Testare l'aggiunta di un farmaco immunoterapico, Cemiplimab (REGN2810), più un intervento chirurgico alla sola chirurgia abituale per il trattamento del cancro della pelle avanzato
Studio randomizzato di fase III sull'immunoterapia perioperatoria con trattamento adattato alla risposta rispetto al trattamento standard di cura per il carcinoma cutaneo a cellule squamose resecabile in stadio III/IV
This phase III trial compares the effect of adding cemiplimab to standard therapy (surgery with or without radiation) versus standard therapy alone in treating patients with stage III/IV squamous cell skin cancer that is able to be removed by surgery (resectable) and that may have come back after a period of improvement (recurrent). The usual treatment for patients with resectable squamous cell skin cancer is the removal of the cancerous tissue (surgery) with or without radiation, which uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. Immunotherapy with monoclonal antibodies, such as cemiplimab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cemiplimab has been approved for the treatment of skin cancer that has spread or that cannot be removed by surgery, but it has not been approved for the treatment of skin cancer than can be removed by surgery. Adding cemiplimab to the usual treatment of surgery with or without radiation may be more effective in treating patients with stage III/IV resectable squamous cell skin cancer than the usual treatment alone.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
- Stage IV Testa e collo Carcinoma a cellule squamose cutanee AJCC V8
- Stage III Testa e collo Carcinoma a cellule squamose cutanee AJCC V8
- Carcinoma a cellule squamose della palpebra
- Carcinoma Squamoso Acantolitico della Pelle
- Carcinoma Squamocellulare a Cellule Chiare della Pelle
- Carcinoma Linfoepiteliale della Pelle
- Carcinoma a Cellule Squamose Fusiforme della Pelle
- Carcinoma a cellule squamose della pelle con differenziazione sarcomatoide
- Carcinoma Squamoso Palpebrale Ricorrente
- Carcinoma Squamoso Acantolitico Ricorrente della Pelle
- Carcinoma Squamocellulare a Cellule Chiare della Pelle Ricorrente
- Carcinoma Linfoepiteliale Cutaneo Ricorrente
- Carcinoma Squamocellulare Ricorrente della Pelle a Cellule Fusate
- Carcinoma Squamoso Cutaneo Ricorrente con Differenziazione Sarcomatoide
- Carcinoma Squamocellulare della Palpebra Resecabile
- Carcinoma Squamoso Acantolitico della Pelle Resecabile
- Carcinoma Squamocellulare a Cellule Chiare della Pelle Resecabile
- Carcinoma Linfoepiteliale Cutaneo Resecabile
- Carcinoma Squamocellulare Spindlocellulare della Pelle Resecabile
- Carcinoma a Cellule Squamose della Pelle Resecabile con Differenziazione Sarcomatoide
Intervento / Trattamento
Intervento / Trattamento
- Procedura: Magnetic Resonance Imaging
- Altro: Questionnaire Administration
- Procedura: Positron Emission Tomography
- Radiazione: Intensity-Modulated Radiation Therapy
- Biologico: Cemiplimab
- Procedura: Computed Tomography
- Procedura: Biospecimen Collection
- Radiazione: Image Guided Radiation Therapy
- Procedura: Surgical Procedure
- Procedura: Surgical Procedure
Descrizione dettagliata
PRIMARY OBJECTIVE:
I. To determine if neoadjuvant immunotherapy combined with response-adapted oncologic surgery improves site-reported event-free survival (EFS) compared to standard-of-care surgery in resectable stage III/IV cutaneous squamous cell carcinoma (CSCC).
SECONDARY OBJECTIVES:
I. To compare utilization of adjuvant radiation between arms. II. To compare disease-free survival (DFS) between arms. III. To compare overall survival (OS) between arms. IV. To compare adverse events (Common Terminology Criteria for Adverse Events [CTCAE] version [v]5.0) between arms.
V. To assess pathologic complete response in arm 2.
PATIENT-REPORTED OUTCOMES:
I. Compare changes in patient reported quality of life as measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) at 1, 6, and 12 months after surgery between treatment arms. (Primary objective) II. To compare patient reported symptoms functioning, and quality of life, as measured by the Cutaneous Squamous Cell Carcinoma NeoAdjuvant, Adjuvant and Perioperative 32 question scale (CSCC NAAP-32), Patient Reported Outcomes Measurement Information System (PROMIS)-Short Form (SF)-Anxiety, PROMIS-SF-Fatigue, and EuroQol-5D (EQ-5D), between arms at 1, 6, and 12 months after surgery.
