Esta página se tradujo automáticamente y no se garantiza la precisión de la traducción. por favor refiérase a versión inglesa para un texto fuente.

Prueba de la adición de BMS-986016 (Relatlimab) a la inmunoterapia habitual después del tratamiento inicial para el cáncer de nasofaringe recurrente o metastásico

5 de noviembre de 2026 actualizado por: National Cancer Institute (NCI)

Un estudio aleatorizado de fase II de nivolumab versus nivolumab y BMS-986016 (Relatlimab) como tratamiento de mantenimiento después del tratamiento de primera línea con platino-gemcitabina-nivolumab para pacientes con carcinoma nasofaríngeo recurrente/metastásico asociado al virus de Epstein-Barr (REMAIN)

This phase II trial tests the addition of BMS-986016 (relatlimab) to the usual immunotherapy after initial treatment for nasopharyngeal cancer that has come back after a period of improvement (recurrent) or that has spread from where it first started (primary site) to other places in the body (metastatic). Relatlimab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. The usual approach of treatment is initial treatment with chemotherapy such as the combination of cisplatin (or carboplatin) and gemcitabine, along with immunotherapy such as nivolumab. After the initial treatment is finished, patients may continue to receive additional immunotherapy. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Gemcitabine is a chemotherapy drug that blocks the cells from making deoxyribonucleic acid (DNA) and may kill cancer cells. Giving BMS-986016 in addition to the usual immunotherapy after initial treatment may extend the time without the tumor cells growing or spreading longer than the usual approach in patients with recurrent or metastatic nasopharyngeal cancer.

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Descripción detallada

PRIMARY OBJECTIVE:

I. To determine if adding BMS-986016 (relatlimab) to nivolumab maintenance therapy shows a signal of improved progression-free survival (PFS) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 in patients who do not progress following treatment with platinum-gemcitabine-nivolumab combination in the first-line treatment of recurrent and/or metastatic nasopharyngeal carcinoma (R/M NPC).

SECONDARY OBJECTIVES:

I. To determine if adding BMS-986016 (relatlimab) to nivolumab maintenance improves overall survival (OS) compared to nivolumab maintenance alone.

II. To compare patterns of failure (local-regional relapse and distant metastasis) between treatment arms.

III. To determine if adding BMS-986016 (relatlimab) to nivolumab maintenance improves objective response, duration of response, and disease control rate compared to nivolumab maintenance alone.

IV. To evaluate the tolerability of nivolumab-BMS-986016 (relatlimab) maintenance and assess and compare toxicity between arms based on the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0) criteria.

V. To evaluate baseline plasma Epstein-Barr virus (EBV) DNA (< 2000 copies/mL versus [vs.] >= 2000 copies/mL) as a prognostic biomarker.

VI. To validate post-induction plasma EBV DNA (detectable [>= 1 copies/mL] vs. undetectable [0 copies/mL]) as a prognostic biomarker.

EXPLORATORY OBJECTIVES:

I. To collect blood and tissue specimens for future translational science studies.

II. To assess post-induction plasma EBV DNA (detectable [>= 1 copies/mL] vs. undetectable [0 copies/mL]) as a predictive biomarker.

OUTLINE:

INDUCTION THERAPY: Patients receive nivolumab intravenously (IV) over 30 minutes on day 1 of each cycle, cisplatin IV or carboplatin IV over 30-60 minutes on day 1 of each cycle and gemcitabine IV over 30 minutes on days 1 and 8 of each cycle. Cycles repeat every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) or magnetic resonance imaging (MRI) and blood sample collection during screening and on study.

MAINTENANCE THERAPY: Patients who do not progress radiologically are randomized to 1 of 2 arms.

ARM I: Patients receive nivolumab IV over 30 minutes. Cycles repeat every 4 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI on study. Patients also undergo positron emission tomography (PET)/CT or bone scan as clinically indicated.

ARM II: Patients receive nivolumab IV over 30 minutes and relatlimab IV over 30-90 minutes. Cycles repeat every 4 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI on study. Patients also undergo PET/CT or bone scan as clinically indicated.

After completion of study treatment, patients are followed up every 4 months for 2 years, every 6 months in years 3-5, and then annually.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

