Clinical Trials /

Cemiplimab, Low-Dose Paclitaxel and Carboplatin for the Treatment of Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck

NCT04862650

Description:

This phase II trial studies the effect of cemiplimab in combination with low-dose paclitaxel and carboplatin in treating patients with squamous cell carcinoma of the head and neck that has come back (recurrent) or spread to other places in the body (metastatic). Immunotherapy with monoclonal antibodies, such as cemiplimab , may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs, like paclitaxel and carboplatin, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving cemiplimab in combination with paclitaxel and carboplatin may work better in treating recurrent or metastatic squamous cell carcinoma of the head and neck.

Related Conditions:
  • Cutaneous Squamous Cell Carcinoma of the Head and Neck
Recruiting Status:

Not yet recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Cemiplimab, Low-Dose Paclitaxel and Carboplatin for the Treatment of Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck
  • Official Title: A Phase II Trial of the Efficacy and Safety of the Combination of Cemiplimab and Low-Dose Paclitaxel and Carboplatin in Patients With Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck

Clinical Trial IDs

  • ORG STUDY ID: OSU-20258
  • SECONDARY ID: NCI-2021-02081
  • NCT ID: NCT04862650

Conditions

  • Clinical Stage IV HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8
  • Metastatic Head and Neck Squamous Cell Carcinoma
  • Metastatic Hypopharyngeal Squamous Cell Carcinoma
  • Metastatic Laryngeal Squamous Cell Carcinoma
  • Metastatic Oral Cavity Squamous Cell Carcinoma
  • Metastatic Oropharyngeal Squamous Cell Carcinoma
  • Pathologic Stage IV HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8
  • Recurrent Head and Neck Squamous Cell Carcinoma
  • Recurrent Hypopharyngeal Squamous Cell Carcinoma
  • Recurrent Laryngeal Squamous Cell Carcinoma
  • Recurrent Oral Cavity Squamous Cell Carcinoma
  • Recurrent Oropharyngeal Squamous Cell Carcinoma
  • Squamous Cell Carcinoma of Unknown Primary
  • Stage IV Hypopharyngeal Carcinoma AJCC v8
  • Stage IV Laryngeal Cancer AJCC v8
  • Stage IV Lip and Oral Cavity Cancer AJCC v8
  • Stage IVA Hypopharyngeal Carcinoma AJCC v8
  • Stage IVA Laryngeal Cancer AJCC v8
  • Stage IVA Lip and Oral Cavity Cancer AJCC v8
  • Stage IVB Hypopharyngeal Carcinoma AJCC v8
  • Stage IVB Laryngeal Cancer AJCC v8
  • Stage IVB Lip and Oral Cavity Cancer AJCC v8
  • Stage IVC Hypopharyngeal Carcinoma AJCC v8
  • Stage IVC Laryngeal Cancer AJCC v8
  • Stage IVC Lip and Oral Cavity Cancer AJCC v8

Interventions

DrugSynonymsArms
CarboplatinBlastocarb, Carboplat, Carboplatin Hexal, Carboplatino, Carboplatinum, Carbosin, Carbosol, Carbotec, CBDCA, Displata, Ercar, JM-8, Nealorin, Novoplatinum, Paraplatin, Paraplatin AQ, Paraplatine, Platinwas, RibocarboTreatment (cemiplimab, paclitaxel, carboplatin)
CemiplimabCemiplimab RWLC, Cemiplimab-rwlc, Libtayo, REGN2810Treatment (cemiplimab, paclitaxel, carboplatin)
PaclitaxelAnzatax, Asotax, Bristaxol, Praxel, Taxol, Taxol KonzentratTreatment (cemiplimab, paclitaxel, carboplatin)

Purpose

This phase II trial studies the effect of cemiplimab in combination with low-dose paclitaxel and carboplatin in treating patients with squamous cell carcinoma of the head and neck that has come back (recurrent) or spread to other places in the body (metastatic). Immunotherapy with monoclonal antibodies, such as cemiplimab , may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs, like paclitaxel and carboplatin, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving cemiplimab in combination with paclitaxel and carboplatin may work better in treating recurrent or metastatic squamous cell carcinoma of the head and neck.

Detailed Description

      PRIMARY OBJECTIVE:

      I. To assess the overall response rate (ORR) at 12 weeks of treatment with the treatment
      combination cemiplimab, paclitaxel, and carboplatin.

      SECONDARY OBJECTIVES:

      I. To assess toxicity/tolerance to the proposed treatment combination (a safety run-in phase
      of ten patients will be performed initially).

      II. To assess progression-free survival (PFS) and overall survival (OS) at one and two years.

      EXPLORATORY OBJECTIVES:

      I. Prospectively test the ability of our clinical nomogram to predict median OS in squamous
      cell carcinoma of the head and neck (SCCHN) patients planning to receive first-line
      cemiplimab in combination with low-dose weekly paclitaxel and carboplatin. II. To assess the
      PFS and OS of patients with combined positive score (CPS) <1%, >1%, and > 20%.

