Inclusion Criteria:
- - Histologically or cytologically documented advanced or metastatic cancer that has
relapsed from or is refractory to standard treatment in two lines of prior therapy in
the advanced setting unless there are fewer than two FDA approved lines of therapy for
the particular disease, or for which no standard treatment is available.
- - At least 2 tumors suitable for direct or ultrasound-guided injection defined as at
least one cutaneous, subcutaneous, or nodal lesion or aggregate of lesions, ≥0.5 cm
for any single lesion and cumulative lesion dimensions.
One lesion must meet criteria
for RECIST measurable disease if in Part 2. Note: One lesion will be biopsied (if
possible)
- - Mandatory initial screening biopsy.
a. For patients undergoing surgical excision/resection: i. Tumor deemed accessible and
safe for biopsy by the Investigator ii. Willing to consent to biopsy and surgical
procedure iii. Patient able to undergo surgical procedure and appropriate anesthesia
b. For patients not undergoing surgical excision/resection to obtain mandatory
screening biopsy: i. Tumor deemed accessible and safe for biopsy by the Investigator
ii. Willing to consent to initial tumor biopsy.
- - Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
- - Patients with no curative treatment options available including surgery and/or
definitive radiation or patients in which these modalities are associated with
significant morbidity.
- - Patients with advanced disease who have received and progressed on standard therapy or
have disease for which there is no standard therapy or have contraindications to
standard therapy.
Part 1a: Patients with cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma
(BCC), melanoma, Merkel cell carcinoma, sebaceous carcinoma, extramammary Paget's disease,
Kaposi sarcoma, HNSCC, adnexal carcinoma, and angiosarcoma, as well as patients with
cutaneous neoplasms that are separate primaries with morbidity from multiple surgeries that
have failed standard therapy. Any malignancy with superficial cutaneous or subcutaneous
lesions or palpable lymph nodes may be eligible based on the discretion of the
investigator.
- - Part 2a: Patients with cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma
(BCC), melanoma, Merkel cell carcinoma, sebaceous carcinoma, extramammary Paget's
disease, Kaposi sarcoma, HNSCC, adnexal carcinoma, and angiosarcoma, as well as
patients with cutaneous neoplasms that are separate primaries with morbidity from
multiple surgeries that have failed standard therapy.
BCC will also be included, given
that pembrolizumab has not been approved for this condition, although cemiplimab is
approved.
- - Parts 1b and 2b: Patients must have cSCC, Merkel cell carcinoma, melanoma, or head and
neck squamous cell carcinoma.
These patients should be refractory to anti-PD-1
therapy, with the exception of patients with HNSCC with PD-L1 expression <1.
- - Parts 1a, 2a and 2b: Patients with BRAF-mutated melanoma should have received
BRAF-targeted therapy.
- - Predicted life expectancy of 3 months or more (in both Part 1 and Part 2)
- Participant or their legally authorized representative (LAR able to provide written
informed consent to participate.
- - Ability to comply with study procedures in the Investigator's opinion.
- - Adequate renal function as defined by Cr <2 mg/dL.
- - Adequate hepatic function.
1. Serum bilirubin ≤1.5 x ULN. 2. AST and ALT ≤2.5 ULN (no liver mets)
3. AST and ALT ≤5.0 ULN (for patients with liver mets)
- - Adequate bone marrow and hematologic function.
1. Coagulation function adequate (PT and aPTT within x1.5 ULN)
2. Platelets ≥ 75,000/mm^2. 3. ANC ≥ 1000/uL.
- - Females of child-bearing potential must have a negative pregnancy test within 14 days
prior to enrollment and on day of treatment.
All patients must agree to use adequate
contraception prior to study entry, for the duration of study participation, and up to
90 days after the last dose of MQ710.
- - Part 2 only: at least one measurable site of disease according to RECIST criteria.
- - Prior non-immunotherapy, anti-tumor treatment including endocrine,
chemical/radiotherapy, targeted therapy, or major surgery (but not anti-PD1/- L1
therapies) was discontinued for more than 4 weeks prior to enrollment.
- - Patients who have failed prior anti-PD1/-PDL1 may be included.
Washout of
anti-PD1/-PDL1 at least 3 weeks prior to initiation of therapy in Part 1a and 2a. No
washout period is required for Part 1b and 2b.
