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Bavarian Nordic initiates Phase II trial

Bavarian Nordic Research

The first patient has been dosed in a Phase 2 study evaluating the combination therapy of the company’s cancer immunotherapy, CV301, and Roches’s checkpoint inhibitor, atezolizumab (TECENTRIQ), for the treatment of patients with locally advanced or metastatic urothelial bladder cancer.

Bavarian Nordic’s CV301 targets tumor-associated antigens, CEA and MUC1, which are overexpressed on multiple solid tumors, including bladder cancer. Preclinical data has shown that vaccination resulted in the induction of tumor specific T-cells that infiltrated the tumor resulting in the upregulation of PD-L1 on tumor cells. The upregulation of PD-L1 is a marker indicating the tumor is under attack from T-cells, presenting an opportunity for a greater response in patients who might otherwise not benefit from treatment with a checkpoint inhibitor alone.

CV301 is administered in an innovative manner designed to generate a potent and durable T-cell response. Patients receive an enhanced priming regimen of the highly attenuated, non-replicating vaccinia virus MVA-BN-CV301 in 4 different injection sites on days 1 and 22, followed by boosters of the recombinant fowlpox virus FPV-CV301 at tapering intervals throughout the two years they are receiving atezolizumab.

Study design

The Phase 2, single-arm, multi-institutional clinical trial is designed to study the combination of CV301 with atezolizumab as a first-line treatment for patients with urothelial bladder cancer who are not eligible for cisplatin-containing chemotherapy (Cohort 1) and as a second-line treatment for patients who have previously been treated with cisplatin-based chemotherapies. The study is expected to enroll 68 patients, using a two-stage design within each cohort.

Stage 1 is planned to enroll approximately 40% of the subjects, with a threshold of around 25% of the subjects needing to achieve an objective response before enrolling the rest of the patients in Stage 2. Key secondary measures will also be evaluated, including: progression free survival (PFS), overall survival (OS) and duration of response.

“Today represents another large step forward in the development of our CV301 program and understanding its potential in bladder cancer,” said Paul Chaplin, President and CEO of Bavarian Nordic. “We are hopeful that the preclinical data demonstrating a synergistic effect of CV301 with checkpoint inhibition will translate into a new, much-needed treatment option for patients living with this disease.”