Sponsor: Ankyra Therapeutics, Inc (industry)
Phase: 1
Start date: Jan. 19, 2024
Planned enrollment: 107
Tolododekin alfa (ANK-101) is an investigational, intratumorally administered IL‑12–aluminum hydroxide “anchored drug conjugate” being developed for advanced solid tumors. A first‑in‑human, open‑label Phase 1 trial (NCT06171750) is ongoing; Part 1 enrolled patients with accessible lesions and reported preliminary safety, pharmacodynamics, and early activity signals presented at the AACR 2025 Annual Meeting. An expansion cohort combining tolododekin alfa with cemiplimab (anti–PD‑1) has begun in cutaneous squamous cell carcinoma. (aacrjournals.org)
Tolododekin alfa consists of recombinant interleukin‑12 (IL‑12) covalently linked to aluminum hydroxide, forming a local depot intended to retain IL‑12 within the tumor microenvironment for weeks, drive IFN‑γ–mediated immune activation, and minimize systemic exposure. In the Phase 1 study, treatment increased intratumoral PD‑L1 expression and CD8+ T‑cell infiltration with low circulating IL‑12 levels. (aacrjournals.org)
Note: Evidence is limited to early Phase 1 data with small patient numbers; efficacy and safety profiles remain to be established in larger studies and in combination regimens. (aacrjournals.org)
Last updated: Oct 2025
Goal: Evaluate safety, tolerability, pharmacokinetics/pharmacodynamics, and preliminary anti-tumor activity of intratumoral tolododekin alfa (ANK-101) in advanced solid tumors; determine a recommended dose for expansion (RDE); and assess safety of ANK-101 combined with cemiplimab in high-risk CSCC.
Patients: Adults (≥18 years) with histologically/cytologically confirmed advanced solid tumors with injectable lesions and measurable disease by RECIST v1.1, ECOG 0–1, and adequate organ function, who have progressed on, are refractory to, intolerant of, or ineligible for standard therapies. Part 1 enrolls patients with superficial cutaneous/subcutaneous/nodal lesions; Part 2 enrolls patients with visceral lesions accessible to image-guided or endoscopic injection and includes an expansion cohort of NSCLC; Part 3 enrolls high-risk locally advanced or metastatic CSCC not amenable to surgery for combination therapy. Key exclusions include tumors impinging on major vessels/airways, prior IL-12, active immunodeficiency/autoimmunity requiring immunosuppression, active hepatitis B/C or uncontrolled HIV-related conditions, active CNS metastases, significant cardiac disease, and for Part 3, prior severe PD-1/PD-L1 immune-related toxicity or cemiplimab hypersensitivity.
Design: Multicenter, open-label, nonrandomized, first-in-human Phase 1 study with sequential dose escalation and expansion. Three parts: Part 1 dose escalation in superficial lesions followed by expansion at the RDE; Part 2 dose escalation in visceral lesions initiated after safety gating from Part 1 with an NSCLC expansion at the RDE; Part 3 combination cohort in CSCC at the RDE with a 5-patient safety run-in and a 21-day pause before enrolling the remaining 10 participants.
Treatments: Tolododekin alfa (ANK-101) is an anchored interleukin-12 (IL-12) drug conjugate designed for intratumoral delivery. IL-12 is covalently linked to aluminum hydroxide to retain biologic activity within the tumor microenvironment for weeks while minimizing systemic exposure, aiming to activate innate and adaptive immunity by recruiting CD8+ T cells, NK cells, and M1 macrophages. Early Phase 1 experience has shown evidence of immune activation in tumor biopsies, disease control with occasional partial responses across multiple tumor types, and favorable tolerability without dose-limiting toxicities at tested concentrations, though these data are preliminary and from a small cohort. Part 1: ANK-101 intratumorally every three weeks into superficial lesions. Part 2: ANK-101 intratumorally every three weeks into visceral lesions. Part 3: ANK-101 at the RDE every three weeks combined with cemiplimab in high-risk CSCC with superficial injectable disease; cemiplimab is an anti–PD-1 antibody approved for CSCC that restores antitumor T-cell activity.
Outcomes: Primary endpoints include incidence and characteristics of dose-limiting toxicities and treatment-emergent adverse events to define the safety profile and establish the recommended dose for expansion; in Part 3, characterization of TEAEs with ANK-101 plus cemiplimab. Secondary endpoints include progression-free survival; pharmacokinetics of IL-12-ABP (Cmax, AUC, half-life, clearance, volume of distribution); anti-drug antibodies; and preliminary efficacy by RECIST v1.1 including objective response rate, disease control rate, and duration of response.
Burden on patient: High. As a first-in-human, dose-escalation study with intratumoral injections every three weeks, patients can expect frequent safety assessments, intensive PK sampling, mandated pre- and post-treatment tumor biopsies when feasible, and serial imaging for RECIST assessments. Procedures may require image-guided or endoscopic injections for visceral lesions and multiple site visits, especially during the DLT window. Travel and time commitments are greater than standard care, and combination therapy in Part 3 adds routine checkpoint inhibitor monitoring for immune-related adverse events.
