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CompletedNCT04526730Updated Jun 29, 2026Results posted

Neoadjuvant Immunotherapy With Tavo + Electroporation in Combination With Nivo. in Melanoma Patients

A Phase 2 interventional study of Tavo and Nivolumab in Melanoma, sponsored by H. Lee Moffitt Cancer Center and Research Institute. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-29.

Sponsored by H. Lee Moffitt Cancer Center and Research Institute · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
17
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This is a Phase 2 open-label, single-arm study of neoadjuvant treatment of intratumoral tavo-EP plus nivolumab IV infusion. Eligible participants will be those with pathological diagnosis of operable locally-regionally advanced melanoma.

02

Conditions studied

  • Melanoma

Keywords

  • Skin Cancer
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In context

Melanoma

3,006 studies on the registry are indexed under Melanoma; 520 are open to participants now.

This study's enrollment of 17 is below the median of 38 across 2,351 interventional studies indexed under Melanoma.

Browse Melanoma studies →

Lead sponsor

H. Lee Moffitt Cancer Center and Research Institute is the lead sponsor of 533 studies on the registry; 74 are open to participants now.

Of its 99 completed or terminated interventional studies of FDA-regulated products, 57 (58%) have results posted.

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

04

Who can participate

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

Inclusion criteria

  • Participant must be ≥ 18 years of age inclusive, at the time of signing the informed consent
  • Histologic diagnosis of melanoma
  • Must be considered surgically operable and may present as any of the following groups:

    1. Primary melanoma with clinically apparent regional lymph node metastases, confirmed by pathological diagnosis.
    2. Clinically detected recurrence of melanoma at regional lymph node basin(s), confirmed by pathological diagnosis.
    3. Clinically or histologically detected primary melanoma involving multiple regional nodal groups, confirmed by pathological diagnosis.
    4. Clinically detected single site of nodal metastatic melanoma arising from an unknown primary, confirmed by pathological diagnosis.
    5. Participants with in transit or satellite metastases with or without lymph node involvement are allowed if they are considered surgically resectable at Screening by the treating surgical oncologist.
    6. Participants with distant cutaneous/subcutaneous, soft tissue or nodal metastases with or without regional lymph node involvement are allowed if they are considered potentially surgically resectable and can be biopsied at Screening by the treating surgical oncologist. Elevated LDH is not an exclusion.
  • Participants are eligible for this study either at presentation for primary melanoma with concurrent regional nodal and/or in-transit or distant metastasis, or at the time of clinically detected nodal, in transit, or distant recurrence
  • Participants must be evaluated by standard-of-care full body imaging studies including positron emission tomography - computed tomography (PET-CT ;preferred; including diagnostic CT component if possible) or CT (if PET-CT cannot be done) as well as magnetic resonance imaging (MRI) of the brain (or CT if MRI cannot be done) as part of the initial clinical work-up at Screening (no more than 4 weeks prior to Cycle 1, Day 1).
  • Have measurable disease based on RECIST v1.1, with at least one anatomically distinct lesion. Lesion or lesions must meet all the following baseline criteria:

    1. Accessible for electroporation
    2. Must be measured in at least one dimension (longest diameter in the plane of measurement is to be recorded)
    3. Greater than 3 mm
  • Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
  • Male Participants: Male subjects of childbearing potential must be surgically sterile, or must agree to use adequate method of contraception during the study and at least 5 months following the last day of study drug administration. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject
  • Female participants: Women of childbearing potential must have negative serum or urine pregnancy test within 72 hours prior to receiving the first study drug administration. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. For women of childbearing potential, must be willing to use an adequate method of contraception from 30 days prior to the first study drug administration and 5 months following last day study drug administration (either tavo or nivolumab); acceptable methods include hormonal contraception (oral contraceptives - as long as on stable dose, patch, implant, and injection), intrauterine devices, or double barrier methods (e.g. vaginal diaphragm/vaginal sponge plus condom, or condom plus spermicidal jelly), sexual abstinence or a vasectomized partner. Women may be surgically sterile or at least 1-year post-last menstrual period. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
  • Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol

Exclusion criteria

Exclusion Criteria:

