About this trial
This phase II trial tests how well pB1-11 and human papillomavirus tumor antigen (TA-HPV) vaccines in combination with pembrolizumab work in treating patients with oropharyngeal cancer that has come back (recurrent) or that has spread from where it first started (primary site) to other places in the body (metastatic) and that is PD-L1 and human papillomavirus (HPV) positive. Oropharyngeal cancer is a type of head and neck cancer involving structures in the back of the throat (the oropharynx), such as the non-bony back roof of the mouth (soft palate), sides and back wall of the throat, tonsils, and back third of the tongue. Scientists have found that some strains or types of a virus called HPV can cause oropharyngeal cancer. pBI-11 is a circular deoxyribonucleic acid (DNA) (plasmid) vaccine that promotes antibody, cytotoxic T cell, and protective immune responses. TA-HPV is an investigational recombinant vaccina virus derived from a strain of the vaccina virus which was widely used for smallpox vaccination. Vaccination with this TA-HPV vaccine may stimulate the immune system to mount a cytotoxic T cell response against tumor cells positive for HPV, resulting in decreased tumor growth. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread by inhibiting the PD-1 receptor. These investigational vaccines could cause or enhance an immune response in the body against HPV, during which time the activity of pembrolizumab against oropharyngeal cancer associated with HPV may be strengthened. These drugs in combination may be more effective in increasing the ability of the immune system to fight oropharyngeal cancer than pembrolizumab alone.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Signed and dated written informed consent
Male or female >= 18 years of age on the day of signing informed consent
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Having been diagnosed with R/M p16+ PD-L1 CPS >= 1 OPC not previously treated for R/M disease. They must be eligible for, and planning to start therapy with pembrolizumab, according to standard of care
Disqualifiers
Disease that can be treated with curative intent as assessed by patient's study physician. If patient in this situation wishes for treatment with palliative intent then they may enroll
Multiple primary oropharyngeal (OP) tumors
Primary cancer not originated from the oropharynx
Has received any therapy for R/M disease. Therapy in the setting of curative intent is allowed
Trial design
Single group
Treatments tested in this trial
DNA Vaccine
Biological/VaccineGiven pBI-11 IM
Human Papillomavirus Tumor Antigen Vaccine
Biological/VaccineGiven into a muscle
Pembrolizumab
Biological/VaccineGiven into vein
Computed Tomography (CT)
Procedure/SurgeryUndergo a CT
Magnetic Resonance Imaging (MRI)
Procedure/SurgeryUndergo an MRI
Magnetic Resonance Imaging
Procedure/SurgeryUndergo blood sample collection
Biopsy
Procedure/SurgeryUndergo tumor biopsy
Treatment groups
Trial outcomes
Primary outcomes
Objective response rate (ORR)
The proportion of eligible, response evaluable patients with a best overall response (BOR). Objective response rate will be summarized as proportions of the total number of eligible, response evaluable patients with 95% confidence intervals. Logistic and Cox (proportional hazards) regression will be used to assess the association between important prognostic variables (e.g, gender, age) with objective response rate. Objective response rate will be monitored using Simon's minimax design.
Disease control rate (DCR)
The proportion of eligible, response evaluable patients with a best overall response of complete response, partial response or stable disease. Disease control rate will be summarized as proportions of the total number of eligible, response evaluable patients with 95% confidence intervals.
Progression-free survival (PFS)
Estimated using the method of Kaplan and Meier (product limit estimator). Logistic and Cox (proportional hazards) regression will be used to assess the association between important prognostic variables (e.g, gender, age) with progression-free survival. The odds ratio (OR) for response and hazard ratio (HR) for progression-free survival will be presented with 95% confidence intervals as measure of effect size.
Overall survival (OS)
Estimated using the method of Kaplan and Meier (product limit estimator). Logistic and Cox (proportional hazards) regression will be used to assess the association between important prognostic variables (e.g, gender, age) with overall survival. The odds ratio for response and hazard ratio for overall survival will be presented with 95% confidence intervals as measure of effect size.
Sponsors and contacts
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Michael K. Gibson
Lead sponsor
Vanderbilt-Ingram Cancer Center
Sponsor institution