A Study of QL1706 Combined With OH2 Injection in Perioperative Treatment of Stage III Resectable Acral Melanoma

NCT07854522 | Not Yet Recruiting Phase 4

• 1 other identifier: QL-MLM-QIBA-1001
• Study Type: interventional
• Target: 76
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a prospective, multicenter, open-label, 1:1 randomized phase II trial enrolling 76 patients with AJCC stage III surgically resectable acral melanoma. Arm A receives neoadjuvant combination of intratumoral OH2 oncolytic HSV2 plus IV QL1706 (Iparomlimab and Tuvonralimab Injection) for 6 q2w cycles before radical surgery, followed by stratified QL1706 adjuvant therapy. Arm B undergoes upfront radical surgery followed by single-agent QL1706 adjuvant therapy for up to 1 year. The primary endpoint is 2-year EFS rate. Secondary endpoints include pathologic response, RFS, OS, and overall safety profile. All patients receive regular imaging follow-up up to 5 years post-surgery.

Conditions

Melanoma; Acral Melanoma

Keywords

QL1706; OH2; immunotherapy; melanoma

Outcome Measures

Primary Outcomes (1)

• 2-Year Event-Free Survival Rate

  Event-free survival (EFS) is defined as the time from randomization to the occurrence of any of the following events: disease progression leading to inoperability (development of locally unresectable disease or distant metastasis), local or distant recurrence, melanoma-related or treatment-related death. The occurrence of a new primary melanoma during treatment or follow-up will also be considered an event.

  From randomization up to 2 years

Secondary Outcomes (4)

• Pathologic Response Rate (pCR, Near pCR, pPR)

  At the time of surgery (approximately 12 weeks after enrollment)

• Relapse-Free Survival (RFS)

  5 years

• Overall Survival (OS)

  5 years

• The incidence and severity of adverse events (AEs)

  5 years

Study Arms (2)

Experimental:(Neoadjuvant Therapy + Radical Surgery + Postoperative Adjuvant Therapy)

EXPERIMENTAL

Patients receive 6 cycles of neoadjuvant therapy (QL1706 3 mg/kg IV Q2W + OH2 intratumoral injection up to 8 mL Q2W), followed by radical surgery within 2 weeks after the last neoadjuvant dose. Postoperatively, patients with pCR or near pCR receive observation and follow-up; patients with pPR or NR receive adjuvant QL1706 5 mg/kg IV Q3W for up to 1 year (calculated from the first neoadjuvant dose). BRAF-mutant recurrent patients receive dabrafenib + trametinib instead of QL1706 during adjuvant phase.

Drug: Iparomlimab and Tuvonralimab Injection (QL1706); Drug: OH2 Injection(Recombinant Human GM-CSF Oncolytic Type II Herpes Simplex Virus)

Active Comparator: (Radical Surgery + Postoperative Adjuvant Therapy)

ACTIVE COMPARATOR

Patients undergo radical surgery directly after enrollment. Postoperatively, all patients receive adjuvant QL1706 5 mg/kg IV Q3W for up to 1 year (calculated from the first adjuvant dose), unless contraindicated. BRAF-mutant recurrent patients receive dabrafenib + trametinib instead of QL1706 during adjuvant phase.

Drug: Iparomlimab and Tuvonralimab Injection (QL1706)

Interventions

Iparomlimab and Tuvonralimab Injection (QL1706) DRUG

A PD-1/CTLA-4 combination antibody produced using MabPair® technology. It contains two engineered monoclonal antibodies (anti-PD-1 IgG4 and anti-CTLA-4 IgG1) expressed at a fixed ratio from a single cell line. Administered intravenously. In the neoadjuvant phase: 3 mg/kg Q2W for 6 cycles. In the adjuvant phase: 5 mg/kg Q3W for up to 1 year. Manufactured by Qilu Pharmaceutical Co., Ltd. Supplied as 50 mg/2 mL vial. Store at 2-8°C, protect from light, do not freeze.

Active Comparator: (Radical Surgery + Postoperative Adjuvant Therapy); Experimental:(Neoadjuvant Therapy + Radical Surgery + Postoperative Adjuvant Therapy)

OH2 Injection(Recombinant Human GM-CSF Oncolytic Type II Herpes Simplex Virus) DRUG

A genetically modified oncolytic type II herpes simplex virus (HSV2) strain HG52, with ICP34.5 and ICP47 genes deleted to enable selective replication in tumor cells and enhance antitumor immunity, and engineered to express human GM-CSF. Administered via intratumoral injection. Planned dose: 10\^7 CCID50/mL, Q2W for up to 6 cycles. Maximum single-visit volume: 8 mL, adjusted based on lesion diameter. Dose may be reduced to 10\^6 CCID50/mL in case of ≥ Grade 3 related AEs. Manufactured by Wuhan Binhui Bio-technology Co., Ltd. Supplied as 1 mL/vial. Store at -70°C or below.