III. Develop a scoring algorithm and validate the CSCC-NAAP-32 for use in this patient population.
EXPLORATORY OBJECTIVES:
I. To compare disease-specific survival (DSS) between arms. II. To correlate pathologic response with DFS in arm 2. III. To assess overall response rate (ORR) in arm 2. IV. To compare patterns of failure between arms. V. To compare pathologic measurements of lymph node yield between arms. VI. To compare primary tumor specimen dimensions and volume between arms.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM 1: Patients undergo surgery per standard of care within 6 weeks of randomization. Starting within 6-12 weeks of surgery, patients may undergo image-guided radiation therapy (IGRT) with intensity modulated radiation therapy (IMRT) for 5 fractions per week for 6 weeks as clinically indicated. Patients also undergo computed tomography (CT), magnetic resonance imaging (MRI), and/or positron emission tomography (PET)/CT prior to treatment, and CT and/or MRI during follow up. Patients may also undergo optional collection of tissue, whole blood, and plasma on study.
ARM 2: Patients receive cemiplimab intravenously (IV) over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then undergo response-adaptive surgery 21 days after last dose of cemiplimab. Starting within 12 weeks of surgery, patients may undergo IGRT with IMRT for 5 fractions per week for 6 weeks as clinically indicated. Starting within 6 weeks of completion of surgery or radiation therapy (if indicated), patients without pathologic complete response (pCR) receive cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 42 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, MRI, and/or PET/CT prior to treatment, and CT and/or MRI on study and during follow up. Patients may also undergo optional collection of tissue, whole blood, and plasma on study.
After completion of study treatment, patients are followed up at 1, 6, and 12 months post-surgery then every 3 months for 2 years, every 6 months in year 3, and then annually thereafter.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
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New South Wales
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Camperdown, New South Wales, Australia, 2050
- Chris O'Brien Lifehouse
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Wollongong, New South Wales, Australia, 2500
- Wollongong Hospital
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Queensland
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Townsville, Queensland, Australia, 4814
- Townsville General Hospital
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Woolloongabba, Queensland, Australia, 4102
- Princess Alexandra Hospital
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Victoria
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Fitzroy, Victoria, Australia, 3065
- Saint Vincent's Hospital
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Melbourne, Victoria, Australia, 3000
- Peter MacCallum Cancer Centre
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Western Australia
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Murdoch, Western Australia, Australia, 6150
- Fiona Stanley Hospital
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 4E6
- BCCA-Vancouver Cancer Centre
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Ontario
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Toronto, Ontario, Canada, M5G 2M9
- University Health Network-Princess Margaret Hospital
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Toronto, Ontario, Canada, M4N 3M5
- Odette Cancer Centre- Sunnybrook Health Sciences Centre
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Alabama
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Birmingham, Alabama, Stati Uniti, 35233
- University of Alabama at Birmingham Cancer Center
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Arizona
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Gilbert, Arizona, Stati Uniti, 85234
- Banner MD Anderson Cancer Center
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Phoenix, Arizona, Stati Uniti, 85054
- Mayo Clinic Hospital in Arizona
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California
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Beverly Hills, California, Stati Uniti, 90211
- Tower Cancer Research Foundation
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Duarte, California, Stati Uniti, 91010
- City of Hope Comprehensive Cancer Center
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Encinitas, California, Stati Uniti, 92024
- UC San Diego Health System - Encinitas
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Irvine, California, Stati Uniti, 92618
- City of Hope at Irvine Lennar
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La Jolla, California, Stati Uniti, 92093
- UC San Diego Moores Cancer Center
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Lancaster, California, Stati Uniti, 93534
- City of Hope Antelope Valley
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Los Angeles, California, Stati Uniti, 90033
- USC / Norris Comprehensive Cancer Center
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Los Angeles, California, Stati Uniti, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, Stati Uniti, 90025
- The Angeles Clinic and Research Institute - West Los Angeles Office
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Oakland, California, Stati Uniti, 94611
- Kaiser Permanente-Oakland
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Palo Alto, California, Stati Uniti, 94304
- Stanford Cancer Institute Palo Alto
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Sacramento, California, Stati Uniti, 95817