156

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Australia
    • Victoria
      • Melbourne, Victoria, Australia, 3000
        • Reclutamiento
        • Peter MacCallum Cancer Centre
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 61 3 9656 1521
        • Investigador principal:
          • Danny Rischin
  • Canadá
    • Ontario
      • Toronto, Ontario, Canadá, M5G 2M9
        • Reclutamiento
        • University Health Network-Princess Margaret Hospital
        • Contacto:
        • Investigador principal:
          • Enrique Sanz Garcia
  • Estados Unidos
    • California
      • Dublin, California, Estados Unidos, 94568
        • Reclutamiento
        • Kaiser Permanente Dublin
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
        • Investigador principal:
          • Jed A. Katzel
      • Fremont, California, Estados Unidos, 94538
        • Reclutamiento
        • Kaiser Permanente-Fremont
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Fresno, California, Estados Unidos, 93720
        • Reclutamiento
        • Kaiser Permanente-Fresno
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Fresno, California, Estados Unidos, 93720
        • Reclutamiento
        • Kaiser Permanente Fresno Orchard Plaza
        • Investigador principal:
          • Jed A. Katzel
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 833-574-2273
      • Los Angeles, California, Estados Unidos, 90033
        • Reclutamiento
        • USC / Norris Comprehensive Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 323-865-0451
        • Investigador principal:
          • Jacob S. Thomas
      • Los Angeles, California, Estados Unidos, 90020
        • Reclutamiento
        • Keck Medicine of USC Koreatown
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 213-388-0908
        • Investigador principal:
          • Jacob S. Thomas
      • Los Angeles, California, Estados Unidos, 90033
        • Reclutamiento
        • Los Angeles General Medical Center
        • Investigador principal:
          • Jacob S. Thomas
        • Contacto:
      • Modesto, California, Estados Unidos, 95356
        • Reclutamiento
        • Kaiser Permanente-Modesto
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Modesto, California, Estados Unidos, 95356
        • Reclutamiento
        • Kaiser Permanente- Modesto MOB II
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
        • Investigador principal:
          • Jed A. Katzel
      • Newport Beach, California, Estados Unidos, 92663
        • Reclutamiento
        • USC Norris Oncology/Hematology-Newport Beach
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 323-865-0451
        • Investigador principal:
          • Jacob S. Thomas
      • Oakland, California, Estados Unidos, 94611
        • Reclutamiento
        • Kaiser Permanente-Oakland
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Palo Alto, California, Estados Unidos, 94304
        • Reclutamiento
        • Stanford Cancer Institute Palo Alto
        • Investigador principal:
          • Alexander D. Colevas
        • Contacto:
      • Roseville, California, Estados Unidos, 95661
        • Reclutamiento
        • Kaiser Permanente-Roseville
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Sacramento, California, Estados Unidos, 95817
        • Reclutamiento
        • University of California Davis Comprehensive Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 916-734-3089
        • Investigador principal:
          • Siao-Yi Wang
      • Sacramento, California, Estados Unidos, 95814
        • Reclutamiento
        • Kaiser Permanente Downtown Commons
        • Investigador principal:
          • Jed A. Katzel
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: kpoct@kp.org
      • Sacramento, California, Estados Unidos, 95823
        • Reclutamiento
        • Kaiser Permanente-South Sacramento
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • San Francisco, California, Estados Unidos, 94115
        • Reclutamiento
        • Kaiser Permanente-San Francisco
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • San Jose, California, Estados Unidos, 95119
        • Reclutamiento
        • Kaiser Permanente-Santa Teresa-San Jose
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • San Leandro, California, Estados Unidos, 94577
        • Reclutamiento
        • Kaiser Permanente San Leandro
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • San Rafael, California, Estados Unidos, 94903
        • Reclutamiento
        • Kaiser San Rafael-Gallinas
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Santa Clara, California, Estados Unidos, 95051
        • Reclutamiento
        • Kaiser Permanente Medical Center - Santa Clara
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Santa Rosa, California, Estados Unidos, 95403
        • Reclutamiento
        • Kaiser Permanente-Santa Rosa
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • South San Francisco, California, Estados Unidos, 94080
        • Reclutamiento
        • Kaiser Permanente-South San Francisco
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Vallejo, California, Estados Unidos, 94589
        • Reclutamiento
        • Kaiser Permanente-Vallejo
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
      • Walnut Creek, California, Estados Unidos, 94596
        • Reclutamiento
        • Kaiser Permanente-Walnut Creek
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 877-642-4691
          • Correo electrónico: Kpoct@kp.org
        • Investigador principal:
          • Jed A. Katzel
    • Georgia
      • Atlanta, Georgia, Estados Unidos, 30308
        • Reclutamiento
        • Emory University Hospital Midtown
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 888-946-7447
        • Investigador principal:
          • Conor E. Steuer
    • Hawaii
      • Honolulu, Hawaii, Estados Unidos, 96819
        • Reclutamiento
        • Kaiser Permanente Moanalua Medical Center
        • Contacto:
        • Investigador principal:
          • Jed A. Katzel
    • Idaho
      • Boise, Idaho, Estados Unidos, 83706
