PBI-MST-01 (NCT04541108) Substudy AZN-05: Intratumoral Microdosing of Rilvegostomig, Volrustomig, Sabestomig, and AZD9592 in HNSCC

NCT ID: NCT06366451

Last Updated: 2025-01-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

EARLY_PHASE1

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-22

Study Completion Date

2025-04-30

Brief Summary

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This is a multi-center, open-label, Phase 0 substudy designed to evaluate the localized pharmacodynamics (PD) of rilvegostomig, volrustomig, sabestomig, and AZD9592 within the tumor microenvironment (TME) when administered intratumorally in microdose quantities via the CIVO device in patients presenting with Head and Neck Squamous Cell Carcinoma (HNSCC) with a surface accessible lesion, who are scheduled for tumor and/or regional node dissection as part of their standard treatment. PD effects due to injected investigational agents, either as single agents or as AZD9592 drug combinations with the evaluated biologics, will be compared to those elicited by pembrolizumab alone, which will also be injected in microdose quantities via the CIVO device.

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Detailed Description

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The CIVO Microdose Injection Device (MID) simultaneously delivers multiple drugs and drug combinations (Up to 8), each in microdose amounts, into a single patient tumor and enables comparisons of the resulting biomarker responses that occurred while that tumor was still in the native microenvironment. AstraZeneca is developing three novel assets: rilvegostomig, volrustomig, and sabestomig, all of which are bispecific monoclonal antibodies designed to stimulate antitumor immunity. In this Phase 0 clinical trial, the PD effects of these investigational assets in the TME of patients presenting with HNSCC will be evaluated. These investigational assets will be injected alone in microdose quantities at tumor sites in HNSCC patients. Pembrolizumab, also used therapeutically in this patient population, will be included in the CIVO injection array administered as a single agent. In addition, microdoses of AZD9592, a novel antibody drug conjugate (ADC), alone or in combinations with the evaluated biologics will also be assessed. The CIVO-injected portion of the tissue will be analyzed for localized response at sites of drug exposure in the TME.

Conditions

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Head and Neck Squamous Cell Carcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This is an exploratory clinical trial to evaluate intratumoral mechanistic effects of novel and approved agents on intact human tumors. This is a cohort substudy of a Master Protocol (PBI-MST-01, NCT04541108) framework, under which comparisons will not be made between substudy cohorts.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Rilvegostomig, Volrustomig, Sabestomig, AZD9592, Pembrolizumab

HNSCC patients presenting with a surface accessible lesion who are scheduled for tumor and/or regional node dissection as part of their standard treatment will be injected one to three days prior to surgery using the CIVO device. The planned injection scheme includes: vehicle control and microdoses of rilvegostomig, volrustomig, sabestomig, AZD9592, and pembrolizumab as single agents and AZD9592 drug combinations with the evaluated biologics.

Group Type EXPERIMENTAL

Rilvegostomig

Intervention Type BIOLOGICAL

Intratumoral microdose injection by the CIVO device.

Volrustomig

Intervention Type BIOLOGICAL

Intratumoral microdose injection by the CIVO device.

Sabestomig

Intervention Type BIOLOGICAL

Intratumoral microdose injection by the CIVO device.

AZD9592

Intervention Type BIOLOGICAL

Intratumoral microdose injection by the CIVO device.

Pembrolizumab

Intervention Type BIOLOGICAL

Intratumoral microdose injection by the CIVO device.

AZD9592 + Rilvegostomig

Intervention Type COMBINATION_PRODUCT

Intratumoral microdose injection by the CIVO device.

AZD9592 + Volrustomig

Intervention Type COMBINATION_PRODUCT

Intratumoral microdose injection by the CIVO device.

AZD9592 + Sabestomig

Intervention Type COMBINATION_PRODUCT

Intratumoral microdose injection by the CIVO device.

AZD9592 + Pembrolizumab

Intervention Type COMBINATION_PRODUCT

Intratumoral microdose injection by the CIVO device.

Interventions

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Rilvegostomig

Intratumoral microdose injection by the CIVO device.

Intervention Type BIOLOGICAL

Volrustomig

Intratumoral microdose injection by the CIVO device.

Intervention Type BIOLOGICAL

Sabestomig

Intratumoral microdose injection by the CIVO device.

Intervention Type BIOLOGICAL

AZD9592

Intratumoral microdose injection by the CIVO device.

Intervention Type BIOLOGICAL

Pembrolizumab

Intratumoral microdose injection by the CIVO device.