Exclusion Criteria:
- - Active infections requiring antibiotics, physician monitoring or recurrent fevers
(>38.0 ℃) associated with a clinical diagnosis of active infection.
- - Acute or chronic active viral disease or positive test for hepatitis B virus,
hepatitis C virus, human immunodeficiency virus (HIV), or received treatment with
antivirals or nucleoside analogs such as those used in the treatment of hepatitis B
(e.g. lamivudine, adefovir, tenofovir, telbivudine, entecavir), ribavirin, cidofovir,
diaminopurine analogs, methyladenosine analogs, or interferon alpha within 4 weeks of
initiation of study treatment.
- - Incomplete recovery from surgery, incomplete healing of an incision site.
- - Any of the following in the 3 months before the first dose of study treatment: Grade 3
or 4 gastrointestinal bleeding/haemorrhage (unless due to resected tumour),
treatment-resistant peptic ulcer disease, erosive oesophagitis or gastritis,
infectious or inflammatory bowel disease, diverticulitis, pulmonary embolism or other
uncontrolled thrombo-embolic event, history or evidence of haemoptysis or menorrhagia.
- - History of myocardial infarction, myocarditis, congestive heart failure (as defined by
New York Heart Association Functional Classsification III or IV), unstable angina,
serious uncontrolled cardiac arrhythmia,or significant cardiovascular or
cerebrovascular event in the 6 months before the first dose of study treatment.
- - Uncontrolled infection within 6 months prior to study entry.
- - History of significant bleeding requiring hospitalization in the 12 months before the
first dose of study treatment.
- - Treatment with PD-1/programmed death ligand (PD-L1), cytotoxic T-lymphocyte associated
protein 4 (CTLA-4), or any other (including experimental) immune checkpoint inhibitor
or immune-stimulatory treatment in the 3 weeks before the first dose of study
treatment.
- - Prior chemotherapy, radiotherapy, biological cancer therapy (not including
anti-PD1/-L1 immunotherapies), targeted therapy, investigational drug, or major
surgery 28 days prior to enrollment or has not recovered to Common Terminology
Criteria for Adverse Events (CTCAE) grade 1 or better from adverse event due to cancer
therapy administered more than 28 days prior to enrollment with the exception of grade
2 or better for alopecia and neuropathy.
- - Has known active CNS metastases and/or carcinomatous meningitis.
- - Received live vaccine within 28 days prior to enrollment.
- - Patient is pregnant or breast-feeding, or expecting to conceive or father children
within the duration of the trial.
- - Patients with tumor that directly contacts, encases or penetrates a major blood
vessel, pericardium, gastrointestinal tract, or other hollow organs that may lead to
perforation due to tumor necrosis.
- - Patients at risk of airway compromise in the event of post-injection tumor
swelling/inflammation based on investigator judgement.
- - History or evidence of autoimmune disease that has required systemic treatment in the
past 2 years (i.e., with use of disease modifying agents, corticosteroids, or
immunosuppressive drugs)
- History of chronic liver disease or evidence of hepatic cirrhosis.
- - History of idiopathic pulmonary fibrosis, pneumonitis (including drug induced),
organizing pneumonia, active interstitial lung disease (ILD) requiring treatment with
systemic steroids.
- - Baseline pulse oximetry less than 92% on room air.
- - History of re-irradiation to a field which includes the carotid arteries.
- - History of leukemia: ALL and CLL (patients with a history of aggressive lymphomas in
remission or patients with a history of allogeneic stem cell transplants are eligible
if no longer on immunosuppressive therapy and without evidence of GvHD)
- Current use of steroids such as prednisone 10 mg/daily or greater (or its equivalent)
or immunosupressants within 2 weeks of initiation of study treatment.
- - Any serious or uncontrolled medical disorder that, in the opinion of the Investigator
or the Medical Monitor, may increase the risk associated with study participation or
study treatment administration, impair the ability of the patient to receive protocol
therapy or interfere with the interpretation of study results.
- - Any other medical or psychological condition that would preclude participation in the
study or compromise ability to give informed consent.
- - Known allergy to MQ710 transgene products or formulation.
- - Patient requires anticoagulation therapy, such as warfarin.
