On June 5, 2022 HOOKIPA Pharma Inc. (NASDAQ: HOOK, ‘HOOKIPA’), a company developing a new class of immunotherapeutics based on its proprietary arenavirus platform, reported positive Phase 1 results from its HB-200 program evaluating single-vector HB-201 and alternating 2-vector HB-202/HB-201 in advanced Human Papillomavirus 16-positive (HPV16+) head and neck cancer patients (Press release, Hookipa Pharma, JUN 5, 2022, View Source [SID1234615563]). HB-200 was generally well tolerated, rapidly induced a high magnitude of tumor-specific T cells and showed early anti-tumor activity in these difficult-to-treat patients. The company also announced the recommended Phase 2 dose for alternating 2-vector HB-202/HB-201, which showed superior immune and tumor response compared to single-vector HB-201. The data were presented in a poster presentation (abstract #2517) at the 2022 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting.

Schedule your 30 min Free 1stOncology Demo!
Discover why more than 1,500 members use 1stOncology™ to excel in:

Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing

                  Schedule Your 30 min Free Demo!

"We’re pleased to report the positive Phase 1 data on our novel arenaviral immunotherapies for advanced head and neck cancers, which highlight the ability of our platform technology to induce a high magnitude of potent, tumor-specific T cell responses," said Joern Aldag, Chief Executive Officer at HOOKIPA. "We’re encouraged by the superior immune response generated by alternating 2-vector immunotherapy, which resulted in an 80 percent disease control rate in patients who have failed several previous regimens. These results help focus our efforts as we move HB-202/HB-201 at the recommended Phase 2 dose into the Phase 2 portion of the trial. The findings on our alternating 2-vector technology also help inform our development plans across our oncology portfolio and especially for our HB-300 program in prostate cancer."

HB-200 Phase 1 results (NCT04180215)
Sixty-eight patients with advanced HPV16+ cancers were treated in the Phase 1 trial as of March 31, 2022. Fifty-four patients had advanced HPV16+ head and neck cancers with a median of three prior therapies (range of 1-11), including a checkpoint inhibitor regimen in 50 of the 54. Of these sixty-eight patients, five were continuing on treatment as of the cut-off date.

Safety
Phase 1 results showed HB-200 was generally well tolerated, with comparable safety between the single-vector HB-201 and alternating 2-vector HB-202/HB-201. The most common treatment-related side effects were flu-like symptoms, with only 8.8 percent of patients experiencing treatment-related side effects rated grade 3 or higher. This favorable tolerability profile in heavily pre-treated patients highlights the potential for combination with checkpoint inhibitors and other agents.

Anti-tumor activity
The poster presented at ASCO (Free ASCO Whitepaper) provided updated anti-tumor activity on 43 Phase 1 patients with HPV16+ HNSCC who received therapy intravenously every three weeks for the first five doses and every six weeks thereafter, which is the route and frequency selected for further evaluation in Phase 2 cohorts. The 43 patients were comprised of 20 persons who received single-vector HB-201 and 23 who received alternating 2-vector HB-202/HB-201.

While promising anti-tumor activity was shown in both groups, alternating 2-vector HB-202/HB-201 showed superior tumor response with 56 percent of treated patients showing target lesion shrinkage compared to 38 percent of HB-201 recipients. In addition, decreases in visceral lesions were predominantly seen in patients who received 2-vector therapy: 59 percent of patients on HB-202/HB-201 compared to 18 percent on HB-201. Further, HB-202/HB-201 demonstrated an 80 percent disease control rate, which compares favorably to historical disease control rates achieved by pembrolizumab in recurrent/metastatic HNSCC patients, specifically 35 percent overall and 40 percent in the HPV+ subset, based on peer-reviewed published data.1

T cell data
While both HB-201 and alternating 2-vector HB-202/HB-201 were highly immunogenic, HB-202/HB-201 induced superior immune response with 32 percent of recipients achieving tumor-specific T cell levels greater than 5 percent of the circulating T cell pool (7 percent of HB-201 recipients achieved this threshold). Tumor specific T cells are essential in eradicating cancer cells.

"Patients with advanced head and neck cancers have limited options," said Siqing Fu, M.D., Ph.D., professor of Investigational Cancer Therapeutics and principal investigator at The University of Texas MD Anderson Cancer Center, who presented the data at the ASCO (Free ASCO Whitepaper) meeting. "It’s encouraging to see a novel arenaviral immunotherapy demonstrate strong T cell response and anti-tumor activity in this difficult-to-treat population. I look forward to seeing future results from the Phase 2 portion in HPV16+ head and neck cancers, as well as in other types of cancer."

About HB-202/HB-201
HB-201 and HB-202/HB-201 are HOOKIPA’s lead oncology candidates engineered with the company’s proprietary replicating arenaviral vector platform. HB-201 is a single-vector compound that uses Lymphocytic Choriomeningitis Virus as its arenaviral backbone. HB-202 is a single-vector compound that uses Pichinde Virus as its arenaviral backbone. Both express the same antigen, an E7E6 fusion protein derived from HPV16. HB-202/HB-201 is an alternating 2-vector immunotherapy designed to further focus the immune response against the target antigen. In pre-clinical studies, alternating administration of HB-201 and HB-202 resulted in a ten-fold increase in immune response and better disease control than either compound alone. Both novel immunotherapy candidates, in combination with pembrolizumab, received Fast Track Designation from the U.S. Food and Drug Administration for the treatment of 1st-line advanced/metastatic HPV16+ head and neck cancers.

About the HB-200 trial (NCT04180215)
This Phase 1/2 clinical trial is an open-label trial evaluating single-vector HB-201 and alternating 2-vector HB-202/HB-201 for the treatment of advanced HPV16+ cancers who progressed on standard of care, including checkpoint inhibitors. The primary endpoint of Phase 1 was a recommended Phase 2 dose.

In Phase 1, HB-201 was evaluated at three dose levels, with two dosing schedules and two administration routes in 40 patients. HB-202/HB-201 was evaluated at four dose levels and two administration routes in 28 patients. Based on safety, anti-tumor activity and T cell response data, HB-202/HB-201 has been advanced for further development in Phase 2.

The Phase 2 part of the trial is open-label with primary endpoints of safety, tolerability and preliminary efficacy, defined by RECIST 1.1, for overall survival, progression-free survival and duration of response. Phase 2 is ongoing, evaluating HB-202/HB-201 alone in the post standard of care setting and in combination with pembrolizumab in 1st line and 2nd plus line settings. HB-201 in combination with pembrolizumab is being assessed for safety only in a small cohort. Initial results of HB-202/HB-201 in combination with pembrolizumab are anticipated in the second half of 2022 and will help inform the randomized Phase 2 trial of HB-202/HB-201 in combination with pembrolizumab planned for the first half of 2023. Initial results of HB-202/HB-201 as a post-standard of care treatment are expected in the first half of 2023.

About Human Papillomavirus-driven Cancers
Human Papillomavirus, or HPV, is a common viral infection estimated to cause about 5 percent of the worldwide cancer burden. This includes up to 60 percent of head and neck, 89 percent of cervical, 78 percent of vaginal, 88 percent of anal, 67 percent of vulvar and 50 percent of penile cancers.

While there are numerous HPV types associated with cancer, HPV16 is the most common cause of cancer. Most HPV infections are cleared from the body with no lasting consequences. However, in some cases, HPV DNA becomes integrated into chromosomal DNA. When host cells take up this DNA, they express the HPV E6 and E7 proteins. This uptake can potentially lead to cancer since expression of these proteins leads to alterations in cell cycle control, which in turn predisposes these cells to become cancerous.