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Squamous Cell CarcinomaPhase 2NCT03714828

Study of TVEC in Patients With Cutaneous Squamous Cell Cancer

A Phase 2 study testing Injection of TVEC into target lesions - week 1-2, Injection of TVEC into target lesions 3wks after 1st injection and Injection of TVEC into target lesions 2wks after 2nd injection in people with Squamous Cell Carcinoma and Skin Cancer, run by University of Arizona at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is single arm Phase 2, single center study of talimogene laherparepvec (TVEC) to treat low risk cutaneous squamous cell carcinomas (cSCC). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Injection of TVEC into target lesions - week 1-2, Injection of TVEC into target lesions 3wks after 1st injection and Injection of TVEC into target lesions 2wks after 2nd injection
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
11 participants
Where
2 sitesUnited States
Study dates
20 Dec 2018to 19 Jul 2023
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Able to give informed consent in English or Spanish
  • Age > 18
  • Have at least one >0.5 cm to <5.0 cm, histologically confirmed low risk cutaneous SCC (including kerathoacanthomas)
  • Size >0.5 cm on trunk or extremities (excluding face, neck feet, nail units, and ankles)
  • Clinically consistent with primary tumors.
  • Lesion considered unresectable (as defined in Section 1.2)
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  • Recurrent lesions will be considered eligible if additional inclusion criteria are met.
  • No immunosuppression
  • Not a site of previous radiation therapy or chronic significant inflammation
  • Fast growing lesions (doubling in size over a 4 week period of time) will be included if they are clinically suggestive of cSCC of the keratoacanthoma type.
  • Well or moderately differentiated tumor as confirmed by skin biopsy
  • Depth less than 2 mm (for non KA type cSCC )
  • No perineural or vascular involvement in preliminary biopsy.
  • Partial biopsy of squamous cell skin cancer identified as a target lesion(s) to determine the histological differentiation of the tumor or other adverse histological features
  • In patients with multiple lesions, up to 3 lesions in a similar anatomical site, (trunk, limbs etc) that is at least 10 cm apart can be selected.
  • Maximum of 5 lesions per patient can be selected for treatment
  • Adequate organ function determined within 28 days prior to enrollment, defined as follows:
  • Hematology:
  • Absolute neutrophil count ≥ 1500/mm3 (1.5x109/L)
  • Platelet count ≥ 75,000/mm3 (7.5x109/L)
  • Hemoglobin ≥ 8 g/dL (without need for hematopoietic growth factor or transfusion support)
  • Renal
  • Serum creatinine ≤ 1.5 x upper limit of normal (ULN), OR 24-hour creatinine clearance ≥ 60 mL/min for subject with creatinine levels > 1.5 x ULN. (Note: Creatinine clearance need not be determined if the baseline serum creatinine is within normal limits. Creatinine clearance should be determined per institutional standard)
  • Hepatic
  • Serum bilirubin ≤ 1.5 x ULN
  • Aspartate aminotransferase (AST) ≤ 2.5 x ULN 23 | Page Version 6-26-2018
  • Alanine aminotransferase (ALT) ≤ 2.5 x ULN
  • Coagulation
  • International normalization ratio (INR) or prothrombin time (PT) ≤ 1.5 x ULN, unless the subject is receiving anticoagulant therapy, in which case PT and partial thromboplastin time (PTT)/ activated PTT (aPTT) must be within therapeutic range of intended use of anticoagulants.
  • PTT or aPTT ≤ 1.5 x ULN unless the subject is receiving anticoagulant therapy as long as PT and PTT/aPTT is within therapeutic range of intended use of anticoagulants.
  • Female subject of childbearing potential should have a negative urine or serum pregnancy test within 72 hours prior to enrollment. If urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.

