A Phase 2 Study of Intratumoral Administration of L19IL2/L19TNF in Locally Advanced Cutaneous Squamous Cell Carcinoma Patients Progressing on or Intolerant to Systemic Treatment

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Trial Details

Sponsor: Philogen S.p.A. (industry)

Phase: 2

Start date: Nov. 14, 2025

Planned enrollment: 92

Trial ID: NCT07228442
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More trial details at ClinicalTrials.gov More info

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chevron Show for: L19IL2 (Darleukin, bifikafusp alfa)

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Goal: To determine the antitumor activity of intratumoral L19IL2 plus L19TNF in locally advanced cutaneous squamous cell carcinoma after progression on or intolerance to immune checkpoint inhibitor therapy, while also characterizing safety and efficacy.

Patients: Adults with histologically confirmed, locally advanced cutaneous squamous cell carcinoma that has progressed on or cannot tolerate immune checkpoint inhibition. Patients must have at least one measurable, injectable cutaneous or subcutaneous lesion; injectable nodal, regional, or in-transit disease is permitted, but visceral metastases are excluded. Other key requirements include ECOG performance status 0–2, adequate hematologic and organ function, and willingness to undergo tumor biopsies. Important exclusions include active systemic anticancer therapy, recent radiotherapy to target lesions, clinically significant cardiovascular disease, active infection, substantial immunosuppression or active autoimmune disease requiring recent systemic treatment, organ transplantation, and pregnancy or breastfeeding.

Design: Open-label, single-arm, multicenter treatment study with no randomization or comparator. Tumor assessments occur at week 8, week 12, every 8 weeks during the first follow-up year, and every 12 weeks during years 2 and 3. Complete response, partial response, or stable disease requires confirmation four weeks later, including histopathologic assessment and independent central review. Follow-up continues for up to 160 weeks after treatment initiation, with overall survival contact every six months after relapse or progression.

Treatments: L19IL2 and L19TNF are administered together by intratumoral injection into all injectable cutaneous, subcutaneous, nodal, or in-transit lesions once weekly for up to four weeks. Patients whose best response is partial response or stable disease may receive a second four-week course at the treating physician’s discretion. The maximum dose per treatment visit is 13 million IU of L19IL2 plus 0.4 mg of L19TNF, with injection volume determined by lesion size and characteristics. L19IL2 is an antibody–cytokine fusion protein targeting the extra-domain B of fibronectin in tumor neovasculature and stroma, thereby localizing IL-2-mediated activation of cytotoxic T cells and natural killer cells; L19TNF uses the same tumor-targeting strategy to deliver TNF. Prior intralesional studies in melanoma have shown responses predominantly in injected lesions, with mostly grade 1–2 local reactions and occasional grade 3 injection-site reactions; early non-melanoma skin cancer data suggest preliminary activity, but efficacy in checkpoint inhibitor-refractory locally advanced cutaneous squamous cell carcinoma remains investigational.

Outcomes: The primary outcome is best overall response rate according to RECIST 1.1, as determined by independent central review, from enrollment through a maximum of 160 weeks after treatment initiation. Responses and stable disease are confirmed by repeat assessment and multiple punch biopsies of treated skin areas. Safety, additional efficacy measures, and overall survival are also followed, although detailed secondary endpoint definitions are not provided.

Burden on patient: Estimated burden is moderate to high. Treatment requires weekly on-site intratumoral injections for four weeks and potentially a second four-week course, with every injectable lesion measured at each visit and injected when feasible. Patients must provide tumor tissue at screening and undergo multiple punch biopsies to confirm response or stable disease. Imaging or clinical tumor assessments are relatively frequent during the first year, followed by visits every 12 weeks in years 2 and 3 and survival contact every six months. The repeated lesion injections, biopsies, prolonged follow-up, and associated travel make participation more demanding than routine surveillance, although there is no placebo arm, randomization, intensive pharmacokinetic sampling, or continuous systemic dosing.

Last updated: Sep 2026

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Sites (19)

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Charite Universitaetsmedizin Berlin KöR

Berlin, 10117, Germany

No email / No phone

Status: Recruiting

Universitaetsklinikum Augsburg

Augsburg, 86179, Germany

No email / No phone

Status: Recruiting

Universitaetsklinikum Essen AöR

Essen, 45147, Germany

No email / No phone

Status: Recruiting

Universitaetsklinikum Halle (Saale) AöR

Halle, 06120, Germany

No email / No phone

Status: Recruiting

Universitaetsklinikum Heidelberg AöR

Heidelberg, 69120, Germany

No email / No phone

Status: Recruiting

Universitaetsklinikum Schleswig-Holstein AöR

Kiel, 24105, Germany

No email / No phone

Status: Recruiting

Universitaetsklinikum Tübingen AöR

Tübingen, 72076, Germany

No email / No phone

Status: Recruiting

Azienda Ospedaliero-Universitaria Senese

Siena, 53100, Italy

No email / No phone

Status: Recruiting

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Roma, 00168, Italy

No email / No phone

Status: Recruiting

Humanitas Mirasole S.p.A.

Rozzano, 20089, Italy

No email / No phone

Status: Recruiting

IRCCS Istituto Nazionale Tumori Fondazione Pascale

Naples, 80131, Italy

No email / No phone

Status: Recruiting

Hospital Clinic De Barcelona

Barcelona, 08036, Spain

No email / No phone

Status: Recruiting

UC Irvine Health- Chao Family Comprehensive Cancer Center

Orange, California, 92868-3201, United States

No email / No phone

Status: Recruiting

Winship Cancer Institute, Emory University

Atlanta, Georgia, 30322, United States

No email / No phone

Status: Recruiting

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215, United States

No email / No phone

Status: Recruiting

Duke University Medical Center

Durham, North Carolina, 27710, United States

No email / No phone

Status: Recruiting

The University of Texas MD Anderson Cancer Center

Houston, Texas, 77030, United States

No email / No phone

Status: Recruiting

Andreas Syngros Hospital Of Venereal And Dermatological Diseases

Athens, 16121, Greece

No email / No phone

Status: Not yet recruiting

The Ohio State University Wexner Medical Center Clinical Laboratories

Columbus, Ohio, 43210, United States

No email / No phone

Status: Not yet recruiting

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