of response of subjects

Percentage of complete response (CR)From Day 1 up to last dose (up to 8 weeks for escalation phase and up to 2 years for expansion phase).

Percentage of subjects with a CR

Percentage of stable disease (SD)From Day 1 up to last dose (up to 8 weeks for escalation phase and up to 2 years for expansion phase).

Percentage of subjects with SD

Median progression-free survival3 years

Median duration of progression-free survival of subjects

Percentage of subjects with detectable RP220 weeks

Data gathered from blood, urine, swabs of injection site, dressings, and oral mucosa to determine the shedding and biodistribution of RP2.

Percentage of overall response rate (ORR)3 years

Percentage of ORR.

Median overall survival3 years

Median overall survival rate of subjects

Percentage of partial response (PR)From Day 1 up to last dose (up to 8 weeks for escalation phase and up to 2 years for expansion phase).

Percentage of subjects with a PR

Trial Locations

Locations (7)

Hospital Universitario d'Hebron

🇪🇸

Barcelona, Spain

Hospital Universitario HM Sanchinarro

🇪🇸

Madrid, Spain

Hospital Clinico de Valencia

🇪🇸

Valencia, Spain

The Clatterbridge Cancer Centre NHS Foundation Trust

🇬🇧

Bebington, Merseyside, United Kingdom

The Royal Marsden NHS Foundation Trust

🇬🇧

London, United Kingdom

Churchill Hospital

🇬🇧

Oxford, United Kingdom

Royal Marsden Hospital

🇬🇧

Sutton, United Kingdom

Hospital Universitario d'Hebron
🇪🇸Barcelona, Spain

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