Sponsor: Imunon (industry)
Phase: 3
Start date: July 9, 2025
Planned enrollment: 500
IMNN-001 (formerly GEN-1) is an investigational, intraperitoneal DNA‑mediated interleukin‑12 (IL‑12) gene therapy being developed for newly diagnosed advanced epithelial ovarian cancer, given with standard neoadjuvant/adjuvant carboplatin–paclitaxel. A randomized Phase I/II study (OVATION‑2; n=112) reported numerically improved progression-free and overall survival versus chemotherapy alone; results were published in Gynecologic Oncology in June 2025 and presented at ASCO 2025. A pivotal Phase 3 study (OVATION‑3) has begun enrollment. (pubmed.ncbi.nlm.nih.gov)
IMNN‑001 consists of a plasmid encoding human IL‑12 formulated in a synthetic lipopolymer (TheraPlas) and delivered intraperitoneally to drive local IL‑12 expression in the peritoneal tumor microenvironment. The goal is to remodel an immunosuppressive milieu by inducing downstream cytokines (e.g., interferon‑γ, TNF‑α) and enhancing antitumor immune activity while minimizing systemic IL‑12 toxicity observed with recombinant cytokine administration. Translational readouts from OVATION‑2 showed marked, localized increases of IL‑12 (~27‑fold), IFN‑γ (~62‑fold), and TNF‑α (~36‑fold) in peritoneal fluid after treatment. (aacrjournals.org)
In patients receiving PARP‑inhibitor maintenance, median PFS was 33.8 vs 22.1 months (HR 0.80), and OS was not estimable vs 37.1 months (HR 0.38), favoring IMNN‑001. (pubmed.ncbi.nlm.nih.gov)
Phase Ib dose‑escalation (OVATION‑1; n=18):
IMNN‑001 has been evaluated as weekly intraperitoneal doses (Phase 2 used 100 mg/m²) given for up to 17 weeks across neoadjuvant and adjuvant periods alongside carboplatin–paclitaxel. A pivotal Phase 3 trial (OVATION‑3) in newly diagnosed advanced ovarian cancer is underway, with the first patient dosed on July 30, 2025. (pubmed.ncbi.nlm.nih.gov)
Notes: OVATION‑2 was not powered for statistical significance; observed survival and surgical outcomes were numerically favorable and hypothesis‑generating pending confirmation in Phase 3. (pubmed.ncbi.nlm.nih.gov)
Last updated: Oct 2025
Goal: To determine whether adding intraperitoneal IMNN-001 to standard neoadjuvant and adjuvant carboplatin/paclitaxel, followed by standard maintenance therapy, improves overall survival and other efficacy measures in newly diagnosed advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer.
Patients: Female patients ≥18 years with histologically confirmed high-grade, non-mucinous epithelial ovarian, fallopian tube, or primary peritoneal cancer, FIGO IIIB/C–IV, eligible for neoadjuvant chemotherapy. ECOG 0–2, adequate marrow, renal, hepatic, and neurologic function, and availability of tumor tissue for HRD vs HRP biomarker status. Key exclusions include low-grade or non-epithelial histologies, active autoimmune disease requiring therapy, significant GI complications (e.g., obstruction, fistula, perforation), prior abdominal/pelvic radiation or chemotherapy, planned bevacizumab use, uncontrolled infection, or conditions precluding IP catheter placement.
Design: Randomized, adaptive, open-label, multicenter trial with 1:1 allocation to chemotherapy plus IMNN-001 versus chemotherapy alone. Stratified by homologous recombination status (HRD vs HRP) and disease stage. Independent DMC oversight. Planned enrollment of 500 with standard-of-care maintenance allowed in both arms.
