Intranasal WSK-IM05 Vaccine Plus Tislelizumab as Neoadjuvant Therapy for HPV+ OPSCC
A Prospective, Single-Arm Clinical Study of Intranasal Recombinant Adenovirus Vaccine WSK-IM05 Combined With Tislelizumab as Neoadjuvant Therapy for HPV-Positive Oropharyngeal Squamous Cell Carcinoma
調査の概要
状態
研究の種類
入学 (推定)
段階
- フェーズ 1
連絡先と場所
研究連絡先
- 名前:Xingchen Peng
- 電話番号:18980606753
- メール:pxx2014@163.com
研究場所
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Sichuan
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Chengdu、Sichuan、中国、610000
- 募集
- West China Hospital, Sichuan University
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コンタクト:
- Sichuan University West China Hospital
- 電話番号:+8602885421141
- メール:pxx2014@163.com
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
1. Age ≥ 18 years, male or female.2. Histologically confirmed oropharyngeal squamous cell carcinoma meeting all of the following criteria: Newly diagnosed, HPV-positive, without distant metastases; Confirmed p16 positive by immunohistochemistry (defined as ≥70% moderate to strong nuclear and cytoplasmic staining of tumor cells);Assessed by head and neck surgery as resectable; Willing to undergo surgical treatment.3. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1.4. Adequate organ and bone marrow function, defined as:Hematology: neutrophil count (NEUT) ≥ 1.5×10⁹/L; platelet count (PLT) ≥ 80×10⁹/L; hemoglobin ≥ 8 g/dL; Liver function: AST, ALT, ALP ≤ 2.5×upper limit of normal (ULN); total bilirubin (TBIL) ≤ 1.5×ULN; Albumin ≥ 2.8 g/dL.Renal function: serum creatinine (Cr) ≤ 1.5×ULN or creatinine clearance (CCr) > 60 mL/min; Coagulation: international normalized ratio (INR) ≤ 1.5; activated partial thromboplastin time (APTT) ≤ 1.5×ULN; Adenovirus type 5(Ad5) neutralizing antibody titer ≤ 1:200.5. Willing to voluntarily sign the informed consent form and able to comply with protocol-required visits and procedures.
Exclusion Criteria:
1. History of other malignancies (except for adequately treated and with no recurrence within 5 years:basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer,cervical carcinoma in situ, intramucosal gastrointestinal carcinoma, or other malignancies deemed eligible by the investigator).2. Any active autoimmune disease or history of autoimmune disease,including but not limited to immune-related neurological disorders, multiple sclerosis, autoimmune(demyelinating) neuropathy, Guillain-Barré syndrome, myasthenia gravis, systemic lupus erythematosus(SLE), connective tissue disease, scleroderma, inflammatory bowel disease (including Crohn's disease and ulcerative colitis), autoimmune hepatitis, toxic epidermal necrolysis (TEN), or Stevens-Johnson syndrome (excluding type I diabetes mellitus managed with stable insulin doses).3. History of allergic disease, severe drug allergy, or known allergy to any component of large molecule protein preparations,PD-1 monoclonal antibody injections, or the intranasal recombinant adenovirus vaccine (note: severe allergy is defined as requiring hospitalization).4. Prior receipt of any of the following treatments:a. Prior use of PD-1 antibody, PD-L1 antibody, PD-L2 antibody, CTLA-4 antibody, EGFR antibody, or EGFR-TKI.b. Prior receipt of an antitumor vaccine.c. Use of any active vaccine against infectious diseases (e.g.,inffuenza vaccine, varicella vaccine) within 4 weeks before first dose or planned during the study period.d. Major surgery or severe trauma within 4 weeks before first dose.e. Prior antitumor toxicity not recovered to ≤ CTCAE v5.0 grade 1 (excluding alopecia or sequelae of prior platinum-related neuropathy) or to the levels specified in inclusion/exclusion criteria.5. Presence of severe medical conditions, such as: Cardiac dysfunction grade II or higher (NYHA criteria), ischemic heart disease (e.g., myocardial infarction or angina), clinically significant supraventricular or ventricular