- University of California Davis Comprehensive Cancer Center
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Sacramento, California, Stati Uniti, 95823
- Kaiser Permanente-South Sacramento
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San Diego, California, Stati Uniti, 92103
- UC San Diego Medical Center - Hillcrest
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San Francisco, California, Stati Uniti, 94115
- Kaiser Permanente-San Francisco
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South Pasadena, California, Stati Uniti, 91030
- City of Hope South Pasadena
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Torrance, California, Stati Uniti, 90505
- Torrance Memorial Physician Network - Cancer Care
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Upland, California, Stati Uniti, 91786
- City of Hope Upland
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Walnut Creek, California, Stati Uniti, 94596
- Kaiser Permanente-Walnut Creek
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Colorado
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Aurora, Colorado, Stati Uniti, 80045
- UCHealth University of Colorado Hospital
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Colorado Springs, Colorado, Stati Uniti, 80909
- UCHealth Memorial Hospital Central
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Colorado Springs, Colorado, Stati Uniti, 80920
- Memorial Hospital North
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Connecticut
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Greenwich, Connecticut, Stati Uniti, 06830
- Smilow Cancer Hospital Care Center at Greenwich
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Guilford, Connecticut, Stati Uniti, 06437
- Smilow Cancer Hospital Care Center - Guilford
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New Haven, Connecticut, Stati Uniti, 06520
- Yale University
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Trumbull, Connecticut, Stati Uniti, 06611
- Smilow Cancer Hospital Care Center-Trumbull
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Waterbury, Connecticut, Stati Uniti, 06708
- Smilow Cancer Hospital-Waterbury Care Center
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Waterford, Connecticut, Stati Uniti, 06385
- Smilow Cancer Hospital Care Center - Waterford
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Delaware
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Newark, Delaware, Stati Uniti, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Stati Uniti, 19713
- Medical Oncology Hematology Consultants PA
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Florida
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Aventura, Florida, Stati Uniti, 33180
- UM Sylvester Comprehensive Cancer Center at Aventura
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Coral Gables, Florida, Stati Uniti, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
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Deerfield Beach, Florida, Stati Uniti, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Doral, Florida, Stati Uniti, 33166
- UM Sylvester Comprehensive Cancer Center at Doral
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Jacksonville, Florida, Stati Uniti, 32224-9980
- Mayo Clinic in Florida
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Miami, Florida, Stati Uniti, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Stati Uniti, 33176
- Miami Cancer Institute
-
Miami, Florida, Stati Uniti, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
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N. Venice, Florida, Stati Uniti, 34275
- Sarasota Memorial Hospital-Venice
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Plantation, Florida, Stati Uniti, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
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Sarasota, Florida, Stati Uniti, 34239
- Sarasota Memorial Hospital
-
Sarasota, Florida, Stati Uniti, 34232
- Florida Cancer Specialists - Sarasota
-
Sarasota, Florida, Stati Uniti, 34243
- Sarasota Memorial Health Care Center at University Parkway
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Sarasota, Florida, Stati Uniti, 34239
- First Physicians Group - Silverstein Institute at Floyd Street
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Sarasota, Florida, Stati Uniti, 34239
- Florida Cancer Specialists - Sarasota Downtown
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Tampa, Florida, Stati Uniti, 33612
- Moffitt Cancer Center
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Tampa, Florida, Stati Uniti, 33607
- Moffitt Cancer Center-International Plaza
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Tampa, Florida, Stati Uniti, 33612
- Moffitt Cancer Center - McKinley Campus
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Venice, Florida, Stati Uniti, 34285
- Florida Cancer Specialists - Venice Island
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Venice, Florida, Stati Uniti, 34275
- Florida Cancer Specialists - Venice Pinebrook
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Georgia
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Atlanta, Georgia, Stati Uniti, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Stati Uniti, 30322
- Emory University Hospital/Winship Cancer Institute
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Illinois
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Alton, Illinois, Stati Uniti, 62002
- Alton Memorial Hospital
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Chicago, Illinois, Stati Uniti, 60611
- Northwestern University
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Chicago, Illinois, Stati Uniti, 60612
- University of Illinois
-
Chicago, Illinois, Stati Uniti, 60612
