LTX-315 in Patients With Transdermally Accessible Tumours as Monotherapy or Combination With Ipilimumab or Pembrolizumab

Inclusion Criteria: Arm A: (Recruitment completed) Arm B:

• Unresectable metastatic disease (any tumor type) and conventional anti-tumor treatmentis not appropriate.

• Have at least one available lesion (cutaneous, sub-cutaneous, oral or lymph node) forinjection between 1-3 cm longest diameter and one bystander lesion (non-injected). Arm C:

• Have unresectable/metastatic diagnosis of malignant melanoma (histologicallyconfirmed).

• Have at least one available lesion (cutaneous, sub-cutaneous, oral or lymph node) forinjection and biopsy which is between 1 and 3 cm in longest diameter.

• Have had previous treatment with an anti-PD-1 antibody (as monotherapy or as part ofcombination (any combination) as 1st or 2nd line metastatic treatment). Arm D:

• Have unresectable/metastatic diagnosis of triple negative breast cancer (histologically confirmed).

• Have at least one available lesion (cutaneous, sub-cutaneous or lymph node) forinjection and biopsy with a minimum longest diameter of 1 cm.

• Have received between one and 4 prior systemic treatments for metastatic triplenegative breast cancer. All arms:

• Be willing to undergo repeat tumour biopsy and/or tumour resection procedures.

• Have an ECOG Performance status (PS): 0 - 1.

• Meet the following laboratory requirements:

1. Absolute neutrophil count (ANC) ≥ 1.5 x 109/L

2. Absolute lymphocyte count ≥ 0.8 x 109/L

3. Platelet count ≥ 75 x 109/L

4. Haemoglobin ≥ 9.0 g/dL

5. aPTT/PT within the institution's normal range

6. Total bilirubin level ≤ 1.5 x ULN

7. ASAT and ALAT ≤ 2.5 x ULN (≤5 x ULN if liver metastasis present)

8. Creatinine ≤ 1.5 x ULN

9. Albumin ≥ 30 g/L

Exclusion Criteria: Arm A: (Completed) Arm B:

• Have a history of systemic auto-immune disease requiring anti-inflammatory orimmunosuppressive therapy within the last 3 months. Patients with history ofautoimmune thyroiditis are eligible provided the patient requires only thyroid hormonereplacement therapy and disease has been stable for ≥ 1 year. Arm C:

• Have had prior therapy with ipilimumab or any other anti-CTLA-4 monoclonal antibody.

• Have had BRAF/MEK inhibitors administered within 2 weeks prior to the study drugadministration.

• Have active systemic autoimmune disease; have had prior pneumonitis; have a history ofsevere hypersensitivity to another monoclonal antibody; are receivingimmunosuppressive therapy; have a history of severe immune-related adverse reactionfrom treatment with a monoclonal antibody, defined as any Grade 4 or 3 toxicityrequiring corticosteroid treatment (> 10 mg/day prednisone or equivalent) for greaterthan 12 weeks. Arm D:

• Have had prior therapy with an anti-PD-1 or anti-PD-L1 monoclonal antibody.

• Have received cancer immunotherapy within 2 weeks prior to study drug administrationor have not recovered from adverse events (to ≤ CTCAE grade 1) due to such agents.

• Have active systemic autoimmune disease; have had prior pneumonitis; have a history ofsevere hypersensitivity to another monoclonal antibody; are receivingimmunosuppressive therapy; and have a history of severe immune-related adversereactions from treatment with a monoclonal antibody, defined as any Grade 4 or 3toxicity requiring corticosteroid treatment (> 10 mg/day prednisone or equivalent) forgreater than 12 weeks. All arms:

• Have received external radiotherapy or cytotoxic chemotherapy within 4 weeks prior tostudy drug administration, or have not recovered from adverse events (≤ CTCAE grade 1)due to agents administered more than 4 weeks earlier. Palliative radiotherapy tonon-target lesions within 4 weeks prior to study drug administration is allowed.

• Are currently taking any agent with a known effect on the immune system. Patients areallowed to be on a stable dose of corticosteroids (up to 10 mg daily prednisolone orequivalent) for at least 2 weeks prior to study drug administration (please seeAppendix IV for prohibited medications).

• Have any other serious illness or medical condition such as, but not limited to:

1. Uncontrolled infection or infection requiring antibiotics

2. Uncontrolled cardiac failure: Classification III or IV (New York HeartAssociation)

3. Uncontrolled systemic and gastro-intestinal inflammatory conditions

4. Bone marrow dysplasia

• Have a known history of positive tests for HIV/AIDS, or have active hepatitis B or C (based on serology).

• Are expected to need any other anti-cancer therapy or immunotherapy to be initiatedduring the study period.

15. Have clinically active or unstable CNS metastases as assessed by the treatingphysician.