Pembrolizumab Plus Epacadostat, Pembrolizumab Monotherapy, and the EXTREME Regimen in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma (KEYNOTE-669/ECHO-304)

January 17, 2024 updated by: Incyte Corporation

A Phase 3 Randomized, Open-Label Clinical Study to Evaluate the Efficacy and Safety of Pembrolizumab Plus Epacadostat, Pembrolizumab Monotherapy, and the EXTREME Regimen as First Line Treatment for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma (KEYNOTE-669/ECHO-304)

The purpose of this study was to evaluate the efficacy and safety of pembrolizumab plus epacadostat, pembrolizumab monotherapy, and the EXTREME regimen (cetuximab + cisplatin or carboplatin + 5-fluorouracil) as first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC).

Study Overview

Study Type

Interventional

Enrollment (Actual)

89

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New South Wales
      • Camperdown, New South Wales, Australia, 2050
        • Chris Obrien Lifehouse
      • North Ryde, New South Wales, Australia, 2109
        • Macquarie University Hospital
    • Queensland
      • Herston, Queensland, Australia, 4029
        • Royal Brisbane & Women s Hospital
      • Salzburg, Austria, 5020
        • Landeskrankenhaus Salzburg
      • Wien, Austria, 1090
        • Allgemeines Krankenhaus der Stadt Wien
      • Quebec, Canada, G1R 3S1
        • CHU de Quebec-Universite Laval-Hotel Dieu de Quebec
    • Ontario
      • Hamilton, Ontario, Canada, L8V 5C2
        • Juravinski Cancer Center Hamilton Health Sciences
      • Toronto, Ontario, Canada, M5G 2M9
        • Princess Margaret Cancer Centre
    • Quebec
      • Montreal, Quebec, Canada, H3T 1E2
        • Jewish General Hospital
      • Miskolc, Hungary, 3526
        • Borsod-Abauj-Zemplen Megyei Korhaz es Egyetemi Oktato Korhaz
      • Szolnok, Hungary, 5000
        • Jasz Nagykun Szolnok Megyei Hetenyi Geza Korhaz Rendelointezet
      • Milano, Italy, 20141
        • Istituto Europeo Di Oncologia
      • Rozzano, Italy, 20089
        • Irrcs Instituto Clinico Humanitas
      • Akashi, Japan, 673-8558
        • Hyogo Cancer Center
      • Fukuoka, Japan, 812-8582
        • Kyushu University Hospital
      • Hiroshima, Japan, 734-8551
        • Hiroshima University Hospital
      • Hokkaido, Japan, 060-8648
        • Hokkaido University Hospital
      • Kobe, Japan, 650-0047
        • Kobe City Medical Center General Hospital
      • Osakasayama City, Japan, 589-8511
        • Kindai University Hospital
      • Saitama, Japan, 362-0806
        • Saitama Cancer Center
      • Shizuoka, Japan, 411-8777
        • Shizuoka Cancer Center Hospital and Research Institute
      • Tokyo, Japan, 135-8550
        • The Cancer Institute Hospital of JFCR
    • Chiba
      • Kashiwa, Chiba, Japan, 277-8577
        • National Cancer Center Hospital East
    • Ishikawa
      • Kanazawa, Ishikawa, Japan, 920-8641
        • Kanazawa University Hospital
    • Kanagawa
      • Yokohama, Kanagawa, Japan, 241-8515
        • Kanagawa Cancer Center
    • Miyagi
      • Natori, Miyagi, Japan, 981-1293
        • Miyagi Cancer Center
      • Sendai, Miyagi, Japan, 980-8574
        • Tohoku University Hospital
      • Seoul, Korea, Republic of, 03080
        • Seoul National University Hospital
      • Seoul, Korea, Republic of, 05505
        • Asan Medical Center
      • Seoul, Korea, Republic of, 03722
        • Severance Hospital Yonsei University Health System
      • Konin, Poland, 62-500
        • Przychodnia Lekarska KOMED
      • Szczecin, Poland, 71-730
        • Zachodniopomorskie Centrum Onkologii
    • Mazowieckie
      • Wieliszew, Mazowieckie, Poland, 05-135
