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Cold sore virus turned into cancer killer? early trial underway

NCT ID NCT04336241

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing This study
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 24, 2026 · Last updated Jun 27, 2026 · Updated 1 time

Summary

This early-phase study tests a genetically modified herpes virus (RP2) in 36 adults with advanced solid tumors that have not responded to standard treatments. The virus is designed to infect and destroy cancer cells while also stimulating the immune system. Some participants also receive the immunotherapy drug nivolumab (Opdivo). The main goals are to find the safest dose and to watch for side effects.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
genetically modified herpes simplex virus (RP2) and nivolumab (Opdivo)
What this could lead to
If successful, this could point toward a new way to treat advanced solid tumors by using a virus to kill cancer cells and boost the immune system.
What could go wrong
This is a very early Phase 1 trial with only 36 people, focused on safety and dosing. It is too soon to know if it works, and side effects from the virus or immune response are possible.
Why investors are watching

Replimune is testing its experimental drug RP2, alone and with an immunotherapy, in 36 adults with advanced solid tumors. This early-stage trial will show whether the drug is safe and at what dose it should move forward, which matters for a small company whose value depends on this program.

If it works: If the trial shows RP2 is safe and shows signs of shrinking tumors, Replimune could advance the drug to later studies and strengthen its position with partners or investors.

If it fails: Phase 1 trials often fail because the drug proves too toxic or shows no benefit. A poor result or delay could set the program back and hurt the company's prospects.

AI-written from the trial record. Speculative, and not investment advice.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 1

The first testing in people. Mainly checks safety and dose, usually in a small group.

Participants

About 36 people

The number the study aims to enrol. It can still change while the study runs.

Started

Oct 2019

Expected to finish

Oct 2026

An estimate. End dates often move.

Lead sponsor

A company

The lead sponsor is a pharmaceutical, biotech, or medical-device company.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Willing and able to participate and comply with all trial requirements and able to provide signed and dated informed consent prior to initiation of any trial procedures * Male or Female ≥ 18 years of age * Patients with advanced or metastatic non-neurological solid tumors, who have progressed on standard therapy or cannot tolerate standard therapy, or for which there is no standard therapy preferred to enrolment in a clinical trial * Consent to provide archival tumour biopsy samples within 6 months, or a fresh tumour biopsy is needed. Patients must also consent to provide on-treatment biopsies as per protocol * At least one measurable and injectable tumor of ≥ 1 cm in longest diameter (or shorter diameter for lymph nodes). * Women of child-bearing potential (WOCBP) must have a negative urine pregnancy test at screening and a negative urine pregnancy test prior to administration of each dose of RP2 or nivolumab * WOCBP must agree to use adequate birth control throughout their participation and for 3 months after RP2 alone and 5 months after nivolumab last study treatment * Males with partners of child-bearing potential must agree to use adequate birth control throughout their participation and for 3 months for RP2 alone and 7 months after nivolumab last study treatment * Have laboratory values (obtained ≤ 28 days prior to first infusion day) in accordance with the study protocol * Have an Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 Cohort 2a only: * Baseline ECG that does not show abnormalities according to the protocol * Baseline troponin \< 0.06 ng/mL * Baseline oxygen saturation levels that do not show abnormalities according to the protocol Cohort 2b and Part 3 only: * Patients in Cohort 2b should have histologically or cytologically confirmed diagnosis of advanced or metastatic uveal melanoma, lung cancer, breast cancer, or gastrointestinal cancers (including but not limited to colorectal cancer \[CRC\] \[microsatellite stable\], gastric cancer, gastroesophageal junction cancer, and oesophageal cancer) (n=30) * Patients with HCC and a diagnosis of hepatitis B must be off antiviral therapy for at least 4 weeks prior to enrollment. * Patients with acute or chronic hepatitis B or C must be expected to not require antiviral therapy during the RP2 treatment period. * Patients with HCC who have evidence of acute or chronic hepatitis C infection must have completed treatment for hepatitis C at least 1 month prior to study enrollment * Patients in Part 3 should have solid tumours (excluding skin cancers) that the investigator deems suitable for RP2 monotherapy, including at least 10 patients with liver metastases from prevalent tumour types (e.g. lung, breast \[including recurrent chest wall\], and gastrointestinal cancers \[colorectal, gastric, and oesophageal cancers\]) (n=15) * Patient has progressed during or after one to three prior systemic anticancer therapies for advanced or metastatic disease or during or within six months of receiving adjuvant therapy. Patients who, in the opinion of the investigator, are deemed not appropriate candidates for standard-of-care systemic anticancer therapy for advanced or metastatic disease, or who, after documented consultation with their treating physician, refuse standard-of-care systemic anticancer therapy may be eligible after discussion with the medical monitor Exclusion Criteria: * Prior treatment with an oncolytic virus therapy * History of viral infections according to the protocol * Systemic infection requiring IV antibiotics within 14 days prior to dosing * Prior complications with herpes infections * Chronic use of anti-virals * Systemic therapies for cancer within five half-lives or 4 weeks of first dose; whichever is shorter * Conditions that require certain doses of steroids (some doses and types will be permitted) * Known active brain metastases - previously treated brain metastases may be permitted * Major surgery ≤ 2 weeks prior to starting study drug * Prior malignancy active with the previous 3 years; except for locally curable cancers that have apparently been cured * Female who has a positive urine pregnancy test or is breast-feeding or planning to become pregnant during study treatment and 90 days for RP2 alone or 5 months for RP2 and nivolumab after the last dose of treatment * Participation in another clinical study within 4 weeks prior to the first dose * History of myocarditis or congestive heart failure (as defined by the New York Heart Association Functional Classification III or IV), or unstable angina, serious uncontrolled cardiac arrhythmia, uncontrolled infection, or myocardial infarction within 6 months of randomization * History of allergy or sensitivity to study drug components * Has known psychiatric or substance abuse disorders that would interfere with cooperating with the requirements of the study Part 2 patients only: * Participants with history of life-threatening toxicity related to prior immune therapy except those that are likely to re-occur with standard countermeasures * Treatment with botanical preparations within 2 weeks prior to treatment * Certain autoimmune diseases, some types will be permitted * History of interstitial lung disease * Severe hypersensitivity to another monoclonal antibody * Has received radiotherapy within 2 weeks of start of study treatment * Has received a live vaccine within 28 days prior to first dose of study drug * History of non-infectious pneumonitis * History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study * Other serious or uncontrolled medical disorders Cohort 2b and Part 3 (only for the subset of patients with liver metastases suitable and intended for injection) * Presence of liver metastases that are estimated to invade more than one-third of the liver * Macroscopic intravascular invasion into the main portal vein, hepatic vein or vena cava * Significant bleeding event within the last 12 months that places the patient at risk for intrahepatic intratumoral injection procedure based on investigator assessment * Prior chemoembolization, radioembolization, or other locoregional liver-directed procedures to the lesion selected for intratumoral injection

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Conditions

The condition(s) this trial relates to.

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Contacts and locations

Locations

  • Churchill Hospital

    Oxford, OX3 9DU, United Kingdom

  • Hospital Clinico de Valencia

    Valencia, 46010, Spain

  • Hospital Universitario HM Sanchinarro

    Madrid, 10 28050, Spain

  • Hospital Universitario d'Hebron

    Barcelona, 119 08035, Spain

  • The Clatterbridge Cancer Centre NHS Foundation Trust

    Bebington, Merseyside, CH63 4JY, United Kingdom

  • The Royal Marsden NHS Foundation Trust

    London, SW3 6JJ, United Kingdom

More trials for these conditions

Other studies related to the condition(s) this trial covers.