Locally Advanced Malignant Solid NeoplasmPhase 1/2NCT04387071
CMP-001 and INCAGN01949 for Patients With Stage IV Pancreatic Cancer and Other Cancers Except Melanoma
A Phase 1/2 study testing Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949 and VLP-encapsulated TLR9 Agonist CMP-001 in people with Locally Advanced Malignant Solid Neoplasm and Metastatic Pancreatic Adenocarcinoma, run by University of Southern California at 4 sites in United States.
Trial summary
This phase Ib/II trial studies the side effects and best dose of CMP-001 and how well it works when given together with INCAGN01949 in treating patients with stage IV pancreatic cancer and other cancers except melanoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Locally Advanced Malignant Solid Neoplasm, Metastatic Pancreatic Adenocarcinoma, Stage IV Pancreatic Cancer AJCC v8
- What is being tested?
- Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949 and VLP-encapsulated TLR9 Agonist CMP-001
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 2 participants
- Where
- 4 sitesUnited States
- Study dates
- 29 Apr 2021to 28 Dec 2022
- Phase
- Phase 1/2
- 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
- Be willing and able to provide written informed consent for the trial
- Histologically or cytologically confirmed pancreatic adenocarcinoma with metastasis or other locally advanced un-resectable solid tumor malignancies (during the phase Ib and pancreatic cancer during phase II) deemed appropriate by the investigator except melanoma
- Patients will have had at least 2 prior therapies for locally advanced, unresectable and/or metastatic disease. Adjuvant therapy will count as one line of therapy if disease progression occurred during treatment or within 6 months of completion. Patients with metastatic pancreatic cancer must have received either fluorouracil/Irinotecan/leucovorin calcium/oxaliplatin (FOLFIRINOX) or a gemcitabine-based regimen as one of their prior lines of therapy. Patients with germline BRCA mutations must have received olaparib as maintenance therapy
- Be willing to undergo an image-guided biopsy of a tumor lesion at baseline, after 2 weeks of IT injection and 4 weeks of IT injection (week 4 and 6), unless tumor is considered inaccessible or biopsy is otherwise considered not in the patients best interest
- Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) performance scale
- Subjects must have at least one extra-central nervous system (CNS), non-bone tumor lesion amenable for IT injection >= 1.5 cm and that is not in close proximity or encasing crucial structures such as major blood vessels, trachea, nerve bundles etc. Measurable disease is required in a minimum of two lesions (one injected and one other) and there must be at least one measurable lesion in addition to the one being injected
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- Absolute neutrophil count (ANC) >= 1.5 x 10^9/L
- Platelets >= 100 x 10^9/L
- Hemoglobin >= 9 g/dL without transfusions within 7 days of assessment (transfusions are allowed prior to this period)
- Serum creatinine =< 1.5 X upper limit of normal (ULN) OR measured or calculated creatinine clearance (glomerular filtration rate [GFR] can also be used in place of creatinine or creatinine clearance [CrCl]) >= 60 mL/min for subject with creatinine levels > 1.5 X institutional ULN
- Creatinine clearance should be calculated per institutional standard
- Serum total bilirubin =< 1.5 X ULN OR
- Aspartate transaminase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine transferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 X ULN OR =< 5 X ULN for subjects with liver metastases
- Albumin >= 2.5 mg/dL
- International normalized ratio (INR) or prothrombin time (PT) =< 1.5 X ULN
- NOTE: Low molecular weight heparin at full dose or prophylactic dose is allowed as long as the treating physician deems it safe to hold the low molecular weight heparin (LMWH) on the day before and the day of the intra-tumoral injection. No other anti-coagulants are permitted
- Because of the intratumor injections patients cannot be on any anticoagulants other than LMWH
- Activated partial thromboplastin time (aPTT) =< 1.5 X ULN
- NOTE: Low molecular weight heparin at full dose or prophylactic dose is allowed as long as the treating physician deems it safe to hold the LMWH on the day before and the day of the intra-tumoral injection. No other anti-coagulants are permitted.
