Assessing Administration of pBI-11 Via Electroporation for the Treatment of Patients With HPV16/18+

Double-Blind Randomized Phase II Clinical Trial Assessing Administration of pBI-11 Via Electroporation for the Treatment of Patients With HPV16/18+ <CIN2

This research is being done to test the safety and feasibility of an investigational DNA vaccine called pBI-11 and to find out what effects, if any, it has on women with persistent human papillomavirus 16 (HPV16+) and/or human papillomavirus (HPV18+) cervical infection.

The DNA vaccine is designed to promote an immune response to treat disease caused by HPV types 16 and 18, viruses that can cause cervical cancer. The pBI-11 DNA vaccine or a placebo will be administered intramuscularly using the TriGridTM Delivery System.

Study Overview

• Status: Not yet recruiting
• Conditions: HPV Infection
• Intervention / Treatment: Biological: pBI-11 (3 doses); Biological: pBI-11 (1 dose); Biological: Placebo (2 doses)

Detailed Description

This is a randomized double-blind placebo-controlled phase II study with cross-over design. The primary goal of this study is three-fold; one is to determine the safety and feasibility of two pBI-11 DNA administrations four weeks apart in patients with persistent HPV16 and/or HPV18+ <CIN2, wherein 3.0 mg of the plasmid DNA is delivered via electroporation mediated intramuscular (IM) administration with the TriGrid Delivery System version 2.0 (TDS-IM v2.0); to evaluate the effect of vaccine on HPV16/18 viral DNA clearance; to evaluate the reliability of the device.

• Study Type: Interventional
• Enrollment (Estimated): 48
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Kimberly Levinson, MD; Phone Number: 410-955-8240; Email: klevins1@jhmi.edu

Study Locations

• United States
  • Alabama
    • Birmingham, Alabama, United States, 35249
      • University of Alabama at Birmingham
      • Contact: Rebecca Arend, MD; Email: rarend@uabmc.edu
      • Principal Investigator: Rebecca Arend, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Negative for Intraepithelial Lesions (NEIL), Atypical Squamous Cells of Undetermined Significance (ASC-US), or Low-grade Squamous Intraepithelial Lesion (LSIL) determined by cervical cytology

AND

• HPV16 and/or 18+ by Roche Cobas 4800, Roche Linear Array HPV Genotyping test, or other FDA-approved HPV genotyping test (Co-infections with HPV types other than HPV16/18 are permissible).
• Age ≥ 18 years
• Baseline Eastern Cooperative Oncology Group performance status of 0 or 1 at the time of enrollment.
• Patients must have adequate organ function at the time of enrollment as defined by the following parameters:
• White blood cell count ≥ 3,000 cells/uL
• Absolute lymphocyte number ≥ 500 cells/uL
• Absolute neutrophil count ≥ 1,500 cells/uL
• Platelets ≥ 90,000 cells/uL
• Hemoglobulin ≥ 9 g/dL
• Total bilirubin < 3 X the institutional limit of normal
• Aspartate Aminotransferase (AST) and Alanine Aminotransferase(ALT) < 3 X the institutional limit of normal
• Creatinine < 2.5 X the institutional limit of normal
• Women of child-bearing potential must agree to use long acting contraception (e.g. tubal ligation, intrauterine device or hormonal implant) or two forms of contraception (e.g. barrier method, oral contraceptives) prior to study entry and for 3 months after final vaccination.
• Ability to understand and the willingness to sign a written informed consent document.
• Able to adhere to the study visit schedule and other protocol requirements.

Exclusion Criteria:

• Histologic evidence of CIN2, cervical intraepithelial neoplasia 3 (CIN3), adenocarcinoma in situ or malignancy.
• Patients with a diagnosis of immunosuppression or active systemic use of immunosuppressive medications such as steroids.
• Patients who are receiving any other investigational agents within 28 days prior to the first dose of study vaccine.
• Patients with an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
• Patients with a history of systemic autoimmune disease such as multiple sclerosis or systemic lupus erythematosus (SLE), but exclusive of a history of thyroiditis, psoriasis, Sjogren's, or inflammatory bowel disease.
• Patients who are pregnant or breast feeding or plan to become pregnant within 12 months of first study treatment.
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to pBI-11 DNA vaccine.
• Patient with active infection of, or receiving treatment for Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV), or Hepatitis B Virus (HBV).
• History of prior malignancy with disease free interval <5 years; however, individuals with completely resected basal cell or squamous cell carcinoma of the skin within this interval may be enrolled.
• Participants with metal implant(s) at the site of injection or any electronic stimulation device, such as cardiac demand pacemakers, automatic implantable cardiac defibrillator, nerve stimulators, or deep brain stimulators.
• Participants with any chronic or active neurologic disorder, including seizures and epilepsy, excluding a single febrile seizure as a child or episode of seizure in pregnancy due to eclampsia.
• Participants with syncopal episode within 12 months of screening, excluding fainting for a known and unrelated cause such as anemia which has been resolved.
• Administration of immunoglobulins and/or any blood products within the 120 days preceding study entry or planned administration during the study period.
• Participants with a skin-fold measurement of the cutaneous and subcutaneous tissue for all eligible injection sites (vastus lateralis muscles with intact lymph drainage) exceeds 50 mm.
• Participants in whom the ability to observe possible local reactions at the injection site (lateralis region) is, in the opinion of the investigator, unacceptably obscured due to a physical condition or permanent body art.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm 1: pBI-11 + pBI-11 + pBI-11; Will receive 3 doses of pBI-11 using the TriGrid Delivery System.	Biological: pBI-11 (3 doses); pBI-11 at Day 0, Week 4, Month 7; Other Names: pBI-11 plasmid DNA
Experimental: Arm 2: Placebo + Placebo + pBI-11; Will receive 2 doses of placebo and 1 dose of pBI-11 using the TriGrid Delivery System	Biological: pBI-11 (1 dose); pBI-11 at Month 7; Biological: Placebo (2 doses); Placebo (saline) vaccine at Day 0, Week 4