  • Participant has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer. Also, includes patients who are considered disease-free for at least 3 years from the last definitive treatment for a second malignancy.
  • Participants who have Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies at Screening). HIV testing at screening is not required unless considered clinically indicated by the treating physician.
  • Participants who have active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected at Screening); Note: Participants who have been vaccinated against Hepatitis B and who are positive only for the Hepatitis B surface antibody are permitted to participate in the study. Hepatitis B and C testing at screening is not required unless considered clinically indicated by the treating physician.
  • Participant has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug. The use of physiologic doses of corticosteroids may be approved after consultation with the Principal Investigator.
  • Participant has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
  • Participant has a history of interstitial lung disease.
  • Participant has an active infection requiring systemic therapy.
  • Participant has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  • Participant has not recovered (i.e., > Grade 1 at Cycle 1, Day 1) from AEs due to a previously administered agent.
  • Participant has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.
  • Participants who are pregnant or breast feeding or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 5 months after the last dose of trial treatment.
  • Participants with electronic pacemakers or defibrillators
  • Participants who have received a live-virus vaccination within 30 days of the first dose of treatment. Seasonal flu vaccines that do not contain live virus are permitted
  • Participants who have received transfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including G-CSF, GM-CSF or recombinant erythropoietin) within 4 weeks prior to study Cycle 1, Day 1.
  • Previous treatment with anti-PD1 or anti-PDL1 immunotherapy.
  • Participation in another clinical study and systemic therapy within 30 days of Cycle 1, Day 1.
  • ECOG Performance Status: >1
  • Inadequate organ function as defined per protocol
  • Participant has severe hypersensitivity (≥Grade 3) to nivolumab and/or any of its excipients
05

Study design

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

Study arms

  • Experimental
    Neoadjuvant Treatment

    Neoadjuvant Phase: (3 x 4-week cycles, total 12 weeks): At every cycle, intratumoral tavo-EP will be administered (on Days 1 and 8) concurrently with 480 mg nivolumab IV infusion on Day 8 of each cycle (tavo-EP will be administered prior to nivolumab infusion). Definitive Surgery Phase: Surgery may be scheduled about 2-4 weeks after the last dose of nivolumab following radiologic and clinical assessment at that point. Pathologic response will be determined by institutional pathologist. Adjuvant Phase: Adjuvant therapy with nivolumab monotherapy will begin approximately 2-4 weeks following definitive surgery; recovery from surgery is required (Day 1 of Cycle 4 will be determined by the treating investigator once the subject is cleared to initiate systemic therapy). Nivolumab (480 mg IV infusion on Day 1 of each 4-week cycle) will be administered for up to 9 cycles during the Adjuvant phase.

    Drug: Tavo · Drug: Nivolumab · Device: OncoSec Medical Electroporation Therapy System

Interventions

  • DrugTavo

    Tavo will be injected on Days 1 and 8 every 4 weeks at a dose volume of ¼ of the calculated lesion volume with a minimum dose volume per lesion of 0.1 mL for lesions of volume \<0.4 cm3

  • DrugNivolumab

    Nivolumab will be administered 480 mg every 4 weeks over 30 minute infusions

  • DeviceOncoSec Medical Electroporation Therapy System

    The OMS (OncoSec Medical Electroporation Therapy System), a medical EP device system, consists of 3 components: 1. an Electroporation Generator that generates electric pulses, 2. a sterile Applicator Tip containing needle array, and 3. an Applicator Handle that connects to the Electroporation Generator at the proximal end and connects to the Applicator Tip at the distal end. Upon user activation of the attached Foot Switch, the OMS Electroporation Generator delivers controlled electrical pulses in a square wave pulse pattern yielding optimal transmembrane potential for electroporation to occur. EP pulses occur between 6 hexagonal opposing needle electrodes. After the first pulse, the polarity between the opposing needle electrode pairs is reversed and the needle pair is pulsed again. After the initial paired pulse, the pulse delivery is rotated clockwise to the next opposing needle pairs until a total of 6 pulses are delivered to complete the EP sequence.