- Because of the intratumor injections patients cannot be on any anticoagulants other than LMWH
- Female participants of childbearing potential should have a negative serum pregnancy test within 24 hours prior to receiving first dose of trial medication
- A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:
- Not a woman of childbearing potential (WOCBP)
- A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
- Has not undergone a hysterectomy or bilateral oophorectomy; or
- Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months) OR
- A WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 180 days after the last dose of trial treatment
- Male participants must agree to use contraception as detailed in the full protocol during the treatment period and for at least 120 days after the last dose of trial treatment and refrain from donating sperm during this period
Who cannot join
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment. The use of physiologic doses of corticosteroids may be approved after consultation with the Investigator. If patients received prior ipilimumab or anti-CTLA4 compound and had adrenal insufficiency, treat these subjects with stress dose steroids prior to intratumoral injections. Patients may receive stress steroids orally or intravenously (IV) before the procedure
- Hypersensitivity to CMP-001 (TLR9 agonist) or INCAGN01949 (anti-OX40) or any of its excipients
- Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to week 1/day 1, or who has not recovered (i.e., =< grade 1 or to baseline) from adverse events due to agents administered more than 4 weeks earlier
- Has had prior chemotherapy, investigational agent, targeted small molecule therapy, or radiation therapy within 3 weeks (or 5 half-lives whichever is shorter) prior to week 1/ day 1 or who has not recovered (i.e., =< grade 1 or at baseline) from adverse events due to a previously administered agent(s)
- Note: Patients with =< grade 2 neuropathy are an exception to this criterion and may qualify for the trial
- Note: If patient received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy
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- Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer. Other malignancies which have been treated with curative intent, or for which patients are not receiving active therapy, may be considered upon discussion with the investigator
- Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Patients with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. Use of prophylactic anti-epileptic drugs is permitted. This exception does not include carcinomatous meningitis, which is excluded regardless of clinical stability
- Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment
- Has history of (non-infectious) pneumonitis that required steroids or current pneumonitis
- Has an active bacterial infection requiring systemic therapy
- Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the patient's participation for the full duration of the trial, or is not in the best interest of the patient to participate, in the opinion of the treating investigator
- Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial
- Has a known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies)
- Has active hepatitis B or C. Treated hepatitis C with sustained virologic response, and patients who are negative for hepatitis B surface antigen (sAg) are not excluded
- Note: Without known history, testing needs to be performed to determine eligibility
- Current, serious, clinically significant cardiac arrhythmias as determined by the treating investigator
- Has received a live vaccine within 30 days of planned start of trial therapy
- Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist) are live attenuated vaccines, and are not allowed
- Patients must not be receiving any anticoagulation. Low molecular weight heparin at full dose or prophylactic dose is allowed as long as the treating physician deems it safe to hold the LMWH on the day before and the day of the intra-tumoral injection
- Patients should not be on aspirin or any anti-platelet agent. Patients may have been receiving aspirin 81 mg if deemed safe by the investigator to hold aspirin for the duration of the study, starting at least 7 days prior to start of treatment
Trial locations and contacts
4 sites in 1 country.
United States4 sites
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
Hoag Memorial Hospital
Newport Beach, California, 92663
Lucile Packard Children's Hospital Stanford University
Palo Alto, California, 94304
HonorHealth Research Institute
Scottsdale, Arizona, 85258
About this study
Official title: The Seena Magowitz Phase IB/II Trial of CMP-001 (a TLR9 Agonist) in Combination With INCAGN01949 (an Activating Anti-OX40 Antibody) for In Situ Intratumoral Injection for Patients With Stage IV Pancreatic and Other Cancers Except Melanoma
This phase Ib/II trial studies the side effects and best dose of CMP-001 and how well it works when given together with INCAGN01949 in treating patients with stage IV pancreatic cancer and other cancers except melanoma. CMP-001 is made up of a short piece of DNA that is packaged in a protein, known as a virus-like particle (VLP). VLPs are detected and processed by cells of the immune system. The DNA contained in CMP-001 activates the immune system and recruit cells of the immune system to the tumor. INCAGN01949 is an antibody, a type of protein, which has been shown to stimulate the immune system. Injecting CMP-001 and INCAGN01949 directly into the tumor may work against tumor cells to slow tumor growth by causing tumor cells to die.
