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    Clinical Trial Results:
    A Multi-Centre, Open-label Phase 2a Trial of the Combination of VB10.16 and Atezolizumab in Patients with Advanced or Recurrent, Non-resectable HPV16-Positive Cervical Cancer

    Summary
    EudraCT number
    2019-002328-33
    Trial protocol
    BE   DE   NO   BG   CZ   PL  
    Global end of trial date
    24 Nov 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    07 Dec 2024
    First version publication date
    07 Dec 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    VB_C-02
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04405349
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Nykode Therapeutics ASA
    Sponsor organisation address
    Oslo Research Park, Gaustadalléen 21, Oslo, Norway, 0349
    Public contact
    Chief Medical Officer, Nykode Therapeutics ASA, +47 22958193,
    Scientific contact
    Chief Medical Officer, Nykode Therapeutics ASA, +47 22958193,
    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
    24 Nov 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    24 Nov 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Nov 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the safety/tolerability and clinical efficacy by overall response rate (ORR) of multiple doses of 3 mg VB10.16 immunotherapy in combination with atezolizumab
    Protection of trial subjects
    The trial was conducted in accordance with the Declaration of Helsinki, adopted by the 18th World Medical Association (WMA) General Assembly, Helsinki, Finland, June 1964, and subsequent amendments and International Council for Harmonisation (ICH) Guideline for Good Clinical Practice E6 (R2) (European Medicines Agency (EMA)/Committee for Medicinal Products for Human Use CHMP)/ICH/135/1995), including archiving of essential documents and the EU Clinical Trial Directives 2001/20/EC and 2005/28/EC.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    16 Jun 2020
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Norway: 9
    Country: Number of subjects enrolled
    Poland: 6
    Country: Number of subjects enrolled
    Belgium: 14
    Country: Number of subjects enrolled
    Bulgaria: 4
    Country: Number of subjects enrolled
    Czechia: 13
    Country: Number of subjects enrolled
    Germany: 6
    Worldwide total number of subjects
    52
    EEA total number of subjects
    52
    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)
    48
    From 65 to 84 years
    4
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The trial was conducted at 14 sites in 6 European countries (Germany, Belgium, Bulgaria, Czech Republic, Poland, and Norway).

    Pre-assignment
    Screening details
    All subjects enrolled in the trial must have a positive HPV-16 test of tumour tissue.

    Period 1
    Period 1 title
    Treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    VB10.16
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    VB10.16
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    3 mg VB10.16 intramuscular, every 3 weeks for the first 5 vaccinations for induction followed by a maintenance period with 6 vaccinations every 6 weeks.

    Number of subjects in period 1
    VB10.16
    Started
    52
    Completed
    15
    Not completed
    37
         Consent withdrawn by subject
    1
         Disease progression
    30
         Adverse event, non-fatal
    3
         Death
    2
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    VB10.16
    Reporting group description
    -

    Reporting group values
    VB10.16 Total
    Number of subjects
    52 52
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    48 48
        From 65-84 years
    4 4
        85 years and over
    0 0
    Gender categorical
    Units: Subjects
        Female
    52 52
        Male
    0 0
    Subject analysis sets

    Subject analysis set title
    Evaluable Analysis Set
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All subjects who received any amount of VB10.16 or atezolizumab and had at least 1 post-baseline efficacy assessment (scan).

    Subject analysis sets values
    Evaluable Analysis Set
    Number of subjects
    47
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    43
        From 65-84 years
    4
        85 years and over
    0
    Age continuous
    Units:
        
    ( )
    Gender categorical
    Units: Subjects
        Female
    47
        Male
    0

    End points

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    End points reporting groups
    Reporting group title
    VB10.16
    Reporting group description
    -

    Subject analysis set title
    Evaluable Analysis Set
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All subjects who received any amount of VB10.16 or atezolizumab and had at least 1 post-baseline efficacy assessment (scan).