Intervention Type BIOLOGICAL

AZD9592 + Rilvegostomig

Intratumoral microdose injection by the CIVO device.

Intervention Type COMBINATION_PRODUCT

AZD9592 + Volrustomig

Intratumoral microdose injection by the CIVO device.

Intervention Type COMBINATION_PRODUCT

AZD9592 + Sabestomig

Intratumoral microdose injection by the CIVO device.

Intervention Type COMBINATION_PRODUCT

AZD9592 + Pembrolizumab

Intratumoral microdose injection by the CIVO device.

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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AZD2936 MEDI5752 AZD7789 Keytruda, MK-3475

Eligibility Criteria

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Inclusion Criteria

1. Ability and willingness to provide written informed consent. Voluntary written consent must be given before performance of any study related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.
2. Male or female ≥ 18 years of age at Visit 1 (Screening).
3. Pathologic diagnosis of Head and Neck Squamous Cell Carcinoma (HNSCC) of the oropharynx, hypopharynx, oral cavity, or larynx.
4. Ability and willingness to comply with the study's visits and assessment schedule.
5. At least one lesion (primary tumor, recurrent tumor, metastasis, or metastatic lymph node) that is surface accessible for CIVO injection that contains viable minimum tumor tissue volume and characteristics (e.g., based on clinical evaluation, available pre-operative imaging, pre-injection ultrasound imaging, or pathology reports indicating lesion with appropriate viable tumor volume without excessive cysts or necrosis) and for which there is a planned surgical intervention. The patient's presentation, surgical and pathology plan may determine whether a lesion is eligible with respect to a given CIVO MID needle configuration.
6. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
7. Female patients who:

* Are postmenopausal for at least one year before the screening visit, OR
* Are surgically sterile, OR
* Are of childbearing potential who agree to practice a highly effective method of contraception from the time of signing the Informed Consent Form (ICF) until 7 months after the CIVO injection OR agree to completely abstain from heterosexual intercourse.
* Agree to refrain from donating, or retrieving for their own use, ova until 7 months after the CIVO injection.
* Agree to refrain from breastfeeding until 7 months after the CIVO injection.
8. Male patients, even if surgically sterile (i.e., status post-vasectomy), who:

* Agree to practice effective barrier contraception from the time of signing the ICF until 7 months after the CIVO injection OR agree to completely abstain from heterosexual intercourse.
* Agree to refrain from fathering a child or donating sperm until 7 months after the CIVO injection.

Exclusion Criteria

1. Tumors and/or effaced nodes that are anticipated by the Investigator to lack a sufficient volume of viable tumor tissue (Based on available pre-operative imaging, pre-injection ultrasound imaging, or pathology reports) for CIVO microdose injection due to necrosis, cysts, excessive stroma, fibrosis, or treatment-induced tissue changes.
2. Tumors near or involving critical structures for which, in the opinion of the treating clinician, injection would pose undue risk to the patient.
3. Prior exposure to immune-mediated therapy including, but not limited to, other anti-CTLA-4, anti-PD-1, anti-PD-L1, and anti-PD-L2 antibodies within the last 5 years.
4. Previous treatment with another ADC containing a chemotherapeutic agent that inhibits topoisomerase 1 activity or with another epidermal growth factor receptor (EGFR) and/or mesenchymal-epithelial transition factor (c-MET) targeted ADC.
5. Patients with concurrent cancer, immune disease or active infection requiring systemic or radiotherapy.
6. Female patients who:

* Intend to become pregnant during the study,
* Are both lactating and breastfeeding, OR
* Have a positive beta-subunit human chorionic gonadotropin (beta-hCG) pregnancy test at screening verified by the Investigator.
7. Any uncontrolled intercurrent illness, condition, serious medical or psychiatric illness, or circumstance that, in the opinion of the Investigator, could interfere with adherence to the study's procedures or requirements, or otherwise compromise the study's objectives.
8. History of organ transplant.
9. Major surgery within 4 weeks prior to injection: subject must have adequate wound healing and have recovered from any prior surgery.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AstraZeneca

INDUSTRY

Sponsor Role collaborator

Presage Biosciences

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Study Director

Role: STUDY_DIRECTOR

Presage Biosciences

Locations

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UC Davis

Sacramento, California, United States

Site Status RECRUITING

Montefiore Medical Center

The Bronx, New York, United States

Site Status RECRUITING

University of North Carolina

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Oregon Health & Science University (OHSU)

