A Phase 2A Study to Assess the Safety and Efficacy of ASN-002 Combined With a Hedgehog Pathway Inhibitor in the Treatment of Multiple Low Risk Basal Cell Carcinomas in Sporadic or Basal Cell Nevus Syndrome Patients
The primary objectives are to: 1. Evaluate the safety and tolerability of intralesional ASN-002 when administered in combination with oral vismodegib in patients with Basal Cell Carcinomas (BCC)s; 2. Evaluate the efficacy of intralesional ASN-002 in target tumours when administered in combination with oral vismodegib in patients with BCCs. The secondary objective is to: 1\) Evaluate the efficacy of intralesional ASN-002 in non-target tumours when administered in combination with oral vismodegib in patients with BCCs. The exploratory objective is to: 1\) Evaluate immunological biomarkers during the course of treatment.
• Histologically confirmed previously untreated, BCC (nodular and superficial), 5-20 mm in maximum diameter, per the selection criteria for study BCC tumours. A punch biopsy (refer to study procedure manual for biopsy size selection) from the thickest part of all the target tumours is required for histological confirmation of BCC and to exclude BCC non-eligible subtypes.
• Note: If a patient has mix of nodular and superficial BCC tumours, at least one target tumour should be a nodular BCC.
• Removal of \< 25% of the area of each biopsied tumour by initial biopsy performed 1-12 weeks before Day 1. If the initial biopsy was performed \>8 weeks prior to screening, the investigator may re-biopsy the tumour, provided not \> 25% of the area of the original tumour is removed. Non-study tumours may be resected or treated at the discretion of the Investigator prior to study entry or if they develop during the study.
• Hedgehog pathway inhibitor treatment naïve.
• Acceptable general health as determined by the investigator, i.e. no serious or active medical or psychiatric illness or recreational or therapeutic drug or alcohol use that, in the opinion of the Investigator, would interfere with treatment, assessment or compliance with the protocol, ability to provide informed consent, or patient safety.
• 18 years of age or older.
• Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2.
• Screening laboratory values as follows:
∙ Neutrophil count \> 1500/mm3
‣ Haemoglobin \> 9 g/dL
‣ Platelet count \>100,000/mm3
‣ Prothrombin INR \< 1.5
‣ Total bilirubin \< 1.5 X upper limit of normal (ULN), except in the case of known Gilbert's syndrome
‣ Aspartate transaminase (AST), alanine transaminase (ALT) or alkaline phosphatase (ALP) \< 2X ULN
‣ Creatinine \< 1.5 X upper limit of normal (ULN)
• Female patients who are documented infertile, postmenopausal for at least 1 year, surgically sterile or using acceptable and highly effective birth control for the duration of the study and for at least 3 months after last administration of the study treatments.
• Male patients with female partners of child bearing potential, agreement to use two adequate contraception methods while being on vismodegib and for 3 months of completion. agreement not to donate semen for 3 months after completion of vismodegib.
⁃ Written informed consent prior to initiation of study-specified procedures.
⁃ Able and willing to comply with all study requirements, including surgical removal of tumour/tumour site at completion of study.
⁃ Baseline tissue sample adequate for determination of histological or other biomarkers.