Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

ImmunoADC Therapy for Induction Conversion in Patients With Stage IVB OSCC/OPSCC

22. september 2026 opdateret af: Lai-ping Zhong, Huashan Hospital

Immunotherapy Combined With ADC (MRG003) for Induction Conversion Therapy to Downstage Primary Stage IVB Oral/Oropharyngeal Squamous Cell Carcinoma:An Exploratory Two-Arm Randomized Controlled Trial (Transforming Trial)

To evaluate the efficacy and safety of Becotatug Vedotin (EGFR-targeted ADC, MRG003) plus Pucotenlimab (PD-1 inhibitor), compared with platinum-based chemotherapy/chemoradiotherapy, as an induction conversion regimen for downstaging primary stage IVB oral squamous cell carcinoma or HPV16-negative oropharyngeal squamous cell carcinoma.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

More than 60% of patients with head and neck squamous cell carcinoma (HNSCC) have locally advanced disease at initial diagnosis, often presenting with a large primary tumor accompanied by marked local invasion and/or regional lymph-node metastasis. In patients with clinical stage IVB oral squamous cell carcinoma (OSCC), tumors frequently invade the masticator space, pterygoid plates, or skull base and/or encase the internal carotid artery; and in patients with clinical stage IVB oropharyngeal squamous cell carcinoma (OPSCC), tumors frequently invade the lateral pterygoid muscle, pterygoid plates, lateral nasopharyngeal wall, or skull base, or encase the carotid artery. Because of extensive infiltration and involvement of critical anatomical structures, radical surgery faces two major challenges in this population: firstly, R0 resection is difficult to achieve, resulting in rapid postoperative recurrence; secondly, radical surgery inevitably causes disfiguring tissue defects and severe functional loss, leading to extremely poor quality of life. The 1- to 2-year overall survival rate for these patients ranges from 22% to 35%.

For the patients with unresectable primary stage IVB OSCC or human papillomavirus (HPV)-negative OPSCC, current standard treatment consists of platinum-based concurrent chemoradiotherapy or radiotherapy following platinum-based induction chemotherapy. Although these regimens are widely used, their efficacy remains unsatisfactory. In recent years, additional approaches have been developed and evaluated, including monoclonal antibodies targeting epidermal growth factor receptor (EGFR), novel radiotherapy fractionation schedules, and induction or neoadjuvant chemotherapy regimens; however, none has demonstrated a clear improvement over standard concurrent chemoradiotherapy. Standard concurrent chemoradiotherapy may also cause toxicities such as late-onset dysphagia and severe xerostomia. Accordingly, developing new therapeutic strategies to improve outcomes in this population has become a major focus in the field of HNSCC.

Neoadjuvant therapy refers to antitumor treatment administered before surgery with the aims of reducing tumor volume, increasing the likelihood of surgical resection, and decreasing the risk of postoperative recurrence; it may therefore improve outcomes in locally advanced malignancies. Given the close interaction between antibody-drug conjugate (ADC) and the host immune system, the combination of these two modalities may theoretically produce synergistic antitumor effects and improve treatment outcomes. Therefore, this prospective, exploratory, two-arm, randomized controlled clinical trial will compare becotatug vedotin, an EGFR-targeted ADC, plus pucotenlimab, an anti-PD-1 monoclonal antibody, with current standard therapy consisting of platinum-based induction chemotherapy or chemoradiotherapy. The investigational regimen is expected to induce deep tumor regression in patients with unresectable primary stage IVB OSCC/OPSCC, achieve tumor downstaging, convert unresectable lesions into lesions amenable to R0 resection, and allow evaluation of efficacy and safety, including potential survival benefits. The study may provide a new therapeutic strategy for patients with stage IVB HNSCC.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

40

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

  • Navn: Ying-ying Huang, MD, PhD
  • Telefonnummer: 7182 +862152889999
  • E-mail: kqyxyhyy@163.com

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Eastern Cooperative Oncology Group (ECOG) performance status: 0-1;
  2. Histopathologically confirmed oral/oropharyngeal squamous cell carcinoma, including tumors of the tongue, gingiva, buccal mucosa, floor of mouth, hard palate, retromolar trigone, base of tongue, soft palate, or parapharyngeal region;
  3. Clinical stage IVB (cT1-4N3M0 or cT4bN0-3M0, AJCC 8th edition);
  4. At least one measurable target lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1;
  5. Complete blood count: white blood cell count >3,000/mm3, hemoglobin >8 g/L, and platelet count >80,000/mm3;
  6. Hepatic function: alanine aminotransferase/aspartate aminotransferase (ALT/AST) <2.5 times the upper limit of normal (ULN), and bilirubin <1.5 times the ULN;
  7. Renal function: serum creatinine <1.5 times the ULN;
  8. Positive PD-L1 expression (combined positive score [CPS] >=1) and positive EGFR expression (immunohistochemistry [IHC] 2+ or 3+);
  9. Written informed consent provided.

