- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02938273
Bioimmunoradiotherapy (Cetuximab/RT/Avelumab)
Bioimmunoradiotherapy (BIR) With Concurrent Avelumab, Cetuximab and Radiotherapy as First Line Treatment in Patients With Locally Advanced Squamous Cell Carcinoma of the Head and Neck. A Feasibility Study in Patients Unfit for Cisplatin
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
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Amsterdam, Netherlands, 1066CX
- Antoni van Leeuwenhoek
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Be willing and able to provide written informed consent for the trial.
- Be ≥18 years of age on day of signing informed consent.
- WHO Performance Status 0,1 or 2
- Have histologically confirmed Locally Advanced (i.e. stage III or IV) head and neck squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx and larynx.
- Unfit for concurrent chemoradiation with cisplatin, e.g. GFR < 60 ml/min, cardiovascular co-morbidity, hearing loss or polyneuropathy or written refusal for treatment with chemotherapy
- Be willing to provide tissue for tumor microenvironment analysis from archival tumor material (i.e. formalin fixed, paraffin embedded (FFPE) tumor tissue block not older than 42 days before start of treatment) or newly obtained core or excisional biopsy, and willingness to provide a core or excisional biopsy at day 14 (±2 days) after start of treatment.
- Have at least one measurable lesion as defined by RECIST 1.1.
- Be willing and able to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures.
Demonstrate adequate organ function, i.e. adequate bone marrow function, including:
- Absolute Neutrophil Count (ANC) ≥1.5 x 109/L;
- Platelets ≥100 x 109/L;
- Hemoglobin ≥6 mmol/L. Adequate renal function, i.e. estimated creatinine clearance ≥30 mL/min as calculated using the Cockcroft-Gault (CG) equation (or local institutional standard method).
Adequate liver function, including:
- Total serum bilirubin ≤1.5 x ULN;
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN or AST and ALT levels ≤ 5 x ULN (for subjects with documented metastatic disease to the liver).
- Have a negative serum pregnancy test at screening (for females of childbearing potential).
- Both male and female subjects should agree to use highly effective contraception if the risk of conception exists. (Note: The effects of the trial drug on the developing human fetus are unknown; thus, women of childbearing potential and men able to father a child must agree to use 2 highly effective contraception, defined as methods with a failure rate of less than 1 % per year.) Highly effective contraception is required throughout the study and for at least 120 days after Avelumab treatment.
Exclusion Criteria:
- Prior treatment with: Systemic therapy, radiotherapy or surgery directed at locally advanced SCCHN. Immunotherapy with IL-2, IFN-α, or anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab), or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways.
- A diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
Current or prior use of immunosuppressive medication within 7 days prior to registration, except the following:
- Intranasal, inhaled, topical steroids, or local steroid injections (e.g. intra-articular injection);
- Systemic corticosteroids at physiologic doses ≤10 mg/day of prednisone or equivalent;
- Steroids as premedication for hypersensitivity reactions (eg, CT scan premedication).
- Known severe hypersensitivity reactions to monoclonal antibodies (Grade ≥3), any history of anaphylaxis, or uncontrolled asthma (i.e., 3 or more features of partially controlled asthma Global Initiative for Asthma 2011.
- Known prior or suspected hypersensitivity to study drugs or any component in their formulations.
- Diagnosis of any other malignancy within 5 years prior to start of treatment except for adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or of the cervix, or low-grade (Gleason 6 or below) prostate cancer on surveillance with no plans for treatment intervention (e.g. surgery, radiation, or castration).
Significant acute or chronic infections including, among others:
- Known history of testing positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
- Positive test for HBV surface antigen and / or confirmatory HCV RNA (if anti-HCV antibody tested positive)
- Prior organ transplantation, including allogeneic stem cell transplantation
Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent, except the following:
- Subjects with diabetes type I, vitiligo, psoriasis, hypo- or hyperthyroid disease not requiring immunosuppressive treatment
- Subjects requiring hormone replacement with corticosteroids if the steroids are administered only for the purpose of hormonal replacement and at doses ≤ 10 mg or 10 mg equivalent prednisone per day
- Administration of steroids through a route known to result in a minimal systemic exposure (topical, intranasal, intro-ocular, or inhalation)
- Persisting toxicity related to prior therapy of Grade >1; however, alopecia and sensory neuropathy Grade ≤ 2 is acceptable
- Pregnancy or lactation
- Known alcohol or drug abuse
- All other significant diseases (for example, inflammatory bowel disease, uncontrolled asthma), which, in the opinion of the Investigator, might impair the subject's tolerance of trial treatment
- Any psychiatric condition that would prohibit the understanding or rendering of informed consent
- Vaccination within 4 weeks of the first dose of avelumab and while on trial is prohibited except for administration of inactivated vaccines (for example, inactivated influenza vaccines).