    Also known as: Electroporation

06

What researchers measure

Primary outcomes

  1. Pathologic Complete Response

    For each subject, the study intervention consists of 3 phases: (1) Neoadjuvant Phase; (2) Surgery Phase; (3) Adjuvant Phase. Completion of all 3 phases is required for primary completion of the study. The study protocol requires that all subjects will be followed for 4 weeks after last dose of nivolumab at End of Study (EOS) visit. That is 4 weeks after the conclusion of the adjuvant phase. For the purpose of reporting the primary outcome measure, Pathologic Complete Response will be estimated based on the proportion of participants who have completed the study phases and were found to have no viable tumor on histologic assessment at definitive surgery after the 12- week Neoadjuvant phase. Surgery will then be scheduled 2-4 weeks after neoadjuvant phase. This will be followed by the adjuvant phase. Therefore, the proportion of participants who continue in Pathologic Complete Response following completion of the 3 study phases would be reported.

    Time frame: At least four weeks after the last dose of nivolumab at End of Study (EOS) visit

Secondary outcomes

  1. Objective Response Rate

    Preoperative ORR assessed by Investigator based on RECIST v1.1 at the conclusion of the Neoadjuvant phase.

    Time frame: Conclusion of the neoadjuvant phase.

  2. Relapse Free Survival

    RFS assessed by Investigator based on RECIST v1.1 at least four weeks after the last dose of nivolumab at End of Study (EOS) visit.

    Time frame: At least four weeks after the last dose of nivolumab at End of Study (EOS) visit

  3. Overall Survival

    Overall survival at 1 year after start of therapy.

    Time frame: At 1 year after start of therapy

  4. Risk of Surgical Delay

    Definitive surgery will be planned at about 12 weeks. Participants will be monitored for surgical delay (either due to toxicity and/or tumor progression). Defined as the number of participants who had Surgery delayed due to progression.

    Time frame: Up to 16 weeks after start or therapy

07

Results

Posted May 6, 2025

Participant flow

Participant flow — Overall Study
MilestoneNeoadjuvant Treatment
Started17
Completed16
Not completed1

Outcome measures

PrimaryPathologic Complete Response

For each subject, the study intervention consists of 3 phases: (1) Neoadjuvant Phase; (2) Surgery Phase; (3) Adjuvant Phase. Completion of all 3 phases is required for primary completion of the study. The study protocol requires that all subjects will be followed for 4 weeks after last dose of nivolumab at End of Study (EOS) visit. That is 4 weeks after the conclusion of the adjuvant phase. For the purpose of reporting the primary outcome measure, Pathologic Complete Response will be estimated based on the proportion of participants who have completed the study phases and were found to have no viable tumor on histologic assessment at definitive surgery after the 12- week Neoadjuvant phase. Surgery will then be scheduled 2-4 weeks after neoadjuvant phase. This will be followed by the adjuvant phase. Therefore, the proportion of participants who continue in Pathologic Complete Response following completion of the 3 study phases would be reported.

Time frame:
At least four weeks after the last dose of nivolumab at End of Study (EOS) visit
Reported as:
Count of participants · Participants
Pathologic Complete Response
ParticipantsNeoadjuvant Treatment
Pathologic Complete Response9
SecondaryObjective Response Rate

Preoperative ORR assessed by Investigator based on RECIST v1.1 at the conclusion of the Neoadjuvant phase.

Time frame:
Conclusion of the neoadjuvant phase.
Reported as:
Count of participants · Participants
Objective Response Rate
ParticipantsNeoadjuvant Treatment
Objective Response Rate10
SecondaryRelapse Free Survival

RFS assessed by Investigator based on RECIST v1.1 at least four weeks after the last dose of nivolumab at End of Study (EOS) visit.

Time frame:
At least four weeks after the last dose of nivolumab at End of Study (EOS) visit
Reported as:
Number · 1-year RFS Probability
Relapse Free Survival
1-year RFS ProbabilityNeoadjuvant Treatment
Relapse Free Survival93 (80 to 100)
SecondaryOverall Survival

Overall survival at 1 year after start of therapy.

