Sponsor: Memorial Sloan Kettering Cancer Center (other)
Phase: 2
Start date: June 9, 2023
Planned enrollment: 43
IO102 (imsapepimut) is a synthetic peptide component of a dual‑antigen, off‑the‑shelf therapeutic cancer vaccine regimen (often combined with IO103, etimupepimut; combination also referenced as “IO102‑IO103” or Cylembio). It is being developed to be given with anti–PD‑1 therapy across solid tumors, most prominently melanoma. A pivotal phase 3 trial in first‑line advanced melanoma reported topline results in August 2025. (drugs.ncats.io)
Melanoma
- Phase 1/2 (NCT03047928, anti‑PD‑1–naïve metastatic melanoma; IO102‑IO103 + nivolumab; n=30): ORR 80% (95% CI 62.7–90.5), complete response 43% (95% CI 27.4–60.8); median PFS 26 months; median OS not reached at 22.9‑month follow‑up. (pubmed.ncbi.nlm.nih.gov)
- Phase 3 IOB‑013/KN‑D18 (first‑line advanced melanoma; IO102‑IO103 + pembrolizumab vs pembrolizumab; n=407): Topline (Aug 11, 2025) showed improved PFS but narrowly missed the pre‑specified significance threshold (HR 0.77, 95% CI 0.58–1.00; p=0.056); median PFS 19.4 vs 11.0 months. In patients without prior perioperative anti‑PD‑1 (n=371), HR 0.74 (95% CI 0.56–0.98; nominal p=0.037). PD‑L1‑negative subgroup: HR 0.54 (95% CI 0.35–0.85), median PFS 16.6 vs 3.0 months (nominal p=0.006). OS trend favored the combination; data immature. (investors.iobiotech.com)
Other tumors (phase 2 basket, IO102‑IO103 + pembrolizumab)
- NSCLC (first‑line, PD‑L1‑high cohort): confirmed ORR 48% (55% unconfirmed), DCR 81%; ~50% progression‑free at 12 months; median DoR not reached (SITC 2024 poster). (investors.iobiotech.com)
- Recurrent/metastatic SCCHN (first‑line, PD‑L1 CPS ≥20 cohort): confirmed ORR 44.4%; median PFS 6.6 months; DCR 66.7% (ESMO 2024 poster). (investors.iobiotech.com)
- Neoadjuvant/adjuvant basket (melanoma; SCCHN): randomized phase 2 underway; enrollment completed January 2025; primary endpoint major pathologic response. (investors.iobiotech.com)
Notes - Product names and combinations are variously reported as IO102‑IO103 or Cylembio (imsapepimut and etimupepimut, adjuvanted). (investors.iobiotech.com)
Last updated: Oct 2025
Goal: Evaluate the safety and antitumor activity of adding the IO102/IO103 therapeutic cancer vaccine regimen to the standard fixed‑dose combination of nivolumab and relatlimab in the first‑line treatment of unresectable stage III/IV melanoma.
Patients: Adults (≥18 years) with histologically confirmed unresectable stage III or metastatic stage IV cutaneous or mucosal melanoma, at least one measurable extracranial, extraskeletal lesion by RECIST v1.1, ECOG 0–1, and adequate organ function. Prior systemic therapy for unresectable/metastatic disease is not allowed; prior neoadjuvant/adjuvant immune checkpoint inhibitors or BRAF/MEK inhibitors are permitted if recurrence occurred >6 months after the last dose. Exclusions include uveal melanoma, untreated or symptomatic CNS metastases or leptomeningeal disease, active autoimmune motor neuropathies, active HBV/HCV with viral load >100 IU/mL, significant immunosuppression, and pregnancy or breastfeeding.
Design: Single‑arm, open‑label, phase 2 study with nonrandomized allocation, planned enrollment of 43 patients, assessing efficacy and safety of the combination regimen in the first‑line setting.
Treatments: All patients receive nivolumab‑relatlimab fixed‑dose combination on Day 1 of each 28‑day cycle for up to 2 years, plus the IO102/IO103 vaccine on Days 1 and 15 of cycles 1–2, then Day 1 of subsequent cycles through 2 years. IO102/IO103 (also known as Cylembio components imsapepimut [IDO1‑targeted peptide] and etimupepimut [PD‑L1‑targeted peptide]) is an off‑the‑shelf long‑peptide vaccine given subcutaneously with the goal of generating CD4+ and CD8+ T‑cell responses against IDO1‑ and PD‑L1‑expressing tumor and immunosuppressive cells, complementing PD‑1/PD‑L1 axis blockade. In earlier melanoma studies, IO102/IO103 combined with anti‑PD‑1 therapy produced high response rates in a phase 1/2 single‑arm trial and demonstrated improved, though not statistically significant, progression‑free survival versus anti‑PD‑1 alone in a subsequent phase 3 trial; safety has been broadly consistent with anti‑PD‑1 therapy with mainly low‑grade injection‑site reactions attributed to the vaccine.
Outcomes: Primary: Overall response rate (RECIST v1.1). Secondary: Incidence and severity of adverse events (CTCAE v5.0), and progression‑free survival by RECIST v1.1. Assessment window extends up to 3 years for efficacy and up to 100 days post‑last dose for safety.
