A phase II study of talimogene laherparepvec followed by talimogene laherparepvec + nivolumab in refractory T cell and NK cell lymphomas, cutaneous squamous cell carcinoma, Merkel cell carcinoma, and other rare skin tumors (NCI #10057).

Authors

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Ann W. Silk

Rutgers Cancer Institute of New Jersey, New Brunswick, NJ

Ann W. Silk, Nicole R. LeBoeuf, Guilherme Rabinowits, Igor Puzanov, Melissa Amber Burgess, Sumana Devata, Dirk Moore, James Steven Goydos, Helen X. Chen, Howard Kaufman, Andrew Zloza, Janice M. Mehnert

Organizations

Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, Dana–Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA, Dana-Farber Cancer Institute/Harvard Medical School, Boston, MA, Vanderbilt University Medical Center, Nashville, TN, University of Pittsburgh Physicians, Pittsburgh, PA, University of Michigan, Ann Arbor, MI, Rutgers School of Public Health, Piscataway, NJ, Cancer Institute of New Jersey, New Brunswick, NJ, CTEP National Cancer Institute, Rockville, MD

Research Funding

NIH

Background: Talimogene laherparepvec, a modified herpes virus agent, induces a response in 65% of injected melanoma tumors. The combination of talimogene laherparepvec with ipilimumab or pembrolizumab appears promising in clinical trials of advanced melanoma. Talimogene laherparepvec-based therapy may be effective in other cancers of the skin and lymph nodes that are anatomically accessible for intratumoral injection. Methods: This phase II study will evaluate intratumoral talimogene laherparepvec monotherapy in 4 parallel disease cohorts: 1) Refractory T cell and NK cell lymphomas including cutaneous T cell lymphoma, 2) Merkel cell carcinoma 3) Cutaneous squamous cell carcinoma and 4) Other advanced/refractory non-melanoma skin cancers. Lymphoma patients must be refractory to or intolerant of all standard life-prolonging therapies. Skin cancer patients must be advanced/unresectable or refractory to one or more treatments including surgery, radiation therapy, or medical therapy. Prior PD-1-directed therapy is allowed. If an objective response is not achieved by Week 12, the PD-1 blocking antibody nivolumab will be added. The primary endpoint is the response rate with talimogene laherparepvec and secondary endpoints include response rate with the combination and overall survival. Using a two-stage design, if 1 or more response is observed in the first 9 patients in each parallel cohort, 8 additional patients will be accrued for a total sample size of 36 to 68 patients across the 4 disease cohorts. Tumor biopsies of injected lesions are mandatory at baseline and Week 6, and optional at Week 16 and the time of progression. Optional biopsies of non-injected lesions (when applicable) at Week 6 and 16 will be analyzed to identify biomarkers of systemic immunity. Tumor tissue and/or blood will be assayed for PD-L1 expression, RNA profiling, immune cell profiling, HVEM, NECTIN 1/2, IDO, tryptophan and L-kynurenine, mutational load, TIL TCR clonality, and prior exposure to herpes simplex type 1 virus and Merkel cell polyomavirus. Clinical trial information: NCT02978625

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Abstract Details

Meeting

2018 ASCO-SITC Clinical Immuno-Oncology Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session B

Track

Developmental Therapeutics,Genitourinary Cancer,Head and Neck Cancer,Lung Cancer,Melanoma/Skin Cancers,Gastrointestinal Cancer,Breast and Gynecologic Cancers,Combination Studies,Implications for Patients and Society,Miscellaneous Cancers,Oncolytic Viruses

Sub Track

Immune Checkpoints and Stimulatory Receptors

Clinical Trial Registration Number

NCT02978625

Citation

J Clin Oncol 36, 2018 (suppl 5S; abstr TPS219)

DOI

10.1200/JCO.2018.36.5_suppl.TPS219

Abstract #

TPS219

Poster Bd #

N4

Abstract Disclosures