Study of Intratumoral (IT) Ulevostinag (MK-1454) in Combination With Intravenous (IV) Pembrolizumab (MK-3475) Compared to IV Pembrolizumab Alone as the First Line Treatment of Metastatic or Unresectable, Recurrent Head and Neck Squamous Cell Carcinoma (HNSCC) (MK-1454-002)

NCT ID: NCT04220866

Last Updated: 2025-10-29

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

18 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-04

Study Completion Date

2022-09-30

Brief Summary

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The purpose of this study is to assess the efficacy and safety of intratumoral (IT) ulevostinag PLUS pembrolizumab (MK-3475) compared to pembrolizumab alone as a first line treatment of adults with metastatic or unresectable, recurrent head and neck squamous cell carcinoma (HNSCC).

The primary study hypotheses are that IT ulevostinag in combination with pembrolizumab results in a superior Objective Response Rate (ORR), per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), compared to pembrolizumab alone:

1. In participants with a tumor that has a programmed cell death-ligand 1 (PD-L1) Combined Positive Scoring (CPS) ≥ 1, and
2. In participants with a tumor that has a PD-L1 CPS ≥ 20.

Detailed Description

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Conditions

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Head and Neck Squamous Cell Carcinoma (HNSCC)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ulevostinag+Pembrolizumab

Participants receive ulevostinag 540 ug via intratumoral (IT) injection on Day 1 of every week for two 3-week cycles (Cycles 1-2), then on Day 1 of each 3-week cycle for up 33 cycles (Cycles 3-35), for a total of 35 cycles PLUS pembrolizumab 200 mg via intravenous (IV) infusion on Day 1 of each 3-week cycle for up to 35 cycles. The total duration of treatment is up to approximately 2 years.

Group Type EXPERIMENTAL

Ulevostinag

Intervention Type DRUG

IT injection

Pembrolizumab

Intervention Type BIOLOGICAL

IV infusion

Pembrolizumab

Participants receive pembrolizumab 200 mg via IV infusion on Day 1 of each 3-week cycle for up to 35 cycles. The total duration of treatment is up to approximately 2 years.

Group Type ACTIVE_COMPARATOR

Pembrolizumab

Intervention Type BIOLOGICAL

IV infusion

Interventions

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Ulevostinag

IT injection

Intervention Type DRUG

Pembrolizumab

IV infusion

Intervention Type BIOLOGICAL

Other Intervention Names

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MK-1454 MK-3475 KEYTRUDA®

Eligibility Criteria

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Inclusion Criteria

* Has histologically or cytologically confirmed diagnosis of metastatic or unresectable, recurrent head and neck squamous cell carcinoma (HNSCC) that is considered incurable by local therapies
* Has not had prior systemic therapy administered in the recurrent or metastatic setting
* Has tumor PD-L1 expression of CPS ≥1. Tumor tissue must be provided for PD-L1 biomarker analysis
* Has measurable disease per RECIST 1.1, as assessed by BICR
* Has at least 1 measurable lesion which is amenable to injection
* Has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
* Demonstrates adequate organ function within 7 days prior to treatment initiation
* Male participants of reproductive potential must agree to refrain from donating sperm and use a male condom plus partner use of an additional contraceptive method during sexual contact with females of childbearing potential during the intervention period with ulevostinag and for at least 120 days after the last dose of ulevostinag
* Female participants of childbearing potential who are not pregnant or breastfeeding must be willing to use a highly effective method of birth control or be surgically sterile or abstain from heterosexual activity during the intervention period and for at least 120 days after the last dose of study intervention, and agree not to donate eggs (ova, oocytes) to others or freeze/store for personal use
* Human immunodeficiency virus (HIV)-infected participants must meet these additional criteria:

1. Has HIV-1 infection documented by using any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry (Day 1)
2. Has well-controlled HIV on anti-retroviral therapy (ART)