Burden on patient: Moderate. Treatment requires clinic visits every 28 days for nivolumab‑relatlimab infusions and additional vaccination visits on Day 1 and Day 15 during the first two cycles, then Day 1 only in later cycles. Routine safety labs and imaging at standard first‑line melanoma intervals are expected; no intensive pharmacokinetic sampling is specified. Subcutaneous vaccine injections may cause local reactions and add chair time and travel, especially in the first two cycles, but overall visit frequency aligns closely with immunotherapy standard of care after cycle 2.
Last updated: Oct 2025
Inclusion Criteria:
1. Age ≥ 18 years at the time of informed consent
2. Patient must be able to provide informed consent.
3. Patient must have a histologically confirmed diagnosis of locally advanced unresectable stage III or metastatic stage IV melanoma not amenable to local therapy.
4. Patient must have not received any prior systemic therapy directed against unresectable stage III or IV melanoma. Prior neoadjuvant and adjuvant ICIs and BRAF/MEK inhibitors are permitted as long as the last dose was \> 6 months prior to recurrence.
5. Patients must have at least one extraskeletal, extracranial measurable melanoma lesion as defined by RECIST v1.1. Note: A formal RECIST read by a study radiologist is not needed at the time of enrollment. Measurable disease can be assessed by the treating investigator.
6. Patients must have Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1.
7. Adequate laboratory function at screening, defined as:
1. Hemoglobin ≥ 9.0 g/dL
2. WBC ≥ 2000/uL
3. Platelet count ≥ 100 × 10\^9 /L
4. Serum direct bilirubin ≤ 1.5 × upper limit of normal (ULN); AST and ALT ≤ 2.5 × ULN. (Total bilirubin \< 3 mg/dL for subjects with Gilbert's disease)
5. Calculated creatinine clearance (CrCl) ≥15 mL/min based on the Cockcroft-Gault equation
8. Patients of childbearing potential\* who are sexually activ partner must use two methods of effective contraception from screening, and must agree to continue using such precautions for 23 weeks after the final dose of investigational product: cessation of birth control after this point should be discussed with a responsible physician. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of birth control.
\*Patients of childbearing potential are defined as those who are assigned female at birth and not surgically sterile (i.e., bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy) or postmenopausal (defined as 12 months with no menses without an alternative medical cause).
9. Male patients who are sexually active with partners of childbearing potential must use highly effective methods of contraception throughout the study and for at least four months following the last dose of study treatment. Male patients must agree not to donate sperm during the study treatment period.
Exclusion Criteria:
1. Uveal melanoma
2. Untreated central nervous system (CNS) metastases or any leptomeningeal involvement. Asymptomatic brain metastases that have been treated with external radiotherapy are permitted.
3. Any immunotherapy treatment for unresectable stage III/IV melanoma or any other prior unresectable malignancy. Prior neoadjuvant and adjuvant ICIs and BRAF/MEK inhibitors are permitted as long as the last dose was \> 6 months prior to recurrence.
4. Systemic steroid therapy higher than physiologic dose steroid replacement (\>10 mg/day of prednisone or equivalent), given within 14 days of starting treatment, or other immunosuppressive medications within 14 days of the start of treatment. Inhaled or topical steroids are permitted in the absence of active autoimmune disease. 5. Treatment with any live/attenuated vaccine within 30 days of first study treatment. Inactivated and mRNA vaccines are permitted.
6\. History of motor neuropathy considered to be of autoimmune origin to be of autoimmune origin (e.g., Guillain-Barre syndrome, myasthenia gravis) 7. Other active, concurrent malignancy that requires ongoing systemic treatment or interferes with radiographic assessment of melanoma response as determined by the investigator 8. History of severe allergic reactions to any unknown allergens or any components of the study drugs.
9\. Uncontrolled (i.e., unstable) concomitant medical condition or organ system dysfunction which, in the Investigator's opinion, could compromise the patient's safety or compliance with the study procedures. Participants with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll. 10. Active hepatitis B virus (HBV) with a viral load \>100 IU/mL 11. Active hepatitis C virus (HCV) with a viral load \>100 IU/mL 12. Patients who are breastfeeding or who are pregnant as evidenced by a positive serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) performed within 14 days of the first dose of study drug.
13\. Prisoners or participants who are involuntarily incarcerated. (Note: Under certain specific circumstances where local regulations permit, a person who has been imprisoned may be permitted to continue as a participant.) 14. Participants who are compulsorily detained for treatment of either a psychiatric or physical illness (e.g., transmissible infection)
Hartford, Connecticut, 06102, United States
No email / 860-676-7000
Status: Recruiting
Basking Ridge, New Jersey, 07920, United States
No email / 646-888-6782
Status: Recruiting
Montvale, New Jersey, 07645, United States
No email / 646-888-6782
Status: Recruiting
Middletown, New Jersey, 07748, United States
No email / 646-888-6782
Status: Recruiting
New York, New York, 10065, United States
No email / 646-888-6782
Status: Recruiting
Uniondale, New York, 11553, United States
No email / 646-888-6782
Status: Recruiting
Commack, New York, 11725, United States
No email / 646-888-6782
Status: Recruiting
Harrison, New York, 10604, United States
No email / 646-888-6782
Status: Recruiting
Allentown, Pennsylvania, 18103, United States
No email / 610-402-7880
Status: Recruiting