Who cannot join

  • Any patient with diagnosis of invasive cancer in the last 3 years with the exception of stage I and II melanoma, cutaneous BCC and SCCs will be excluded.
  • Subjects on acitretin, capecitabine, topical chemotherapies or treatments.
  • History or evidence of symptomatic autoimmune disease (eg, pneumonitis, glomerulonephritis, vasculitis, or other), or history of active autoimmune disease that has required systemic treatment (ie, use of corticosteroids, immunosuppressive drugs or biological agents used for treatment of autoimmune diseases) in past 2 months prior to enrollment. Replacement therapy (eg, thyroxine for hypothyroidism, insulin for diabetes or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment for autoimmune disease.
  • Evidence of clinically significant immunosuppression such as the following:
  • Primary immunodeficiency state such as Severe Combined Immuno deficiency Disease
  • Acquired immunodeficiency syndrome
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  • Concurrent opportunistic infection
  • Receiving systemic immunosuppressive therapy (> 2 weeks) including oral steroid doses > 10 mg/day of prednisone or equivalent within 2 months prior to enrollment.
  • Active herpetic skin lesions or prior complications of herpetic infection (e.g., herpetic keratitis or encephalitis).
  • Requires intermittent or chronic systemic (intravenous or oral) treatment with an antiherpetic drug (e.g., acyclovir), other than intermittent topical use.
  • Previous treatment with talimogene laherparepvec or any other oncolytic virus
  • Prior therapy with tumor vaccine
  • Received live vaccine within 28 days prior to enrollment. 24 | Page Version 6-26-2018
  • Currently receiving treatment with another investigational device or drug study, or < 28 days since ending treatment with another investigational device or drug study(s)
  • Other investigational procedures while participating in this study are excluded.
  • Known to have acute or chronic active hepatitis B infection
  • Known to have acute or chronic active hepatitis C infection
  • History of other malignancy within the past 3 years with the following exceptions:
  • adequately treated mucosa associated lymphoid tissue (MALT) tumor
  • malignancy treated with curative intent and with no known active disease present for ≥ 3 years before enrollment and felt to be at low risk for recurrence by the treating physician
  • adequately treated non-melanoma skin cancer, lentigo maligna, stage I or II cutaneous melanoma, without evidence of disease.
  • adequately treated cervical carcinoma in situ without evidence of disease
  • adequately treated breast ductal carcinoma in situ without evidence of disease
  • prostatic intraepithelial neoplasia without evidence of prostate cancer
  • adequately treated urothelial papillary noninvasive carcinoma or carcinoma in situ
  • Subject has known sensitivity to talimogene laherparepvec or any of its components to be administered during dosing.
  • Female subject is pregnant or breast-feeding, or planning to become pregnant during study treatment and through 3 months after the last dose of talimogene laherparepvec
  • Female subject of childbearing potential who is unwilling to use acceptable method(s) of effective contraception during study treatment and through 3 months after the last dose of talimogene laherparepvec. (Note: Women not of childbearing potential are defined as: Any female who is post-menopausal [age > 55 years with cessation of menses for 12 or more months or less than 55 years but not spontaneous menses for at least 2 years or less than 55 years and spontaneous menses within the past 1 year, but currently amenorrheic (eg, spontaneous or secondary to hysterectomy), and with postmenopausal gonadotropin levels (luteinizing hormone and follicle-stimulating hormone levels > 40 IU/L) or postmenopausal estradiol levels (< 5 ng/dL) or according to the definition of "postmenopausal range" for the laboratory involved] or who have had a hysterectomy, bilateral salpingectomy, or bilateral oophorectomy). 25 | Page Version 6-26-2018
  • Sexually active subjects and their partners unwilling to use male latex condom to avoid potential viral transmission during sexual contact while on treatment and within 30 days after treatment with talimogene laherparepvec.
  • Subject who is unwilling to minimize exposure with his/her blood or other body fluids to individuals who are at higher risks for HSV-1 induced complications such as immunosuppressed individuals, individuals known to have HIV infection, pregnant women, or children under the age of 1 year, during talimogene laherparepvec treatment and through 30 days after the last dose of talimogene laherparepvec.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Honor Health Research Institute

    Scottsdale, Arizona, 85258

  • University of Arizona Cancer Center

    Tucson, Arizona, 85724

Other trials in United States

About this study

Official title: A Single Arm Phase 2 Study of Talimogene Laherparepvec in Patients With Cutaneous Squamous Cell Cancer

This is single arm Phase 2, single center study of talimogene laherparepvec (TVEC) to treat low risk cutaneous squamous cell carcinomas (cSCC).