Exclusion Criteria:

  1. Unresolved toxicity of grade 2 or higher due to prior anticancer therapy;
  2. Known grade 3-4 hypersensitivity reaction to any study treatment;
  3. Active severe clinical infection (>grade 2 infection according to NCI-CTCAE version 5.0);
  4. Uncontrolled hypertension or active cardiovascular disease, including cerebrovascular accident within 6 months before randomization, myocardial infarction within 6 months before randomization, unstable angina, congestive heart failure of New York Heart Association (NYHA; Appendix 5) class II or higher, or a serious arrhythmia that cannot be controlled with medication or may potentially affect study treatment;
  5. Active autoimmune disease requiring systemic immunomodulatory or corticosteroid therapy for a chronic condition (e.g., disease-modifying drugs, glucocorticoids, or immunosuppressants). Replacement therapy, such as thyroxine, insulin, or physiologic glucocorticoid replacement for adrenal or pituitary insufficiency, is not considered systemic therapy;
  6. History of another malignancy and its treatment;
  7. History of radiotherapy to the maxillofacial and neck region;
  8. HPV-positive oropharyngeal cancer;
  9. Pregnant or breastfeeding women;
  10. Known history of human immunodeficiency virus (HIV) infection, or uncontrolled active hepatitis B, defined as hepatitis B surface antigen (HBsAg) positivity together with a detectable hepatitis B virus DNA (HBV-DNA) copy number above the upper limit of normal of the local laboratory at the study center;
  11. Participation in another clinical study within 30 days before enrollment;
  12. Any other condition that, in the investigator's judgment, makes the participant unsuitable for the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Experimental Arm

Combination therapy of immunotherapy and antibody-drug conjugate. Drugs: Becotatug vedotin: 2.3 mg/kg by intravenous infusion once every 21 days. Pucotenlimab: 200 mg by intravenous infusion once every 21 days.

Each treatment cycle is 21 days, and two cycles will be administered. On each dosing day, pucotenlimab will be infused first, followed by becotatug vedotin.

2.3 mg/kg by intravenous infusion once every 21 days

200 mg by intravenous infusion once every 21 days

Aktiv komparator: Control Arm

Participants in the control arm will undergo MDT assessment by the investigators and receive a platinum-based induction chemotherapy regimen. Cisplatin: 75mg/m2 by intravenous infusion once every 21 days. Each treatment cycle is 21 days, and two cycles will be administered. All required assessments must be completed within 3 days before dosing. Treatment may continue only after the safety evaluation is satisfactory.

75mg/m2 by intravenous infusion once every 21 days

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Clinical downstaging rate
Tidsramme: 6 months

The ratio of patients could achieve clinical downstaging after two cycles of drug treatment according to the AJCC 8th edition.

6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Rate of 2-year overall survival
Tidsramme: 2 years

Overall survival is calculated from the date of randomization to death. The rate of 2-year overall survival is reported as the percentage of patients who are overall survival for 2 years from the date of randomization.

2 years
Surgical R0 resection rate
Tidsramme: 6 months

The ratio of R0 resection, complete removal of all grossly visible tumor with no residual tumor cells at the microscopic resection margins, i.e., microscopically negative margins.

6 months
Rate of 2-year progression free survival
Tidsramme: 2 years

Progression free survival is calculated from the date of randomization to local tumor recurrence or progression, locoregional recurrence or progression, distant metastasis, or death. The rate of 2-year progression free survival is reported as the percentage of patients who are progression free survival for 2 years from the date of randomization.

2 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Lai-ping Zhong, Huashan Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

20. oktober 2026

Primær færdiggørelse (Anslået)

30. oktober 2028

Studieafslutning (Anslået)

30. december 2030

Datoer for studieregistrering

Først indsendt

22. september 2026

Først indsendt, der opfyldte QC-kriterier

22. september 2026

Først opslået (Faktiske)

28. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

28. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

22. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Transforming

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

After the completion of the trial.

IPD-delingstidsramme

2 years after completion of the trial, for 6 months.

IPD-delingsadgangskriterier

Access to IPD data can be obtained upon scientifically sound request from the study PI, who will contact the Clinical Research Unit, Huashan Hospital, Fudan University. Access will be released after the approval from the Clinical Research Unit.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .