NCT06947928

Brief Summary

This Phase 2/3, multicenter, randomized, double-blind, placebo-controlled trial will evaluate the Objective Response Rate (ORR) of IFx-Hu2.0 as an adjunctive therapy to pembrolizumab in adult participants (≥18 years) with advanced or metastatic Merkel Cell Carcinoma. A total of 118 participants will be randomized to receive either IFx-Hu2.0 or placebo via intralesional injection in a single lesion, followed by pembrolizumab.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
118

participants targeted

Target at P50-P75 for phase_2

Timeline
78mo left

Started Dec 2025

Longer than P75 for phase_2

Geographic Reach
1 country

18 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress9%
Dec 2025Dec 2032

First Submitted

Initial submission to the registry

April 14, 2025

Completed
13 days until next milestone

First Posted

Study publicly available on registry

April 27, 2025

Completed
8 months until next milestone

Study Start

First participant enrolled

December 11, 2025

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2027

Expected
5.8 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 30, 2032

Last Updated

April 17, 2026

Status Verified

April 1, 2026

Enrollment Period

1.3 years

First QC Date

April 14, 2025

Last Update Submit

April 14, 2026

Conditions

Keywords

Merkel Cell CarcinomaAdvancedMetastaticMCCpembrolizumabInnate Immune AgonistSkin CancerX-MarkX MarkRare Skin Cancers

Outcome Measures

Primary Outcomes (1)

  • Objective response rate (ORR)

    ORR defined as the proportion of participants who achieve a complete response (CR) or partial response (PR) at 12 weeks and confirmed on a second response assessment at least 28 days after the initial response assessment, in the treatment arm based on BICR assessment according to RECIST v1.1. Confirmed response persisting at the time of response assessment, at approximately 24 weeks will constitute the data utilized for the endpoint analysis.

    12 weeks post-treatment initiation and confirmed on a second response assessment at least 28 days after the initial response assessment

Secondary Outcomes (1)

  • Progression free survival (PFS)

    Up to 5 years

Study Arms (2)

Treatment Arm

EXPERIMENTAL

Participants randomized to the treatment arm will receive IFx-Hu2.0 (0.1 mg) via intralesional injection in a single lesion once per week for 3 consecutive weeks. Pembrolizumab (200 mg) will be administered intravenously (IV) on Day 1, followed by administration every 3 weeks during the first year of treatment. In the second year, the pembrolizumab dose will be 400 mg every 6 weeks. Pembrolizumab treatment will continue until progressive disease (PD), unacceptable immune-related toxicities, or for a maximum duration of 2 years.

Drug: IFx-Hu2.0Drug: Pembrolizumab

Control Arm

PLACEBO COMPARATOR

Participants randomized to the control arm will receive placebo (0.9% Sodium Chloride Injection, USP) via intralesional injection in a single lesion once per week for 3 consecutive weeks. Pembrolizumab (200 mg) will be administered IV on Day 1, followed by administration every 3 weeks during the first year of treatment. In the second year, the dose will be 400 mg every 6 weeks. Pembrolizumab treatment will continue until PD, unacceptable immune-related toxicities, or for a maximum duration of 2 years.

Drug: PlaceboDrug: Pembrolizumab

Interventions

Therapeutic Classification: • Innate immune agonist Route of Administration: • Intralesional

Also known as: pAc/emm55
Treatment Arm

Route of Administration: • Intralesional

Control Arm

Therapeutic Classification: • Immunotherapy (Immune checkpoint inhibitor) Route of administration: • Intravenous (IV) infusion

Also known as: KEYTRUDA
Control ArmTreatment Arm

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • At least 18 years of age.
  • Life expectancy equal to or greater than six months.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status \< 2.
  • Must be recurrent and/or unresectable Stage III or Stage IV American Joint Committee on Cancer (AJCC) (8th edition) and have histologically confirmed Merkel cell carcinoma
  • Must have at least one injectable lesion equal to or greater than 3 mm.
  • Must have measurable disease as defined by RECIST v1.1.
  • Participants should be CPI naïve i.e., no prior therapy with CPI including but not limited to Pembrolizumab, avelumab, ipilimumab, nivolumab.
  • Tumor tissue from an archival core biopsy or resected site of disease must be provided for biomarker analyses. If archival tissue is not available, then a new biopsy should be performed.
  • Adequate hematological, hepatic, and renal function according to laboratory ranges and medical criteria defined within the study protocol.

You may not qualify if:

  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with protocol requirements.
  • Participants with known active brain metastases with the exception of treated brain metastases that have imaging proving stability at least 4 weeks prior to the start of study treatment, no new metastases, and not requiring steroids.
  • Participants with recurrent resectable MCC
  • Participants with prior systemic chemotherapy
  • Pregnant or breastfeeding females and females desiring to become pregnant or breastfeed within the timeframe of this study.
  • A condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of randomization. Inhaled or topical steroids are permitted in the absence of active autoimmune disease.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (18)

USC Norris Comprehensive Cancer Center

Los Angeles, California, 90033, United States

RECRUITING

University of California San Francisco - Helen Diller Family Comprehensive Cancer Center

San Francisco, California, 94143, United States

RECRUITING

Stanford Health Care - Skin Cancer Program

Stanford, California, 94304, United States

RECRUITING

University of Colorado Hospital - Anschutz Cancer Pavilion

Aurora, Colorado, 80045, United States

RECRUITING

Mayo Clinic Comprehensive Cancer Center

Jacksonville, Florida, 32224, United States

RECRUITING

Sylvester Comprehensive Cancer Center

Miami, Florida, 33136, United States

RECRUITING

Moffitt Cancer Center

Tampa, Florida, 33612, United States

RECRUITING

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215, United States

RECRUITING

Mayo Clinic Comprehensive Cancer Center

Rochester, Minnesota, 55905, United States

RECRUITING

Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States

RECRUITING

Atlantic Health System

Morristown, New Jersey, 07960, United States

RECRUITING

East Carolina University

Greenville, North Carolina, 27834, United States

RECRUITING

UPMC Hillman Cancer Center

Pittsburgh, Pennsylvania, 15232, United States

RECRUITING

The University of Texas MD Anderson Cancer Center

Houston, Texas, 77384, United States

RECRUITING

Inova Schar Cancer

Fairfax, Virginia, 22031, United States

RECRUITING

Virginia Commonwealth University

Richmond, Virginia, 23298, United States

RECRUITING

Fred Hutchinson Cancer Research Center

Seattle, Washington, 98109, United States

RECRUITING

West Virginia University

Morgantown, West Virginia, 26506, United States

RECRUITING

MeSH Terms

Conditions

Carcinoma, Merkel CellNeoplasm MetastasisSkin Neoplasms

Interventions

pembrolizumab

Condition Hierarchy (Ancestors)

Polyomavirus InfectionsDNA Virus InfectionsVirus DiseasesInfectionsTumor Virus InfectionsCarcinoma, NeuroendocrineNeuroendocrine TumorsNeuroectodermal TumorsNeoplasms, Germ Cell and EmbryonalNeoplasms by Histologic TypeNeoplasmsAdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms, Nerve TissueNeoplastic ProcessesPathologic ProcessesPathological Conditions, Signs and SymptomsNeoplasms by SiteSkin DiseasesSkin and Connective Tissue Diseases

Study Officials

  • Andrew S Brohl, MD

    Collaborator

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR
Expanded Access
Yes

Study Record Dates

First Submitted

April 14, 2025

First Posted

April 27, 2025

Study Start

December 11, 2025

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

December 30, 2032

Last Updated

April 17, 2026

Record last verified: 2026-04

Locations