arrhythmias; Poorly controlled diabetes (fasting blood glucose ≥ 10 mmol/L); Poorly controlled hypertension (systolic blood pressure > 150 mmHg and/or diastolic blood pressure > 100 mmHg); Echocardiography showing ejection fraction < 50%; QTc interval: > 450 msec in males, > 470 msec in females; Any ECG abnormality that, in the investigator's opinion, poses additional risk for the study drug.6. History of interstitial lung disease, non-infectious pneumonitis, or high suspicion of interstitial lung disease; or conditions that might interfere with detection or management of suspected drug-related pulmonary toxicity. Patients with a prior history of drug-induced or radiation-induced non-infectious pneumonitis who are asymptomatic may be enrolled. Active tuberculosis or past tuberculosis that remains uncontrolled after treatment.7. Patients with hyperthyroidism or organic thyroid disease. Hypothyroidism managed with a stable dose of thyroid replacement hormone may be enrolled (as conffrmed by the investigator and/or endocrinologist).8. Active infection, or unexplained fever within 48 hours before first dose, or use of systemic antibiotics within 1 week before signing informed consent.9. Active hepatitis B (HBV DNA ≥ 2000 IU/mL or 10⁴ copies/mL) or active hepatitis C (positive HCV antibody with HCV RNA above the lower limit of detection), or known positive HIV test or known acquired immunodeffciency syndrome (AIDS).10. Clear history of neurological or psychiatric disorders, such as epilepsy or dementia.11. Clear history of drug abuse or alcohol abuse within 3 months.12. Pregnant or breast feeding women; participants (and their partners) who plan to conceive within 3 months after the study period, have unprotected sexual intercourse, or are unwilling to use adequate contraceptive measures (e.g., condom,intrauterine device, or partner sterilization).13. Receipt of any investigational drug within 4 weeks before first dose, or concurrent enrollment in another clinical study, unless it is an observational (non-interventional) study or the follow-up phase of an interventional study.14. Any other condition that,in the investigator's judgment, might interfere with the study, including inability to complete study treatment and follow-up.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:順次割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:WSK-IM05 (4×10^10 vp) + Tislelizumab
Participants receive two cycles (each cycle = 3 weeks) of neoadjuvant treatment.
On day 1 of each cycle: intranasal WSK-IM05 vaccine at a dose of 4×10^10 vp and tislelizumab 200 mg intravenously.
After two cycles, patients undergo radical surgery followed by standard postoperative therapy plus 15 cycles of adjuvant tislelizumab (200 mg every 3 weeks).
Dose-limiting toxicity (DLT) is assessed during the first 21 days after the first dose.
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Intranasal recombinant adenovirus vaccine WSK-IM05 at a dose of 4×10^10 vp administered via nasal spray on day 1 of each 3-week cycle for 2 cycles.
Intranasal recombinant adenovirus vaccine WSK-IM05 at a dose of 1.6x10^11 vp administered via nasal spray on day 1 of each 3-week cycle for 2 cycles.
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実験的:Arm 2: WSK-IM05 (8×10^10 vp) + Tislelizumab
Participants receive two cycles (each cycle = 3 weeks) of neoadjuvant treatment.
On day 1 of each cycle: intranasal WSK-IM05 vaccine at a dose of 8×10^10 vp and tislelizumab 200 mg intravenously.
After two cycles, patients undergo radical surgery followed by standard postoperative therapy plus 15 cycles of adjuvant tislelizumab (200 mg every 3 weeks).
Dose-limiting toxicity (DLT) is assessed during the first 21 days after the first dose.
|
Intranasal recombinant adenovirus vaccine WSK-IM05 at a dose of 1.6x10^11 vp administered via nasal spray on day 1 of each 3-week cycle for 2 cycles.
