Sponsor: Virogin Biotech Canada Ltd (industry)
Phase: 2
Start date: Jan. 24, 2024
Planned enrollment: 97
VG161 (recombinant human IL-12/15–PD-L1-blocker oncolytic HSV-1 injection) is an investigational cancer treatment injected directly into tumors. Human results have been reported in early-phase studies of liver cancer; they do not establish its benefit against standard treatment. (nature.com)
VG161 is an engineered herpes simplex virus type 1 designed to replicate in and destroy cancer cells. It also delivers IL-12, IL-15, IL-15 receptor α, and a protein that blocks the PD-1/PD-L1 interaction, aiming to stimulate antitumor immune activity. Its ICP34.5 neurovirulence gene has been deleted. (pmc.ncbi.nlm.nih.gov)
In a phase 1 study, 44 patients with advanced primary liver cancer received VG161. Among 34 evaluable patients with hepatocellular carcinoma selected for the analysis after at least two prior treatment lines, 6 had a partial response: an objective response rate of 17.65% under modified RECIST criteria. The disease-control rate, which also counts stable disease, was 64.71%. These are small, nonrandomized-study results, not proof of a survival advantage. (assets-eu.researchsquare.com)
A separate pooled analysis of 24 patients with intrahepatic cholangiocarcinoma reported antitumor activity and immune changes, but its abstract did not provide a response rate. The authors described the findings as hypothesis-generating and called for larger studies. (pubmed.ncbi.nlm.nih.gov)
The published phase 1 liver-cancer study reported no dose-limiting toxicities. Fever and reduced blood-cell counts were reported; the available early-phase data remain too limited to define uncommon or long-term risks. In a separate, small combination study of VG161 plus camrelizumab, 11 of 16 patients (68.8%) had a grade 3 or higher treatment-emergent adverse event; those findings cannot isolate VG161’s contribution. (nature.com)
Last updated: Sep 2026
Goal: Evaluate the safety, tolerability, and antitumor activity of intratumoral VG161 alone or with nivolumab in previously treated hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).
Patients: Adults with advanced, metastatic, or unresectable HCC or ICC that has progressed after specified prior systemic therapy, ECOG performance status 0–1, a measurable lesion, and at least one safely injectable lesion measuring at least 15 mm. HCC patients must have received at least two prior treatment lines; ICC patients must have received chemotherapy and, when indicated, IDH1-targeted therapy or PD-1 inhibition.
Design: Open-label, multicenter, nonrandomized phase IIa/IIb study with a safety run-in, separate single-arm HCC and ICC monotherapy cohorts, and an HCC/ICC combination cohort. The monotherapy cohorts use interim response-based rules to determine whether enrollment continues.
Treatments: VG161 is injected directly into a tumor at 1.0 × 10^8 plaque-forming units on three days. The combination cohort also receives intravenous nivolumab on days 8 and 15 of each cycle, with an option to switch to 480 mg every four weeks after cycle one. VG161 is an investigational oncolytic herpes simplex virus type 1 engineered to destroy tumor cells and stimulate immunity through IL-12, IL-15, and PD-1/PD-L1 pathway blockade. In a small, nonrandomized phase 1 analysis of previously treated HCC, 6 of 34 evaluable patients had a partial response by modified RECIST; benefit over standard treatment remains unproven. Nivolumab is a PD-1–blocking antibody intended to enhance antitumor T-cell activity.
Outcomes: Primary measures are adverse-event incidence and severity in the safety run-in, objective response rate in the HCC and ICC monotherapy cohorts, and three-month progression-free survival in the HCC cohort. Secondary measures include progression-free and overall survival, duration of response, safety in the monotherapy cohorts, blood VG161 levels and viral shedding, immunogenicity, and circulating cytokine and immune-cell markers; most are assessed over 12 months.