- Rush MD Anderson Cancer Center
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DeKalb, Illinois, Stati Uniti, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Stati Uniti, 62526
- Decatur Memorial Hospital
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Geneva, Illinois, Stati Uniti, 60134
- Northwestern Medicine Cancer Center Delnor
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Orland Park, Illinois, Stati Uniti, 60462
- Northwestern Medicine Orland Park
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Shiloh, Illinois, Stati Uniti, 62269
- Memorial Hospital East
-
Warrenville, Illinois, Stati Uniti, 60555
- Northwestern Medicine Cancer Center Warrenville
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Indiana
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Carmel, Indiana, Stati Uniti, 46032
- IU Health North Hospital
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Goshen, Indiana, Stati Uniti, 46526
- Goshen Center for Cancer Care
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Indianapolis, Indiana, Stati Uniti, 46237
- Franciscan Health Indianapolis
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Indianapolis, Indiana, Stati Uniti, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
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Iowa
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Council Bluffs, Iowa, Stati Uniti, 51503
- Heartland Oncology and Hematology LLP
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Council Bluffs, Iowa, Stati Uniti, 51503
- Methodist Jennie Edmundson Hospital
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Kansas
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Kansas City, Kansas, Stati Uniti, 66160
- University of Kansas Cancer Center
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Overland Park, Kansas, Stati Uniti, 66210
- University of Kansas Cancer Center-Overland Park
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Overland Park, Kansas, Stati Uniti, 66211
- University of Kansas Hospital-Indian Creek Campus
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Westwood, Kansas, Stati Uniti, 66205
- University of Kansas Hospital-Westwood Cancer Center
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Kentucky
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Lexington, Kentucky, Stati Uniti, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, Stati Uniti, 40202
- The James Graham Brown Cancer Center at University of Louisville
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Louisville, Kentucky, Stati Uniti, 40245
- UofL Health Medical Center Northeast
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Louisiana
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Baton Rouge, Louisiana, Stati Uniti, 70805
- LSU Health Baton Rouge-North Clinic
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Baton Rouge, Louisiana, Stati Uniti, 70808
- Our Lady of the Lake Physician Group
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New Orleans, Louisiana, Stati Uniti, 70112
- University Medical Center New Orleans
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Michigan
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Ann Arbor, Michigan, Stati Uniti, 48109
- University of Michigan Rogel Cancer Center
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Brighton, Michigan, Stati Uniti, 48116
- University of Michigan - Brighton Center for Specialty Care
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Detroit, Michigan, Stati Uniti, 48202
- Henry Ford Hospital
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Grand Rapids, Michigan, Stati Uniti, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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West Bloomfield, Michigan, Stati Uniti, 48322
- Henry Ford West Bloomfield Hospital
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Wyoming, Michigan, Stati Uniti, 49519
- University of Michigan Health - West
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Minnesota
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Minneapolis, Minnesota, Stati Uniti, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, Stati Uniti, 55905
- Mayo Clinic in Rochester
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Missouri
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City of Saint Peters, Missouri, Stati Uniti, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Columbia, Missouri, Stati Uniti, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
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Creve Coeur, Missouri, Stati Uniti, 63141
- Siteman Cancer Center at West County Hospital
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Kansas City, Missouri, Stati Uniti, 64154
- University of Kansas Cancer Center - North
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Lee's Summit, Missouri, Stati Uniti, 64064
- University of Kansas Cancer Center - Lee's Summit
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St Louis, Missouri, Stati Uniti, 63110
- Washington University School of Medicine
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St Louis, Missouri, Stati Uniti, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Stati Uniti, 63136
- Siteman Cancer Center at Christian Hospital
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Nebraska
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Bellevue, Nebraska, Stati Uniti, 68123
- Nebraska Medicine-Bellevue
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Omaha, Nebraska, Stati Uniti, 68114
- Nebraska Methodist Hospital
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Omaha, Nebraska, Stati Uniti, 68198
- University of Nebraska Medical Center
