Combining Neo-adjuvant ATR-inhibition With Nodal SBRT for Early-stage Resectable HPV+ OPSCCs

A Phase Ib/II Study Combining Neo-adjuvant ATR-inhibition With Nodal SBRT for Early-stage Resectable HPV+ OPSCCs

This research study is testing whether a new study drug (called ATRN-119) is safe and effective when combined with a single, highly targeted dose of radiation therapy (called stereotactic body radiation therapy or SBRT) to treat early-stage throat cancer that is caused by HPV.

The goal of this study is to treat cancer effectively while reducing side effects and helping patients maintain a better quality of life over the long term. Researchers hope that this approach will be just as successful-or possibly more successful-than current treatments, which already have high cure rates.

Participants will:

• Take 800mg of ATRN-119 every day for 10 days
• Receive 1 treatment (called a "fraction") of SBRT to the neck on day 3 of ATRN-119 dosing.
• Keep a short diary to track ATRN-119 dosing. The diary will be provided by study team
• Receive standard of care treatment after treatment with ATRN-119 + SBRT including TransOral Robotic Surgery (TORS) to remove the primary tumor with Neck Dissection and adjuvant therapy (if indicated)
• Receive additional safety checkups and tests by researchers during routine visits with their cancer doctor for 2 years after study treatment

Study Overview

• Status: Not yet recruiting
• Conditions: HPV Positive Oropharyngeal Squamous Cell Carcinoma; Squamous Cell Carcinoma; HPV (Human Papillomavirus)-Associated Carcinoma; HPV Associated Cancers; Oropharyngeal HPV Squamous Cell Carcinoma
• Intervention / Treatment: Drug: ATRN-119; Radiation: Stereotactic Body Radiation Therapy (SBRT)

• Study Type: Interventional
• Enrollment (Estimated): 35
• Phase: Phase 2; Phase 1

Contacts and Locations

• Study Contact: Name: Nick Lukens, MD; Phone Number: 215-662-6567; Email: RadOncCRU@PennMedicine.upenn.edu
• Study Contact Backup: Name: Casey Hanna; Phone Number: 215 - 615 - 1611; Email: casey.hanna@pennmedicine.upenn.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 18
• Patients that have been diagnosed with HPV-positive throat cancer (OPSCC) at an early stage (stage I or II), confirmed by a biopsy.
• Patients' blood calcium level is within a safe range
• Patients' blood, kidney, and liver health are strong enough, shown through specific medical test results
• If a participant is female, she must not be pregnant or breastfeeding.
• If a participant is male, he must agree to use highly effective birth control from the start of the study until a short period after the last dose of the study drug.

Exclusion Criteria:

• Patients with late-stage tumors (Stage III or IV)
• If the cancer has already spread to distant parts of the body (M1) when first diagnosed
• Prior advanced head and neck cancer requiring radiation or major surgery
• Patients whose original tumor site cannot be identified
• Patients that have a known additional malignancy that is progressing or requires active treatment
• Patients that had a surgical procedure performed within 7 days prior to first scheduled dose of ATRN-119. This does not include procedures that are used to diagnose or determine extent of study disease (such as biopsies).
• Patients taking medications that strongly affect how the body processes certain drugs (CYP enzymes) at the same time as the study treatment.
• Patients with active infections and/or receiving systemic antibiotics or anti-viral medications.
• Patients with uncontrolled HIV or active hepatitis B or C are usually not eligible. However, those whose infections are well-controlled on treatment for at least a month and meet certain viral load limits can participate
• Current or past diagnosis of leukemia within the past 5 years.
• Patients with a history of non-malignant gastrointestinal (GI) bleeding, gastric stress ulcerations, or peptic ulcer disease within the past 3-months.
• Patient has uncontrolled hypertension at time of enrollment.
• Patients who recently had serious kidney problems or kidney disease.
• Patients cannot have taken another experimental drug within 30 days-or within a period equal to five times that drug's half-life-before starting this study
• Medical illness that, in the opinion of the Investigator, may impact the safety of the patient
• Patients who use recreational drugs or have mental health conditions that might make it hard to follow study visits, based on the doctor's judgment.
• Known hypersensitivity to ATRN-119 or its ingredients
• Patients with serious liver disease or liver problems that could affect how the body processes the study drug
• Patients who are fairly limited in daily activities (ECOG score of 2 or higher)
• Patients with serious other health problems that the doctor thinks could prevent them from completing the study
• Pregnancy or lactation
• Inability to provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment Arm; Patients will take 800mg of ATRN-119 every day for 10 days. On day 3 of dosing, they will return to clinic for 1 fraction of SBRT.	Drug: ATRN-119; ATRN-119 at 800 mg QD (every day) for 10 days; Radiation: Stereotactic Body Radiation Therapy (SBRT); 10 Gy administered to nodal disease (neck) only on day 3 of ATRN-119 dosing

