RE: re. off topic18 Oct 2022 19:00
Hi Bermuda
I hope that you don’t mind me coming back to you with a question regarding your post on Sunday, it states:-
“Before Scancell can open the head and neck arm of the Modi-1 trial, they'll need to run 2 more safety cohorts - low followed by high dose of Modi-1 plus checkpoint inhibitor. Approval from the Safety Review Board is needed to commence the 3rd safety cohort and that will be based on their review of the data from the ongoing (2nd) safety cohort. So the Royal Marsden trial can't be Modi-1”.
What you say does of course make absolute sense. It encouraged me to have a look at Modi-1 on the clinical trial site, it states:-
“The study aims to enrol 144 (114 in non-neoadjuvant cohorts and 30 in the exploratory neoadjuvant SCCHN cohort)”.
There are 3 arms to the trial:-
2 arms for the neoadjuvant SCCHN cohort, one arm taking Modi-1 with pembrolizumab (checkpoint inhibitor) and the other arm taking Modi-1 without pembrolizumab.
This confirms what you have said and states:-
“SCCHN Neoadjuvant expansion cohort only; patients who are treatment-naïve and are scheduled to have tumour resection surgery, in whom a period of 6 weeks of neoadjuvant immunotherapy can be administered. Patients will only be enrolled once the Modi-1 expansion doses and a lack of increased anti-CCP antibodies (with, and without, concomitant pembrolizumab) has been established”.
My question is about the remaining arm of the trial i.e. the 114 non-neoadjuvant group. Referring to this group it states:-
“The main objectives of this study are to assess the safety, tolerability, immunological activity, and preliminary efficacy of the Modi-1/Modi-1v vaccine, both as monotherapy and in combination with a checkpoint inhibitor (CPI) such as pembrolizumab or nivolumab (where these are standard of care in a non-neoadjuvant setting), in patients with advanced triple negative breast cancer (TNBC), advanced/unresectable human papillomavirus-negative squamous cell carcinoma of the head and neck (SCCHN), high grade serous ovarian carcinoma (HGSOC), or renal cell carcinoma (RCC).”
I interpret that this arm also includes patients with head and neck (SCCHN), however in this case it is non-neoadjuvant. Is it possible that some patients with SCCHN in this arm are receiving Modi-1 as a monotherapy (i.e. without a CPI)? If it is then maybe there is a possibility that Modi-1 is indeed being trialled on a SCCHN patient at the Royal Marsden?
(You will gather that I have read this as a “lay person” trying to understand it all. Forgive me if my question is in any way stupid).