ClinicalTrials.gg
CompletedNCT03444376Updated Jul 30, 2025Results posted

The Combination of GX-188E Vaccination and Pembrolizumab in Patients With HPV 16 and/or 18+ Advanced Cervical Cancer

A Phase 1/2 interventional study of GX-188E and KEYTRUDA® in Cervical Cancer, sponsored by Genexine, Inc.. Completed at 9 sites in South Korea. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-30.

Sponsored by Genexine, Inc. · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
65
Allocation
Not applicable
Ages
18 Years and older
Sex
Female
01

Study summary

A Multi-Center, Open-label Phase Ib-II Trial of the Combination of GX-188E Vaccination and Pembrolizumab in Patients with Advanced, Non-Resectable HPV-Positive Cervical Cancer

Read the detailed description

This is an open-label Phase Ib-II trial to evaluate the safety and efficacy of GX-188E (IM administration using Ichor TDS-IM device) + pembrolizumab (P) in patients with advanced HPV-16+ or HPV-18+ cervical cancer.

02

Conditions studied

  • Cervical Cancer

Keywords

  • KEYTRUDA®
  • pembrolizumab
  • GX-188E
  • TDS-IM device
  • KEYNOTE-567
03

In context

Uterine Cervical Neoplasms

2,366 studies on the registry are indexed under Uterine Cervical Neoplasms; 677 are open to participants now.

This study's enrollment of 65 is below the median of 100 across 1,738 interventional studies indexed under Uterine Cervical Neoplasms.

Browse Uterine Cervical Neoplasms studies →

Lead sponsor

Genexine, Inc. is the lead sponsor of 36 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patients must be female and age ≥ 18 years (19 years for Korean sites)
  2. Patients with confirmed advanced or HPV-positive (HPV-16 or HPV-18) cervical cancer, who have disease progression after treatment with all available therapies for metastatic disease that are known to confer clinical benefit, or are intolerant to treatment, or refuse standard treatment.
  3. (ECOG) Performance Status of 0-1
  4. of at least 6 months
  5. Patients must agree to provide either an sample or fresh biopsy sample for baseline biomarker tissue analyses, including staining for . If archival tissue is not available and the patient does not have biopsy-accessible tumor lesions, the patient will be excluded.

Exclusion criteria

Exclusion Criteria:

  1. Patient has disease that is suitable for local therapy administered with curative intent.
  2. Patient has a known additional that is progressing or has required active treatment within the past 3 years.
  3. Patient is expected to require any other form of antineoplastic therapy while on study; including systemic chemotherapy, radiation therapy (except for palliative purposes) biological therapy, or immunotherapy not specified in this protocol.
  4. Patient has a history of active central nervous system (CNS) and/or carcinomatous meningitis.
  5. Patients have received prior therapy with an , anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137) and was discontinued from that treatment due to a Grade 3 or higher immune-related Adverse Event (irAE)
  6. Patients with active disease requiring systemic treatment within the past 2 years (i.e. with use of disease modifying agents, or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment and is allowed.
  7. Patients has had an allogeneic solid organ or bone marrow transplant
Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
65 participants (actual)

Study arms

  • Experimental
    GX-188E, KEYTRUDA®

    GX-188E: 1st day of week 1,2,4,7,13,19, 46/ 2mg KEYTRUDA® : Day 1 q3 weeks/ 200mg

    Drug: GX-188E · Drug: KEYTRUDA®

Interventions

  • GX-188E (1.0mg/0.5ml/vial), Intramuscular administration using electroporator, Ichor TDS-IM device

    Also known as: tirvalimogene teraplasmid

  • pembrolizumab(100mg/4mL/vial), Intravenous administration

    Also known as: pembrolizumab

06

What researchers measure

Primary outcomes

  1. DLT Evaluation for Safety and Tolerability(Part A)

    Patient will be evaluated for the first 21 days for dose-limiting toxicities.

    Time frame: within 21days

  2. ORR for Efficacy (Part B&C)

    ORR within 24 weeks (ORR24) evaluated by RECIST v1.1

    Time frame: within 24 weeks

Secondary outcomes

  1. ORR for Efficacy (Part A)

    Overall Response Rate within 24 weeks (ORR24) by RECIST v1.1 and immune-related Response Criteria (irRC)

    Time frame: within 24 weeks

  2. BORR (Part B&C)

    Best Overall Response Rate(BORR) by RECIST v1.1

    Time frame: up to 1 year

  3. Time-to-Best Response

    Time-to-Best Response by RECIST v1.1 and iRECIST

    Time frame: up to 1 year

  4. Duration of Response (DOR)

    Duration of Response (DOR) by RECIST v1.1 and iRECIST

    Time frame: up to 1 year

  5. Progression-Free Survival (PFS)

    6month- PFS by RECIST v1.1 and iRECIST

    Time frame: up to 6 months

  6. Overall Survival (OS)

    Overall Survival (OS) by RECIST v1.1 and iRECIST

    Time frame: up to 1 year

07

Results

Posted Jul 30, 2025

Participant flow

A total of 90 subjects were enrolled, of which 25 subjects were considered as screen failures. Of 90 Screened, 65 met Inclusion/Exclusion Criteria and were Randomized to treatment.