Read the detailed description
PRIMARY OBJECTIVES:
- To determine the maximum tolerated dose and tolerance of virus-like particle VLP-encapsulated TLR9 agonist CMP-001 (CMP-001 [TLR9 agonist]) in combination with agonistic anti-OX40 monoclonal antibody INCAGN01949 (INCAGN01949) (an activating antibody against OX40) both given intratumorally for patients with previously treated (for their metastatic disease) pancreatic ductal adenocarcinoma and other types of cancer except melanoma. (Phase IB) II. To determine the efficacy (disease control rate of complete response [CR] + partial response [PR] + stable disease [SD] X 16 weeks) of CMP001 (TLR9 agonist) in combination with INCAGN01949 (anti-OX40 antibody) for patients with previously treated (for their metastatic disease) pancreatic ductal adenocarcinoma. (Phase II) III. To determine effects on tumor markers. (Phase II)
SECONDARY OBJECTIVES:
- Define the toxicity of the combination of CMP-001 (TLR9) + INCAGN01949 (OX40).
II. Determine progression free survival and overall survival.
EXPLORATORY OBJECTIVES:
- Using flow cytometry on peripheral blood OX40 expression will be analyzed within the lymphocyte subsets (effector T cell [Teff] and regulatory T cell [Treg]).
II. On tissue samples collected prior to, and during, treatment, will:
IIa. Use flow cytometry to enumerate CD4+ and CD8+ T cell subsets, and the expression of activation/differentiation markers (including CD127, HLA-DR, CD45RO, CCR7, CXCR3) on each.
IIb. Use reverse transcriptase-polymerase chain reaction (RT-PCR) and sequencing to amplify and characterize the T-cell receptor (TCR)a and b sequences of tumor-infiltrating T cells, looking for evidence of oligoclonal T cell expansion, OX40 expression.
IIc. If there is adequate tumor tissue, perform ribonucleic acid sequencing (RNAseq) to determine different immune cell populations, including T cells and macrophages.
OUTLINE: This is a phase Ib, dose-escalation study of INCAGN01949, followed by a phase II study.
Patients receive CMP-001 subcutaneously (SC) on day 1 of weeks 1 and 2 and intratumorally (IT) on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days, and then every 12 weeks.
- Conditions
- Locally Advanced Malignant Solid Neoplasm, Metastatic Pancreatic Adenocarcinoma, Stage IV Pancreatic Cancer AJCC v8, Unresectable Malignant Solid Neoplasm
- Being tested
- Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, VLP-encapsulated TLR9 Agonist CMP-001
- Medical subject headings
- Pancreatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949Biological
Also called Anti-OX40 Agonist Antibody INCAGN01949, Anti-OX40 Monoclonal Antibody INCAGN0194, INCAGN 1949, INCAGN-1949
Given IT
VLP-encapsulated TLR9 Agonist CMP-001Drug
Also called ARB-1598, CMP-001, CYT 003, CYT-003
Given SC and IT
| Study group | Role | What they receive |
|---|---|---|
| Dose Level 1 (CMP-001, INCAGN01949) | Experimental | Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 500 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
| Dose Level -1 (CMP-001, INCAGN01949) | Experimental | Arm Description: Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 250 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
| Dose Level 2 (CMP-001, INCAGN01949) | Experimental | Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 1000 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
| Dose Level 3 (CMP-001, INCAGN01949) | Experimental | Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 1670 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
| Dose Level 4 (CMP-001, INCAGN01949 | Experimental | Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 2505 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
| Dose Level 5 (CMP-001, INCAGN01949) | Experimental | Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 3507 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
| Dose Level 6 (CMP-001, INCAGN01949) | Experimental | Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 4559 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Receives: Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949; Drug: VLP-encapsulated TLR9 Agonist CMP-001 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Disease Control Rate
Defined as the best response recorded from the start of treatment until disease progression/recurrence, evaluated according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.1 for target lesions and assessed by MRI: Complete Response (CR) = Disappearance of all target lesions; Partial Response (PR) = at least a 30% decrease in the sum of the diameters of the target lesions compared to the baseline; Stable Disease = Neither enough shrinkage for PR nor enough growth for PD; Progressive Disease = at least a 20% increase in the sum of the diameters of the target lesions from the smallest measurement recorded, with an absolute increase of at least 5 mm, or the appearance of one or more new lesions. All proportions will be estimated using an exact 95% binomial confidence interval.