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Omaha, Nebraska, Stati Uniti, 68118
- Nebraska Medicine-Village Pointe
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Omaha, Nebraska, Stati Uniti, 68114
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
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New Hampshire
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Lebanon, New Hampshire, Stati Uniti, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
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New Jersey
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Basking Ridge, New Jersey, Stati Uniti, 07920
- Memorial Sloan Kettering Basking Ridge
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Middletown, New Jersey, Stati Uniti, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, Stati Uniti, 07645
- Memorial Sloan Kettering Bergen
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New Mexico
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Albuquerque, New Mexico, Stati Uniti, 87106
- University of New Mexico Cancer Center
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New York
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Commack, New York, Stati Uniti, 11725
- Memorial Sloan Kettering Commack
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Harrison, New York, Stati Uniti, 10604
- Memorial Sloan Kettering Westchester
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Lake Success, New York, Stati Uniti, 11042
- Northwell Health/Center for Advanced Medicine
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Mineola, New York, Stati Uniti, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Stati Uniti, 10065
- Memorial Sloan Kettering Cancer Center
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New York, New York, Stati Uniti, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
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New York, New York, Stati Uniti, 10075
- Lenox Hill Hospital
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New York, New York, Stati Uniti, 10065
- Manhattan Eye Ear and Throat Hospital
-
Rochester, New York, Stati Uniti, 14642
- University of Rochester
-
Stony Brook, New York, Stati Uniti, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Stati Uniti, 13210
- State University of New York Upstate Medical University
-
Syracuse, New York, Stati Uniti, 13215
- SUNY Upstate Medical Center-Community Campus
-
The Bronx, New York, Stati Uniti, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Stati Uniti, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Stati Uniti, 10461
- Montefiore Medical Center-Weiler Hospital
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Uniondale, New York, Stati Uniti, 11553
- Memorial Sloan Kettering Nassau
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Webster, New York, Stati Uniti, 14580
- Wilmot Cancer Institute at Webster
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North Carolina
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Albemarle, North Carolina, Stati Uniti, 28002
- Atrium Health Stanly/LCI-Albemarle
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Chapel Hill, North Carolina, Stati Uniti, 27599
- UNC Lineberger Comprehensive Cancer Center
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Charlotte, North Carolina, Stati Uniti, 28203
- Carolinas Medical Center/Levine Cancer Institute
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Charlotte, North Carolina, Stati Uniti, 28210
- Atrium Health Pineville/LCI-Pineville
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Charlotte, North Carolina, Stati Uniti, 28262
- Atrium Health University City/LCI-University
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Concord, North Carolina, Stati Uniti, 28025
- Atrium Health Cabarrus/LCI-Concord
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Durham, North Carolina, Stati Uniti, 27710
- Duke University Medical Center
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Gastonia, North Carolina, Stati Uniti, 28054
- Levine Cancer Institute-Gaston
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Monroe, North Carolina, Stati Uniti, 28112
- Atrium Health Union/LCI-Union
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Raleigh, North Carolina, Stati Uniti, 27609
- Duke Cancer Center Raleigh
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Shelby, North Carolina, Stati Uniti, 28150
- Atrium Health Cleveland/LCI-Cleveland
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Winston-Salem, North Carolina, Stati Uniti, 27157
- Wake Forest University Health Sciences
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Ohio
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Avon, Ohio, Stati Uniti, 44011
- UH Seidman Cancer Center at UH Avon Health Center
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Beachwood, Ohio, Stati Uniti, 44122
- UHHS-Chagrin Highlands Medical Center
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Centerville, Ohio, Stati Uniti, 45459
- Miami Valley Hospital South
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Cincinnati, Ohio, Stati Uniti, 45219
- University of Cincinnati Cancer Center-UC Medical Center
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Cleveland, Ohio, Stati Uniti, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Stati Uniti, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Stati Uniti, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Stati Uniti, 45415
- Miami Valley Hospital North
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Franklin, Ohio, Stati Uniti, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
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Greenville, Ohio, Stati Uniti, 45331
- Miami Valley Cancer Care and Infusion
-