Read the detailed description

The purpose of this study is to assess the effect of Talimogene laherparepvec (TVEC) in patients diagnosed with lower risk cSCC in need of alternative therapeutic approaches.

Immune recognition and cytotoxic responses play an important role in the pathogenesis and progression of cutaneous squamous cell carcinoma (cSCC). TVEC is an HSV-1 oncolytic immunological agent FDA approved for the local treatment of unresectable recurrent melanoma. It is proposed that T-VEC directly destroys cancer cells and induces production of GM-CSF to enhance systemic antitumor immune priming. This proposed mechanism of action supports the novel approach to implement TVEC in the management of cSCC. Particularly, in patients with increased burden of primary tumors.

The study subjects enrolled in the study were Immunocompetent, > 18 years of age, and diagnosed with at least one histologically confirmed primary low-risk cSCC according to the Brigham and Women staging system. Unresectable lesions or patients unable/unwilling to undergo standard of care treatment were eligible to participate. Study lesions included target lesions injected (TLIs) and target non-injected lesions (TNILs). TNILs were selected to evaluate for abscopal effect when feasible. The TLIs were treated according to TVEC FDA approved protocol and followed for 1yr after the 1st injection. The primary endpoint of the study was to evaluate the overall response rate, defined as the proportion of subjects who achieved complete response and partial response in the TLIs. Safety and adverse effect profile (AEs), duration of response, time to response, durable response rate, and time to progression, were the some of the secondary endpoints included.

Being tested
Injection of TVEC into target lesions - week 1-2, Injection of TVEC into target lesions 3wks after 1st injection, Injection of TVEC into target lesions 2wks after 2nd injection, Injection of TVEC into target lesions 2wks after 3rd injection
Keywords
Skin cancer, Squamous cell, Squamous Cell Carcinoma, Skin lesion, Keratoacanthoma, talimogene laherparepvec
Medical subject headings
Carcinoma, Squamous Cell, Skin Neoplasms, Keratoacanthoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Injection of TVEC into target lesions - week 1-2Drug

    Target lesions are identified and documented with measurements and photographs. Photographs will be taken with regional and close up view of the anatomical area and lesion.

    Inject 0.5ml - 4ml (based on lesion size - section 7.1, Table 5) Talimogene laherparepvec at nominal concentration of 106 plaque forming units (PFU)/mL with approximately 1.15 mL in a 2 mL vial for the initial dose. This will be administered intralesionally to 1-3 cSCC lesions per anatomical site with a maximum of 5 injectable lesions per patient.

  • Injection of TVEC into target lesions 3wks after 1st injectionDrug

    Target lesions are identified and documented with measurements and photographs. Photographs will be taken with global and close up view of the anatomical area and lesion.

    Inject 0.5ml - 4ml (based on lesion size) and number of lesions selected. Talimogene laherparepvec at nominal concentration of 108 PFU/mL with approximately 1.15 mL in a 2 mL vial for the second and subsequent doses.

  • Injection of TVEC into target lesions 2wks after 2nd injectionDrug

    Target lesions are identified and documented with measurements and photographs. Photographs will be taken with global and close up view of the anatomical area and lesion.

    Inject 0.5ml - 4ml (based on lesion size) and number of lesions selected.Talimogene laherparepvec at nominal concentration of 108 PFU/mL with approximately 1.15 mL in a 2 mL vial for the subsequent doses.

  • Injection of TVEC into target lesions 2wks after 3rd injectionDrug

    Target lesions are identified and documented with measurements and photographs. Photographs will be taken with global and close up view of the anatomical area and lesion.

    Inject 0.5ml - 4ml (based on lesion size) and number of lesions selected. Talimogene laherparepvec at nominal concentration of 108 PFU/mL with approximately 1.15 mL in a 2 mL vial for the subsequent doses.

