Preliminary results from phase II study of combination treatment with HF10, a replication-competent HSV-1 oncolytic virus, and ipilimumab in patients with stage IIIb, IIIc, or IV unresectable or metastatic melanoma. ASCO 2016. #9543. J Clin Oncol 34, 2016. Andtbacka, Ross, Agarwala, et al.
Background: HF10 is a
replication-competent oncolytic virus derived from HSV-1. We report on
preliminary safety data and antitumor activity of HF10 + ipilimumab (ipi)
combination in an ongoing Phase 2 trial in melanoma. Methods: Key entry
criteria: age 18 yrs or older, ECOG greater than/= to 2, Stage IIIB, IIIC or IV
unresectable/unresected melanoma, ipi naïve (IV administration) and measurable
non-visceral lesion(s) suitable for injection. HF10 injected into single or
multiple tumors (1 x 107 TCID50/mL/dose, up to 5mL depending on
tumor size and number); 4 injections q1wk; then up to 15 injections q3wk. Four
ipi IV infusions (3 mg/kg; concurrent with HF10) are administered at q3wk. AEs
assessed per CTCAE 4.0. Tumor responses assessed per mWHO and irRC at 12, 18
and 24 wks and at 36 and 48 wks, for patients (pts) continuing on HF10
monotherapy. Primary endpoint is Best Overall Response Rate (BORR) at 24 wks.
Dose limiting toxicity defined as greater than/=to, G3 nonhematologic/hematologic toxicity, greater than/= to, G2 neurologic toxicity or allergic event occurring within 1st 3wks
of therapy. Results: Of 43 pts enrolled and treated at abstract data
cut-off 01Feb16: 58% men, age range 29 to 92 yrs, disease stage 21% IIIB, 44%
IIIC and 35% IV and 49% with ≥ 1 prior cancer therapy. Majority of HF10-related
AEs are ≤ G2, similar to HF10 monotherapy and consistent with other oncolytic
viruses. No DLTs or ≥ G4 AEs were reported. G3 AEs were experienced by 11.6% of
pts. Of 3 pts with HF10-related G3 AEs, 1 had left groin pain, a thromboembolic
event and lymphedema, 1 had hypoglycemia and 1 had diarrhea. Of 37 efficacy
evaluable pts, BORR by irRC at 24 weeks is 37.8% and
disease stability rate is 56.8% (18.9% SD). Enrollment and treatment are
ongoing. Conclusions: The combination with HF10 does not appear to
exacerbate ipi toxicity. Efficacy evaluation (overall and local) suggests that
HF10+ipi has both local and systemic antitumor activity and substantially
improves the response rate of ipi alone. Intratumoral HF10 serial injections
are safe and well-tolerated in combination with ipi and are a potential novel
therapeutic approach for metastatic melanoma.
Go ratties, go!!! - c
Go ratties, go!!! - c
Celeste, Any idea why they wouldn't go right to testing this with an anti-pd1 instead of Ipi?
ReplyDeleteNo, I do not know why they made that choice. If they had paired it with nivo or pembro we would be better able to contrast the results with the T-VEC and pembro studies currently ongoing...which would have been nice. I don't know if the ipi combo was all they could get approval for or if they thought since ipi works at an earlier point in the immune response it might provide better results. However, both of those ideas are pure speculation on my part.
ReplyDeletePS That would be a really great question to pose to the clinical coordinator or lead researcher!
ReplyDelete