Mentor, Ohio, Stati Uniti, 44060
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Troy, Ohio, Stati Uniti, 45373
- Upper Valley Medical Center
-
West Chester, Ohio, Stati Uniti, 45069
- University of Cincinnati Cancer Center-West Chester
-
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Oklahoma
-
Oklahoma City, Oklahoma, Stati Uniti, 73104
- University of Oklahoma Health Sciences Center
-
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Oregon
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Portland, Oregon, Stati Uniti, 97213
- Providence Portland Medical Center
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Pennsylvania
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Chadds Ford, Pennsylvania, Stati Uniti, 19317
- Christiana Care Health System-Concord Health Center
-
Erie, Pennsylvania, Stati Uniti, 16505
- UPMC Hillman Cancer Center Erie
-
Erie, Pennsylvania, Stati Uniti, 16544
- Saint Vincent Hospital
-
Hershey, Pennsylvania, Stati Uniti, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Johnstown, Pennsylvania, Stati Uniti, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
Monroeville, Pennsylvania, Stati Uniti, 15146
- Forbes Hospital
-
Philadelphia, Pennsylvania, Stati Uniti, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Stati Uniti, 19107
- Thomas Jefferson University Hospital
-
Pittsburgh, Pennsylvania, Stati Uniti, 15212
- Allegheny General Hospital
-
Pittsburgh, Pennsylvania, Stati Uniti, 15224
- West Penn Hospital
-
Pittsburgh, Pennsylvania, Stati Uniti, 15232
- UPMC Hillman Cancer Center
-
Wexford, Pennsylvania, Stati Uniti, 15090
- Wexford Health and Wellness Pavilion
-
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South Carolina
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Charleston, South Carolina, Stati Uniti, 29425
- Medical University of South Carolina
-
Rock Hill, South Carolina, Stati Uniti, 29732
- Levine Cancer Institute-Rock Hill
-
Rock Hill, South Carolina, Stati Uniti, 29730
- Rock Hill Radiation Therapy Center
-
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Tennessee
-
Nashville, Tennessee, Stati Uniti, 37232
- Vanderbilt University/Ingram Cancer Center
-
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Texas
-
Conroe, Texas, Stati Uniti, 77384
- UT MD Anderson - The Woodlands
-
Dallas, Texas, Stati Uniti, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Stati Uniti, 75237
- UT Southwestern Simmons Cancer Center - RedBird
-
Fort Worth, Texas, Stati Uniti, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Houston, Texas, Stati Uniti, 77030
- UT MD Anderson Cancer Center
-
Houston, Texas, Stati Uniti, 77079
- UT MD Anderson - West Houston
-
League City, Texas, Stati Uniti, 77573
- UT MD Anderson - League City
-
Richardson, Texas, Stati Uniti, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
San Antonio, Texas, Stati Uniti, 78229
- University of Texas Health Science Center at San Antonio
-
Sugar Land, Texas, Stati Uniti, 77478
- UT MD Anderson - Sugar Land
-
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Utah
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Salt Lake City, Utah, Stati Uniti, 84112
- Huntsman Cancer Institute/University of Utah
-
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Vermont
-
Berlin Corners, Vermont, Stati Uniti, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, Stati Uniti, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, Stati Uniti, 05405
- University of Vermont and State Agricultural College
-
Saint Johnsbury, Vermont, Stati Uniti, 05819
- Dartmouth Cancer Center - North
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Virginia
-
Charlottesville, Virginia, Stati Uniti, 22908
- University of Virginia Cancer Center
-
Fairfax, Virginia, Stati Uniti, 22031
- Inova Schar Cancer Institute
-
Richmond, Virginia, Stati Uniti, 23298
- VCU Massey Comprehensive Cancer Center
-
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Washington
-
Seattle, Washington, Stati Uniti, 98101
- Virginia Mason Medical Center
-
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Wisconsin
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La Crosse, Wisconsin, Stati Uniti, 54601
- Gundersen Lutheran Medical Center
-
Madison, Wisconsin, Stati Uniti, 53705
- William S Middleton VA Medical Center
-
Madison, Wisconsin, Stati Uniti, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Stati Uniti, 53718
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
Marshfield, Wisconsin, Stati Uniti, 54449
- Marshfield Medical Center-Marshfield
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Menomonee Falls, Wisconsin, Stati Uniti, 53051
- Froedtert Menomonee Falls Hospital
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Milwaukee, Wisconsin, Stati Uniti, 53226
- Medical College of Wisconsin
-
Oak Creek, Wisconsin, Stati Uniti, 53154
- Drexel Town Square Health Center
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West Bend, Wisconsin, Stati Uniti, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
-
Weston, Wisconsin, Stati Uniti, 54476
- Marshfield Medical Center - Weston
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
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Pathologically (histologically or cytologically) proven diagnosis of invasive cutaneous squamous cell carcinoma (CSCC) or regional lymph node or in-transit metastasis of CSCC
-
The following CSCC subtypes are eligible according to World Health Organization (WHO) classification if the predominant histology is confirmed CSCC.
-
Spindle cell squamous cell carcinoma (SCC)
-
Squamous cell carcinoma with sarcomatoid differentiation
-
Acantholytic SCC
-
Clear cell SCC
-
Lymphoepithelial carcinoma
- Note: Keratoacanthoma SCC and Verrucous SCC subtypes are not eligible.