Study groups in NCT03714828
Study groupRoleWhat they receive
Treatment (talimogene laherparepvec)ExperimentalThe subject participation period will be approximately 48 weeks. This will include a screening visit, 4 injection visits and 5 follow up visits. Total length of study/patient is 8.5 to 10.5 months. TVEC will be administered by injection with a needle directly into one or more tumors.
Receives: Drug: Injection of TVEC into target lesions - week 1-2; Drug: Injection of TVEC into target lesions 3wks after 1st injection; Drug: Injection of TVEC into target lesions 2wks after 2nd injection; Drug: Injection of TVEC into target lesions 2wks after 3rd injection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Response Rate

    The primary end point is to evaluate the overall response rate (ORR) defined as proportion of subjects who achieved complete response (CR) and partial response (PR) in the cSCC Target injected lesions (TILs).

    Measured: 8.5-10.5 months

Secondary outcomes (9)
  1. Number of Participants With Events Requiring the Discontinuation of Study Drug

    1. Number of participants with events requiring the discontinuation of study drug
    2. 75% or greater number of Target injection lesions (TILs) meeting criteria for withdrawal.
    3. Identification of high-risk features in one or more TILs during study participation.
    4. Persistent discomfort (consecutive weeks of lesion pain, burning, or itching of Grade 2 or more).

    Measured: 8.5-10.5 months

  2. Time of Response.

    To measure time of response in cSCC individual TILs.

    Measured: 8.5-10.5 months

  3. Duration of Overall Response.

    To measure the duration of overall response (DOR) of individual TILs.

    Measured: 8.5-10.5 months

  4. Assess Durable Response.

    Assess durable response rate (DRR) of TILs. DRR was assessed when the time of CR or PR with response lasting continuously for at least 6 months.

    Measured: 8.5-10.5 months

  5. Time to Progression.

    To measure the time to progression (TTP) of individual TILs.

    Measured: 8.5-10.5 months

  6. Overall Response Rate by Ultrasound.

    Overall response rate (ORR) (CR+PR) assessed by imaging technique (high frequency ultrasound). The subjects received ultrasound assessments of their TILs at baseline/screening visit (0), and at visit 6 (first follow up visit, approximately 4-5 months from baseline).The tumor volume change was assessed between the 2 visits, and percent of subjects with tumor volume reduction was reported.

    Measured: Baseline and 4-5 months

  7. Overall Clinical Response Rate - Targeted Lesions.

    Overall clinical response rate (CR+PR) of individual TILs with talimogene laherparepvec (not as overall subject response).

    Measured: 8.5-10.5 months

  8. Percentage of Participants With Overall Clinical Response Rate - Non-injected Lesion(s).

    Percentage of Participants with overall clinical response rate (CR+PR) in cSCC Target non-injected lesion(s) (TNILs).

    Measured: 8.5-10.5 months

  9. Number of Safety Adverse Events (SAE) as Assessed According to the NCI Common Terminology Criteria for Adverse Events (CTCAE) 4.0

    1. Number of safety adverse events (SAE) as assessed according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) 4.0
    2. Clinically significant laboratory values i. Clinically significant laboratory values are based on participant condition and side effect. These will vary and will be determined by the clinical judgement of the research healthcare provider. Note: laboratory values will be collected for initial participant screening and side effects only, no other clinical laboratory values are scheduled in this protocol.

    Measured: 8.5-10.5 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Oct 2018
  2. Study start20 Dec 2018
  3. Primary completion19 Jul 2023
  4. Study completion19 Jul 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
11 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03714828
Sponsor's protocol ID
1807738975
Other IDs
29088
Status last verified
Oct 2024
First submitted
8 Oct 2018
Last updated
9 Oct 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Injection of TVEC into target lesions - week 1-2, Injection of TVEC into target lesions 3wks after 1st injection and Injection of TVEC into target lesions 2wks after 2nd injection in people with Squamous Cell Carcinoma and Skin Cancer, run by University of Arizona at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 31 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Response Rate (time frame: 8.5-10.5 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Oct 2024.

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