Biomarker-based Study in R/M SCCHN

NCT ID: NCT03088059

Last Updated: 2023-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

340 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-16

Study Completion Date

2025-12-31

Brief Summary

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This is a biomarker-driven trial that will enroll patients with recurrent or metastatic squamous cell carcinoma of the head and neck progressing after first-line platinum-based chemotherapy. Based on potential biomarkers and molecular alterations identified in the biopsy from the central platform, patients will be allocated in different cohorts. There will be biomarker-positive patient cohorts and immunotherapy cohorts.

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Detailed Description

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Conditions

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Carcinoma, Squamous Cell of Head and Neck

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Patient Cohort B1

Patients who are p16 negative and have an EGFR amplification/mutation or PTEN high or HER2 mutation/amplification will be randomized between afatinib or the standard of care (Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care).

Group Type EXPERIMENTAL

Afatinib

Intervention Type DRUG

Afatinib 40 mg given orally, once daily, 1 cycle is 28 days

standard of care

Intervention Type DRUG

Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care

Patient Cohort B2

Patients who are p16 negative and cetuximab naïve will be randomized between afatinib or the standard of care (Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care)

Group Type EXPERIMENTAL

Afatinib

Intervention Type DRUG

Afatinib 40 mg given orally, once daily, 1 cycle is 28 days

standard of care

Intervention Type DRUG

Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care

Patient Cohort B3

Patients who are p16 negative and have an amplification of CCND1 will be randomized between palbociclib or the standard of care (Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care)

Group Type EXPERIMENTAL

Palbociclib

Intervention Type DRUG

Palbociclib 125 mg given orally, once daily, 1 cycle is 28 days (21 days on treatment, then 7 days off)

standard of care

Intervention Type DRUG

Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care

Patient Cohort B4

Patients who are p16 negative and 'platinum sensitive' SCCHN will receive niraparib

Group Type EXPERIMENTAL

Niraparib

Intervention Type DRUG

Niraparib 300 mg given orally, once daily, 1 cycle is 28 days

Patient Cohort B5

Patients whith oropharyngeal cancer and which are p16 positive will receive niraparib

Group Type EXPERIMENTAL

Niraparib

Intervention Type DRUG

Niraparib 300 mg given orally, once daily, 1 cycle is 28 days

Patient Cohort I1

Patients who are anti-PD(L)1-naïeve or resistant (primary or secondary resistance) will receive IPH2201 antibody (monalizumab).

Group Type EXPERIMENTAL

IPH2201

Intervention Type DRUG

protocol v2.0 and 2.1 : Monalizumab 10mg/kg given intravenously over 60 minutes, once every 14 days, 1 cycle is 14 days protocol v4.0 : Monalizumab 750mg given intravenously over 60 minutes, once every 28 days, 1 cycle is 28 days

Patient Cohort I2

Patient who are PD(L)1 pretreated will be randomized between monalizumab + durvalumab or the standard of care (Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care)

Group Type EXPERIMENTAL

standard of care

Intervention Type DRUG

Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care

IPH2201

Intervention Type DRUG

protocol v2.0 and 2.1 : Monalizumab 10mg/kg given intravenously over 60 minutes, once every 14 days, 1 cycle is 14 days protocol v4.0 : Monalizumab 750mg given intravenously over 60 minutes, once every 28 days, 1 cycle is 28 days

Durvalumab

Intervention Type DRUG

Durvalumab 1500mg given intravenously over 60 minutes, once every 28 days, 1 cycle is 28 days

Patient Cohort I3

Patient who are progressing prior PD(L)1 after having received at least 2 months of anti-PD(L)-1 will receive INCAGN01876.

Group Type EXPERIMENTAL

INCAGN01876

Intervention Type DRUG

INCAGN01876 300 mg given intravenously over 30 minutes, once every 14 days, 1 cycle is 28 days

Interventions

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Afatinib

Afatinib 40 mg given orally, once daily, 1 cycle is 28 days

Intervention Type DRUG

Palbociclib

Palbociclib 125 mg given orally, once daily, 1 cycle is 28 days (21 days on treatment, then 7 days off)

Intervention Type DRUG

standard of care

Methotrexate, Paclitaxel, Docetaxel, Carboplatin, 5-Fluorouracil, Bleomycine, Gemcitabine, Mitomycine or Best supportive care

Intervention Type DRUG

IPH2201

protocol v2.0 and 2.1 : Monalizumab 10mg/kg given intravenously over 60 minutes, once every 14 days, 1 cycle is 14 days protocol v4.0 : Monalizumab 750mg given intravenously over 60 minutes, once every 28 days, 1 cycle is 28 days

Intervention Type DRUG

Durvalumab

Durvalumab 1500mg given intravenously over 60 minutes, once every 28 days, 1 cycle is 28 days