Part A
Participant flow — Part A
MilestoneSingle Arm (GX-188E + Pembrolizumab)
Started6
Completed2
Not completed4
Withdrew: Disease relapse or progression1
Withdrew: Withdrawal by subject2
Withdrew: Adverse event1
Part B
Participant flow — Part B
MilestoneSingle Arm (GX-188E + Pembrolizumab)
Started31
Completed8
Not completed23
Withdrew: Disease relapse or progression18
Withdrew: Withdrawal by subject2
Withdrew: Adverse event2
Withdrew: Physician decision1
Part C
Participant flow — Part C
MilestoneSingle Arm (GX-188E + Pembrolizumab)
Started65
Completed12
Not completed53
Withdrew: Disease relapse or progression43
Withdrew: Withdrawal by subject5
Withdrew: Adverse event2
Withdrew: Physician decision2
Withdrew: Death1

Outcome measures

PrimaryDLT Evaluation for Safety and Tolerability(Part A)

Patient will be evaluated for the first 21 days for dose-limiting toxicities.

Time frame:
within 21days
Reported as:
Number · participants
DLT Evaluation for Safety and Tolerability(Part A)
participantsGX-188E, KEYTRUDA®
DLT Evaluation for Safety and Tolerability(Part A)0
PrimaryORR for Efficacy (Part B&C)

ORR within 24 weeks (ORR24) evaluated by RECIST v1.1

Time frame:
within 24 weeks
Reported as:
Number · percentage of responders
ORR for Efficacy (Part B&C)
percentage of respondersGX-188E, KEYTRUDA®
Part B41.4 (25.89 to 100.00)
Part C35.0 (22.93 to 47.07)
SecondaryORR for Efficacy (Part A)

Overall Response Rate within 24 weeks (ORR24) by RECIST v1.1 and immune-related Response Criteria (irRC)

Time frame:
within 24 weeks
Reported as:
Number · percentage of responders
ORR for Efficacy (Part A)
percentage of respondersGX-188E, KEYTRUDA®
ORR for Efficacy (Part A)50.0 (11.81 to 88.19)
SecondaryBORR (Part B&C)

Best Overall Response Rate(BORR) by RECIST v1.1

Time frame:
up to 1 year
Reported as:
Number · percentage of responders
BORR (Part B&C)
percentage of respondersGX-188E, KEYTRUDA®
Part A50.0 (11.81 to 88.19)
Part B41.4 (23.52 to 61.06)
Part C35.0 (22.93 to 47.07)
SecondaryTime-to-Best Response

Time-to-Best Response by RECIST v1.1 and iRECIST

Time frame:
up to 1 year
Reported as:
Median · Months
Time-to-Best Response
MonthsGX-188E, KEYTRUDA®
Part A2.07 (2.07 to NA)
Part B2.10 (2.04 to 4.01)
Part C2.10 (2.07 to 3.02)
SecondaryDuration of Response (DOR)

Duration of Response (DOR) by RECIST v1.1 and iRECIST

Time frame:
up to 1 year
Reported as:
Median · Months
Duration of Response (DOR)
MonthsGX-188E, KEYTRUDA®
Part ANA (2.40 to NA)
Part B5.78 (2.40 to NA)
Part CNA (5.32 to NA)
SecondaryProgression-Free Survival (PFS)

6month- PFS by RECIST v1.1 and iRECIST

Time frame:
up to 6 months
Reported as:
Median · Months
Progression-Free Survival (PFS)
MonthsGX-188E, KEYTRUDA®
Part A4.25 (2.04 to NA)
Part B4.14 (2.07 to 8.38)
Part C4.40 (2.14 to 8.31)
SecondaryOverall Survival (OS)

Overall Survival (OS) by RECIST v1.1 and iRECIST

Time frame:
up to 1 year
Reported as:
Median · Months
Overall Survival (OS)
MonthsGX-188E, KEYTRUDA®
Part A15.54 (3.48 to NA)
Part B14.42 (8.97 to NA)
Part C23.79 (14.03 to NA)