      III. Compare the predictive power of our nomogram to that of CPS in the prospective cohort,
      as well as evaluate the combined correlation of nomogram and CPS to median OS.

      OUTLINE:

      Patients receive cemiplimab intravenously (IV) over 30 minutes every 3 weeks (Q3W) for up to
      104 weeks, and paclitaxel IV over 60 minutes and carboplatin IV over 30 minutes once weekly
      (QW) for up to 24 weeks. Treatment continuous in the absence of disease progression or
      unacceptable toxicity.

      After completion of study treatment, patients are followed up at 14 days and then every 12
      weeks.
    

Trial Arms

NameTypeDescriptionInterventions
Treatment (cemiplimab, paclitaxel, carboplatin)ExperimentalPatients receive cemiplimab IV over 30 minutes every 3 weeks (Q3W) for up to 104 weeks, and paclitaxel IV over 60 minutes and carboplatin IV over 30 minutes once weekly (QW) for up to 24 weeks. Treatment continuous in the absence of disease progression or unacceptable toxicity.
  • Carboplatin
  • Cemiplimab
  • Paclitaxel

Eligibility Criteria

        Inclusion Criteria:

          -  Recurrent/metastatic (R/M) SCCHN of the oral cavity, oropharynx, larynx and
             hypopharynx

          -  No prior systemic therapy for treatment of R/M disease

          -  Patients with squamous cell carcinoma of an unknown primary are eligible provided
             their tumor tested positive for p-16 and they have previously received treatment for
             locoregional head and neck cancer

          -  Must be at least four weeks since prior systemic therapy, radiation and/or surgery

          -  At least one measurable lesion as defined by Response Evaluation Criteria In Solid
             Tumors (RECIST) v1.1 on screening computed tomography (CT) or magnetic resonance
             imaging (MRI)

          -  18 years of age and older

          -  Eastern Cooperative Oncology Group (ECOG) performance status 0-1

          -  White blood cell (WBC) count > 2,500 cells/uL

          -  Absolute neutrophil count (ANC) >1,500 cells/uL

          -  Platelet count >= 100,000 cells/uL

          -  Hemoglobin >= 9 g/dL

          -  Creatinine =< 1.6 mg/dL

          -  Total bilirubin =< 1.6 mg/dL

          -  Serum glutamic oxaloacetic transaminase (SGOT) (aspartate transaminase [AST]), serum
             glutamic-pyruvic transaminase (SGPT) (alanine aminotransferase [ALT]) =< 2.5 x upper
             limit of normal (ULN)

          -  Potassium >= lower limit of normal (LLN)

          -  Willingness to use medically acceptable contraception throughout the study period and
             four weeks after the final administration of treatment

          -  For female subjects with reproductive potential: a negative serum pregnancy test at
             baseline

          -  Ability and willingness to provide written informed consent and to comply with the
             study visits and assessment schedule

        Exclusion Criteria:

          -  Disease which is amenable to curative local therapy

          -  Nasopharyngeal, salivary gland, lip, or sinonasal carcinoma

          -  Disease that requires corticosteroids (>10 mg prednisone or equivalent daily within
             four weeks prior to the first dose of cemiplimab) or other immune suppressives at
             baseline

          -  Previous treatment with mAb-based immune therapies

          -  Previous treatment with PI3K inhibitors

          -  Known brain metastases, unless stable for at least 21 days prior to registration

          -  Known infection human immunodeficiency virus (HIV), hepatitis B or C

          -  Clinically significant cardiac disease (e.g., congestive heart failure, unstable or
             uncontrolled angina, myocardial infarction) within the past six months

          -  History of pneumonitis within the past five years

          -  Recipient of live vaccines (including attenuated) within 30 days of study treatment

          -  Female patients who are pregnant or breast-feeding

          -  Any other condition or circumstance that could interfere with adherence to the study's
             procedures or requirements or otherwise compromise the study's objectives in the
             opinion of the Principal Investigator
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall response rate (ORR)
Time Frame:12 weeks
Safety Issue:
Description:ORR defined as the proportion of patients with a documented complete response (CR) + partial response (PR) at week 12 of treatment based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. An ORR of 40% (percent) or higher will be consider a positive result. Simon two-stage optimal design will be used.

Secondary Outcome Measures

Measure:Progression-free survival (PFS)
Time Frame:From the date of enrollment until documented disease progression, assessed up to 2 years
Safety Issue:
Description:PFS will be calculated based on RECIST criteria.
Measure:Overall survival (OS)
Time Frame:From the date of patient enrollment into the trial until death, assessed up to 2 years
Safety Issue:
Description:
Measure:Incidence of adverse events
Time Frame:Up to 24 weeks
Safety Issue:
Description:Toxicity will be graded by the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Marcelo Bonomi

Last Updated

April 28, 2021