        • Suspendido
        • Saint Alphonsus Cancer Care Center-Boise
      • Caldwell, Idaho, Estados Unidos, 83605
        • Suspendido
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Estados Unidos, 83814
        • Reclutamiento
        • Kootenai Health - Coeur d'Alene
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Nampa, Idaho, Estados Unidos, 83687
        • Suspendido
        • Saint Alphonsus Cancer Care Center-Nampa
      • Post Falls, Idaho, Estados Unidos, 83854
        • Reclutamiento
        • Kootenai Clinic Cancer Services - Post Falls
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Sandpoint, Idaho, Estados Unidos, 83864
        • Reclutamiento
        • Kootenai Clinic Cancer Services - Sandpoint
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60612
        • Activo, no reclutando
        • University of Illinois
      • Chicago, Illinois, Estados Unidos, 60611
        • Reclutamiento
        • Northwestern University
        • Contacto:
        • Investigador principal:
          • Jochen H. Lorch
      • Danville, Illinois, Estados Unidos, 61832
        • Reclutamiento
        • Carle at The Riverfront
        • Investigador principal:
          • Prem Sobti
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@Carle.com
      • DeKalb, Illinois, Estados Unidos, 60115
        • Reclutamiento
        • Northwestern Medicine Cancer Center Kishwaukee
        • Contacto:
        • Investigador principal:
          • Jochen H. Lorch
      • Effingham, Illinois, Estados Unidos, 62401
        • Reclutamiento
        • Carle Physician Group-Effingham
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@carle.com
        • Investigador principal:
          • Prem Sobti
      • Geneva, Illinois, Estados Unidos, 60134
        • Reclutamiento
        • Northwestern Medicine Cancer Center Delnor
        • Contacto:
        • Investigador principal:
          • Jochen H. Lorch
      • Glenview, Illinois, Estados Unidos, 60026
        • Reclutamiento
        • Northwestern Medicine Glenview Outpatient Center
        • Investigador principal:
          • Jochen H. Lorch
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 312-695-1102
      • Grayslake, Illinois, Estados Unidos, 60030
        • Reclutamiento
        • Northwestern Medicine Grayslake Outpatient Center
        • Investigador principal:
          • Jochen H. Lorch
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 312-695-1102
      • Lake Forest, Illinois, Estados Unidos, 60045
        • Reclutamiento
        • Northwestern Medicine Lake Forest Hospital
        • Contacto:
        • Investigador principal:
          • Jochen H. Lorch
      • Mattoon, Illinois, Estados Unidos, 61938
        • Reclutamiento
        • Carle Physician Group-Mattoon/Charleston
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@carle.com
        • Investigador principal:
          • Prem Sobti
      • Orland Park, Illinois, Estados Unidos, 60462
        • Reclutamiento
        • Northwestern Medicine Orland Park
        • Investigador principal:
          • Jochen H. Lorch
        • Contacto:
      • Urbana, Illinois, Estados Unidos, 61801
        • Reclutamiento
        • Carle Cancer Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 800-446-5532
          • Correo electrónico: Research@carle.com
        • Investigador principal:
          • Prem Sobti
      • Warrenville, Illinois, Estados Unidos, 60555
        • Reclutamiento
        • Northwestern Medicine Cancer Center Warrenville
        • Contacto:
        • Investigador principal:
          • Jochen H. Lorch
    • Iowa
      • Ankeny, Iowa, Estados Unidos, 50023
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Ankeny Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Carroll, Iowa, Estados Unidos, 51401
        • Reclutamiento
        • Saint Anthony Regional Hospital
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-689-7658
          • Correo electrónico: sbenson@iora.org
        • Investigador principal:
          • Seema Harichand-Herdt
      • Clive, Iowa, Estados Unidos, 50325
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Council Bluffs, Iowa, Estados Unidos, 51503
        • Suspendido
        • Heartland Oncology and Hematology LLP
      • Council Bluffs, Iowa, Estados Unidos, 51503
        • Suspendido
        • Methodist Jennie Edmundson Hospital
      • Council Bluffs, Iowa, Estados Unidos, 51503
        • Suspendido
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MEJ
      • Des Moines, Iowa, Estados Unidos, 50314
        • Reclutamiento
        • Broadlawns Medical Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-282-2200
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50314
        • Reclutamiento
        • Mercy Medical Center - Des Moines
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Richard L. Deming
      • Des Moines, Iowa, Estados Unidos, 50309
        • Reclutamiento
        • Iowa Methodist Medical Center
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-6727
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50309
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Des Moines, Iowa, Estados Unidos, 50314
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
      • Fort Dodge, Iowa, Estados Unidos, 50501
        • Reclutamiento
        • UI Healthcare Mission Cancer and Blood - Fort Dodge
        • Investigador principal:
          • Seema Harichand-Herdt
        • Contacto:
      • Waukee, Iowa, Estados Unidos, 50263
        • Reclutamiento
        • UI Health Care Mission Cancer and Blood - Waukee Clinic
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 515-241-3305
        • Investigador principal:
          • Seema Harichand-Herdt
    • Missouri
      • St Louis, Missouri, Estados Unidos, 63128
        • Reclutamiento
        • Mercy Hospital South
        • Investigador principal:
          • Jay W. Carlson
        • Contacto:
      • St Louis, Missouri, Estados Unidos, 63141
        • Reclutamiento
        • Mercy Hospital Saint Louis
        • Investigador principal:
          • Jay W. Carlson