Experimental:(Neoadjuvant Therapy + Radical Surgery + Postoperative Adjuvant Therapy)

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Voluntarily sign the written informed consent form.
• Male or female patients aged ≥18 years and ≤75 years at the time of enrollment.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
• Histologically and/or cytologically confirmed resectable Stage III acral melanoma (according to the AJCC 8th edition staging system for cutaneous malignant melanoma) with at least one measurable lesion.
• Expected survival ≥4 months.
• Adequate organ function: a) Hematology (without any blood component or growth factor support within 7 days before the start of study treatment): i. Absolute neutrophil count (ANC) ≥1.5×10⁹/L (1,500/mm³); ii. White blood cell count ≥3.0×10⁹/L; iii. Platelet count \>100×10⁹/L (100,000/mm³); iv. Hemoglobin ≥90 g/L. b) Renal: i. Serum creatinine ≤1.5×ULN, or 24-hour creatinine clearance ≥50 mL/min (calculated according to the Cockcroft-Gault formula); ii. Urine protein \<2+ or 24-hour urine protein quantification \<1.0 g. c) Hepatic: i. Serum total bilirubin (TBil) ≤1.5×ULN; ii. AST and ALT ≤2.5×ULN; iii. Serum albumin (ALB) ≥28 g/L. d) Coagulation: i. International normalized ratio (INR) and activated partial thromboplastin time (APTT) ≤1.5×ULN (if the subject is receiving anticoagulant therapy, the subject must be on a stable dose of anticoagulant, and the coagulation parameters \[PT/INR and APTT\] at screening should be within the expected therapeutic range for the anticoagulant used). e) Cardiac function: i. Left ventricular ejection fraction (LVEF) ≥50%.
• 、Female patients of childbearing potential (including those with premature menopause, menopause \<2 years, and those who have not undergone surgical sterilization), male patients, and their partners must agree to use effective contraception during the study period, including surgical sterilization, oral contraceptives, intrauterine devices, abstinence, or barrier contraception combined with spermicide. All patients must continue contraception for 6 months after the last treatment.
• 、Subjects with a history of genital herpes must have a 3-month interval after the herpes has resolved.
• 、Subjects must be willing and able to comply with scheduled visits, treatment plans, laboratory tests, and other study requirements.

You may not qualify if:

• Patients who have previously received treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-CTLA-4 agents.
• Patients whose lesions do not meet the volume requirements for intratumoral injection or are unsuitable for intratumoral injection.
• Patients who have received anti-herpes simplex virus therapy (e.g., acyclovir, ganciclovir, valacyclovir, vidarabine) within 4 weeks prior to randomization, except for patients with hepatitis B who are receiving ongoing treatment with entecavir, tenofovir disoproxil fumarate, or adefovir dipivoxil.
• Receipt of a live attenuated vaccine within 4 weeks prior to randomization.
• Use of an investigational drug within 4 weeks prior to randomization.
• Lesions that cannot accommodate an intratumoral injection volume of 1 mL.
• Receipt of another anti-tumor monoclonal antibody (mAb) therapy within 4 weeks prior to randomization, or failure of adverse events from prior therapy (occurring more than 4 weeks earlier) to recover to ≤ Grade 1.
• Patients with a history of other malignancy (including unknown primary site) within 5 years prior to randomization. Note: Patients with curatively treated Stage 1 or 2 basal/squamous cell carcinoma of the skin, superficial bladder cancer, or carcinoma in situ are excluded.
• Patients with known hypersensitivity to the investigational drug, its active ingredients, or excipients.
• Patients who are positive for hepatitis B surface antigen (HBsAg) with a hepatitis B virus DNA copy number \>1×10³ copies/mL; patients who test positive for hepatitis C virus (HCV) antibody or human immunodeficiency virus (HIV) antibody.
• Patients with any unstable systemic disease, including but not limited to: severe infection, uncontrolled diabetes, unstable angina, cerebrovascular accident or transient ischemic attack, myocardial infarction, congestive heart failure, severe arrhythmia requiring medication, liver, kidney, or metabolic disease.
• Patients with active central nervous system (CNS) metastases. Patients with adequately treated CNS metastases whose neurological symptoms have recovered to ≤ Grade 1 (CTCAE criteria) for at least 2 weeks prior to randomization (excluding residual signs or symptoms related to CNS treatment) may participate in the study. In addition, patients must not be using corticosteroids, or must be on a stable dose of ≤10 mg prednisone/day (or equivalent), or must have tapered to ≤10 mg prednisone/day.
• Patients with autoimmune disease, history of liver or other organ transplantation, active tuberculosis; or patients who have undergone major surgery, live vaccination, or immunotherapy within 4 weeks prior to randomization.
• Tumor invasion of major blood vessels such as iliac or femoral vessels.
• Patients with diseases (e.g., mental illness) or conditions (e.g., alcoholism or drug abuse) that may increase the risk of study drug administration, affect study compliance, or interfere with the interpretation of study results.

Sponsors & Collaborators

• Qilu Pharmaceutical Co., Ltd.: collaborator
• Peking University Cancer Hospital & Institute: lead

MeSH Terms

Conditions

Melanoma

Condition Hierarchy (Ancestors)

Neuroendocrine Tumors; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Nerve Tissue; Nevi and Melanomas; Skin Neoplasms; Neoplasms by Site; Skin Diseases; Skin and Connective Tissue Diseases

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 28, 2026
• First Posted: October 2, 2026
• Study Start: October 1, 2026
• Primary Completion (Estimated): September 1, 2029
• Study Completion (Estimated): June 1, 2030
• Last Updated: October 2, 2026

Record last verified: 2026-08