Treatments: Both arms receive paclitaxel 175 mg/m2 IV over 3 hours plus carboplatin AUC 6 IV over 1 hour on Day 1 every 3 weeks for 6 cycles total (3 neoadjuvant, then interval debulking surgery, then 3 adjuvant). Standard-of-care maintenance with a PARP inhibitor (e.g., olaparib or niraparib) per guidelines. The experimental arm adds IMNN-001 100 mg/m2 intraperitoneally on Days 8 and 15 of cycle 1, then Days 1, 8, and 15 of cycles 2–6 (17 total IP doses), with IMNN-001 administered at least 30 minutes after carboplatin when given the same day. IMNN-001 is an intraperitoneal, DNA-mediated interleukin-12 therapy using a PEG-PEI-cholesterol lipopolymer to drive local IL-12 expression, enhancing IFN-γ–driven antitumor immunity in the peritoneal cavity with low systemic cytokine exposure. In a prior randomized phase 1/2 study (OVATION-2), IMNN-001 plus chemotherapy showed numerically longer PFS and OS versus chemotherapy alone and improved surgical response metrics; safety was manageable without cytokine release syndrome signals. A global phase 3 program is ongoing to confirm these findings.
Outcomes: Primary: Overall survival from randomization to death from any cause (48 months). Secondary: Chemotherapy Response Score (CRS1–3) at interval debulking; surgical cytoreduction status (R0/R1/R2); time to second-line therapy or death; and objective response rate by RECIST v1.1 prior to surgery.
Burden on patient: Moderate. Beyond standard neoadjuvant/adjuvant carboplatin/paclitaxel and interval debulking, participants in the experimental arm undergo intraperitoneal port placement and 17 IP administrations across 6 cycles with associated visits and monitoring, increasing procedure-related and visit burden. All participants require baseline tumor tissue acquisition for HRD vs HRP classification, which may involve laparoscopy or image-guided core biopsy if not already available. Maintenance PARP therapy is standard and does not add unusual burden. There are no intensive PK schedules described, but added IP procedures and additional treatment days elevate logistics, clinic time, and potential catheter-related risks compared with standard care alone.
Last updated: Oct 2025
Inclusion Criteria:
1. Participants must be female, ≥18 years of age, able to understand the study procedures, and agree to participate in the study by providing written informed consent.
2. Participants with a histologically confirmed diagnosis of high-grade non-mucinous epithelial ovarian (serous, endometrioid, carcinosarcoma, mixed epithelial pathologies), fallopian tube or peritoneal cancer that is Stage IIIB/C or IV according to the International Federation of Gynecology and Obstetrics (FIGO) or tumor, node and metastasis staging criteria.
3. Participants eligible to receive neoadjuvant chemotherapy.
4. Participants will provide a tumor tissue sample at pre-screening or screening, via laparoscopy or image guided core biopsy for determination of confirmed biomarker tumor status (HRD vs. HRP). See biomarker status definitions in the section below.
5. Participants of childbearing potential must have a negative serum pregnancy test (beta human chorionic gonadotropin) within 14 days prior to initiation of protocol therapy and be practicing an effective form of contraception. If applicable, participants must discontinue breastfeeding prior to study entry.
6. Participants must have adequate:
1. Bone marrow function: Absolute neutrophil count (ANC) greater than or equal to 1,500/µl. Exceptions may be made in patients with benign ethnic neutropenia \>800/ul with approval of a medical monitor. This ANC cannot have been induced or supported by granulocyte colony stimulating factors. Platelets greater than or equal to 100,000/µl.
2. Renal function: eGFR \> 60 ml/min/1.73m2
3. Hepatic function: Bilirubin ≤ 1.5 x ULN. SGOT (AST) and SGPT (ALT) ≤ 3.0 x ULN and alkaline phosphatase ≤ 2.5 x ULN. Exceptions due to hepatic metastases can be considered in consultation with medical monitor.
4. Neurologic function: Neuropathy (sensory and motor) less than or equal to Grade 1 as defined by CTCAE version 5.0.
7. Participants must have an ECOG score of 0, 1 or 2.
8. Participants should be free of active infection requiring parenteral antibiotics or a serious uncontrolled medical illness or disorder within 4 weeks of study entry.