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 314-251-7066
    • Montana
      • Anaconda, Montana, Estados Unidos, 59711
        • Reclutamiento
        • Community Hospital of Anaconda
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Billings, Montana, Estados Unidos, 59101
        • Reclutamiento
        • Billings Clinic Cancer Center
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Bozeman, Montana, Estados Unidos, 59715
        • Reclutamiento
        • Bozeman Health Deaconess Hospital
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Great Falls, Montana, Estados Unidos, 59405
        • Reclutamiento
        • Benefis Sletten Cancer Institute
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Kalispell, Montana, Estados Unidos, 59901
        • Reclutamiento
        • Logan Health Medical Center
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
      • Missoula, Montana, Estados Unidos, 59804
        • Reclutamiento
        • Community Medical Center
        • Investigador principal:
          • John M. Schallenkamp
        • Contacto:
    • Nebraska
      • Omaha, Nebraska, Estados Unidos, 68114
        • Reclutamiento
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 402-334-4773
        • Investigador principal:
          • Yungpo B. Su
      • Omaha, Nebraska, Estados Unidos, 68114
        • Reclutamiento
        • Nebraska Methodist Hospital
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 402-354-5144
        • Investigador principal:
          • Yungpo B. Su
      • Omaha, Nebraska, Estados Unidos, 68114
        • Suspendido
        • Oncology Associates PC
    • New Jersey
      • Basking Ridge, New Jersey, Estados Unidos, 07920
        • Reclutamiento
        • Memorial Sloan Kettering Basking Ridge
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
      • Middletown, New Jersey, Estados Unidos, 07748
        • Reclutamiento
        • Memorial Sloan Kettering Monmouth
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
      • Montvale, New Jersey, Estados Unidos, 07645
        • Reclutamiento
        • Memorial Sloan Kettering Bergen
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
    • New York
      • Commack, New York, Estados Unidos, 11725
        • Reclutamiento
        • Memorial Sloan Kettering Commack
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
      • Harrison, New York, Estados Unidos, 10604
        • Reclutamiento
        • Memorial Sloan Kettering Westchester
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
      • New York, New York, Estados Unidos, 10065
        • Reclutamiento
        • Memorial Sloan Kettering Cancer Center
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
      • Uniondale, New York, Estados Unidos, 11553
        • Reclutamiento
        • Memorial Sloan Kettering Nassau
        • Investigador principal:
          • Alan L. Ho
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 212-639-7592
    • Ohio
      • Cincinnati, Ohio, Estados Unidos, 45219
        • Activo, no reclutando
        • University of Cincinnati Cancer Center-UC Medical Center
      • West Chester, Ohio, Estados Unidos, 45069
        • Activo, no reclutando
        • University of Cincinnati Cancer Center-West Chester
    • Oklahoma
      • Oklahoma City, Oklahoma, Estados Unidos, 73104
        • Reclutamiento
        • University of Oklahoma Health Sciences Center
        • Contacto:
        • Investigador principal:
          • Minh Phan
      • Tulsa, Oklahoma, Estados Unidos, 74146
        • Suspendido
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Ontario, Oregon, Estados Unidos, 97914
        • Suspendido
        • Saint Alphonsus Cancer Care Center-Ontario
      • Portland, Oregon, Estados Unidos, 97213
        • Reclutamiento
        • Providence Portland Medical Center
        • Investigador principal:
          • Dan S. Zuckerman
        • Contacto:
      • Portland, Oregon, Estados Unidos, 97225
        • Reclutamiento
        • Providence Saint Vincent Medical Center
        • Investigador principal:
          • Dan S. Zuckerman
        • Contacto:
    • South Carolina
      • Charleston, South Carolina, Estados Unidos, 29425
        • Reclutamiento
        • Medical University of South Carolina
        • Contacto:
        • Investigador principal:
          • John M. Kaczmar
    • Washington
      • Seattle, Washington, Estados Unidos, 98122
        • Reclutamiento
        • Swedish Medical Center-First Hill
        • Investigador principal:
          • Dan S. Zuckerman
        • Contacto:
    • Wisconsin
      • Mukwonago, Wisconsin, Estados Unidos, 53149
        • Reclutamiento
        • ProHealth D N Greenwald Center
        • Contacto:
        • Investigador principal:
          • Timothy R. Wassenaar
      • Oconomowoc, Wisconsin, Estados Unidos, 53066
        • Reclutamiento
        • ProHealth Oconomowoc Memorial Hospital
        • Investigador principal:
          • Timothy R. Wassenaar
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 262-928-7878
      • Waukesha, Wisconsin, Estados Unidos, 53188
        • Reclutamiento
        • ProHealth Waukesha Memorial Hospital
        • Investigador principal:
          • Timothy R. Wassenaar
        • Contacto:
          • Site Public Contact
          • Número de teléfono: 262-928-7632
      • Waukesha, Wisconsin, Estados Unidos, 53188
        • Reclutamiento
        • UW Cancer Center at ProHealth Care
        • Investigador principal:
          • Timothy R. Wassenaar
        • Contacto:
  • Hong Kong
      • Shatin, Hong Kong
        • Reclutamiento
        • Chinese University of Hong Kong-Prince of Wales Hospital
        • Contacto:
        • Investigador principal:
          • Brigette B. Ma
  • Singapur
      • Singapore, Singapur, 119074
        • Reclutamiento
        • National University Hospital Singapore
        • Contacto:
        • Investigador principal:
          • Boon C. Goh
      • Singapore, Singapur, 168583
        • Reclutamiento
        • National Cancer Centre Singapore
        • Contacto:
        • Investigador principal:
          • Wan Teck D. Lim

