Nivolumab Plus Epacadostat in Combination With Chemotherapy Versus the EXTREME Regimen in Squamous Cell Carcinoma of the Head and Neck (CheckMate 9NA/ECHO-310)
A Randomized, Global, Phase 3 Trial of Nivolumab Plus Epacadostat in Combination With Chemotherapy (Platinum + 5-fluorouracil) Versus the EXTREME Regimen (Cetuximab + Platinum + 5-fluorouracil) in First-line Treatment of Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN) / CheckMate 9NA /ECHO-310
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Phase
Phase
- Phase 3
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically confirmed SCCHN from any of the following primary sites: oral cavity, oropharynx, hypopharynx, and larynx.
- Must have recurrent or metastatic disease that is not amenable to therapy with curative intent (surgery and/or radiation therapy with or without chemotherapy).
- No prior treatment with systemic anti-cancer therapy for SCCHN unless protocol-defined conditions are met.
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to1.
- Measurable disease by computed tomography (CT) or magnetic resonance imaging (MRI) per RECIST v1.1.
- Documentation of program death ligand-1 (PD-L1) status prior to randomization.
Exclusion Criteria:
- Recurrent or metastatic carcinoma of the nasopharynx and paranasal sinuses, squamous cell carcinoma that originated from the skin and salivary gland or non-squamous histologies (e.g., mucosal melanoma) and SCCHN of unknown primary origin.
- Untreated central nervous system (CNS) metastases.
- Carcinomatous meningitis.
- Active, known or suspected autoimmune disease.
- Physical and laboratory test findings outside the protocol-defined range.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm A
Nivolumab plus epacadostat in combination with platinum (carboplatin/cisplatin) plus 5-fluorouracil.
|
Nivolumab administered intravenously at the protocol-defined dose every 3 weeks.
Epacadostat administered orally at the protocol-defined dose twice daily.
Other Names:
Carboplatin administered intravenously at the protocol-defined dose every 3 weeks for 6 cycles.
Cisplatin administered intravenously at the protocol-defined dose every 3 weeks for 6 cycles.
5-Fluorouracil administered intravenously at the protocol-defined dose on Days 1-4 for 6 cycles.
|
|
Active Comparator: Arm B
EXTREME regimen.
|
Carboplatin administered intravenously at the protocol-defined dose every 3 weeks for 6 cycles.
Cisplatin administered intravenously at the protocol-defined dose every 3 weeks for 6 cycles.
5-Fluorouracil administered intravenously at the protocol-defined dose on Days 1-4 for 6 cycles.
Cetuximab administered intravenously at the protocol-defined dose weekly.
|
|
Experimental: Arm C
Nivolumab plus placebo for epacadostat in combination with platinum (carboplatin/cisplatin) plus 5-fluorouracil.
|
Nivolumab administered intravenously at the protocol-defined dose every 3 weeks.
Matching placebo for epacadostat administered orally twice daily.
Carboplatin administered intravenously at the protocol-defined dose every 3 weeks for 6 cycles.
Cisplatin administered intravenously at the protocol-defined dose every 3 weeks for 6 cycles.
5-Fluorouracil administered intravenously at the protocol-defined dose on Days 1-4 for 6 cycles.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-free survival (PFS) with nivolumab plus epacadostat in combination with chemotherapy (Arm A) compared to the EXTREME regimen (Arm B)
Time Frame: Up to approximately 35 months
|
Defined as the time between the date of randomization and the date of first documented disease progression (per Response Evaluation Criteria in Solid Tumors version 1.1 [RECIST v1.1]) or death due to any cause, whichever occurs first.
|
Up to approximately 35 months
|
|
Overall survival (OS) with nivolumab plus epacadostat in combination with chemotherapy (Arm A) compared to the EXTREME regimen (Arm B)
Time Frame: Up to approximately 48 months
|
Defined as the time between the date of randomization and the date of death.
|
Up to approximately 48 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective response rate (ORR) with nivolumab plus epacadostat in combination with chemotherapy (Arm A) and the EXTREME regimen (Arm B)
Time Frame: Up to approximately 35 months
|
Defined as the number of participants with a best overall response of complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
|
Up to approximately 35 months
|
|
Duration of response (DOR) with nivolumab plus epacadostat in combination with chemotherapy (Arm A) and the EXTREME regimen (Arm B)
Time Frame: Up to approximately 35 months
|
Defined as the time between the date of first documented response (CR or PR per RECIST v1.1) to the date of the first disease progression (per RECIST v1.1) or death due to any cause, whichever occurs first.
|
Up to approximately 35 months
|
|
ORR with nivolumab plus placebo in combination with chemotherapy (Arm C)
Time Frame: Up to approximately 35 months
|
Defined as the number of participants with a best overall response of complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
|
Up to approximately 35 months
|
|
PFS with nivolumab plus placebo in combination with chemotherapy (Arm C)
Time Frame: Up to approximately 35 months
|
Defined as the time between the date of randomization and the date of first documented disease progression (per RECIST v1.1) or death due to any cause, whichever occurs first.
|
Up to approximately 35 months
|
|
DOR with nivolumab plus placebo in combination with chemotherapy (Arm C)
Time Frame: Up to approximately 35 months
|
Defined as the time between the date of first documented response (CR or PR per RECIST v1.1) to the date of the first disease progression (per RECIST v1.1) or death due to any cause, whichever occurs first.
|
Up to approximately 35 months
|
|
Time to meaningful symptomatic deterioration (TTSD) with nivolumab plus epacadostat in combination with chemotherapy (Arm A) compared to the EXTREME regimen (Arm B)
Time Frame: Up to approximately 60 months
|
TTSD assessed by the 10-item Functional Assessment of Cancer Therapy-Head & Neck (FACT-HN) Symptom Index (FHNSI-10).
|
Up to approximately 60 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Vinny Hayreh, MD, Bristol-Myers Squibb Research and Development
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Head and Neck Neoplasms
- Neoplasms, Squamous Cell
- Carcinoma
- Carcinoma, Squamous Cell
- Squamous Cell Carcinoma of Head and Neck
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Carboplatin
- Fluorouracil
- Nivolumab
- Cetuximab
Other Study ID Numbers
Other Study ID Numbers
- CA2099NA/ECHO-310
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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