        • Mazowiecki Szpital Onkologiczny
      • Coimbra, Portugal, 3000-075
        • Inst. Portugues de Oncologia de Coimbra Frencisco Gentil EPE
      • Lisboa, Portugal, 1649-035
        • Centro Hospitalar Lisboa Norte EPE - Hospital de Santa Maria
      • Lisboa, Portugal, 1099-023
        • Inst. Portugues de Oncologia de Lisboa Francisco Gentil EPE
      • Porto, Portugal, 4200-072
        • Inst. Portugues de Oncologia de Porto Francisco Gentil EPE
      • Badalona, Spain, 08916
        • Hospital Germans Trias i Pujol. ICO de Badalona
      • Barcelona, Spain, 08035
        • Hospital General Universitari Vall D Hebron
      • Madrid, Spain, 28041
        • Hospital Universitario 12 De Octubre
      • Madrid, Spain, 28034
        • Hospital Ramón y Cajal
      • Madrid, Spain, 28981
        • Hospital Infanta Cristina
      • Sevilla, Spain, 41014
        • Hospital de Nuestra Senora de Valme
      • Zaragoza, Spain, 50009
        • Hospital Clinico Lozano Blesa
      • Tainan, Taiwan, 70457
        • National Cheng Kung University Hospital
      • Taipei, Taiwan, 10048
        • National Taiwan University Hospital
      • Taoyuan, Taiwan, 33305
        • Chang Gung Medical Foundation. Linkou
      • Adana, Turkey, 01370
        • Adana Sehir Hastanesi
      • Ankara, Turkey, 06100
        • Hacettepe Universitesi Tip Fakultesi Hastanesi
      • Edirne, Turkey, 22030
        • Trakya Universitesi Tip Fakultesi
      • Istanbul, Turkey, 34093
        • Istanbul Universitesi Onkoloji Enstitusu
      • Istanbul, Turkey, 34214
        • Medipol Hastanesi
      • Izmir, Turkey, 35040
        • Ege Universitesi Tip Fakultesi Hastanesi
      • Malatya, Turkey, 44280
        • Inonu Universitesi Turgut Ozal Tip Merkezi
      • London, United Kingdom, N18 1QX
        • North Middlesex Hospital
      • London, United Kingdom, NW1 2PG
        • University College London Hospitals (UCLH)
      • London, United Kingdom, SW3 6JJ
        • The Royal Marsden Foundation Trust
      • London, United Kingdom, SW3 6JJ
        • The Royal Marsden Nhs Foundation Trust - Chelsea
      • Taunton, United Kingdom, TA1 5DA
        • Musgrove Park Hospital
    • California
      • Anaheim, California, United States, 19026
        • Pacific Cancer Medical Center
      • Sacramento, California, United States, 95817
        • UC Davis Comprehensive Cancer Center
      • Santa Rosa, California, United States, 95403
        • St. Joseph Heritage Healthcare
    • Colorado
      • Aurora, Colorado, United States, 80045
        • University of Colorado Cancer Center
    • Connecticut
      • New Haven, Connecticut, United States, 06520
        • Yale Cancer Center
    • Georgia
      • Douglasville, Georgia, United States, 30134
        • Northwest Georgia Oncology Centers PC
    • Kansas
      • Westwood, Kansas, United States, 66205
        • U of Kansas Cancer Center
    • Kentucky
      • Louisville, Kentucky, United States, 40223
        • Baptist Health
    • Montana
      • Billings, Montana, United States, 59102
        • St. Vincent Healthcare Cancer Ctr
    • New Mexico
      • Albuquerque, New Mexico, United States, 87106
        • New Mexico Cancer Care Alliance
    • Oklahoma
      • Tulsa, Oklahoma, United States, 74146
        • Oklahoma Cancer Specialists and Research
    • Oregon
      • Portland, Oregon, United States, 97213
        • Providence Portland Med Center
    • Utah
      • Salt Lake City, Utah, United States, 19026
        • Huntsman Cancer Institute Univ of Utah
    • Washington
      • Seattle, Washington, United States, 98101
        • Viginia Mason Med Ctr