Time frame:
At 1 year after start of therapy
Reported as:
Number · 1 Year OS Percent Probability
Overall Survival
1 Year OS Percent ProbabilityNeoadjuvant Treatment
Overall Survival94 (83 to 100)
SecondaryRisk of Surgical Delay

Definitive surgery will be planned at about 12 weeks. Participants will be monitored for surgical delay (either due to toxicity and/or tumor progression). Defined as the number of participants who had Surgery delayed due to progression.

Time frame:
Up to 16 weeks after start or therapy
Reported as:
Count of participants · Participants
Risk of Surgical Delay
ParticipantsNeoadjuvant Treatment
Risk of Surgical Delay1

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Neoadjuvant Treatment2/16 (12.5%)8/16 (50%)16/16 (100%)
Most frequent serious events
Showing 10 of 21
Most frequent serious events
EventNeoadjuvant Treatment
Myocardial infarctionCardiac disorders2/16
Chest pain - cardiacCardiac disorders1/16
ColitisGastrointestinal disorders1/16
DiarrheaGastrointestinal disorders1/16
PancreatitisGastrointestinal disorders1/16
Flu like symptomsGeneral disorders1/16
CholecystitisHepatobiliary disorders1/16
Hepatobiliary disorders - Other, specifyHepatobiliary disorders1/16
Allergic reactionImmune system disorders1/16
Urinary tract infectionInfections and infestations1/16
Most frequent other events
Showing 10 of 117
Most frequent other events
EventNeoadjuvant Treatment
Tumor painNeoplasms benign, malignant and unspecified (incl cysts and polyps)15/16
HyperglycemiaMetabolism and nutrition disorders9/16
FatigueGeneral disorders9/16
AnemiaBlood and lymphatic system disorders8/16
HyperkalemiaMetabolism and nutrition disorders7/16
DiarrheaGastrointestinal disorders7/16
Rash maculo-papularSkin and subcutaneous tissue disorders6/16
HypoalbuminemiaMetabolism and nutrition disorders5/16
Investigations - Other, specifyInvestigations5/16
NauseaGastrointestinal disorders5/16

Baseline characteristics

Age, Continuous
Age, Continuous(years)Neoadjuvant Treatment
Median69 (30 to 88)
Sex: Female, Male
Sex: Female, Male(Participants)Neoadjuvant Treatment
Female7
Male9
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Neoadjuvant Treatment
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White15
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Neoadjuvant Treatment
United States16
08

Study locations

1 site
  • Moffitt Cancer Center
    Tampa, Florida 33612, United States
09

References and documents

Publications

  • Tarhini AA, Eroglu Z, Eljilany I, Zager JS, Gonzalez RJ, Sarnaik AA, Cruse CW, Khushalani NI, De Aquino DB, Abraham E, Acevedo DM, Richards A, Schell MJ, Kalos D, Chen PL, Messina JL, Canton DA, Sondak VK. Neoadjuvant Intratumoral Plasmid IL-12 Electro-Gene-Transfer and Nivolumab in Patients with Operable, Locoregionally Advanced Melanoma. Clin Cancer Res. 2024 Dec 2;30(23):5333-5341. doi: 10.1158/1078-0432.CCR-24-2768. PubMed 39417680 ↗
  • Jacobs L, Yshii L, Junius S, Geukens N, Liston A, Hollevoet K, Declerck P. Intratumoral DNA-based delivery of checkpoint-inhibiting antibodies and interleukin 12 triggers T cell infiltration and anti-tumor response. Cancer Gene Ther. 2022 Jul;29(7):984-992. doi: 10.1038/s41417-021-00403-8. Epub 2021 Nov 9. PubMed 34754076 ↗

Study documents

  • Protocol and statistical analysis plan · Jul 26, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 29, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04526730
Lead sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
OncoSec Medical Incorporated
Responsible party
Sponsor
First posted
Aug 26, 2020
Start date
Dec 22, 2020
Primary completion
Mar 26, 2024
Completion
May 22, 2025
Results posted
May 6, 2025
Last update
Jun 29, 2026

Study contacts

Ahmad Tarhini, MD, PhD
principal investigator · Moffitt Cancer Center

Oversight

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

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