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • PRIOR TO STEP 1 REGISTRATION:

  • Pathologically (histologically or cytologically) proven diagnosis of nasopharyngeal carcinoma (NPC) that has recurred locoregionally and/or is present at distant sites. Patients who present with metastatic disease (de novo) at diagnosis are also eligible. For locoregional recurrence, the disease must not be amenable to potentially curative surgery or re-irradiation. Eligible patient must have the following characteristics:

    • Tumor showing (histological/cytological) Epstein-Barr encoded ribonucleic acid (EBER)-positivity (e.g., In situ hybridization, immunohistochemistry) or
    • A known history of detectable plasma EBV DNA (via a polymerase chain reaction [PCR]-based assay) at any time point since the initial diagnosis of NPC.

  • Measurable disease as defined by RECIST 1.1 criteria. Lesion(s) that have been irradiated previously can be counted as measurable as long as radiological progression after the prior radiation therapy has been demonstrated.

    • Contrast enhanced CT scan of the chest. The contrast enhanced CT component of a whole-body PET-CT is also acceptable. The plain (non-contrast) CT component of a PET-CT is not acceptable.
    • CT the abdomen and pelvis, if clinically indicated (diagnostic quality with contrast, unless contraindicated).
    • Patients with known locoregional disease must have contrast enhanced MRI or CT of the nasopharynx and neck as this disease site(s) may be assessed as target lesions. For patients without known locoregional disease, imaging of the nasopharynx and neck is optional.
    • Symptomatic and active brain metastases and/or leptomeningeal metastasis on CT and/or MRI imaging: Patients who have prior therapies for brain and leptomeningeal metastasis or cord/cauda compression who are clinically stable for >= 2 months prior to registration and have discontinued systemic steroids therapy (> 10 mg/day prednisone or equivalent) > 4 weeks prior to registration are eligible.
    • Patients with base of skull involvement by NPC are allowed unless their disease is directly invading the brain parenchyma, associated with clinical symptoms and/or significant vasogenic edema on radiological imaging.

  • Age >= 18 years.

  • Eastern Cooperative Oncology Group (ECOG) (Zubrod) performance status of 0-2.

  • Negative urine or serum pregnancy test (in persons of childbearing potential) within 14 days prior to registration. Childbearing potential is defined as any person who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal.

  • Absolute neutrophil count (ANC) >= 1500 cells/mm^3.

  • Platelets >= 100,000 cells/mm^3.

  • Hemoglobin (Hgb) >= 8.0 g/dL (Transfusion is accepted. Erythropoietin dependency not accepted.).

  • Total bilirubin =< 1.5 × institutional upper limit of normal (ULN) or direct bilirubin =< ULN for patients with total bilirubin levels > 1.5 × ULN. Patients with known Gilbert's disease who have serum bilirubin level =< 3 × ULN may be enrolled.

  • Alanine transaminase (ALT) (serum glutamic pyruvic transaminase [SGPT]) =< 3 × ULN (=< 5 × ULN for patients with liver metastases).

  • Serum creatinine =< 1.5 × ULN or calculated creatinine clearance (CrCl) based on Cockcroft-Gault equation >= 30 mL/min for patients with serum creatinine levels > 1.5 × ULN. Cisplatin or carboplatin may be used at the discretion of the investigator - except for patients with CrCl between 30-50 mL/min, for whom carboplatin should be used instead of cisplatin. CrCl must be > 50 mL/min for cisplatin to be used.

  • Albumin-adjusted calcium level based on corrected calcium equation =< 1.5 × ULN (patients are allowed to have treatment for hypercalcemia prior to starting treatment).

  • No prior systemic treatment of palliative intent for recurrent/metastatic (R/M) NPC including cytotoxic chemotherapy. Prior treatment for non-recurrent and non-metastatic NPC is allowed. Systemic therapy given prior to curative intent re-irradiation or surgery is allowed for potentially curable locoregional recurrence.

  • No prior treatment with a PD-1 inhibitor (except if given as adjuvant or neoadjuvant therapy for NPC), PD-L1 inhibitor, anti-PD-L2 inhibitor, LAG-3 inhibitor, CTLA-4 inhibitor (except if given as adjuvant or neoadjuvant therapy for non-recurrent and non-metastatic NPC), or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways.

  • The interval between the last dose of curative-intent treatment for non-recurrent, non-metastatic NPC, including definitive radiotherapy (RT) and/or induction, concurrent, or adjuvant chemotherapy and recurrence must be ˃ 6 months.

  • Clinically significant toxicities from any prior systemic therapy or radiotherapy must have resolved to grade 0 or 1 as per National Cancer Institute (NCI) CTCAE v 5.0 - except alopecia, dry mouth, dysgeusia, dysphagia, and fatigue. Patients with a history of grade 3-4 cisplatin related neuropathy must have recovered to grade 0-2 prior to registration. Patients with a history of hearing impairment, or ototoxicity from prior cisplatin, of any grade are allowed.

  • No prior palliative RT within 30 days prior to registration unless the irradiated site(s) are not the target lesions. The irradiated site(s) also must not be the only sites of measurable recurrent disease.

  • No major surgical procedures within 30 days prior to registration.

  • No history of unstable angina requiring hospitalization within the last 6 months.

  • No history of myocardial infarction within the last 6 months.

  • New York Heart Association Functional Classification II or better (New York Heart Association [NYHA] Functional Classification III/IV are not eligible). Patients with symptomatic coronary artery disease, congestive heart failure or a known history of having a left ventricular ejection fraction < 50% must be stably controlled with medication in the opinion of the treating physician, in consultation with a cardiologist if appropriate.

  • No prior history of myocarditis.

  • No active infection requiring IV antibiotics, IV antiviral, or IV antifungal treatments at the time of study registration.

  • No history of (non-infectious) pneumonitis that required steroids or current pneumonitis requiring steroids and/or immunosuppressive therapy, idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans), or idiopathic pneumonitis.

  • No history of multi-drug resistant mycobacterium tuberculosis (TB) or active TB, as defined by systemic treatment received =< 2 years prior to registration. Note: Patients who had a history of treated TB ˃ 2 years prior to registration are allowed.

  • No prior solid organ transplant or bone marrow transplant.

  • No conditions requiring systemic treatment with either immunosuppressive doses of corticosteroids (> 10 mg daily prednisone or equivalents) or other immunosuppressive medications within 14 days of registration. Inhaled or topical steroids and adrenal replacement doses < 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease. Steroid premedication for the prophylaxis of CT contrast-related allergies is allowed. The use of dexamethasone as an anti-emetic premedication prior to chemotherapy is also allowed.