    Primary: Objective Response Rate per RECIST 1.1

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    End point title
    Objective Response Rate per RECIST 1.1 [1]
    End point description
    The proportion of subjects who have Complete Response or Partial Response per RECIST 1.1 at any time during the study. The ORR and corresponding 95% CI were calculated using the Clopper and Pearson exact method for binomial proportions.
    End point type
    Primary
    End point timeframe
    Any time during the study.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: One arm trial, no statistical analysis performed for the primary endpoint.
    End point values
    Evaluable Analysis Set
    Number of subjects analysed
    47
    Units: Percentage of subjects
        number (confidence interval 95%)
    19.1 (9.1 to 33.3)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first administration of IMP (VB10.16 or atezolizumab) to 30 days after last administration of IMP.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    VB10.16
    Reporting group description
    -

    Serious adverse events
    VB10.16
    Total subjects affected by serious adverse events
         subjects affected / exposed
    26 / 52 (50.00%)
         number of deaths (all causes)
    6
         number of deaths resulting from adverse events
    6
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm progression
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vascular disorders
    Lymphoedema
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 4
    Fatigue
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Vaginal haemorrhage
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Product issues
    Device occlusion
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Aphasia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences causally related to treatment / all
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    Lymphadenitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Large intestine perforation
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin necrosis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Urinary retention
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Kidney infection
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pelvic inflammatory disease
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tonsillitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    VB10.16
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    50 / 52 (96.15%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Tumour pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Hypertension
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Lymphoedema
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    3
    Hot flush
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Surgical and medical procedures
    Tooth extraction
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    13 / 52 (25.00%)
         occurrences all number
    29
    Pyrexia
         subjects affected / exposed
    5 / 52 (9.62%)
         occurrences all number
    5
    Asthenia
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    4
    Injection site bruising
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences all number
    3
    Injection site discomfort
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences all number
    4
    Oedema peripheral
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences all number
    4
    Administration site pain
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    17
    Chills
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Injection site pain
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    3
    Peripheral swelling
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Feeling of body temperature change
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Injection site haematoma
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Injection site inflammation
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Malaise
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Injection site extravasation
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Reproductive system and breast disorders
    Vaginal haemorrhage
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    3
    Pelvic pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    7 / 52 (13.46%)
         occurrences all number
    7
    Cough
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    4
    Wheezing
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Immune-mediated lung disease
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Nasal dryness
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Productive cough
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Depressed mood
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Depression
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Hallucination
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Insomnia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Product issues
    Device dislocation
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences all number
    3
    Weight decreased
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences all number
    4
    Amylase increased
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Blood creatinine increased
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    5
    Blood potassium decreased
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Blood thyroid stimulating hormone increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    C-reactive protein increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Lipase increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Pancreatic enzymes increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    SARS-CoV-2 test positive
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Thyroxine free increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Tri-iodothyronine free increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Weight increased
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Hand fracture
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Infusion related reaction
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    3
    Wound dehiscence
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    6
    Disturbance in attention
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Dysaesthesia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Lumbosacral plexopathy
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Neuropathy peripheral
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    2
    Peripheral sensory neuropathy
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Radicular pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    18 / 52 (34.62%)
         occurrences all number
    46
    Neutropenia
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    4
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    2
    Lymph node pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Lymphadenitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Lymphadenopathy
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Thrombocytopenia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    3
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    8 / 52 (15.38%)
         occurrences all number
    8
    Diarrhoea
         subjects affected / exposed
    8 / 52 (15.38%)
         occurrences all number
    9
    Nausea
         subjects affected / exposed
    6 / 52 (11.54%)
         occurrences all number
    6
    Abdominal pain
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    6
    Vomiting
         subjects affected / exposed
    5 / 52 (9.62%)
         occurrences all number
    5
    Abdominal pain lower
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    3
    Dysphagia