Adverse events

Collected over 24 months. Non-serious events are listed at a 2% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
GX-188E, KEYTRUDA®31/65 (47.7%)25/65 (38.5%)54/65 (83.1%)
Most frequent serious events
Showing 10 of 28
Most frequent serious events
EventGX-188E, KEYTRUDA®
Urinary tract infectionInfections and infestations7/65
PyrexiaGeneral disorders3/65
PneumoniaInfections and infestations2/65
AstheniaGeneral disorders2/65
AppendicitisInfections and infestations1/65
GastroenteritisInfections and infestations1/65
Kidney infectionInfections and infestations1/65
LymphangitisInfections and infestations1/65
Ophthalmic herpes zosterInfections and infestations1/65
PeritonitisInvestigations1/65
Most frequent other events
Showing 10 of 57
Most frequent other events
EventGX-188E, KEYTRUDA®
AnaemiaBlood and lymphatic system disorders19/65
HypothyroidismEndocrine disorders10/65
Blood creatinine increasedInvestigations8/65
PyrexiaGeneral disorders8/65
CoughRespiratory, thoracic and mediastinal disorders8/65
ConstipationGastrointestinal disorders7/65
DiarrhoeaGastrointestinal disorders7/65
Abdominal painGastrointestinal disorders6/65
NauseaGastrointestinal disorders6/65
VomitingGastrointestinal disorders6/65

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)GX-188E, KEYTRUDA®
Part A — <=18 years0
Part A — Between 18 and 65 years5
Part A — >=65 years1
Part B — <=18 years0
Part B — Between 18 and 65 years29
Part B — >=65 years2
Part C — <=18 years0
Part C — Between 18 and 65 years59
Part C — >=65 years6
Sex: Female, Male
Sex: Female, Male(Participants)GX-188E, KEYTRUDA®
Female65
Male0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)GX-188E, KEYTRUDA®
American Indian or Alaska Native0
Asian65
Native Hawaiian or Other Pacific Islander0
Black or African American0
White0
More than one race0
Unknown or Not Reported0
PD-L1 expression status
PD-L1 expression status(Participants)GX-188E, KEYTRUDA®
Part A — Positive (≥1 CPS)0
Part A — Negative (<1 CPS)6
Part B — Positive (≥1 CPS)15
Part B — Negative (<1 CPS)16
Part C — Positive (≥1 CPS)39
Part C — Negative (<1 CPS)26
Histologic Type
Histologic Type(Participants)GX-188E, KEYTRUDA®
Part A — Squamous Cell Carcinoma3
Part A — Adenocarcinoma3
Part B — Squamous Cell Carcinoma23
Part B — Adenocarcinoma8
Part C — Squamous Cell Carcinoma50
Part C — Adenocarcinoma15
HPV type
HPV type(Participants)GX-188E, KEYTRUDA®
Part A — HPV-163
Part A — HPV-18 or both3
Part B — HPV-1624
Part B — HPV-18 or both7
Part C — HPV-1649
Part C — HPV-18 or both16
08

Study locations

9 sites
  • Inje University Busan Paik Hospital
    Busan, South Korea
  • Keimyung University Dongsan Medical Center
    Daegu, 42601, South Korea
  • National Cancer Center
    Gyeonggi-do, 10408, South Korea
  • Seoul National University Bundang Hospital
    Gyeonggi-do, 13620, South Korea
  • Severance Hospital, Yonsei University Health System
    Seoul, 03722, South Korea
  • Asan Medical Center
    Seoul, 05505, South Korea
  • Samsung Medical Center
    Seoul, 06351, South Korea
  • The Catholic University of Korea Seoul St. Mary's Hospital
    Seoul, 06591, South Korea
  • Korea University Guro Hospital
    Seoul, 152-703, South Korea
09

References and documents

Publications

  • Lim MC, Choi YJ, Hur SY, Kim YM, No JH, Kim BG, Cho CH, Kim SH, Jeong DH, Lee JK, Kim JH, Choi YJ, Woo JW, Sung YC, Park JS. GX-188E DNA vaccine plus pembrolizumab in HPV 16- and/or 18-positive recurrent or advance cervical cancer: a phase 2 trial. EClinicalMedicine. 2024 Jul 13;74:102716. doi: 10.1016/j.eclinm.2024.102716. eCollection 2024 Aug. PubMed 39823099 ↗
  • Youn JW, Hur SY, Woo JW, Kim YM, Lim MC, Park SY, Seo SS, No JH, Kim BG, Lee JK, Shin SJ, Kim K, Chaney MF, Choi YJ, Suh YS, Park JS, Sung YC. Pembrolizumab plus GX-188E therapeutic DNA vaccine in patients with HPV-16-positive or HPV-18-positive advanced cervical cancer: interim results of a single-arm, phase 2 trial. Lancet Oncol. 2020 Dec;21(12):1653-1660. doi: 10.1016/S1470-2045(20)30486-1. PubMed 33271094 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 30, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03444376
Lead sponsor
Genexine, Inc.
Responsible party
Sponsor
First posted
Feb 23, 2018
Start date
Jun 19, 2018
Primary completion
Apr 29, 2022
Completion
Dec 21, 2023
Results posted
Jul 30, 2025
Last update
Jul 30, 2025

Study contacts

Soo-Young Hur, M.D
principal investigator · The Catholic University of Korea

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: HPV E6/E7 DNA Vaccine GX-188E

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