  • No active autoimmune disease requiring systemic treatment (i.e., disease modifying agents, corticosteroids, or immunosuppressive drugs) within the past 2 years. These may include (but not limited to) patients with a history of immune-related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), rheumatoid arthritis, connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's disease, ulcerative colitis, autoimmune hepatitis, glomerulonephritis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome.

    • Note: Patients are permitted to enroll if they have vitiligo; type I diabetes mellitus; hypothyroidism, pituitary or adrenal insufficiency requiring only hormone replacement; alopecia; and/or psoriasis not requiring systemic treatment. Conditions not expected to recur in the absence of an external trigger are permitted to enroll.

  • No prior live vaccine within 30 days prior to registration. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist [registered trademark]) are live attenuated vaccines and are not allowed. Coronavirus disease 2019 (COVID-19) vaccines that are approved by the local drug regulatory authority of the participating region are allowed.

  • No known history of grade 3-4 allergic reaction or hypersensitivity reaction to cisplatin, carboplatin, or gemcitabine.

  • No known history of grade 4 hypersensitivity (or infusion) reaction to any monoclonal antibody. Patients who had prior grade 3 hypersensitivity (or infusion) reaction but could tolerate resumption of the antibody treatment after appropriate pre-medication are eligible.

  • PRIOR TO STEP 2 REGISTRATION:

  • Collection of plasma EBV DNA at baseline is mandatory for all patients prior to Step 2 registration and induction treatment.

    • Note: Submission of the baseline sample will be batch shipped.

  • PRIOR TO STEP 3 REGISTRATION/RANDOMIZATION: PATIENTS WITHOUT PROGRESSIVE DISEASE (PD) ONLY:

  • All patients must have received minimum of 3 cycles, and up to a maximum of 6 cycles of induction treatment within 20 weeks from cycle 1, day 1 of induction treatment (i.e., patients must have completed all induction treatment within 20 weeks from cycle 1 day 1, including the treatment breaks). Patients must have completed 6 cycles of induction treatment, except in the following circumstances:

    • Significant dose delays as a result of treatment-related toxicities.
    • Intercurrent illness(s), that rendered the patient unable to continue induction treatment.
    • Note: If a patient received < 6 cycles of induction treatment for reasons other than the above circumstances, they will not be eligible for randomization.

  • A CT scan within 30 days prior to Step 3 registration/randomization is required. If the most recent scan performed is not within this time frame, a repeat scan is required to assess response.

  • Did not meet any criteria that result in permanent discontinuation of study treatment during induction treatment phase.

  • Must meet the criteria for starting/resuming a new cycle of maintenance treatment.

  • Did not experience any nivolumab-related autoimmune toxicities that would result in permanent discontinuation of nivolumab during the induction treatment phase.

  • Collection of the plasma EBV DNA post-induction treatment is mandatory.

    • Note: Submission of the post-induction sample will be batch shipped.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación Secuencial
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Arm I (Nivolumab)

Patients receive nivolumab IV over 30 minutes. Cycles repeat every 4 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI on study. Patients also undergo PET/CT or bone scan as clinically indicated.
Procedimiento: Magnetic Resonance Imaging

Undergo MRI

Otros nombres:
  • Resonancia magnética
  • Resonancia magnetica
  • Exploración de imágenes por resonancia magnética
  • Imágenes Médicas, Resonancia Magnética / Resonancia Magnética Nuclear
  • SRES
  • Imágenes de RM
  • Imágenes de RMN
  • RMN
  • Imágenes de resonancia magnética nuclear
  • Imágenes por resonancia magnética (IRM)
  • resonancia magnética nuclear
  • Imágenes por resonancia magnética (procedimiento)
  • Resonancias magnéticas
  • Resonancia magnética estructural
Biológico: Nivolumab

Given IV

Otros nombres:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX1106
  • BMS 936558
  • ABC 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Procedimiento: Computed Tomography

Undergo CT or PET/CT

Otros nombres:
  • Connecticut
  • GATO
  • Análisis de gato
  • Tomografía Axial Computarizada
  • Tomografía axial computarizada
  • Tomografía computarizada
  • tomografía
  • Tomografía axial computarizada (procedimiento)
  • Tomografía computarizada (TC)
  • Escaneo de gato de diagnóstico
  • Tipo de servicio de escaneo de gato de diagnóstico
Procedimiento: Positron Emission Tomography

Undergo PET/CT

Otros nombres:
  • Imágenes médicas, tomografía por emisión de positrones
  • MASCOTA
  • Escaneo de mascotas
  • Tomografía por emisión de positrones
  • Tomografía de emisión de positrones
  • PT
  • Tomografía por emisión de positrones (procedimiento)
Procedimiento: Bone Scan

Undergo bone scan

Otros nombres:
  • Gammagrafía ósea
Experimental: Arm II (Nivolumab, relatlimab)

Patients receive nivolumab IV over 30 minutes and relatlimab IV over 30-90 minutes. Cycles repeat every 4 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI on study. Patients also undergo PET/CT or bone scan as clinically indicated.
Procedimiento: Magnetic Resonance Imaging

Undergo MRI

Otros nombres:
  • Resonancia magnética
  • Resonancia magnetica
  • Exploración de imágenes por resonancia magnética
  • Imágenes Médicas, Resonancia Magnética / Resonancia Magnética Nuclear
  • SRES
  • Imágenes de RM
  • Imágenes de RMN
  • RMN
  • Imágenes de resonancia magnética nuclear
  • Imágenes por resonancia magnética (IRM)
  • resonancia magnética nuclear
  • Imágenes por resonancia magnética (procedimiento)
  • Resonancias magnéticas
  • Resonancia magnética estructural
Biológico: Nivolumab