Portland, Oregon, United States

Site Status NOT_YET_RECRUITING

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Sarah Cannon Medical Center

Charleston, South Carolina, United States

Site Status RECRUITING

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Presage Biosciences

Role: CONTACT

800-530-5404

Facility Contacts

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Clinical Research Supervisor

Role: primary

Research Coordinator

Role: primary

Research Coordinator

Role: primary

Research Coordinator

Role: primary

Research Coordinator

Role: primary

Research Coordinator

Role: primary

Research Coordinator

Role: primary

References

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Derry JMJ, Burns C, Frazier JP, Beirne E, Grenley M, DuFort CC, Killingbeck E, Leon M, Williams C, Gregory M, Houlton J, Clayburgh D, Swiecicki P, Huszar D, Berger A, Klinghoffer RA. Trackable Intratumor Microdosing and Spatial Profiling Provide Early Insights into Activity of Investigational Agents in the Intact Tumor Microenvironment. Clin Cancer Res. 2023 Sep 15;29(18):3813-3825. doi: 10.1158/1078-0432.CCR-23-0827.

Reference Type BACKGROUND
PMID: 37389981 (View on PubMed)

Gundle KR, Deutsch GB, Goodman HJ, Pollack SM, Thompson MJ, Davis JL, Lee MY, Ramirez DC, Kerwin W, Bertout JA, Grenley MO, Sottero KHW, Beirne E, Frazier J, Dey J, Ellison M, Klinghoffer RA, Maki RG. Multiplexed Evaluation of Microdosed Antineoplastic Agents In Situ in the Tumor Microenvironment of Patients with Soft Tissue Sarcoma. Clin Cancer Res. 2020 Aug 1;26(15):3958-3968. doi: 10.1158/1078-0432.CCR-20-0614. Epub 2020 Apr 16.

Reference Type BACKGROUND
PMID: 32299817 (View on PubMed)

Klinghoffer RA, Bahrami SB, Hatton BA, Frazier JP, Moreno-Gonzalez A, Strand AD, Kerwin WS, Casalini JR, Thirstrup DJ, You S, Morris SM, Watts KL, Veiseh M, Grenley MO, Tretyak I, Dey J, Carleton M, Beirne E, Pedro KD, Ditzler SH, Girard EJ, Deckwerth TL, Bertout JA, Meleo KA, Filvaroff EH, Chopra R, Press OW, Olson JM. A technology platform to assess multiple cancer agents simultaneously within a patient's tumor. Sci Transl Med. 2015 Apr 22;7(284):284ra58. doi: 10.1126/scitranslmed.aaa7489.

Reference Type BACKGROUND
PMID: 25904742 (View on PubMed)

Frazier JP, Bertout JA, Kerwin WS, Moreno-Gonzalez A, Casalini JR, Grenley MO, Beirne E, Watts KL, Keener A, Thirstrup DJ, Tretyak I, Ditzler SH, Tripp CD, Choy K, Gillings S, Breit MN, Meleo KA, Rizzo V, Herrera CL, Perry JA, Amaravadi RK, Olson JM, Klinghoffer RA. Multidrug Analyses in Patients Distinguish Efficacious Cancer Agents Based on Both Tumor Cell Killing and Immunomodulation. Cancer Res. 2017 Jun 1;77(11):2869-2880. doi: 10.1158/0008-5472.CAN-17-0084. Epub 2017 Mar 31.

Reference Type BACKGROUND
PMID: 28364003 (View on PubMed)

Dey J, Kerwin WS, Grenley MO, Casalini JR, Tretyak I, Ditzler SH, Thirstrup DJ, Frazier JP, Pierce DW, Carleton M, Klinghoffer RA. A Platform for Rapid, Quantitative Assessment of Multiple Drug Combinations Simultaneously in Solid Tumors In Vivo. PLoS One. 2016 Jun 30;11(6):e0158617. doi: 10.1371/journal.pone.0158617. eCollection 2016.

Reference Type BACKGROUND
PMID: 27359113 (View on PubMed)

Moreno-Gonzalez A, Olson JM, Klinghoffer RA. Predicting responses to chemotherapy in the context that matters - the patient. Mol Cell Oncol. 2015 Jun 10;3(1):e1057315. doi: 10.1080/23723556.2015.1057315. eCollection 2016 Jan.

Reference Type BACKGROUND
PMID: 27308571 (View on PubMed)

Other Identifiers

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PBI-MST-01

Identifier Type: OTHER

Identifier Source: secondary_id

MST01-AZN-05

Identifier Type: -

Identifier Source: org_study_id

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