Exclusion Criteria

* Has disease that is suitable for local therapy administered with curative intent
* Has progressive disease (PD) within 6 months of completion of curatively intended systemic treatment for locoregionally advanced HNSCC
* Has had chemotherapy or biological cancer therapy in the recurrent or metastatic setting for the treatment of HNSCC
* Has had radiation therapy (or other non-systemic therapy) within 2 weeks prior to randomization or participant has not fully recovered from adverse events (AEs) due to a previously administered treatment
* Is expected to require any other form of antineoplastic therapy while on study
* Has a history of a second malignancy, unless potentially curative treatment has been completed, with no evidence of malignancy for at least 2 years
* Has clinically active central nervous system (CNS) metastases and/or carcinomatous meningitis
* Has an active autoimmune disease that has required systemic treatment in the past 2 years
* 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 study treatment
* Has had an allogenic tissue/solid organ transplant
* Has a history of vasculitis
* Has a history of interstitial lung disease
* Has an active infection requiring systemic therapy
* Has a known history of active tuberculosis (TB; Bacillus tuberculosis)
* Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis
* Has had a severe hypersensitivity reaction to treatment a monoclonal antibody/components of the study treatment
* Has known Hepatitis B virus or Hepatitis C virus infections
* Has received prior therapy with an anti-programmed cell death 1 (anti-PD-1), anti-programmed cell death-ligand 1 (anti-PD-L1), or anti-programmed cell death-ligand 2 (anti-PD-L2) agent or if the participant has previously participated in Merck Sharp \& Dohme (MSD) MK-3475 clinical trials
* HIV infected participant who has had an HIV-related opportunistic infection within 6 months
* HIV infected participants who have a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease
* Is pregnant, breastfeeding, or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment
* Has not fully recovered from any effects of major surgery without significant detectable infection
* Has a history of re-irradiation for HNSCC at the projected injection site in the head and neck
* Has received a live-virus vaccine within 30 days of planned study treatment start
* Has been treated with a stimulator of interferon genes (STING) agonist (e.g. ulevostinag, ADU-S100)
* Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy, or used an investigational device, any of which occurred within 4 weeks of the first dose of study treatment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Locations

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UCLA Hematology & Oncology ( Site 0005)

Los Angeles, California, United States

Site Status

University of California at San Francisco ( Site 0006)

San Francisco, California, United States

Site Status

Henry Ford Hospital ( Site 0012)

Detroit, Michigan, United States

Site Status

Washington University ( Site 0021)

St Louis, Missouri, United States

Site Status

Sanford Cancer Center Oncology Clinic ( Site 0014)

Sioux Falls, South Dakota, United States

Site Status

Huntsman Cancer Institute ( Site 0004)

Salt Lake City, Utah, United States

Site Status

Chris OBrien Lifehouse ( Site 0040)

Camperdown, New South Wales, Australia

Site Status

Calvary Central Districts Hospital ( Site 0042)

Elizabeth Vale, South Australia, Australia

Site Status

Monash Health-Monash Medical Centre ( Site 0041)

Clayton, Victoria, Australia

Site Status

Ordensklinikum Linz Gmbh - Barmherzige Schwestern ( Site 0051)

Linz, Upper Austria, Austria

Site Status

Allgemeines Krankenhaus der Stadt Wien ( Site 0049)

Vienna/Wien, Vienna, Austria

Site Status

SCRI-CCCIT GesmbH ( Site 0050)

Salzburg, , Austria

Site Status

Centro Regional Integrado de Oncologia ( Site 0062)

Fortaleza, Ceará, Brazil

Site Status

Hospital de Caridade de Ijui ( Site 0061)

Ijuí, Rio Grande do Sul, Brazil

Site Status

Instituto do Cancer do Estado de Sao Paulo - ICESP ( Site 0058)

São Paulo, , Brazil

Site Status

Real e Benemerita Associacao Portuguesa de Beneficencia ( Site 0064)

São Paulo, , Brazil

Site Status

Centre Antoine Lacassagne ( Site 0070)

Nice, Alpes-Maritimes, France

Site Status

Centre Leon Berard ( Site 0072)

Lyon, Auvergne, France

Site Status

IUCT - Oncopole ( Site 0069)