Intranasal recombinant adenovirus vaccine WSK-IM05 at a dose of 8×10^10 vp administered via nasal spray on day 1 of each 3-week cycle for 2 cycles.
|
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実験的:Arm 3: WSK-IM05(1.6×10^11 vp) + Tislelizumab
Participants receive two cycles (each cycle = 3 weeks) of neoadjuvant treatment.
On day 1 of each cycle: intranasal WSK-IM05 vaccine at a dose of 1.6×10^11 vp and tislelizumab 200 mg intravenously.
After two cycles, patients undergo radical surgery followed by standard postoperative therapy plus 15 cycles of adjuvant tislelizumab (200 mg every 3 weeks).
Dose-limiting toxicity (DLT) is assessed during the first 21 days after the first dose.
|
Intranasal recombinant adenovirus vaccine WSK-IM05 at a dose of 1.6x10^11 vp administered via nasal spray on day 1 of each 3-week cycle for 2 cycles.
Tislelizumab at a dose of 200 mg administered intravenously on day 1 of each 3-week cycle for 2 cycles (neoadjuvant phase), followed by 200 mg intravenously every 3 weeks for 15 cycles (adjuvant phase after surgery).
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Incidence of Dose-Limiting Toxicities (DLTs)
時間枠:First 21 days after first dose of WSK-IM05
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Proportion of participants experiencing DLTs within the DLT observation period (first 21 days after the first dose), as defined per protocol.
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First 21 days after first dose of WSK-IM05
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Incidence and Severity of Treatment-Related Adverse Events (TRAEs)
時間枠:From first dose through 30 days after last dose of WSK-IM05
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Type, incidence, severity (grade 1-5 according to CTCAE v5.0), and causality assessment of all treatment-related adverse events.
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From first dose through 30 days after last dose of WSK-IM05
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Incidence of Serious Adverse Events (SAEs)
時間枠:From first dose through 30 days after last dose
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Including immune-related adverse events (irAEs), injection/administration site reactions, allergic reactions, etc.
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From first dose through 30 days after last dose
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Major Pathological Response (MPR)
時間枠:At time of surgery (approx. Week 6-10)
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Proportion of participants who undergo surgery with residual viable tumor ≤10% (%RVT ≤10%) in the tumor bed according to irPRC criteria, regardless of lymph node status.
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At time of surgery (approx. Week 6-10)
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Pathological Complete Response (pCR)
時間枠:At time of surgery (approx. Week 6-10)
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Proportion of participants who undergo surgery with no residual viable tumor cells (%RVT = 0) in the tumor bed and resected lymph nodes according to irPRC criteria.
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At time of surgery (approx. Week 6-10)
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Objective Response Rate (ORR)
時間枠:After 2 cycles of neoadjuvant therapy (prior to surgery, approx. Week 5-9)
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Proportion of participants achieving complete response (CR) or partial response (PR) according to RECIST 1.1 criteria.
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After 2 cycles of neoadjuvant therapy (prior to surgery, approx. Week 5-9)
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Event-Free Survival (EFS)
時間枠:From first dose up to approximately 3 years
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Time from first dose to first occurrence of any of the following: disease progression during neoadjuvant therapy leading tolerability to undergo radical surgery; local, regional, or distant tumor recurrence after surgery; or death from any cause.
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From first dose up to approximately 3 years
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Quantitative HPV Viral Load
時間枠:Baseline, after 2 cycles of neoadjuvant therapy, and after surgery/radiotherapy
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Quantitative HPV titer in blood and saliva samples assessed before treatment and after neoadjuvant therapy, as a marker of treatment response.
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Baseline, after 2 cycles of neoadjuvant therapy, and after surgery/radiotherapy
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Vaccine-Induced Systemic and Local Immune Responses
時間枠:Baseline and after neoadjuvant therapy
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Assessment of HPV16 E6/E7 Tetramer+ CD8+ T cells, TNF-α+/IFN-γ+ CD8+ T cells in peripheral blood, and anti-HPV16 E6/E7 antibodies.