Last updated: Oct 2025
Inclusion Criteria:
* ≥ 18 years of age on day of signing informed consent
* histologically or cytologically confirmed diagnosis of cutaneous, subcutaneous, soft tissue, or nodal advanced solid tumor malignancy; metastatic disease eligible
* measurable disease per RECIST v1.1 - Note: Must have at least 1 tumor lesion with longest dimension of ≥ 10 mm (≥ 15 mm for the short axis for malignant lymph node lesions) that - For Part 1 only: can be easily palpated or detected by ultrasound to facilitate IT injection of ANK-101 (i.e., tumor in skin, muscle, subcutaneous tissue, or accessible lymph node) or; - For Part 2 only: can be accessed by interventional radiologic or endoscopic procedures for injection (e.g., ultrasound or computed tomography \[CT\] guided). - For Part 2 Dose Expansion Cohort only: Histologically confirmed Stage III or Stage IV NSCLC
* Part 3 CSCC Combination Cohort: Histologically confirmed high-risk locally advanced or metastatic CSCC not amenable to surgical management as determined by a multidisciplinary tumor board.
* documented disease progression, be refractory to, or intolerant of existing SOC therapy(ies) known to provide clinical benefit (including surgical cure) or not be eligible for SOC therapy(ies)
* ECOG performance status 0-1
* life expectancy \> 12 weeks
* adequate bone marrow, hepatic and renal function
* baseline electrocardiogram (EKG) without evidence of acute ischemia or prolonged QTc interval \> 460 msec
* Human immunodeficiency virus (HIV) infected participants must be on anti-retroviral therapy (ART) and have well-controlled HIV infection/disease
* last dose of previous anticancer therapy (including investigational agents) ≥ 28 days, radiotherapy ≥ 14 days (targeted palliative radiotherapy is allowed for lesions not planned for injections), or surgical intervention ≥ 21 days prior to the start of treatment
* resolution of all prior anticancer therapy toxicities (except for alopecia or vitiligo) to ≤ Grade 1 (as per NCI CTCAE Version 5.0)
* willing to provide pre- and post-treatment tumor biopsy samples if medically feasible
* participant is capable of understanding and complying with protocol requirements
Exclusion Criteria:
* injectable tumors impinging upon major airways or blood vessels
* prior treatment with recombinant interleukin-12 (IL-12)
* have received systemic therapy with immunosuppressive agents ≤ 28 days before the start of treatment
* have received live vaccines within 28 days prior to the start of ANK-101 treatment
* have primary or acquired immunodeficient states (e.g., leukemia, lymphoma)
* a woman of childbearing potential (WOCBP) who has a positive serum pregnancy test (within 72 hours) prior to the start of treatment or female participant who is breastfeeding
* prior organ transplantation
* known history of hepatitis B virus, known active hepatitis C virus, or a positive serological test at screening within 28 days prior to the start of treatment
* HIV-infected participants with a history of Kaposi sarcoma and/or Multicentric Castleman Disease
* active autoimmune disease or medical conditions requiring chronic steroid (i.e., ≥ 20 mg/day prednisone or equivalent) or other immunosuppressive therapy within 28 days prior to the start of treatment
* known active central nervous system (CNS) metastases
* congestive heart failure (\> New York Heart Association Class II), active coronary artery disease, unevaluated new onset angina within 3 months or unstable angina (angina symptoms at rest), or clinically significant cardiac arrhythmias
* uncontrolled bleeding disorders within 4 weeks prior to the start of treatment or known bleeding diathesis - Note: Part 2 only: Participants with active bleeding diathesis or requirement for therapeutic anticoagulation that cannot be interrupted or altered for procedures
* history of hypersensitivity to compounds of similar biological composition to IL-12, aluminum hydroxide, or drugs formulated with polysorbate-20
* other systemic conditions or organ abnormalities that, in the opinion of the Investigator, may interfere with the conduct and/or interpretation of the current study
* any acute or chronic psychiatric problems or substance abuse disorder that, in the opinion of the Investigator, make the participant unsuitable for participation
* Part 3 only: prior Grade 3 or greater immune-mediated adverse events (imAEs) following treatment with an agent that blocks the programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway.
* Part 3 only: hypersensitivity to cemiplimab or any of its excipients or contraindications to cemiplimab per approved local labeling
Toronto, Ontario, M5G 2M9, Canada
[email protected] / (416) 946-4575
Status: Recruiting
Bethesda, Maryland, 20892, United States
[email protected] / 240-781-3253
Status: Recruiting
Boston, Massachusetts, 02114, United States
[email protected] / 617-724-4000
Status: Recruiting
Portland, Oregon, 97213, United States
[email protected] / No phone
Status: Recruiting
Pittsburgh, Pennsylvania, 15232, United States
[email protected] / 412-623-1191
Status: Recruiting