Combination of UCPVax Vaccine and Atezolizumab for the Treatment of Human Papillomavirus Positive Cancers (VolATIL)
Status:
Recruiting
Trial end date:
2022-09-01
Target enrollment:
Participant gender:
Summary
70% all cases of cervical cancer, 95% of anal cancers and about 70% of oropharyngeal cancers
are linked to Human Papillomavirus (HPV) infection. HPV oncogenic proteins are
trans-activators of telomerase. Indeed, E6 oncoprotein transactivates the human telomerase
(hTert). Our group has conducted a clinical trial (NCT02402842) in advanced squamous cell
anal cancer (SCCA) and investigators have shown a correlation between the presence of
anti-HPV immunity and anti-telomerase T helpher 1 (TH1) CD4 T cell responses, establishing
telomerase as an appropriate antigen in HPV-related cancers.
Tumor-reactive CD4+ T cells have been found to ensure efficient effector Cytotoxic T
Lymphocytes (CTL) recruitment at the tumor site. Promoting tumor specific TH1 CD4 activation
might be an attractive therapeutic option to enhance anti-PD-1/PD-L1 (Programmed cell
Death-1/Programmed cell Death-Ligand1) efficacy. However, no option is currently available to
expand tumor specific TH1 lymphocytes in most patients. Then, investigators have identified
four novel MHC (Major Histocompatibility Complex) class II-restricted peptides derived from
human telomerase reverse transcriptase (TERT) referred as "Universal Cancer Peptides" (UCP).
UCPVax is a therapeutic cancer vaccine developed by our team and composed of two separate
peptides called UCP2 and UCP4 derived from telomerase. This UCPVax vaccine is currently
evaluated in a multicenter phase I/II study in Non Small Lung Cancer (NSCLC) (NCT2818426) and
seems to show to be safe and immunogenic.
PD-1/PD-L1 immune checkpoint is a relevant candidate target for immunotherapy in HPV+
cancers, based on the prominent role of PD-1 and its ligand PD-L1 in HPV-driven
immune-evasion. There is a strong rational of using PD-1 therapy in HPV+ cancers, however
anti-PD-1/PD-L1 treatment induces a limited number of long term responses in HPV disease.
Combining anti-PD-1/PD-L1 therapy with an antitumor vaccine gains serious consideration in
HPV+ cancers. Indeed, anti-cancer vaccines can induce tumor-specific T cells expansion and
activation and therefore restore the cancer-immunity cycle in patients lacking pre-existing
anti-tumor responses.
So investigators propose to determine the clinical interest and immunological efficacy of a
treatment combining the CD4 helper T-inducer cancer vaccine (UCPVax) with atezolizumab in
patients with HPV+ cancers by evaluation of the objective response rate at 4 months according
to iRecist criteria.