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety - Frequency and Severity Local Adverse Events and Abnormalities	Count of the frequency and severity of local adverse events and abnormalities per CTCAE 5.0	Post-first study vaccination up to 12 months
Safety - Frequency and Severity Systemic Adverse Events and Abnormalities	Count of the frequency and severity of systemic adverse events and abnormalities per CTCAE 5.0	Post-first study vaccination up to 12 months
Safety - Frequency and Severity Solicited Local Adverse Events and Abnormalities	Count of the frequency and severity of solicited local adverse events and abnormalities per CTCAE 5.0	Through 7 days after each study vaccine
Safety - Frequency and Severity Solicited Systemic Adverse Events and Abnormalities	Count of the frequency and severity of solicited systemic adverse events and abnormalities per CTCAE 5.0.	At Week 0 up to 7 days post vaccine, At week 4 up to 7 days post vaccine, At 7 months up to 7 days post vaccine
Pain Scores assessed by Visual Analog Scale	The mean and standard deviation of the visual analog scale (VAS) based pain scores reported by the participants on the tolerability questionnaire. Scale range 0-10 with higher scores indicating worse pain.	Week 0, Week 4, 7 months
Acceptability as assessed by survey	The percentage of "Yes" responses to the acceptability question posed in the tolerability questionnaire	Week 0, Week 4, 7 months
Percentage of participants with no HPV16/18 detection	Effect of 2 doses of pBI-11 on HPV16/18 clearance. The percentage of participants with no detection of HPV16 or HPV18 in cervical specimens by Roche Cobas test.	At 6 months post first study vaccine
Reliability - Percentage of Device Faults	Percentage of administration procedures where a device fault is observed.	Duration of study, approximately 12 months
Reliability -Percentage of Delays	Percentage of administration procedures during which a device fault results in a delay in completion of the administration procedure of > 15 minutes.	Duration of study, approximately 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effect of 3 doses of pBI-11 on HPV16/18 clearance - Percentage of Participants that Exhibit HPV16/18 Positivity (Active arm)	The percentage of participants in the active arm that exhibit HPV16/18 positivity by Roche Cobas test	At Month 12 post first study vaccine
Effect of 1 dose of pBI-11 on HPV16/18 clearance - Percentage of participants that exhibit HPV16/18 positivity (Placebo arm)	The percentage of participants in the placebo arm that exhibit HPV16/18 positivity by Roche Cobas test	At Month 12 post first study vaccine
Levels of HPV16/18 E6/E7-specific T cells	Magnitude of HPV16/18 E6, and E7 cellular immune responses as assessed by interferon-gamma ELISpot, relative to baseline sample	At Week 8 post first study vaccine
Changes in Cytopathology	Changes in cytopathology of specimens taken pre- and post-vaccination by each regimen	Baseline, 6 months, and 12 months post-first study vaccine

Collaborators and Investigators

• Sponsor: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
• Collaborators: National Cancer Institute (NCI); PapiVax Biotech, Inc.
• Investigators: Principal Investigator: Kimberly Levinson, MD, Johns Hopkins University

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): March 1, 2029
• Study Completion (Estimated): March 1, 2030

Study Registration Dates

• First Submitted: January 8, 2024
• First Submitted That Met QC Criteria: January 8, 2024
• First Posted (Actual): January 18, 2024

Study Record Updates

• Last Update Posted (Actual): May 27, 2026
• Last Update Submitted That Met QC Criteria: May 26, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Pathologic Processes; Disease Attributes; Infections; Virus Diseases; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; DNA Virus Infections; Tumor Virus Infections; Pathological Conditions, Signs and Symptoms; Papillomavirus Infections
• Other Study ID Numbers: J23124; P50CA098252 (U.S. NIH Grant/Contract); IRB00408026 (Other Identifier: Johns Hopkins IRB)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No