Intervention Type DRUG

Niraparib

Niraparib 300 mg given orally, once daily, 1 cycle is 28 days

Intervention Type DRUG

INCAGN01876

INCAGN01876 300 mg given intravenously over 30 minutes, once every 14 days, 1 cycle is 28 days

Intervention Type DRUG

Other Intervention Names

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Monalizumab

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed recurrent and/or metastatic SCCHN of the oral cavity, oropharynx, hypopharynx or larynx not amenable to curative treatment.
* At least one measurable lesion by MRI or CT-scan according to RECIST 1.1, evaluated within 2 weeks prior to registration. Such lesion must not have been previously irradiated; if the measurable lesion(s) have been irradiated, clear progression must be documented.
* Progressive disease after first line platinum-based chemotherapy with or without cetuximab given as palliative treatment or progressive disease within 1 year if platinum-based chemotherapy was given as a part of the multimodal curative treatment. Patients pre-treated with anti-PD1/anti-PDL1 are allowed.
* ECOG performance status 0 -1 with a life expectancy of at least 12 weeks.
* Tumor core biopsy from any accessible tumor at the recurrent or metastatic site available for central testing.
* Patients must have adequate organ function, evaluated within 14 days prior to cohort allocation:
* Hemoglobin ≥ 9 g/100 ml,
* Neutrophils ≥ 1,500/mm3,
* Platelets ≥ 100,000/mm3,
* Total bilirubin \<1.5 times the upper limit of normal (ULN) (\< 3 times the upper limit of normal for Gilbert's disease),
* Serum ALT and AST ≤ 2.5 x ULN,
* Adequate renal function measured by:
* Estimated creatinine clearance ≥45ml using Cockcroft and Gault formula or Creatinine ≤ 1.5 ULN
* International Normalized Ratio (INR) or Prothrombin Time (PT) must be within the normal ranges as per institution's standard. A window of 5% is allowed.
* Patients receiving anticoagulant therapy are allowed to participate as long as the PT/INR values are within the expected target range of their current dose.
* Clinically normal cardiac function based on -left ventricular ejection fraction (≥ 50%) as assessed either by multi-gated acquisition scan or cardiac ultrasound and 12 lead ECG without clinically relevant abnormalities.
* Patients ≥ 18 years old and must be able to give written informed consent.
* Patients ≥ 70 years old must undergo the G8 screening.
* Women of child-bearing potential must have a negative pregnancy test (serum or urine within the 72 hours prior to cohort allocation).
* Patients of childbearing / reproductive potential must agree to use highly effective methods of contraception based on the Clinical Trial Facilitation Group (CTFG) guidance as of registration and up to 6 months after the last treatment dose. Highly effective methods can achieve failure rate of less than 1% per year when used consistently and correctly. Such methods include: For Women: combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal and transdermal), progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable), intrauterine device, intrauterine hormone-releasing system, bilateral tubal occlusion, vasectomized partner and sexual abstinence. For Men: condoms, sexual abstinence (the reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient) and no sperm donations during treatment and up to 6 months after last dose of treatment.
* Female subjects who are breast feeding should agree to discontinue nursing prior to the first dose of study treatment and up to 6 months after the last study treatment.
* Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations.

Exclusion Criteria

* Unresolved and significant toxicity CTCAE version 4.03 grade ≥ 2 from previous anticancer therapy other than alopecia.
* History of any of the following cardiovascular conditions within 6 months prior to registration:
* myocardial infarction,
* severe/unstable angina,
* ongoing cardiac dysrhythmias of CTCAE version 4.03 Grade 2 or more,
* atrial fibrillation of any grade,
* coronary/peripheral artery bypass graft,
* symptomatic congestive heart failure according to New York Heart Association (NYHA) Class III or Class IV,
* significant active cardiac disease including uncontrolled high blood pressure defined as systolic ≥150 and diastolic ≥100.
* cerebrovascular accident including transient ischemic attack
* thromboembolic events like symptomatic pulmonary embolism.
* Nasopharynx and sino-nasal tumor.
* Surgery or investigational drugs or chemotherapy or other anticancer therapy within 3 weeks before cohort allocationor or for investigational drugs, within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter. Participant must have recovered from any surgical procedure. Curative radiation therapy (60-70 Gy) within 6 weeks of cohort allocation. Palliative radiation therapy (e.g. 8 Gy on a painful lesion) will be allowed.
* Known untreated and uncontrolled brain metastases or leptomeningeal carcinomatosis.
* Known diagnosis of immune deficiency or a positive serology of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
* Active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA \[qualitative\] is detected) or pre-existing liver cirrhosis.
* Known pre-existing interstitial lung disease (ILD). Bronchoemphysema is not considered as ILD.
* Other uncontrolled active illnesses or nonmalignant systemic disease (examples include, but are not limited to active infections requiring antibiotics, bleeding disorders, uncontrolled diabetes, uncontrolled ventricular arrhythmia, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome …).
* Any psychiatric, psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
* Any malignancy (other than SCCHN, non-melanoma skin cancer or localized cervical cancer or localized and presumed cured prostatic cancer or basal cell carcinoma of the skin and carcinoma in situ of the cervix or bladder) within the last 3 years prior to treatment allocation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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European Organisation for Research and Treatment of Cancer - EORTC

