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    Clinical Trial Results:
    REVEAL 2: A Prospective, Randomized, Double-Blind, Placebo-Controlled Phase 3 Study of VGX-3100 Delivered Intramuscularly Followed by Electroporation with CELLECTRA™ 5PSP for the Treatment of HPV-16 and/or HPV-18 Related High Grade Squamous Intraepithelial Lesion (HSIL) of the Cervix

    Summary
    EudraCT number
    2018-004114-17
    Trial protocol
    GB   LT   EE   ES   BE   PL   FI   IT  
    Global end of trial date
    15 Sep 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Sep 2023
    First version publication date
    27 Sep 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    HPV-303
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03721978
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Inovio Pharmaceuticals, Inc.
    Sponsor organisation address
    660 W. Germantown Pike, Suite 110, Plymouth Meeting, United States, PA 19462
    Public contact
    Clinical Development, Inovio Pharmaceuticals, Inc., +1 267-440-4200, HPV303ClinicalTeam@inovio.com
    Scientific contact
    Clinical Development, Inovio Pharmaceuticals, Inc., +1 267-440-4200, HPV303ClinicalTeam@inovio.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    16 Aug 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    15 Sep 2022
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Sep 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Among baseline biomarker-positive women determine the efficacy of VGX-3100 compared with placebo with respect to combined histopathologic regression of cervical HSIL and virologic clearance of HPV-16 and/or HPV-18
    Protection of trial subjects
    This protocol was conducted in accordance with the applicable GCP regulations and guidelines and when applicable, in compliance with the regulations on electronic records and electronic signature. Subjects were not required to follow special instructions specific to the investigational product (IP) used in this clinical trial as the IP was handled and administered to subjects by the clinical trial personnel at the clinical trial site. Subjects were provided with investigator emergency contact information and advised to report all AEs. Written informed consent was to be obtained from each subject prior to enrollment into the clinical trial, and/or from the subject’s legally authorized representative.
    Background therapy
    Topical anesthetic (e.g., eutectic mixture of local anesthetics [EMLA] or equivalent) may have be offered to subjects to prevent significant discomfort from the treatment procedure; subjects may have been offered a mild sedative (e.g., 0.5 to 1 mg lorazepam or equivalent 1 hour prior to treatment) for anxiety related to the treatment procedure and were not to be allowed to operate a motor vehicle for 3 to 4 hours after receiving medication; subjects may have been offered an analgesic (e.g., ibuprofen or ketorolac) after injection/EP; subjects who were allergic to or had contraindications to listed concomitant medications may have been offered a suitable alternative; all concomitant medications have been added to eCRF respectively.
    Evidence for comparator
    This was a placebo-controlled study.
    Actual start date of recruitment
    28 Feb 2019
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    1 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Argentina: 5
    Country: Number of subjects enrolled
    Brazil: 24
    Country: Number of subjects enrolled
    South Africa: 12
    Country: Number of subjects enrolled
    United States: 41
    Country: Number of subjects enrolled
    Spain: 20
    Country: Number of subjects enrolled
    Estonia: 51
    Country: Number of subjects enrolled
    Finland: 5
    Country: Number of subjects enrolled
    Lithuania: 45
    Worldwide total number of subjects
    203
    EEA total number of subjects
    121
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    203
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects meeting all the inclusion criteria and none of the exclusion criteria were entered into the clinical trial. Eligible subjects were randomly assigned to receive either 6 mg VGX-3100 or placebo (ratio 2:1) IM followed by Electroporation (EP).

    Pre-assignment
    Screening details
    All screening evaluations were to be completed within 10 weeks prior to the first dose of clinical trial treatment (Day 0), except for the safety laboratory assessments, which were to be performed within 60 days prior to Day 0.

    Period 1
    Period 1 title
    Treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    This clinical trial was double-blinded with blinding maintained throughout the clinical trial by use of identical packaging for both the active product VGX-3100 and the placebo. There was no difference in appearance for both the active product and the placebo.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    VGX-3100 + EP
    Arm description
    Eligible subjects received three (3) 6-mg doses of VGX-3100 refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.
    Arm type
    Experimental

    Investigational medicinal product name
    VGX-3100
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    Eligible subjects received three (3) 6-mg doses (in 1 mL) of VGX-3100 refrigerated formulation.

    Arm title
    Placebo + EP
    Arm description
    Eligible subjects received three (3) doses Placebo refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    Eligible subjects received three (3) does Placebo (in 1 mL) of VGX-3100 refrigerated formulation.

    Number of subjects in period 1
    VGX-3100 + EP Placebo + EP
    Started
    134
    69
    Completed
    121
    64
    Not completed
    13
    5
         Consent withdrawn by subject
    6
    1
         Adverse event, non-fatal
    1
    1
         Other
    -
    2
         Progressive disease
    1
    -
         Lost to follow-up
    5
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    VGX-3100 + EP
    Reporting group description
    Eligible subjects received three (3) 6-mg doses of VGX-3100 refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.

    Reporting group title
    Placebo + EP
    Reporting group description
    Eligible subjects received three (3) doses Placebo refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.

    Reporting group values
    VGX-3100 + EP Placebo + EP Total
    Number of subjects
    134 69 203
    Age categorical
    Units: Subjects
        <25
    18 14 32
        ≥25
    116 55 171
    Age continuous
    Units: years
        median (full range (min-max))
    30 (18 to 60) 31 (18 to 66) -
    Gender categorical
    Units: Subjects
        Female
    134 69 203
        Male
    0 0 0
    Subject analysis sets

    Subject analysis set title
    ITT Analysis Set
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT analysis set consisted of 203 subjects who were randomly assigned to receive either VGX-3100 + EP (134 subjects) or placebo + EP (69 subjects).

    Subject analysis set title
    mITT Analysis Set
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT set included all subjects who received at least one (1) dose of clinical trial treatment and who had the analysis endpoint of interest. Subjects in this sample were grouped to treatment as randomized. Analysis of the mITT set was considered supportive for the corresponding ITT set for the analysis of efficacy and also served as sensitivity analyses regarding missing data.

    Subject analysis set title
    Per Protocol (PP) Set
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The PP set was composed of subjects who received all doses of clinical trial treatments, had no protocol violations, and had the analysis endpoint of interest.

    Subject analysis set title
    Safety Analysis Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety set included all subjects who received at least one (1) dose of clinical trial treatment. Subjects were analyzed as to the treatment actually received.

    Subject analysis sets values
    ITT Analysis Set mITT Analysis Set Per Protocol (PP) Set Safety Analysis Set
    Number of subjects
    203
    198
    183
    202
    Age categorical
    Units: Subjects
        <25
    32
        ≥25
    171
    Age continuous
    Units: years
        median (full range (min-max))
    30 (18 to 66)
    Gender categorical
    Units: Subjects
        Female
    203
        Male
    0

    End points

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    End points reporting groups
    Reporting group title
    VGX-3100 + EP
    Reporting group description
    Eligible subjects received three (3) 6-mg doses of VGX-3100 refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.

    Reporting group title
    Placebo + EP
    Reporting group description
    Eligible subjects received three (3) doses Placebo refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.

    Subject analysis set title
    ITT Analysis Set
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT analysis set consisted of 203 subjects who were randomly assigned to receive either VGX-3100 + EP (134 subjects) or placebo + EP (69 subjects).

    Subject analysis set title
    mITT Analysis Set
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT set included all subjects who received at least one (1) dose of clinical trial treatment and who had the analysis endpoint of interest. Subjects in this sample were grouped to treatment as randomized. Analysis of the mITT set was considered supportive for the corresponding ITT set for the analysis of efficacy and also served as sensitivity analyses regarding missing data.

    Subject analysis set title
    Per Protocol (PP) Set
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The PP set was composed of subjects who received all doses of clinical trial treatments, had no protocol violations, and had the analysis endpoint of interest.

    Subject analysis set title
    Safety Analysis Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety set included all subjects who received at least one (1) dose of clinical trial treatment. Subjects were analyzed as to the treatment actually received.

    Primary: Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – Baseline Biomarker-positive Subjects (ITT population)

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    End point title
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – Baseline Biomarker-positive Subjects (ITT population)
    End point description
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 has been measured at Week 36 for baseline Biomarker-positive Subjects (ITT population).
    End point type
    Primary
    End point timeframe
    At Week 36
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    21
    4
    Units: Subjects
    number (not applicable)
        Responders (n)
    6
    0
        Responders (%)
    28.6
    0
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    A p-value of superiority was based on a test of risk difference and corresponding 95% confidence interval using the method of Miettinen and Nurminen. Superiority was to be concluded if the one-sided p-value was <0.025 and the corresponding lower bound of the 95% CI exceeded zero.
    Comparison groups
    VGX-3100 + EP v Placebo + EP
    Number of subjects included in analysis
    25
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.115
    Method
    Miettinen and Nurminen
    Parameter type
    Difference in Percentage
    Point estimate
    28.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -24.6
         upper limit
    50.4

