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A single-arm phase II study of cetuximab plus platinum and taxane-based chemotherapy followed by AVElumab and Cetuximab as first-line therapy for recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients with PD-L1 combined positive score (CPS)≥1≤19: the immunotherapy sequence reversal
EU CTIS ID: 2024-512053-24-00
What this study is testing
To evaluate if TPE followed by avelumab and cetuximab maintenance is able to increase the 6-months (6m)-PFS from 40% to 55% of PD-L1 CPS≥1≤19 R/M HNSCC patients.
- Therapeutic exploratory (Phase II)
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- Subjects able to sign the informed consent and ≥18 y-old.
- Adequate liver function: total bilirubin level < 1.5 X Upper Limit of Normal (ULN) (except from known medical reason not interfering with liver function, such as Gilbert syndrome), AP, GGT <3 x ULN and AST and ALT levels ≤ 2.5 × ULN.
- Adequate renal function: calculated or analyzed creatinine clearance ≥ 30 mL/min. For patients with a CrCl between ≥30 and <60 mL/min, carboplatin will be administered at a dose of AUC 5 every 21 days. If CrCl is ≥60 mL/min, cisplatin can be used instead of carboplatin. (Note: Symptomatic peripheral neuropathy NCI-CTC v5.0 grade ≥2 and / or ototoxicity grade ≥2 (except for cases in which ototoxicity is due to trauma or tumor-related mechanical impairment) and/or creatinine clearance < 60 mL/min are acceptable and they must be approached with carboplatin (instead of cisplatin) since the trial start.)
- All patients deemed eligible by the investigator to receive first-line TPE regardless of their participation in the clinical study, will be considered for inclusion
- Archival or fresh tissue of primary disease (i.e. T and/or N and/or M) OR recurrent/metastatic disease available at baseline (before starting TPE) (available as Formalin-Fixed Paraffin-Embedded - FFPE - or as unstained 10-20 slices).
- Participants have to provide peripheral blood samples (at least 8-10 mL stored in EDTA) according the timing described in the translational part of thef Thecurrent
You likely can't join if
- Nasopharyngeal, salivary gland, nasal sinus, and non-melanoma skin cancers are not allowed.
- Significant neurologic or known psychiatric or substance abuse disorders that would interfere with cooperation and the requirements of the trial.
- Clinically significant (i.e., active) cardiovascular disease: cerebral vascular accident/stroke (≤6 months prior to enrollment), myocardial infarction (≤6 months prior to enrollment), unstable angina, congestive heart failure (≥ New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication.
- Prior organ transplantation including allogenic stem-cell transplantation
- Active uncontrolled infection requiring systemic therapy (i.e. IV antibiotics).
- Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) are NOT ELIGIBLE.
See the full eligibility criteria
Who can join
- Subjects able to sign the informed consent and ≥18 y-old.
- Adequate liver function: total bilirubin level < 1.5 X Upper Limit of Normal (ULN) (except from known medical reason not interfering with liver function, such as Gilbert syndrome), AP, GGT <3 x ULN and AST and ALT levels ≤ 2.5 × ULN.
- Adequate renal function: calculated or analyzed creatinine clearance ≥ 30 mL/min. For patients with a CrCl between ≥30 and <60 mL/min, carboplatin will be administered at a dose of AUC 5 every 21 days. If CrCl is ≥60 mL/min, cisplatin can be used instead of carboplatin. (Note: Symptomatic peripheral neuropathy NCI-CTC v5.0 grade ≥2 and / or ototoxicity grade ≥2 (except for cases in which ototoxicity is due to trauma or tumor-related mechanical impairment) and/or creatinine clearance < 60 mL/min are acceptable and they must be approached with carboplatin (instead of cisplatin) since the trial start.)
- All patients deemed eligible by the investigator to receive first-line TPE regardless of their participation in the clinical study, will be considered for inclusion
- Archival or fresh tissue of primary disease (i.e. T and/or N and/or M) OR recurrent/metastatic disease available at baseline (before starting TPE) (available as Formalin-Fixed Paraffin-Embedded - FFPE - or as unstained 10-20 slices).
- Participants have to provide peripheral blood samples (at least 8-10 mL stored in EDTA) according the timing described in the translational part of thef Thecurrent
- Palliative radiotherapy and/or surgery within 4 weeks before the study entry are allowed.
- Histologically or cytologically confirmed diagnosis of HNSCC
- Confirmed R/M HNSCC (i.e. oral cavity, oropharynx, larynx, hypopharynx) not suitable for curative loco-regional therapy.
- PD-L1 CPS≥1≤19 (assessment allowed either on primary and/or recurrent/metastatic site of disease).
- Measurable disease according to RECIST Criteria 1.1.
- Subjects should not have had prior systemic therapy administered in the R/M HNSCC setting.
- Systemic therapy that was completed more than 6 months prior to signing consent, if given as a part of multimodal curative treatment for locally advanced disease, is allowed.
- ECOG Performance Status (PS) 0-1.
- Adequate bone marrow function: neutrophils ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, hemoglobin ≥ 9 g/dL.
What rules you out
- Nasopharyngeal, salivary gland, nasal sinus, and non-melanoma skin cancers are not allowed.
- Significant neurologic or known psychiatric or substance abuse disorders that would interfere with cooperation and the requirements of the trial.
- Clinically significant (i.e., active) cardiovascular disease: cerebral vascular accident/stroke (≤6 months prior to enrollment), myocardial infarction (≤6 months prior to enrollment), unstable angina, congestive heart failure (≥ New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication.
- Prior organ transplantation including allogenic stem-cell transplantation
- Active uncontrolled infection requiring systemic therapy (i.e. IV antibiotics).
- Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) are NOT ELIGIBLE.
- Hepatitis B virus (HBV) Participants with active infectious diseases (a, b): a) Active hepatitis B infection (1, 2) (i.e. Positive test for hepatitis B virus (HBV) DNA) (1) Participants who are HBsAg positive with NEGATIVE HBV-DNA viral load before trial inclusion are ELIGIBLE. Negativization of HBV DNA viral load can be occurred spontaneously or after antiviral treatment (2) Participants with antecedents of hepatitis B (i.e., anti-hepatitis B core [HBc] positive, HBsAg and hepatitis B virus [HBV]-deoxyribonucleic acid [DNA] NEGATIVE) are ELIGIBLE. b) Active hepatitis C infection (3) (i.e. Positive test for hepatitis C virus (HCV) RNA). (3) Participants who have positive anti-HCV antibodies with NEGATIVE HCV-RNA viral load before trial inclusion are ELIGIBLE. Negativization of HCV RNA viral load can be occurred spontaneously or after antiviral treatment
- Live vaccination within 30 days of planned start of study treatment (inactivated vaccines are allowed).
- Pregnancy (absence of pregnancy must be confirmed by negative serum or urine pregnancy test - ß-HCG - for women of childbearing potential) and/or breastfeeding are not allowed. Subjects of childbearing potential willing to use effective contraceptive method [Pearl Index < 1; e.g. oral contraceptive (pill), hormone spiral, hormone implant, transdermal patch, a combination of two barrier methods (condom and diaphragm), sterilization, sexual abstinence] for the entire study duration and 30 days post-dosing.
- Life expectancy lower than 3 months according to the judgement of trial investigator is not allowed.
- Previous chemotherapy, or biological therapy (i.e. Cetuximab), or immunotherapy administered for R/M setting of HNSCC is not allowed.
- Diagnosis of immunodeficiency or subjects receiving systemic steroid therapy (> 10 mg/day of prednisone or equivalent) or any other form of immunosuppressive therapy within 30 days prior to start of study treatment which cannot be interrupted.
- Known allergic/hypersensitivity reaction to investigational products or any component in their formulations.
- Active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
- Active autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent. Patients with type I diabetes, vitiligo, psoriasis, or hypo- or hyperthyroid diseases not requiring immunosuppressive treatment are eligible.
- Any diagnosed and/or treated additional malignancy within 5 years before the study entry with the exception of: curatively treated basal cell carcinoma of the skin, curatively treated squamous cell carcinoma of the skin, curatively treated prostate cancer, curatively resected in situ cervical cancer, and curatively resected in situ breast cancer.
- Subjects with a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subjects’ participation for the full duration of the trial, or is not in the best interest of the subject to participate, according to the opinion of the treating investigator.
The study team makes the final eligibility decision.
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 18-64 years, 65+ years. The study team makes the final eligibility decision.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.