Description:
Immune checkpoint inhibitors (CPI) such as pembrolizumab or nivolumab have been recently
approved for the treatment of recurrent/metastatic head and neck cancer (HNSCC). However,
only a minority of patients respond to therapy. From the clinical point of view the optimal
management of patients progressing on or after CPI therapy is still a challenge.
Retrospective analysis showed that HNSCC patients, who progressed on/after CPI, demonstrated
an overall response rate (ORR) of up to 30% subsequent to chemotherapy +/- cetuximab
treatment. It is the aim of this study to evaluate if paclitaxel plus cetuximab after first
line pembrolizumab failure is an effective salvage therapy in 50 R/M HNSCC patients. The
primary endpoint is ORR according to RECIST V 1.1.
Title
- Brief Title: Paclitaxel Plus Cetuximab After First-line Checkpoint Inhibitor Failure
- Official Title: Paclitaxel Plus Cetuximab for the Treatment of Recurrent and/or Metastatic Head and Neck Cancer After First-line Checkpoint Inhibitor Failure: A Multicenter, Single Arm Study
Clinical Trial IDs
- ORG STUDY ID:
PACE ACE
- NCT ID:
NCT04278092
Conditions
- Head and Neck Squamous Cell Carcinoma
Interventions
Drug | Synonyms | Arms |
---|
Paclitaxel | | Paclitaxel plus Cetuximab |
Cetuximab | | Paclitaxel plus Cetuximab |
Purpose
Immune checkpoint inhibitors (CPI) such as pembrolizumab or nivolumab have been recently
approved for the treatment of recurrent/metastatic head and neck cancer (HNSCC). However,
only a minority of patients respond to therapy. From the clinical point of view the optimal
management of patients progressing on or after CPI therapy is still a challenge.
Retrospective analysis showed that HNSCC patients, who progressed on/after CPI, demonstrated
an overall response rate (ORR) of up to 30% subsequent to chemotherapy +/- cetuximab
treatment. It is the aim of this study to evaluate if paclitaxel plus cetuximab after first
line pembrolizumab failure is an effective salvage therapy in 50 R/M HNSCC patients. The
primary endpoint is ORR according to RECIST V 1.1.
Trial Arms
Name | Type | Description | Interventions |
---|
Paclitaxel plus Cetuximab | Experimental | Paclitaxel combination with weekly cetuximab will be administered for up to six cycles. Thereafter weekly cetuximab maintenance will be given. | |
Eligibility Criteria
Inclusion Criteria:
- The patient has provided written informed consent prior to any study-related
procedure.
- The patient is at least 18 years of age
- Histologically proven locally advanced unresectable, recurrent and/or metastatic
squamous cell carcinoma of the oropharynx, hypopharynx, larynx or oral cavity not
amenable for salvage surgery
- p16 status has to be determined for oropharyngeal carcinomas
- Documented progressive disease based on investigator assessment according to RECIST
1.1, following receipt of a pembrolizumab based regimen given as first line therapy
for R/M SCCHN
- Measurable disease according to RECIST 1.1.
- The patient has a life expectancy of at least 3 months.
- Has a performance status of ≤ 2 on the ECOG Performance Scale
- Female patient of childbearing potential should have a negative urine or serum
pregnancy prior to study . If the urine test is positive or cannot be confirmed as
negative, a serum pregnancy test will be required.
- Female patients of childbearing potential should be willing to use 2 methods of birth
control or be surgically sterile, or abstain from heterosexual activity for the course
of the study until 120 days after the last dose of study medication. Patients of
childbearing potential are those who have not been surgically sterilized or have not
been free from menses for > 1 year.
- Male patients should agree to use an adequate method of contraception starting with
the first dose of study therapy until 120 days after the last dose of study therapy.
- Demonstrate adequate organ function as defined in table 1, all screening labs should
be performed within 14 days of treatment initiation.
Exclusion Criteria:
- Prior taxane therapy is not allowed except as part of induction therapy for locally
advanced disease (completed at least 6 months before study entry)
- Prior cetuximab therapy is not allowed except as part of either induction therapy or
in combination with radiotherapy treatment for locally advanced disease (completed at
least 6 months before study entry)
- Patients with nasopharyngeal carcinomas or salivary glands cancers
- Is currently participating and receiving study therapy or has participated in a study
of an investigational agent and received study therapy within 4 weeks of the first
dose of treatment.
- Has a diagnosis of immunodeficiency including a known history of Human
Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
- Has known active Hepatitis A/B or Hepatitis C
- Has had prior pembrolizumab within 2 weeks prior to study day 1 or who has not
recovered (i.e., recovery to ≤ Grade 1 or baseline grade prior to pembrolizumab) from
(immune- related) adverse events other than endocrine side effects.
- Has had prior chemotherapy or radiation therapy within 2 weeks prior to study day 1 or
who has not recovered (i.e., recovery to ≤ Grade 1 or baseline grade prior to
pembrolizumab) from adverse events due to a previously administered agent.
- Has had chemotherapy, targeted therapy or investigational drugs after checkpoint
inhibitor failure for second line therapy .
- Has a known additional malignancy that is progressing or requires active treatment.
Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the
skin that has undergone potentially curative therapy or in situ cervical cancer.
- Has an active infection requiring systemic therapy.
- Has a history or current evidence of any condition, therapy, or laboratory abnormality
that might confound the results of the trial, interfere with the patient's
participation for the full duration of the trial, or is not in the best interest of
the patient to participate, in the opinion of the treating investigator.
- Has known psychiatric or substance abuse disorders that would interfere with
cooperation with the requirements of the trial.
- Is pregnant or breastfeeding, or expecting to conceive or father children within the
projected duration of the trial, starting with the pre-screening or screening visit
until 120 days after the last dose of trial treatment.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Overall response rate |
Time Frame: | 3 months |
Safety Issue: | |
Description: | To evaluate the Overall Response Rate (CR/PR) rate according to RECIST V 1.1 |
Secondary Outcome Measures
Measure: | Median Overall Survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | The interval between start of treatment and death from any cause |
Measure: | Median Progression Free Survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | The interval between start of treatment and date of progression, or death, from any cause |
Measure: | Median Duration of response |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Health-related quality-of-life scores per patient measured according to the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) C-30 scoring manual |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Health-related quality-of-life scores per patient measured according to the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) H&N35 scoring manual |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Number of participants with adverse events |
Time Frame: | 2 years |
Safety Issue: | |
Description: | AEs, treatment-related AEs, serious adverse events (SAEs), and treatment-related SAEs will be tabulated using worst grade per NCI CTCAE v 5.0 criteria. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Medical University of Vienna |
Last Updated
August 31, 2021