- Any of the following in the previous 6 months: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident, transient ischemic attack, deep vein thrombosis or symptomatic pulmonary embolism.
- Subjects with brain metastases
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Bioimmunoradiotherapy
Concurrent Radiation therapy (i.e. 5 times a week, 7 weeks, total dose 70 Gy) with cetuximab (loading dose 400 mg/m2 i.v.
day -7, 250 mg/m2 i.v weekly wk 1-7) and Avelumab10 mg/kg i.v. at day -7, 7, 21,35 + maintenance therapy i.e avelumab10 mg/kg i.v.
every 2 weeks for 6 months (wk 8,10, 12, 14, 16, 18, 20, 22, 24, 26.
|
Avelumab10 mg/kg i.v. at day -7, 7, 21,35 + maintenance therapy i.e avelumab10 mg/kg i.v.
every 2 weeks for 6 months
Other Names:
5 times a week, 7 weeks, total dose 70 Gy
loading dose 400 mg/m2 i.v.
day -7, 250 mg/m2 i.v weekly wk 1-7
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
occurence of grade 3-5 toxicity in new combination
Time Frame: 6 months after start of treatment
|
according to CTC 4.03
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6 months after start of treatment
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Overall Response Rate
Time Frame: at week 10 and week 26 of treatment
|
at week 10 and week 26 of treatment
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
differences in tumor microenvironment
Time Frame: prior to treatment and at day 14
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investigate therapy induced changes in tumor microenvironment in tissue biopsies through immunochemistry
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prior to treatment and at day 14
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Jan Paul de Boer, MD, PhD, The Netherlands Cancer Institute
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- N16BIR
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Carcinoma, Squamous Cell of Head and Neck
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Washington University School of MedicineMerck Sharp & Dohme LLCActive, not recruitingHead and Neck Cancer | Squamous Cell Carcinoma of the Head and Neck | Cancer of Head and Neck | Carcinoma, Squamous Cell of Head and Neck | Neoplasms, Head and Neck | Squamous Cell Carcinoma, Head and NeckUnited States
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Bristol-Myers SquibbActive, not recruitingSquamous Cell Carcinoma of the Head and Neck; Head and Neck Cancer; Head and Neck Carcinoma; Cancer of the Head and NeckFrance
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Washington University School of MedicineCelgene CorporationActive, not recruitingHead and Neck Cancer | Squamous Cell Carcinoma of the Head and Neck | Cancer of Head and Neck | Neoplasms, Head and Neck | Cancer of the Head and Neck | Carcinoma, Squamous Cell of the Head and NeckUnited States
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)RecruitingRecurrent Head and Neck Squamous Cell Carcinoma | Advanced Head and Neck Squamous Cell Carcinoma | Metastatic Head-and-neck Squamous-cell Carcinoma | Locally Advanced Head and Neck Squamous Cell Carcinoma | Stage III Cutaneous Squamous Cell Carcinoma of the Head and Neck | Stage IV Cutaneous...United States
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University of PittsburghNational Cancer Institute (NCI)TerminatedSquamous Cell Carcinoma of the Head and Neck | Squamous Cell Carcinoma, Head And Neck | Carcinoma, Squamous Cell of Head and NeckUnited States
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National Cancer Institute (NCI)Not yet recruitingStage II Squamous Cell Carcinoma of the Head and Neck | Stage III Squamous Cell Carcinoma of the Head and Neck | Stage IV Squamous Cell Carcinoma of the Head and NeckUnited States
-
Eben RosenthalNational Cancer Institute (NCI)CompletedHead and Neck Cancer | Head and Neck Squamous Cell Carcinoma | Squamous Cell Carcinoma of the Head and Neck (SCCHN)United States
-
Case Comprehensive Cancer CenterNot yet recruitingHead and Neck Squamous Cell Carcinoma | Recurrent Squamous Cell Carcinoma of the Head and Neck | Metastatic Squamous Cell CarcinomaUnited States
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Washington University School of MedicineActive, not recruitingSquamous Cell Carcinoma of the Head and Neck | Squamous Cell Carcinoma, Head and NeckUnited States
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Arnaud Bewley, MDNational Cancer Institute (NCI); Genentech, Inc.TerminatedStage III Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8 | Resectable Cutaneous Squamous Cell Carcinoma of the Head and Neck | Locally Advanced Cutaneous Squamous Cell Carcinoma of the Head and NeckUnited States
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