    Primary: Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – Baseline Biomarker-positive Subjects (mITT population)

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    End point title
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – Baseline Biomarker-positive Subjects (mITT population)
    End point description
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 was measured at Week 36 for Baseline Biomarker-positive Subjects (mITT population).
    End point type
    Primary
    End point timeframe
    At Week 36
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    21
    4
    Units: Subjects
    number (not applicable)
        Subjects contributing analysis data
    19
    4
        Responders (n)
    6
    0
        Responders (%)
    31.6
    0
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    A p-value of superiority was based on a test of risk difference and corresponding 95% CI using the method of Miettinen and Nurminen. Superiority was concluded if the one-sided p-value was <0.025 and the corresponding lower bound of the 95% CI exceeded zero (0).
    Comparison groups
    VGX-3100 + EP v Placebo + EP
    Number of subjects included in analysis
    25
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.101
    Method
    Miettinen and Nurminen
    Parameter type
    Difference in Percentage
    Point estimate
    31.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -22.2
         upper limit
    54.5

    Primary: Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – Baseline Biomarker-positive Subjects (PP Population)

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    End point title
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – Baseline Biomarker-positive Subjects (PP Population)
    End point description
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 was measured at Week 36 for Baseline Biomarker-positive Subjects (PP Population).
    End point type
    Primary
    End point timeframe
    At week 36
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    21
    3
    Units: Subjects
    number (not applicable)
        Subjects contributing analysis data
    19
    3
        Responders (n)
    6
    0
        Responders (%)
    31.6
    0
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    A p-value of superiority was based on a test of risk difference and corresponding 95% CI using the method of Miettinen and Nurminen. Superiority was concluded if the one-sided p-value was <0.025 and the corresponding lower bound of the 95% CI exceeded zero (0).
    Comparison groups
    VGX-3100 + EP v Placebo + EP
    Number of subjects included in analysis
    24
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.132
    Method
    Miettinen and Nurminen
    Parameter type
    Difference in Percentage
    Point estimate
    31.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -29.4
         upper limit
    54.5

    Secondary: Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – All Subjects (ITT Population)

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    End point title
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – All Subjects (ITT Population)
    End point description
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 was measured at Week 36 – All Subjects (ITT Population).
    End point type
    Secondary
    End point timeframe
    At week 36
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    134
    69
    Units: Subjects
    number (not applicable)
        Responders (n)
    37
    6
        Responders (%)
    27.6
    8.7
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    A p-value of superiority was based on a test of risk difference and corresponding 95% confidence interval using the method of Miettinen and Nurminen. Superiority was to be concluded if the one-sided p-value was <0.025 and the corresponding lower bound of the 95% CI exceeded zero.
    Comparison groups
    VGX-3100 + EP v Placebo + EP
    Number of subjects included in analysis
    203
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.001
    Method
    Miettinen and Nurminen
    Parameter type
    Difference in Percentage
    Point estimate
    18.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    7.8
         upper limit
    28.6

    Secondary: Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – All Subjects (mITT Population)

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    End point title
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – All Subjects (mITT Population)
    End point description
    End point type
    Secondary
    End point timeframe
    At week 36
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    130
    68
    Units: Subjects
    number (not applicable)
        Subjects contributing analysis data
    125
    64
        Responders (n)
    37
    6
        Responders (%)
    29.6
    9.4
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    A p-value of superiority was based on a test of risk difference and corresponding 95% CI using the method of Miettinen and Nurminen. Superiority was concluded if the one-sided p-value was <0.025 and the corresponding lower bound of the 95% CI exceeded zero (0).
    Comparison groups
    VGX-3100 + EP v Placebo + EP
    Number of subjects included in analysis
    198
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.001
    Method
    Miettinen and Nurminen
    Parameter type
    Difference in Percentage
    Confidence interval

    Secondary: Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – All Subjects (PP Population)

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    End point title
    Histopathological Regression of Cervical HSIL Lesions and Virologic Clearance of HPV-16 and/or HPV-18 at Week 36 – All Subjects (PP Population)
    End point description
    End point type
    Secondary
    End point timeframe
    At week 36
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    122
    61
    Units: Subjects
    number (not applicable)
        Subjects contributing analysis data
    118
    58
        Responders (n)
    37
    6
        Responders (%)
    31.4
    10.3
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    A p-value of superiority was based on a test of risk difference and corresponding 95% CI using the method of Miettinen and Nurminen. Superiority was concluded if the one-sided p-value was <0.025 and the corresponding lower bound of the 95% CI exceeded zero (0).
    Comparison groups
    VGX-3100 + EP v Placebo + EP
    Number of subjects included in analysis
    183
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.001
    Method
    Miettinen and Nurminen
    Parameter type
    Difference in Percentage
    Point estimate
    21
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    8.3
         upper limit
    31.9