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Phase Ib: Feasibility of a neo-adjuvant approach combining ATRN with SBRT before TORS	This will be judged by whether patients are able to have their planned surgery within 6 weeks after the study treatment, and whether there are no problems during surgery that the study doctor believes were caused by the study treatment.	Within 6 weeks after study treatment
Phase II: Major pathologic response (MPR) rate of radiated nodal disease	Researchers will measure how many patients have a strong treatment response in the affected lymph nodes that were treated with radiation, based on what is seen when the tissue is examined.	Immediately after standard of care primary tumor removal surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Phase II: To assess safety of ATR inhibitor ATRN-119 with nodal SBRT prior to surgery	This will be judged based on whether there are any surgery problems that the study doctor thinks were caused by the earlier treatment, as well as any side effects from the treatment.	From start of study treatment through standard of care 2-year Follow-Up visit
Phase II: Radiographic response rates	This looks at how many patients' tumors shrink or improve based on imaging tests like scans. This is assessed by comparing pre- and post- study treatment MRI (or CT) Neck scans using typical descriptive changes noted by a head and neck specialized radiologist.	Pre-treatment MRI will be taken prior to enrollment as part of standard of care. Post-treatment Research MRI will be completed 1 week before standard of care tumor removal surgery.
Phase II: Type of adjuvant treatment required	Percentage of patients requiring additional radiation therapy +/- chemotherapy after their main treatment as compared to historic controls (e.g. 75% requiring RT, 25% requiring chemotherapy). Additional therapy is determined by the participant's care team as part of their standard of care treatment, so not all patients will receive additional radiation or chemotherapy.	Within 4 months of primary tumor removal surgery
Phase II: Pathologic response of primary tumor and nodal disease	This looks at how strongly the main tumor and the affected lymph nodes respond to treatment. Pathologic response rates will be determined by comparing pre- and post- surgery tumor tissue samples for patients who have enough pre-op tissue to analyze from pathology.	Immediately after primary tumor removal surgery
Phase II: Assessment of Patient Reported quality of life	Patients will be asked to take the M.D. Anderson Head & Neck Symptom Inventory Questionnaire (MDASI-HN) at multiple timepoints throughout the study. The MDASI Head and Neck (MDASI-HN) questionnaire is scored by averaging patient-rated items on a 0-10 scale covering 13 core symptoms, 9 head/neck-specific symptoms, and 6 interference items. Higher scores indicate greater symptom severity and worse interference with daily life.	From enrollment to 24 Month Follow-Up Visit

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Phase II: Relapse-free survival (RFS) at two years	Participants will be checked over a 2-year period to see if their disease comes back. A "relapse" means the disease returns either in the same place, nearby areas, or elsewhere in the body. Any return of the disease must be confirmed with medical testing (like examining tissue under a microscope).	From the completion of treatment, either surgery in those not receiving adjuvant therapy, or completion of all adjuvant therapy and will last for 2 years
Phase II: Measures of activation of anti-tumor immunity in primary tumor and blood	Researchers will study samples taken from each patient's main tumor and blood both before and after treatment given prior to the main therapy. This helps them see how the treatment affects the cancer and the body.	From enrollment to date of primary tumor removal surgery

Collaborators and Investigators

• Sponsor: John Lukens
• Collaborators: Aprea Therapeutics

Study record dates

Study Major Dates

• Study Start (Estimated): May 31, 2026
• Primary Completion (Estimated): May 31, 2030
• Study Completion (Estimated): May 31, 2030

Study Registration Dates

• First Submitted: April 13, 2026
• First Submitted That Met QC Criteria: May 5, 2026
• First Posted (Actual): May 11, 2026

Study Record Updates

• Last Update Posted (Actual): May 11, 2026
• Last Update Submitted That Met QC Criteria: May 5, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Pathologic Processes; Neoplasms; Disease Attributes; Infections; Virus Diseases; Neoplasms by Histologic Type; Neoplasms, Glandular and Epithelial; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; DNA Virus Infections; Carcinoma; Neoplasms, Squamous Cell; Tumor Virus Infections; Pathological Conditions, Signs and Symptoms; Carcinoma, Squamous Cell; Papillomavirus Infections; Investigative Techniques; Therapeutics; Surgical Procedures, Operative; Radiotherapy; Stereotaxic Techniques; Neurosurgical Procedures; Radiosurgery
• Other Study ID Numbers: 859861

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No