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Cheilitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Dyspepsia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Gastritis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Haemorrhoids
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Melaena
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Rectal haemorrhage
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Tongue discomfort
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Night sweats
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Rash
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Erythema
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Skin irritation
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    6 / 52 (11.54%)
         occurrences all number
    8
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Urinary retention
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Dysuria
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Haematuria
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    7 / 52 (13.46%)
         occurrences all number
    9
    Hyperthyroidism
         subjects affected / exposed
    6 / 52 (11.54%)
         occurrences all number
    6
    Autoimmune thyroiditis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 52 (13.46%)
         occurrences all number
    10
    Back pain
         subjects affected / exposed
    5 / 52 (9.62%)
         occurrences all number
    5
    Pain in extremity
         subjects affected / exposed
    5 / 52 (9.62%)
         occurrences all number
    5
    Myalgia
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    4
    Groin pain
         subjects affected / exposed
    3 / 52 (5.77%)
         occurrences all number
    3
    Muscle spasms
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Sacral pain
         subjects affected / exposed
    2 / 52 (3.85%)
         occurrences all number
    2
    Coccydynia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Joint swelling
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Muscular weakness
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Musculoskeletal pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Neck pain
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    4
    COVID-19
         subjects affected / exposed
    5 / 52 (9.62%)
         occurrences all number
    5
    Gardnerella infection
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Gonorrhoea
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Gynaecological chlamydia infection
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Oral herpes
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Pelvic inflammatory disease
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Respiratory tract infection viral
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Sinusitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Skin infection
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Tonsillitis
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    2
    Tooth abscess
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    4 / 52 (7.69%)
         occurrences all number
    4
    Hyperglycaemia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    2
    Hypoalbuminaemia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Hypomagnesaemia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Hyponatraemia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Hypophosphataemia
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1
    Increased appetite
         subjects affected / exposed
    1 / 52 (1.92%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    29 Jun 2020
    An appendix describing study considerations and instructions based on the COVID-19 global health crisis was added. • Exclusion criterion #14 was modified to clarify that subjects were to be excluded if they had received an investigational drug within 30 days or 5 half-lives before study entry (Visit 1). • Exclusion criterion #22a was modified to remove the provision of a >3 × ULN limit of total bilirubin with Gilbert’s syndrome such that any subject with >1.5 × ULN total bilirubin was excluded, and exclusion criterion #22b was modified to specify upper limits for transaminases if elevated due to the course of the subject's malignancy. • For subjects who were discontinued by the investigator due to safety concerns, an additional visit was added after 3 months for laboratory assessments. • Prohibited therapies were modified to indicate that study treatment was to be postponed in case any unforeseeable vaccinations were necessary during the study, and text describing the permitted palliative radiotherapy was clarified. • Changes were made to indicate that the sponsor would provide access to further treatment with atezolizumab after the end of the study (if clinically indicated). • Text was added to indicate that results of safety laboratory tests and pregnancy tests were to be reviewed before study treatment was administered. • National Cancer Institute (NCI) CTCAE (Versions 4.0 and 5.0) grading details for a range of potential AEs associated with the use of atezolizumab were included in an appendix. Changes were made to reflect revisions in an addendum to the current atezolizumab IB and SPC, including changes regarding management of atezolizumab-specific AEs. • Exclusion criteria were modified to state that active, known, or suspected autoimmune disease would lead to exclusion and a new section listing exclusionary autoimmune diseases was added. • Subgroup analyses by PD-L1 status and tumour type were added to the statistical methods section of the protocol
    17 Dec 2020
    This global protocol amendment was implemented for several reasons. Some of the changes made were as follows: • Information on a newly identified risk for treatment with atezolizumab was added, after the manufacturer confirmed a risk of severe cutaneous adverse reactions. • The text describing the final study visits for subjects completing the study and for those terminating early and the text describing the handling of missing/delayed treatments were clarified. • The Schedule of Events was modified to show the quarterly telephone calls during follow-up and the pregnancy tests that are conducted at home by subjects for the first 6 months of follow-up. • Collection of laboratory blood samples the day before administration of study treatment (including Visit 1) was added. • Instructions for the collection, processing, and shipping of blood samples for evaluation of peripheral T-cell response were added. • The acceptability of local imaging assessment for subject management by the investigator was clarified. • The sample size was modified in case of a larger than expected drop-out rate. • An appendix describing the process for conducting remote source data verification was added. • Circumstances allowing rescreening of screen-failed subjects were updated. • The option of subject consent for remote screening was added in light of the COVID-19 pandemic and to reduce unnecessary travel. • Text suggesting that archived samples could only be used from subjects who had received prior anticancer therapy was removed. • Reporting of disease progression as an AE was clarified. • Different changes were made to the eligibility criteria.
    28 Mar 2022
    This global protocol amendment was implemented for several reasons. The changes made were as follows: • The sponsor’s name was updated, after VACCIBODY AS changed their name to Nykode Therapeutics ASA. • Information on the management of atezolizumab-specific AEs was updated, as described in the most recent IB (Version 18, July 2021; Addendum 1, August 2021). • The ongoing use of atezolizumab in patients who completed the 48 weeks of planned study treatment was clarified, including clarification regarding AE reporting during this time.

    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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