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Baseline and after neoadjuvant therapy
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Biomarkers of Efffcacy
時間枠:Baseline (tumor tissue) and at surgery (post-treatment tissue)
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Correlation of tumor PD-L1 expression, tumor mutation burden (TMB), and changes in the tumor immune microenvironment with clinical efffcacy.
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Baseline (tumor tissue) and at surgery (post-treatment tissue)
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協力者と研究者
スポンサー
出版物と役立つリンク
一般刊行物
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- Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C. Epidemiology of Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma. J Clin Oncol. 2015 Oct 10;33(29):3235-42. doi: 10.1200/JCO.2015.61.6995. Epub 2015 Sep 8.
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- Craig SG, Anderson LA, Schache AG, Moran M, Graham L, Currie K, Rooney K, Robinson M, Upile NS, Brooker R, Mesri M, Bingham V, McQuaid S, Jones T, McCance DJ, Salto-Tellez M, McDade SS, James JA. Recommendations for determining HPV status in patients with oropharyngeal cancers under TNM8 guidelines: a two-tier approach. Br J Cancer. 2019 Apr;120(8):827-833. doi: 10.1038/s41416-019-0414-9. Epub 2019 Mar 20.
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- Uppaluri R, Haddad RI, Tao Y, Le Tourneau C, Lee NY, Westra W, Chernock R, Tahara M, Harrington KJ, Klochikhin AL, Brana I, Vasconcelos Alves G, Hughes BGM, Oliva M, Pinto Figueiredo Lima I, Ueda T, Rutkowski T, Schroeder U, Mauz PS, Fuereder T, Laban S, Oridate N, Popovtzer A, Mach N, Korobko Y, Costa DA, Hooda-Nehra A, Rodriguez CP, Bell RB, Manschot C, Benjamin K, Gumuscu B, Adkins D; KEYNOTE-689 Investigators. Neoadjuvant and Adjuvant Pembrolizumab in Locally Advanced Head and Neck Cancer. N Engl J Med. 2025 Jul 3;393(1):37-50. doi: 10.1056/NEJMoa2415434. Epub 2025 Jun 18.
- Massarelli E, William W, Johnson F, Kies M, Ferrarotto R, Guo M, Feng L, Lee JJ, Tran H, Kim YU, Haymaker C, Bernatchez C, Curran M, Zecchini Barrese T, Rodriguez Canales J, Wistuba I, Li L, Wang J, van der Burg SH, Melief CJ, Glisson B. Combining Immune Checkpoint Blockade and Tumor-Specific Vaccine for Patients With Incurable Human Papillomavirus 16-Related Cancer: A Phase 2 Clinical Trial. JAMA Oncol. 2019 Jan 1;5(1):67-73. doi: 10.1001/jamaoncol.2018.4051.
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研究記録日
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研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
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QC基準を満たした最後の更新が送信されました
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WSK-IM05 (4×10^10 vp)の臨床試験
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AerasEuropean and Developing Countries Clinical Trials Partnership (EDCTP)完了
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Janssen Vaccines & Prevention B.V.完了気道感染症 | 呼吸器合胞体ウイルスイギリス, フィンランド, アメリカ
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University of OxfordNational Institute of Allergy and Infectious Diseases (NIAID); Wellcome Trust完了
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Crucell Holland BVThe PATH Malaria Vaccine Initiative (MVI); Seattle Children's Research Institute (SCRI)完了
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Janssen Vaccines & Prevention B.V.完了
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Janssen Vaccines & Prevention B.V.完了
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Janssen Pharmaceutical K.K.引きこもった
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Imperial College LondonAstraZeneca; University of Oxford積極的、募集していないCOVID19 | SARS-CoV-2 感染症イギリス