• Patients with a diagnosis of high-risk OPD defined by any of the following:

‣ Proliferative leukoplakia (PL)

⁃ Localized leukoplakia showing at least moderate dysplasia not treated with surgery

⁃ Erythroplakia (regardless of dysplasia)

⁃ High-risk LOH profile: 9p21 or CDKN2A or MTAP loss; regardless of personal oral cancer history

⁃ Any degree of dysplasia with a known TP53 mutation

⁃ A history of treated stage 1 or 2 (AJCC 2017 8th edition) HNSCC with at least moderate dysplasia at the resection margins or known 9p21 loss or a known TP53 mutation

• No evidence of head and neck cancer recurrence within the last 3 months (if applicable).

• Willing to provide blood and tissue for diagnostic biopsies.

• At least one target injectable measurable lesion ≥1 cm in longest diameter that can be followed.

• Any smoking history is permitted. While discouraged, patients are permitted to continue tobacco use while on the study.

• Age 18 years or older at the time of consent.

• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2.

• Participant must have normal marrow function and coagulation profile as defined within 21 days prior to study registration:

‣ absolute neutrophil count ≥1,000/mcL

⁃ hemoglobin ≥9 g/dL

⁃ platelets ≥75,000/mcL, and (d) PT/INR \<2.5, and (e) aPTT \<1.5x ULN.

• Women of childbearing potential (WOCBP) must agree to use appropriate method(s) of contraception. WOCBP and men should plan to use an adequate method to avoid pregnancy for 90 days after the last dose of RP2. WOCBP and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Serum or urine BhCG testing is required within 24 hours of initial RP2 dosing.