    Secondary: Overview of Adverse Events (Safety Population)

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    End point title
    Overview of Adverse Events (Safety Population)
    End point description
    The incidence of TEAEs with onset within 7 days and 28 days after each clinical trial treatment was measured. The incidence if TEAEs was similar between the two (2) treatment groups.
    End point type
    Secondary
    End point timeframe
    Within 7 days and 28 days after each clinical trial treatment
    End point values
    VGX-3100 + EP Placebo + EP
    Number of subjects analysed
    134
    67
    Units: Subjects
        Any AE
    131
    67
        Any pretreatment AE
    25
    12
        Any TEAE
    131
    67
        Any serious TEAE
    9
    9
        Any IP- or EP-related TEAE
    127
    62
        Any IP- or EP-related serious TEAE
    0
    0
        Any TEAE with CTCAE ≥3
    15
    9
        Any IP- or EP-related TEAE with CTCAE ≥3
    2
    3
        Any TEAE of special interest
    0
    0
        Any TEAE leading to treatment discontinuation
    2
    1
        Any TEAE leading to death
    0
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Within 7 days and 28 days after each clinical trial treatment
    Adverse event reporting additional description
    The incidence of TEAEs with onset measured within 7 days and 28 days after each clinical trial treatment. None of the serious TEAEs reported in the VGX-3100 + EP group and in the placebo + EP group were related to IP or EP. No subject deaths were reported in either treatment group.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    VGX-3100 + EP
    Reporting group description
    Eligible subjects received three (3) 6-mg doses of VGX-3100 refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.

    Reporting group title
    Placebo + EP
    Reporting group description
    Eligible subjects received three (3) doses Placebo refrigerated formulation IM (deltoid [preferred site] or anterolateral quadriceps [alternate site]), followed immediately by EP with the CELLECTRA™ 5PSP device.

    Serious adverse events
    VGX-3100 + EP Placebo + EP
    Total subjects affected by serious adverse events
         subjects affected / exposed
    9 / 134 (6.72%)
    9 / 67 (13.43%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma of the cervix
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 67 (1.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cervix carcinoma stage 0
         subjects affected / exposed
    4 / 134 (2.99%)
    3 / 67 (4.48%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    2 / 134 (1.49%)
    1 / 67 (1.49%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma of the cervix
         subjects affected / exposed
    2 / 134 (1.49%)
    2 / 67 (2.99%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Ovarian rupture
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 67 (1.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 67 (1.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    COVID-19
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 67 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    VGX-3100 + EP Placebo + EP
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    131 / 134 (97.76%)
    67 / 67 (100.00%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    66 / 134 (49.25%)
    37 / 67 (55.22%)
         occurrences all number
    66
    37
    Dizziness
         subjects affected / exposed
    8 / 134 (5.97%)
    2 / 67 (2.99%)
         occurrences all number
    8
    2
    General disorders and administration site conditions
    Injection site pain
         subjects affected / exposed
    123 / 134 (91.79%)
    58 / 67 (86.57%)
         occurrences all number
    123
    58
    Fatigue
         subjects affected / exposed
    56 / 134 (41.79%)
    33 / 67 (49.25%)
         occurrences all number
    56
    33
    Injection site swelling
         subjects affected / exposed
    43 / 134 (32.09%)
    19 / 67 (28.36%)
         occurrences all number
    43
    19
    Injection site erythema
         subjects affected / exposed
    36 / 134 (26.87%)
    15 / 67 (22.39%)
         occurrences all number
    36
    15
    Injection site pruritus
         subjects affected / exposed
    33 / 134 (24.63%)
    22 / 67 (32.84%)
         occurrences all number
    33
    22
    Injection site bruising
         subjects affected / exposed
    21 / 134 (15.67%)
    11 / 67 (16.42%)
         occurrences all number
    21
    11
    Malaise
         subjects affected / exposed
    18 / 134 (13.43%)
    12 / 67 (17.91%)
         occurrences all number
    18
    12
    Pyrexia
         subjects affected / exposed
    11 / 134 (8.21%)
    5 / 67 (7.46%)
         occurrences all number
    11
    5
    Injection site haematoma
         subjects affected / exposed
    10 / 134 (7.46%)
    7 / 67 (10.45%)
         occurrences all number
    10
    7
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    36 / 134 (26.87%)
    17 / 67 (25.37%)
         occurrences all number
    36
    17
    Reproductive system and breast disorders
    Dysmenorrhoea
         subjects affected / exposed
    4 / 134 (2.99%)
    5 / 67 (7.46%)
         occurrences all number
    4
    5
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    56 / 134 (41.79%)
    29 / 67 (43.28%)
         occurrences all number
    56
    29
    Arthralgia
         subjects affected / exposed
    29 / 134 (21.64%)
    14 / 67 (20.90%)
         occurrences all number
    29
    14
    Back pain
         subjects affected / exposed
    2 / 134 (1.49%)
    4 / 67 (5.97%)
         occurrences all number
    2
    4
    Infections and infestations
    COVID-19
         subjects affected / exposed
    12 / 134 (8.96%)
    8 / 67 (11.94%)
         occurrences all number
    12
    8
    Urinary tract infection
         subjects affected / exposed
    8 / 134 (5.97%)
    1 / 67 (1.49%)
         occurrences all number
    8
    1