9. Any hormonal therapy directed at the malignant tumor must be discontinued at least one week prior to the first treatment. Continuation of hormone replacement therapy is permitted.
Exclusion Criteria:
1. Participant who has received prior treatment with IMNN-001.
2. Participant who has received oral or parenteral corticosteroids (\>10 mg prednisone) within 2 weeks of first dose of IMNN-001 (if applicable) or who have a clinical requirement for ongoing systemic immunosuppressive therapy such as chronic steroid use not related to chemotherapy administration.
3. Participant has mucinous, germ cell, transitional cell, clear cell, undifferentiated, or non-epithelial ovarian cancer.
4. Participant has low-grade or Grade 1 epithelial ovarian cancer.
5. Participant of childbearing potential, not practicing adequate contraception, participant who is pregnant, or participant who is breastfeeding are not eligible for this trial.
6. Participant has a bowel obstruction by clinical symptoms or computed tomography (CT) scan, sub-occlusive mesenteric disease, abdominal or gastrointestinal fistula, gastrointestinal perforation, or intra-abdominal abscess.
7. Participant has been diagnosed and/or treated with any therapy for invasive cancer \<3 years from study enrollment, completed adjuvant chemotherapy and/or targeted therapy at least 3 years from enrollment, or completed adjuvant hormonal therapy less than 4 weeks from enrollment.
8. Participant with definitively treated non-invasive malignancies such as cervical carcinoma in situ, ductal carcinoma in situ, grade 1 or 2 Stage IA endometrioid endometrial cancer, or non-melanomatous skin cancer are allowed.
9. Participant with concurrent severe medical problems unrelated to the malignancy that would significantly limit full compliance with the study or expose the participant to extreme risk or decreased life expectancy.
10. Participant has known active hepatitis or HIV with detectable viral load.
11. Participant has a known contraindication or uncontrolled hypersensitivity to the components of paclitaxel, carboplatin, IMNN-001, or their excipients.
12. Prior treatment for high-grade non-mucinous epithelial ovarian, fallopian tube, or peritoneal cancer (e.g., immunotherapy, anticancer therapy, surgery, radiation therapy).
13. Participant is receiving treatment for active autoimmune disease. "Active" refers to any condition currently requiring therapy. Examples of autoimmune disease include systemic lupus erythematosus, multiple sclerosis, inflammatory bowel disease and rheumatoid arthritis.
14. Participant who has received prior radiotherapy to any portion of the abdominal cavity or pelvis is excluded. Prior radiation for localized cancer of the breast, head and neck, or skin is permitted, if it was completed at least 3 years prior to registration, and the participant remains free of recurrent or metastatic disease.
15. Participant who has received prior chemotherapy for any abdominal or pelvic tumor is excluded. Participant may have received prior adjuvant chemotherapy for localized breast cancer, if it was completed at least three years prior to registration, and that the participant remains free of recurrent or metastatic disease.
16. Participant with history or evidence upon physical examination of CNS disease, including primary brain tumor, seizures not controlled with standard medical therapy, any brain metastases, or history of cerebrovascular accident (CVA, stroke), transient ischemic attack (TIA) or subarachnoid hemorrhage within six months of the first date of treatment on this study.
17. Participant who will receive bevacizumab with the neoadjuvant or adjuvant treatment, or as maintenance will be excluded.
18. Participant with any condition/anomaly that would interfere with the appropriate placement of the IP catheter for study drug administration including abdominal surgery within 4 weeks of study entry (for reason other than IP port placement or laparoscopic diagnosis of epithelial ovarian cancer), intestinal dysfunction as defined in #6 above.
St Louis, Missouri, 63110, United States
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Status: Recruiting
Portland, Oregon, 97213, United States
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Chattanooga, Tennessee, 37403, United States
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Spokane, Washington, 99204, United States
[email protected] / No phone
Status: Recruiting