Given IV

Otros nombres:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX1106
  • BMS 936558
  • ABC 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Procedimiento: Computed Tomography

Undergo CT or PET/CT

Otros nombres:
  • Connecticut
  • GATO
  • Análisis de gato
  • Tomografía Axial Computarizada
  • Tomografía axial computarizada
  • Tomografía computarizada
  • tomografía
  • Tomografía axial computarizada (procedimiento)
  • Tomografía computarizada (TC)
  • Escaneo de gato de diagnóstico
  • Tipo de servicio de escaneo de gato de diagnóstico
Procedimiento: Positron Emission Tomography

Undergo PET/CT

Otros nombres:
  • Imágenes médicas, tomografía por emisión de positrones
  • MASCOTA
  • Escaneo de mascotas
  • Tomografía por emisión de positrones
  • Tomografía de emisión de positrones
  • PT
  • Tomografía por emisión de positrones (procedimiento)
Biológico: Relatlimab

Given IV

Otros nombres:
  • BMS-986016
  • BMS986016
  • Inmunoglobulina G4, anti-(proteína del gen 3 de activación de linfocitos humanos) (cadena pesada humana), disulfuro con cadena ligera humana, dímero
  • BMS 986016
Procedimiento: Bone Scan

Undergo bone scan

Otros nombres:
  • Gammagrafía ósea
Experimental: Induction therapy (Platinum-gemcitabine-nivolumab)

Patients receive nivolumab IV over 30 minutes on day 1 of each cycle, cisplatin IV or carboplatin IV over 30-60 minutes on day 1 of each cycle and gemcitabine IV over 30 minutes on days 1 and 8 of each cycle. Cycles repeat every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI and blood sample collection during screening and on study.
Droga: Carboplatin

Given IV

Otros nombres:
  • Blastocarbo
  • Carboplat
  • Carboplatino Hexal
  • Carboplatino
  • Carbosina
  • Carbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorín
  • Novoplatino
  • Paraplatino
  • Paraplatino AQ
  • Platinado
  • Ribocarbo
  • JM8
Droga: Cisplatin

Given IV

Otros nombres:
  • CDDP
  • Cis-diaminodicloridoplatino
  • Cismaplat
  • Cisplatino
  • Neoplatino
  • Platinol
  • Abiplatino
  • Blastolem
  • Briplatino
  • Cis-diamina-dicloroplatino
  • Cis-diaminodicloro Platino (II)
  • Cis-diaminodicloroplatino
  • Cis-dicloroamina Platino (II)
  • Dicloruro de diamina cis-platinoso
  • Cis-platino
  • Cis-platino II
  • Dicloruro de diamina cis-platino II
  • Cisplatina
  • Cisplatilo
  • Citoplatino
  • Citosina
  • DDP
  • Lederplatino
  • Metaplatino
  • Cloruro de Peyrone
  • Sal de peyrone
  • Placis
  • Plastistil
  • Platamina
  • Platiblastina
  • Platiblastina-S
  • Platinex
  • Platinol-AQ
  • Platinol-AQ VHA Plus
  • Platinoxano
  • Platino
  • Diaminodicloruro de platino
  • Platiran
  • Platistina
  • Platosina
Procedimiento: Biospecimen Collection

Undergo blood sample collection

Otros nombres:
  • Recolección de muestras biológicas
  • Muestra biológica recolectada
  • Coleccion de especimenes
  • Recolección de muestras
Procedimiento: Magnetic Resonance Imaging

Undergo MRI

Otros nombres:
  • Resonancia magnética
  • Resonancia magnetica
  • Exploración de imágenes por resonancia magnética
  • Imágenes Médicas, Resonancia Magnética / Resonancia Magnética Nuclear
  • SRES
  • Imágenes de RM
  • Imágenes de RMN
  • RMN
  • Imágenes de resonancia magnética nuclear
  • Imágenes por resonancia magnética (IRM)
  • resonancia magnética nuclear
  • Imágenes por resonancia magnética (procedimiento)
  • Resonancias magnéticas
  • Resonancia magnética estructural
Biológico: Nivolumab

Given IV

Otros nombres:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX1106
  • BMS 936558
  • ABC 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Procedimiento: Computed Tomography

Undergo CT or PET/CT

Otros nombres:
  • Connecticut
  • GATO
  • Análisis de gato
  • Tomografía Axial Computarizada
  • Tomografía axial computarizada
  • Tomografía computarizada
  • tomografía
  • Tomografía axial computarizada (procedimiento)
  • Tomografía computarizada (TC)
  • Escaneo de gato de diagnóstico
  • Tipo de servicio de escaneo de gato de diagnóstico
Droga: Gemcitabine

Given IV

Otros nombres:
  • dFdCyd
  • dfdc
  • Difluorodesoxicitidina

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Progression-free survival (PFS)
Periodo de tiempo: Time from randomization to progressive disease (PD) or death due to any cause, assessed up to 6 years