Measured: Through end of treatment, up to 2 months
Objective Response Rate (CR + PR)
Will be evaluated using the RECIST 1.1 and iRECIST. Changes (i.e. improvements) in tumor measurements from baseline values will be assigned a status of complete response (CR) or partial response (PR) or stable disease (SD). Objective response measurements will comprise the sum of CR plus PR.
Measured: Through end of treatment, up to 2 months.
Secondary outcomes (3)
Incidence of Adverse Events
All adverse events occurring on or after week 1/day 1 will be summarized by body systems and per grade according to National Cancer Institute (NCI)-Common Terminology Criteria (CTC) version 5.
Measured: Through study completion, up to 9 months
Progression Free Survival (PFS)
PFS is defined as the interval from the date of registration (i.e. assignment of patient number) to the earliest date of documented evidence of recurrent or progressive disease, or the date of death due to any cause, whichever occurs first. All proportions will be estimated using an exact 95% binomial confidence interval, and a Kaplan-Meier analysis will be performed.
Measured: Through study completion, up to 9 months
Overall Survival
Will be measured from the date of registration (i.e. assignment of patient number) to the date of death due to any cause, or the date of last contact (censored observations). All proportions will be estimated using an exact 95% binomial confidence interval, and a Kaplan-Meier analysis will be performed.
Measured: Through study completion, up to 9 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 May 2020
- Study start29 Apr 2021
- Primary completion28 Dec 2022
- Study completion28 Dec 2022
Why it stopped: Study drug no longer available
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Locally Advanced Malignant Solid NeoplasmStudies of the same condition, open and under way.
- More trials run by University of Southern CaliforniaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 2 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Southern California
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Diana L Hanna, MD, Principal investigator, University of Southern California
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04387071
- Sponsor's protocol ID
- 0C-19-19/TGen 19-001
- Other IDs
- NCI-2020-03144, 0C-19-19/TGen 19-001, P30CA014089
- Status last verified
- Feb 2026
- First submitted
- 9 May 2020
- Last updated
- 17 Apr 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 17 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Seena Magowitz Phase IB/II Trial of CMP-001 (a TLR9 Agonist) in Combination With INCAGN01949 (an Activating Anti-OX40 Antibody) for In Situ Intratumoral Injection for Patients With Stage IV Pancreatic and Other Cancers Except Melanoma
- ClinicalTrials.gov ID
- NCT04387071
- Acronym / sponsor ID
- 0C-19-19/TGen 19-001
- Conditions
- Locally Advanced Malignant Solid Neoplasm, Metastatic Pancreatic Adenocarcinoma, Stage IV Pancreatic Cancer AJCC v8, Unresectable Malignant Solid Neoplasm
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Study drug no longer available
- Enrolment
- 2 participants (actual)
- Lead sponsor
- University of Southern CaliforniaUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- 29 Apr 2021 (actual)
- Primary completion
- 28 Dec 2022 (actual)
- Study completion
- 28 Dec 2022 (actual)
- First posted
- 13 May 2020 (actual)
- Results
- Posted 17 Feb 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase Ib/II trial studies the side effects and best dose of CMP-001 and how well it works when given together with INCAGN01949 in treating patients with stage IV pancreatic cancer and other cancers except melanoma. CMP-001 is made up of a short piece of DNA that is packaged in a protein, known as a virus-like particle (VLP). VLPs are detected and processed by cells of the immune system. The DNA contained in CMP-001 activates the immune system and recruit cells of the immune system to the tumor. INCAGN01949 is an antibody, a type of protein, which has been shown to stimulate the immune system. Injecting CMP-001 and INCAGN01949 directly into the tumor may work against tumor cells to slow tumor growth by causing tumor cells to die.
Detailed description
PRIMARY OBJECTIVES:
- To determine the maximum tolerated dose and tolerance of virus-like particle VLP-encapsulated TLR9 agonist CMP-001 (CMP-001 [TLR9 agonist]) in combination with agonistic anti-OX40 monoclonal antibody INCAGN01949 (INCAGN01949) (an activating antibody against OX40) both given intratumorally for patients with previously treated (for their metastatic disease) pancreatic ductal adenocarcinoma and other types of cancer except melanoma. (Phase IB) II. To determine the efficacy (disease control rate of complete response [CR] + partial response [PR] + stable disease [SD] X 16 weeks) of CMP001 (TLR9 agonist) in combination with INCAGN01949 (anti-OX40 antibody) for patients with previously treated (for their metastatic disease) pancreatic ductal adenocarcinoma. (Phase II) III. To determine effects on tumor markers. (Phase II)
SECONDARY OBJECTIVES:
- Define the toxicity of the combination of CMP-001 (TLR9) + INCAGN01949 (OX40).
II. Determine progression free survival and overall survival.
EXPLORATORY OBJECTIVES:
- Using flow cytometry on peripheral blood OX40 expression will be analyzed within the lymphocyte subsets (effector T cell [Teff] and regulatory T cell [Treg]).
II. On tissue samples collected prior to, and during, treatment, will:
IIa. Use flow cytometry to enumerate CD4+ and CD8+ T cell subsets, and the expression of activation/differentiation markers (including CD127, HLA-DR, CD45RO, CCR7, CXCR3) on each.
IIb. Use reverse transcriptase-polymerase chain reaction (RT-PCR) and sequencing to amplify and characterize the T-cell receptor (TCR)a and b sequences of tumor-infiltrating T cells, looking for evidence of oligoclonal T cell expansion, OX40 expression.
IIc. If there is adequate tumor tissue, perform ribonucleic acid sequencing (RNAseq) to determine different immune cell populations, including T cells and macrophages.
OUTLINE: This is a phase Ib, dose-escalation study of INCAGN01949, followed by a phase II study.
Patients receive CMP-001 subcutaneously (SC) on day 1 of weeks 1 and 2 and intratumorally (IT) on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days, and then every 12 weeks.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 7
| Arm | Type | Receives |
|---|---|---|
| Dose Level 1 (CMP-001, INCAGN01949) | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 500 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
| Dose Level -1 (CMP-001, INCAGN01949) | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Arm Description: Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 250 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
| Dose Level 2 (CMP-001, INCAGN01949) | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 1000 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
| Dose Level 3 (CMP-001, INCAGN01949) | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 1670 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
| Dose Level 4 (CMP-001, INCAGN01949 | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 2505 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
| Dose Level 5 (CMP-001, INCAGN01949) | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 3507 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
| Dose Level 6 (CMP-001, INCAGN01949) | Experimental | Biological: Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949, Drug: VLP-encapsulated TLR9 Agonist CMP-001Patients receive CMP-001 at 5 mg SC on day 1 of weeks 1 and 2 and 10 mg IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. Patients also receive INCAGN01949 at 4559 mcg/m^2 IT on day 1 of weeks 3-6 in the absence of disease progression or unacceptable toxicity. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (28 listed)
- Be willing and able to provide written informed consent for the trial
- Histologically or cytologically confirmed pancreatic adenocarcinoma with metastasis or other locally advanced un-resectable solid tumor malignancies (during the phase Ib and pancreatic cancer during phase II) deemed appropriate by the investigator except melanoma
- Patients will have had at least 2 prior therapies for locally advanced, unresectable and/or metastatic disease. Adjuvant therapy will count as one line of therapy if disease progression occurred during treatment or within 6 months of completion. Patients with metastatic pancreatic cancer must have received either fluorouracil/Irinotecan/leucovorin calcium/oxaliplatin (FOLFIRINOX) or a gemcitabine-based regimen as one of their prior lines of therapy. Patients with germline BRCA mutations must have received olaparib as maintenance therapy
- Be willing to undergo an image-guided biopsy of a tumor lesion at baseline, after 2 weeks of IT injection and 4 weeks of IT injection (week 4 and 6), unless tumor is considered inaccessible or biopsy is otherwise considered not in the patients best interest
- Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) performance scale
Key exclusion criteria (21 listed)
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment. The use of physiologic doses of corticosteroids may be approved after consultation with the Investigator. If patients received prior ipilimumab or anti-CTLA4 compound and had adrenal insufficiency, treat these subjects with stress dose steroids prior to intratumoral injections. Patients may receive stress steroids orally or intravenously (IV) before the procedure
- Hypersensitivity to CMP-001 (TLR9 agonist) or INCAGN01949 (anti-OX40) or any of its excipients
- Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to week 1/day 1, or who has not recovered (i.e., =< grade 1 or to baseline) from adverse events due to agents administered more than 4 weeks earlier
- Has had prior chemotherapy, investigational agent, targeted small molecule therapy, or radiation therapy within 3 weeks (or 5 half-lives whichever is shorter) prior to week 1/ day 1 or who has not recovered (i.e., =< grade 1 or at baseline) from adverse events due to a previously administered agent(s)
- Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer. Other malignancies which have been treated with curative intent, or for which patients are not receiving active therapy, may be considered upon discussion with the investigator
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949Also: Anti-OX40 Agonist Antibody INCAGN01949, Anti-OX40 Monoclonal Antibody INCAGN0194, INCAGN 1949, INCAGN-1949Given IT | Biological | Dose Level -1 (CMP-001, INCAGN01949), Dose Level 1 (CMP-001, INCAGN01949), Dose Level 2 (CMP-001, INCAGN01949), Dose Level 3 (CMP-001, INCAGN01949), Dose Level 4 (CMP-001, INCAGN01949, Dose Level 5 (CMP-001, INCAGN01949), Dose Level 6 (CMP-001, INCAGN01949) |
| VLP-encapsulated TLR9 Agonist CMP-001Also: ARB-1598, CMP-001, CYT 003, CYT-003Given SC and IT | Drug | Dose Level -1 (CMP-001, INCAGN01949), Dose Level 1 (CMP-001, INCAGN01949), Dose Level 2 (CMP-001, INCAGN01949), Dose Level 3 (CMP-001, INCAGN01949), Dose Level 4 (CMP-001, INCAGN01949, Dose Level 5 (CMP-001, INCAGN01949), Dose Level 6 (CMP-001, INCAGN01949) |
Primary outcome
Disease Control Rate
Time frame: Through end of treatment, up to 2 months
Defined as the best response recorded from the start of treatment until disease progression/recurrence, evaluated according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.1 for target lesions and assessed by MRI: Complete Response (CR) = Disappearance of all target lesions; Partial Response (PR) = at least a 30% decrease in the sum of the diameters of the target lesions compared to the baseline; Stable Disease = Neither enough shrinkage for PR nor enough growth for PD; Progressive Disease = at least a 20% increase in the sum of the diameters of the target lesions from the smallest measurement recorded, with an absolute increase of at least 5 mm, or the appearance of one or more new lesions. All proportions will be estimated using an exact 95% binomial confidence interval.
Objective Response Rate (CR + PR)
Time frame: Through end of treatment, up to 2 months.
Will be evaluated using the RECIST 1.1 and iRECIST. Changes (i.e. improvements) in tumor measurements from baseline values will be assigned a status of complete response (CR) or partial response (PR) or stable disease (SD). Objective response measurements will comprise the sum of CR plus PR.
3 secondary outcomes
Incidence of Adverse Events
Time frame: Through study completion, up to 9 months
Progression Free Survival (PFS)
Time frame: Through study completion, up to 9 months
Overall Survival
Time frame: Through study completion, up to 9 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Apr 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Diana L Hanna, MD principal investigator
University of Southern California
4 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Agonistic Anti-OX40 Monoclonal Antibody INCAGN01949 and VLP-encapsulated TLR9 Agonist CMP-001 in people with Locally Advanced Malignant Solid Neoplasm and Metastatic Pancreatic Adenocarcinoma, run by University of Southern California at 4 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 28 inclusion and 21 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: stopped early, as of the sponsor's last update on 17 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 4 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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 17 Feb 2026). 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?
Disease Control Rate (time frame: Through end of treatment, up to 2 months). The study lists 2 primary outcomes in all. 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 17 Apr 2026.