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Jul 2018
    • The number of participating sites and countries were updated. • A footnote was added to the primary hypothesis for the purpose of clarification and alignment with the timeframe for analysis. • The wording of secondary endpoints 1(a) and 1(b) were modified to more accurately state that all AEs, not just SAEs were to be reported through the entire duration that a subject was in the clinical trial. • Exploratory objective 2 and associated endpoints were removed. • The wording of secondary objective 8 was revised to reflect more clearly that immunology results were to be assessed relative to baseline levels. • For exploratory objective 3, DNA methylation was added to investigate as an additional potential biomarker. • Exploratory endpoint 4 was added to describe the association of the baseline tissue-based score derived using immunologic markers (immunoscore) to the Week 36 efficacy endpoint. • Text was clarified in the immunogenicity assessment, safety assessment, and trial population sections of the synopsis. • Human leukocyte antigen (HLA) testing was removed. • Revisions to the inclusion and exclusion criteria (synopsis, Sections 4.1, and 4.2) • Updates to the Schedule of Events table • General updates and clarifications Additional minor grammatical and administrative changes were made throughout the document for improvement of general readability.
    15 Nov 2018
    • The EudraCT number was added to the protocol. • The number of participating countries was changed from 15 to 20. This change was made to the protocol synopsis. • The protocol was updated throughout to remove the digital photography procedure. • In Section 5.10.2 CELLECTRA™ 5PSP Device, wording was added to allow sites either to ship unused CELLECTRA™ 5PSP arrays back to Inovio or to destroy them on-site. • In Section 5.10.2 CELLECTRA™ 5PSP Device, text was updated as follows: upon completion or termination of ‘the study’ was replaced by ‘Inovio’s studies’, to indicate that the Base Station and Handset must be returned to Inovio Pharmaceuticals, Inc after completion of Inovio’s studies utilizing the CELLECTRA™ 5PSP device. • In Section 8.5.2.2 Immunogenicity, the Week 8 immunogenicity evaluation was removed from the text.
    01 Jun 2022
    • The primary population to which the primary objective was applied was changed from “all subjects” to “subjects defined as biomarker-positive at baseline,” as identified by microRNA (miRNA) profiling performed from peripheral blood prior to dosing with VGX-3100 (Section 6.10). This change was made in order to define a population of patients in whom VGX-3100 is more likely to be efficacious as defined by the primary endpoint of regression of cervical HSIL and clearance of HPV-16/18. • The protocol was revised to remove 4-quadrant biopsy as a potential procedure at Week 36 throughout the protocol. • Stopping Rules (Criteria for Pausing of Study) added to Data Safety Monitoring Board Charter version 3.0. • Updated acceptable contraception methods in Protocol Synopsis, Inclusion Criteria and Section 4.1, Inclusion Criteria. A footnote was added to clarify that use of condoms or condoms and spermicide are not acceptable forms of contraception. • Updated Table 1: Schedule of Events and Sections 6.1.1, 6.1.2, and 6.4.12, method of collection for cervical digene™ samples. Text was changed and updated the method of collection of cervical digene™ samples from swabs to brushes at screening, Day 0, Weeks 15, 28, and 36. • Clarifications on different sections added. • Administrative Changes.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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