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Measurable disease based on RECIST v1.1.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Adequate organ function per protocol-defined criteria.
  • Documentation of results from testing of human papilloma virus (HPV) status for oropharyngeal cancer.
  • Baseline archival tumor specimen available or willing to undergo a prestudy treatment tumor core or excisional biopsy of a tumor lesion not previously irradiated, to obtain the specimen.

Exclusion Criteria:

  • Carcinoma of the nasopharynx, salivary gland, unknown primary origin, or nonsquamous histologies as primary tumors.
  • Disease progression within 6 months of completion of curatively intended systemic treatment for locoregionally advanced HNSCC.
  • Use of protocol-defined prior/concomitant therapy.
  • Known additional malignancy that is progressing or has required active treatment within the past 3 years.
  • Known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  • Active autoimmune disease that has required systemic treatment in past 2 years.
  • Known history of human immunodeficiency virus (HIV) infection. HIV testing is not required unless mandated by local health authority.
  • Known history of or is positive for active hepatitis B (defined as hepatitis B surface antigen [HBsAg] reactive) or hepatitis C (defined as HCV RNA [qualitative] is detected).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Pembrolizumab
Pembrolizumab administered intravenously every 3 weeks.
Other Names:
  • MK-3475
Experimental: Pembrolizumab + Epacadostat
Pembrolizumab administered intravenously every 3 weeks.
Other Names:
  • MK-3475
Epacadostat administered orally twice daily.
Other Names:
  • INCB024360
Active Comparator: EXTREME
EXTREME regimen includes cetuximab + cisplatin or carboplatin + 5-fluorouracil.
Cetuximab administered intravenously on Cycle 1 Day 1 followed by administration every week.
Cisplatin administered intravenously every 3 weeks for
Carboplatin administered intravenously every 3 weeks for
5-Fluorouracil administered intravenously every 3 weeks for

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Objective Response Rate (ORR) of Pembrolizumab + Epacadostat, Pembrolizumab Monotherapy and the EXTREME Regimen
Time Frame: Minimum Week 9

ORR was defined as the percentage of participants who had a complete response (CR), disappearance of all target lesions or partial response (PR), >=30% decrease in the sum of the longest diameter of target lesions per RECIST v1.1 by investigator determination.

Responses are based on investigator assessments per RECIST 1.1 without confirmation using all available scans.

Minimum Week 9

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety and Tolerability of Pembrolizumab + Epacadostat Versus Pembrolizumab Versus the EXTREME Regimen as Measured by Number of Participants Experiencing Adverse Events (AEs)
Time Frame: Up to 14 months

AE is defined as any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment.

Data reported from start of study to data cutoff 17 Jan 2019, up to 14 months.

Up to 14 months
Safety and Tolerability of Pembrolizumab + Epacadostat Versus Pembrolizumab Versus the EXTREME Regimen as Measured by Number of Participants Discontinuing Study Treatment Due to AEs
Time Frame: Up to 14 months

AE is defined as any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment.

Data reported from start of study to data cutoff 17 Jan 2019, up to 14 months.

Up to 14 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Study Director: Mark Jones, MD, Incyte Corporation

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2017

Primary Completion (Actual)

July 19, 2018

Study Completion (Estimated)

December 27, 2024

Study Registration Dates

First Submitted

November 27, 2017

First Submitted That Met QC Criteria

November 27, 2017

First Posted (Actual)

November 30, 2017

Study Record Updates

Last Update Posted (Actual)

January 22, 2024

Last Update Submitted That Met QC Criteria

January 17, 2024

Last Verified

January 1, 2024

More Information

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.

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