Toulouse, Haute-Garonne, France

Site Status

Centre Oscar Lambret ( Site 0071)

Lille, Nord, France

Site Status

Gustave Roussy ( Site 0068)

Villejuif, Val-de-Marne, France

Site Status

Chaim Sheba Medical Center ( Site 0076)

Ramat Gan, Tel Aviv, Israel

Site Status

Rambam Medical Center ( Site 0077)

Haifa, , Israel

Site Status

Hadassah Medical Center. Ein Kerem ( Site 0078)

Jerusalem, , Israel

Site Status

Haukeland Universitetssykehus, Klinisk forskningspost voksne ( Site 0086)

Bergen, Hordaland, Norway

Site Status

Oslo Universitetssykehus Radiumhospitalet ( Site 0085)

Oslo, , Norway

Site Status

Severance Hospital ( Site 0103)

Seoul, , South Korea

Site Status

Asan Medical Center ( Site 0104)

Seoul, , South Korea

Site Status

H.U. Vall de Hebron ( Site 0112)

Barcelona, , Spain

Site Status

Hospital Clinico de Barcelona ( Site 0116)

Barcelona, , Spain

Site Status

Hospital Universitario Ramon y Cajal ( Site 0115)

Madrid, , Spain

Site Status

Hospital Universitario Virgen de la Victoria ( Site 0114)

Málaga, , Spain

Site Status

Royal Marsden NHS Foundation Trust ( Site 0031)

London, London, City of, United Kingdom

Site Status

Royal Marsden Hospital Sutton-Surrey ( Site 0032)

Sutton, Surrey, United Kingdom

Site Status

Countries

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United States Australia Austria Brazil France Israel Norway South Korea Spain United Kingdom

References

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Harrington KJ, Champiat S, Brody JD, Cho BC, Romano E, Golan T, Hyngstrom JR, Strauss J, Oh DY, Popovtzer A, Gomez-Roca C, Perets R, Kim SB, Wong DJ, Powell SF, Khilnani A, Jemielita T, Zhao Q, Zhao R, Ingham M. Phase I and II Clinical Studies of the STING Agonist Ulevostinag with and without Pembrolizumab in Participants with Advanced or Metastatic Solid Tumors or Lymphomas. Clin Cancer Res. 2025 Aug 14;31(16):3400-3411. doi: 10.1158/1078-0432.CCR-24-3630.

Reference Type RESULT
PMID: 40499147 (View on PubMed)

McIntosh JA, Liu Z, Andresen BM, Marzijarani NS, Moore JC, Marshall NM, Borra-Garske M, Obligacion JV, Fier PS, Peng F, Forstater JH, Winston MS, An C, Chang W, Lim J, Huffman MA, Miller SP, Tsay FR, Altman MD, Lesburg CA, Steinhuebel D, Trotter BW, Cumming JN, Northrup A, Bu X, Mann BF, Biba M, Hiraga K, Murphy GS, Kolev JN, Makarewicz A, Pan W, Farasat I, Bade RS, Stone K, Duan D, Alvizo O, Adpressa D, Guetschow E, Hoyt E, Regalado EL, Castro S, Rivera N, Smith JP, Wang F, Crespo A, Verma D, Axnanda S, Dance ZEX, Devine PN, Tschaen D, Canada KA, Bulger PG, Sherry BD, Truppo MD, Ruck RT, Campeau LC, Bennett DJ, Humphrey GR, Campos KR, Maddess ML. A kinase-cGAS cascade to synthesize a therapeutic STING activator. Nature. 2022 Mar;603(7901):439-444. doi: 10.1038/s41586-022-04422-9. Epub 2022 Mar 16.

Reference Type DERIVED
PMID: 35296845 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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https://www.merckclinicaltrials.com

Merck Clinical Trials Information

Other Identifiers

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MK-1454-002

Identifier Type: OTHER

Identifier Source: secondary_id

2019-003060-42

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

1454-002

Identifier Type: -

Identifier Source: org_study_id

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