Will be assessed in both treatment arms and will be estimated using the Kaplan-Meier method. The comparison of PFS distributions between treatment arms will be performed using the log-rank test. Additional analyses of treatment effect will be performed using Cox models with the stratification factors included as a fixed covariates, as well as other tumor and patient characteristics, listed below. Median PFS and the corresponding 95% confidence intervals (CIs) for each arm will be estimated with the Brookmeyer-Crowley method. Multivariable analysis will be performed using a Cox proportional hazards model and relevant patient and tumor characteristics (country [Asian sites versus (vs.) Non-Asian sites], keratinizing squamous carcinoma, sex, age, and baseline Epstein-Barr virus (EBV) deoxyribonucleic acid [DNA]). Hazard ratios and their respective 85% lower confidence bound, and 95% confidence intervals will be provided.
Time from randomization to progressive disease (PD) or death due to any cause, assessed up to 6 years

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Overall survival (OS)
Periodo de tiempo: Time from randomization to death due to any cause, assessed up to 6 years

Will be estimated using the Kaplan-Meier method and between-arm differences will be assessed using the log-rank test. Median OS and the corresponding 95% CIs using log-log transformation to survival function for each arm will be estimated with the Brookmeyer-Crowley method.
Time from randomization to death due to any cause, assessed up to 6 years
Tumor response
Periodo de tiempo: Up to 6 years

Will be assessed using Response Evaluation Criteria in Solid Tumors version 1.1. Cox proportional hazards models will be used to determine hazard ratios (cause-specific hazard ratios in the case of endpoints with competing risks) and to assess the effects of covariates of interest. Fine-Gray sub-distribution hazards Cox model will be used to complement the competing risk analyses.
Up to 6 years
Locoregional failure
Periodo de tiempo: Up to 6 years

Cox proportional hazards models will be used to determine hazard ratios (cause-specific hazard ratios in the case of endpoints with competing risks) and to assess the effects of covariates of interest. Fine-Gray sub-distribution hazards Cox model will be used to complement the competing risk analyses.
Up to 6 years
Distant metastasis
Periodo de tiempo: Up to 6 years

Cox proportional hazards models will be used to determine hazard ratios (cause-specific hazard ratios in the case of endpoints with competing risks) and to assess the effects of covariates of interest. Fine-Gray sub-distribution hazards Cox model will be used to complement the competing risk analyses.
Up to 6 years
Incidence of adverse events (AEs)
Periodo de tiempo: Up to 6 years

Will be graded using Common Terminology Criteria for Adverse Events version 5.0. Counts of all AEs by grade will be provided by treatment arm. Counts and frequencies will be provided for the worst grade AE experienced by the patient by treatment arm. The rate of patients with at least 1 grade 3 or higher AE will be compared between the treatment arms using a chi-square test for proportions and confidence intervals for rate difference will be computed using Miettinen-Nurminen (score) method
Up to 6 years
Post-induction plasma EBV DNA as a prognostic biomarker
Periodo de tiempo: Up to 6 years

Will be defined as a binary biomarker (detectable: >= 1 copies/mL vs. undetectable: 0 copies/mL). Biomarker effect HRs from multivariable Cox models, including key tumor and patient characteristics will also be reported.
Up to 6 years
Pre-induction plasma EBV DNA vs. progressive disease (PD) during induction treatment
Periodo de tiempo: Up to 6 years

Will include all patients treated with concurrent (induction) treatment and a binary biomarker based on pre-induction plasma EBV DNA (< 2000 vs. ≥2000 copies/mL). PD rates during induction for each biomarker subgroup will be computed assuming a binomial distribution and compared between biomarker subgroups using a chi-square test. Multivariable Cox models, including key tumor and patient characteristics will also be included.
Up to 6 years
Persistent plasma EBV DNA vs. PFS
Periodo de tiempo: Up to 6 years

Will examine the association between persistent EBV DNA after induction treatment and PFS. Only randomized patients with positive pre-induction plasma EBV DNA will be included (~90-95%). Patients will be classified into "EBV DNA positive to negative" and "EBV DNA consistently positive" based on the pre-induction and post-induction EBV DNA. Multivariable Cox models, including key tumor and patient characteristics will also be included.
Up to 6 years

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Post-induction EBV DNA as a predictive biomarker
Periodo de tiempo: Up to 6 years

Will be assessed of the predictive role of post-induction EBV DNA on PFS and OS will be performed using the binary biomarker. Cox proportional hazards model with treatment arm, binary biomarker, and its interaction will be used for these analyses. Treatment effect hazard ratios and 95% confidence intervals will be reported. Adjusted HR estimates will be obtained after adding key patient and tumor characteristics.
Up to 6 years

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

National Cancer Institute (NCI)

Investigadores

  • Investigador principal: Brigette B Ma, NRG Oncology

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

15 de julio de 2024

Finalización primaria (Estimado)

30 de abril de 2029

Finalización del estudio (Estimado)

30 de abril de 2029

Fechas de registro del estudio

Enviado por primera vez

7 de septiembre de 2023

Primero enviado que cumplió con los criterios de control de calidad

7 de septiembre de 2023

Publicado por primera vez (Actual)

8 de septiembre de 2023

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

6 de noviembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

5 de noviembre de 2026

Última verificación

1 de septiembre de 2026

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • NCI-2023-06678
  • U10CA180868 (Subvención/contrato del NIH de EE. UU.)
  • NCI-2023-06678 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • NRG-HN011 (Otro identificador: CTEP)
  • NRG-HN011 (Otro identificador: NRG Oncology)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

SÍ

Descripción del plan IPD

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

Sí

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

producto fabricado y exportado desde los EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

Suscribir