Burden on patient: Moderate to high. Patients need repeated visits for image-guided intratumoral injections over three days, with additional intravenous treatment visits in the combination cohort, plus imaging and safety monitoring. Serial blood sampling for viral, pharmacologic, and immune assessments adds burden, particularly in the safety run-in. The number of cycles and exact visit frequency are not specified.
Last updated: Sep 2026
Inclusion Criteria:
1. Signed written informed consent.
2. Males or females aged 18 years and older.
3. Performance status: Eastern Cooperative Oncology Group (ECOG) 0 or 1.
4. For subject in Cohort 2: cytologically confirmed advanced/metastatic or surgically unresectable HCC, with documented disease progression after at least two lines of FDA approved systemic therapy, including immunotherapy or anti-angiogenesis therapy as the first line treatment and at least one regimen of the following agents as the second line: anti-angiogenesis agents, tyrosine kinase inhibitors or immunotherapy.
5. For subject in Cohort 3: Histologically or cytologically confirmed advanced/metastatic or surgically unresectable ICC, with documented disease progression after chemotherapy as the first line systemic therapy. For patients with known IDH1 mutation, they must receive the appropriate targeted therapy with a IDH1 inhibitor and for patients with MSI-H tumors, they must receive immunotherapy with PD-1 inhibitors.
6. For subjects in Cohort 1 and Cohort 4: should fulfill either inclusion criteria 4) or 5).
7. Liver function: Child-Pugh A-B for cohort 1 and 2.
8. At least one measurable lesion per RECIST 1.1
9. At least 1 injectable lesion; ≥15 mm in longest diameter and deemed injectable as per Investigator's discretion. Subjects with deep or visceral lesions (such as hepatic or intraperitoneal lymph nodes) that can be safely injected under guided imaging can be considered for intratumoral injection of VG161..
Exclusion Criteria:
1. Participation in any trial of any other investigational agent within the last 4 weeks prior to dosing. Wash out periods to be reviewed on a case by case basis with Medical Monitor, as required.
2. Tumors to be injected lying in mucosal regions or close to an airway, major blood vessel or spinal cord that, in the opinion of the Investigators, could cause occlusion or compression in the case of tumor swelling or erosion into a major vessel in the case of necrosis.
3. Subjects with any primary Central Nervous System (CNS) malignancy including glioma and current, active, progressing CNS malignancy, including carcinomatosis meningitis are excluded. Subjects with treated brain metastases are eligible if there is no evidence of progression for at least 4 weeks after CNS-directed treatment, as ascertained by clinical examination and brain imaging (magnetic resonance imaging \[MRI\] or computed tomography \[CT\] scan) during the screening period and off steroids (for at least 2 weeks prior to first dose of IP).
4. Major surgery within 14 days prior to dosing.
5. Intercurrent serious infections within 28 days prior to Screening or treated systematically with antibiotics within 14 days prior to signing ICF.
6. Life-threatening illness unrelated to cancer.
7. Active Herpes infection.
8. Treatment with antiviral agents within 14 days prior to dosing.
9. Uncontrolled congestive heart failure.
10. Known to test positive for human immunodeficiency virus (HIV) or syphilis.
11. Active infection including hepatitis B (HBV) or hepatitis C (HCV) that currently under anti-virus treatment which can affect study drug treatment as per investigator's decision.
12. Use of ganciclovir or acyclovir within 14 days prior to dosing.
13. Subjects with a condition requiring systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days prior to dosing. Inhaled or topical steroids, and adrenal replacement steroid doses ≤10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.
14. Subjects who have been on systemic anticoagulants within 14 days prior to dosing and/or with International Normalized Ratio (INR) \> 1.5 x the upper limit of the reference range are excluded from this study.
15. Subjects with prior radiation therapy to the tumor lesion to be injected are excluded from the study, unless there is evidence of tumor progression in the most recent imaging, following completion of radiotherapy.
Phoenix, Arizona, 85054, United States
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Rochester, Minnesota, 55905, United States
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