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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CHU Saint-Pierre-Site Porte de Hal

Brussels, , Belgium

Site Status

Cliniques Universitaires Saint-Luc

Brussels, , Belgium

Site Status

Hopitaux Universitaires Bordet-Erasme - Institut Jules Bordet

Brussels, , Belgium

Site Status

Grand Hopital de Charleroi - Grand Hôpital de Charleroi - Site Notre Dame

Charleroi, , Belgium

Site Status

Universitair Ziekenhuis Antwerpen

Edegem, , Belgium

Site Status

Universitair Ziekenhuis Gent

Ghent, , Belgium

Site Status

Hopital De Jolimont

Haine-Saint-Paul, , Belgium

Site Status

AZ Groeninge Kortrijk - Campus Kennedylaan

Kortrijk, , Belgium

Site Status

U.Z. Leuven - Campus Gasthuisberg

Leuven, , Belgium

Site Status

U.Z. Leuven - Campus Gasthuisberg

Leuven, , Belgium

Site Status

GasthuisZusters Antwerpen - Sint-Augustinus

Wilrijk, , Belgium

Site Status

CHU Dinant Godinne - UCL Namur

Yvoir, , Belgium

Site Status

CHU de Bordeaux - Groupe Hospitalier Saint-André - Hopital Saint-Andre

Bordeaux, , France

Site Status

Centre Georges-Francois-Leclerc

Dijon, , France

Site Status

Centre Oscar Lambret

Lille, , France

Site Status

Institut de Cancerologie de l'Ouest (ICO) - Centre Rene Gauducheau

Nantes, , France

Site Status

Centre Antoine Lacassagne

Nice, , France

Site Status

Institut Curie

Paris, , France

Site Status

Institut de Cancerologie Strasbourg Europe

Strasbourg, , France

Site Status

Institut de Cancérologie de Lorraine

Vandœuvre-lès-Nancy, , France

Site Status

Gustave Roussy

Villejuif, , France

Site Status

Azienda Ospedaliero-Universitaria Careggi

Florence, , Italy

Site Status

Azienda Ospedaliero-Universitaria Careggi

Florence, , Italy

Site Status

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, , Italy

Site Status

IRCCS - Fondazione G. Pascale

Napoli, , Italy

Site Status

Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"

Napoli, , Italy

Site Status

ICO L'Hospitalet - Hospital Duran i Reynals (Institut Catala D'Oncologia)

Barcelona, , Spain

Site Status

Hospital Universitario 12 De Octubre

Madrid, , Spain

Site Status

Hospital Clinico Universitario De Valencia

Valencia, , Spain

Site Status

University Hospitals Birmingham NHS Foundation Trust (UHB) - UHB-Queen Elisabeth Medical Centre

Birmingham, , United Kingdom

Site Status

NHS Lothian - Western General Hospital

Edinburgh, , United Kingdom

Site Status

NHS Lothian - Western General Hospital

Edinburgh, , United Kingdom

Site Status

NHS Greater Glasgow and Clyde - Beatson West of Scotland Cancer Centre - Gartnavel General Hospital

Glasgow, , United Kingdom

Site Status

Guy's and St Thomas' NHS - Guy s and St Thomas' NHS - Guy's Hospital

London, , United Kingdom

Site Status

Oxford University Hospitals NHS Trust - Churchill Hospital

Oxford, , United Kingdom

Site Status

Sheffield Teaching Hospitals NHS Foundation Trust - Weston Park Hospital

Sheffield, , United Kingdom

Site Status

Countries

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Belgium France Italy Spain United Kingdom

References

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Galot R, Le Tourneau C, Guigay J, Licitra L, Tinhofer I, Kong A, Caballero C, Fortpied C, Bogaerts J, Govaerts AS, Staelens D, Raveloarivahy T, Rodegher L, Laes JF, Saada-Bouzid E, Machiels JP. Personalized biomarker-based treatment strategy for patients with squamous cell carcinoma of the head and neck: EORTC position and approach. Ann Oncol. 2018 Dec 1;29(12):2313-2327. doi: 10.1093/annonc/mdy452.

Reference Type DERIVED
PMID: 30307465 (View on PubMed)

Other Identifiers

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2017-000086-74

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

EORTC-1559-HNCG

Identifier Type: -

Identifier Source: org_study_id

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