-
-
For patients with regional metastasis without a primary tumor at screening: a clinical history of CSCC that drains to the involved regional lymph nodes or in-transit metastases in question is required
- For example, a parotid mass shown to be SCC by cytologic analysis of a fine needle aspirate in a patient with a clinical history of CSCC on the ipsilateral scalp would be eligible
-
For patients with regional metastases without a primary tumor and an ambiguous clinical history: tumor genomic sequencing suggesting a primary tumor of cutaneous origin would be acceptable evidence to establish eligibility
-
NOTE: Tumor genomic sequencing is not required to determine eligibility, but may be part of the routine evaluation of patients with cancers of unknown primary at some institutions. For example, a parotid mass shown to be SCC by cytologic analysis of fine needle aspirate without a primary tumor and an ambiguous clinical history, but with a tumor genomic sequencing assay demonstrating a high tumor mutation burden (≥ 10 mutations/Mb) and/or a high fraction of ultraviolet (UV) related mutations (> 50% of mutations [cytosine (C)/thymine (T)]C > T or CC > TT) and/or the presence of "signature 7" mutations would be eligible (Chang 2021)
-
-
Previously untreated or recurrent CSCC
-
Clinical American Joint Committee on Cancer (AJCC) 8th Edition (eyelid, head and neck sites) or Union for International Cancer Control (UICC) (non-head and neck sites) stage III or IV
-
Primary tumor site must be in the head and neck cutaneous region, other non-head and neck cutaneous regions, or eyelid cutaneous region
-
No mucosal squamous cell carcinoma (vermillion lip, nasal, oral, sinonasal, conjunctival, anogenital)
-
Tumor must be resectable with curative intent. Note: Tumor with bony skull base invasion and/or skull base foramen involvement (T4b) is not eligible. (Patients with T4b eyelid tumors using UICC Staging, and not involving the brain, are eligible.)
-
At least 1 lesion that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
-
No definitive clinical or radiologic evidence of distant metastatic disease (M1), visceral and/or distant nodal disease
-
Age ≥ 18
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
-
Not pregnant and not nursing
- 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) ≥ 1,000 cells/mm^3
-
Platelets ≥ 75,000 cells/mm^3
-
Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin [Hgb] ≥ 8.0 g/dl is acceptable)
-
Creatinine clearance (CrCL) > 30mL/min by the Cockcroft-Gault formula
-
Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (NOTE: For patients with Gilbert's syndrome, total bilirubin ≤ 3 x ULN. Gilbert's syndrome must be documented appropriately as past medical history.)
-
Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x institutional ULN
-
No prior systemic therapy for the study cancer (including patients currently receiving immunotherapy for a separate malignancy)
-
No prior radiotherapy to the region of the study cancer that would result in cumulative doses of radiation to organs at risk for radiation injury that exceed protocol limitations
-
No history of myocardial infarction/unstable angina within the last 6 months
-
New York Heart Association functional classification IIb or better (New York Heart Association [NYHA] functional classification III/IV are not eligible) (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association functional classification)
-
No active infection requiring systemic antibiotics, antiviral, or antifungal treatments
-
No history of allogeneic stem cell transplantation, or autologous stem cell transplantation
-
No history of a solid organ transplant (other than corneal transplant)
-
No active, known, or suspected autoimmune disease
-
Active or known disease is defined as:
- Requiring higher than physiologic steroid levels (> 10mg prednisone/day or equivalent) or
- Requiring disease-modifying agents or
- Ongoing or recent (within 5 years prior to registration) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk for immune-related adverse events (irAEs)
-
NOTES:
-
Patients meeting the following criteria are not considered immunosuppressed and are eligible to enroll:
- Patients who require a brief course of steroids (eg, prophylaxis for imaging assessments due to hypersensitivity to contrast agents) are not excluded
- Patients with type I diabetes mellitus, and endocrinopathies (including hypothyroidism due to autoimmune thyroiditis) only requiring hormone replacement, or skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll
- Physiologic replacement doses ≤ 10 mg prednisone/day or equivalent allowed, as long as they are not being administered for immunosuppressive intent. Inhaled or topical steroids are permitted
-
Patients with the following immunosuppressed conditions are eligible to enroll:
- Patients with HIV infection on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible
- Patients with chronic lymphocytic leukemia (CLL) with no history of anti-CLL therapy within 6 months prior to registration are eligible
-
-
-
No history of interstitial lung disease (eg, idiopathic pulmonary fibrosis, organizing pneumonia)
-
No active, noninfectious pneumonitis requiring immune-suppressive therapy
-
No active tuberculosis
-
No live vaccines within 28 days prior to registration
-
No history of allergic reaction to the study agent, compounds of similar chemical or biologic composition to the study agent (or any of its excipients)
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Comparatore attivo: Arm 1 (surgery, radiation)
Patients undergo surgery per standard of care within 6 weeks of randomization. Starting within 6-12 weeks of surgery, patients may undergo IGRT with IMRT for 5 fractions per week for 6 weeks as clinically indicated. Patients also undergo CT, MRI, and/or PET/CT prior to treatment, and CT and/or MRI during follow up. Patients may also undergo optional collection of tissue, whole blood, and plasma on study. |
Undergo MRI
Altri nomi:
Ancillary studies Undergo PET/CT
Altri nomi:
Undergo IMRT
Altri nomi:
Undergo CT and/or PET/CT
Altri nomi:
Undergo collection of blood and/or plasma
Altri nomi:
Undergo IGRT
Altri nomi:
Undergo surgery per SOC
Altri nomi:
Undergo response-adaptive surgery
Altri nomi:
|
|
Sperimentale: Arm 2 (cemiplimab, surgery, radiation)
Patients receive cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then undergo response-adaptive surgery 21 days after last dose of cemiplimab. Starting within 12 weeks of surgery, patients may undergo IGRT with IMRT for 5 fractions per week for 6 weeks as clinically indicated. Starting within 6 weeks of completion of surgery or radiation therapy (if indicated), patients without pCR receive cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 42 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, MRI, and/or PET/CT prior to treatment, and CT and/or MRI on study and during follow up. Patients may also undergo optional collection of tissue, whole blood, and plasma on study. |
Undergo MRI
Altri nomi:
Ancillary studies Undergo PET/CT
Altri nomi:
Undergo IMRT
Altri nomi:
Given IV
Altri nomi:
Undergo CT and/or PET/CT
Altri nomi:
Undergo collection of blood and/or plasma
Altri nomi:
Undergo IGRT
Altri nomi:
Undergo surgery per SOC
Altri nomi:
Undergo response-adaptive surgery
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Event-free survival (EFS)
Lasso di tempo: Up to 6 years
|
Defined as the time from randomization to any of the following events: progression of disease that precludes surgery, toxic effects related to treatment that preclude surgery, inability to resect all gross disease), disease recurrence (local, regional, or distant) after surgery (or after radiographic complete response), disease progression after radiographic partial response or stable disease without surgery (or biopsy, as applicable), or death due to any cause, whichever occurs first. EFS rates will be estimated using the Kaplan-Meier method, and the stratified log-rank test will be used to assess whether perioperative immunotherapy (neoadjuvant/adjuvant) with response-adapted oncologic surgery improves EFS as recorded by the site compared to standard-of-care surgery in resectable stage III/IV cutaneous squamous cell carcinoma (CSCC). |
Up to 6 years
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Utilization of adjuvant radiation
Lasso di tempo: Up to 6 years
|
Rates of utilization of adjuvant radiation for each arm will be computed using a binomial distribution assumption. A 95% confidence interval (CI) for the rate difference between arms will be calculated using the stratified Newcombe (Wilson) method (Yan 2010). |
Up to 6 years
|
|
Disease-free survival (DFS)
Lasso di tempo: From randomization to recurrent or death, assessed up to 6 years
|
DFS will use the same analytic methods as EFS. |
From randomization to recurrent or death, assessed up to 6 years
|
|
Overall survival (OS)
Lasso di tempo: From randomization to death, assessed up to 6 years
|
OS will use the same analytic methods as EFS. |
From randomization to death, assessed up to 6 years
|
|
Incidence of adverse events
Lasso di tempo: At 30 days and then up to 6 years
|
Adverse events (AEs) will be graded using Common Terminology Criteria for Adverse Events version (v) 5.0. Counts and frequencies of all AEs by grade will be provided by each treatment arm. For the experimental arm, AEs will be summarized for each treatment phase (neoadjuvant, adjuvant, and post-treatment [after adjuvant]). Counts and frequencies will be provided for the worst grade AE experienced by the patient by treatment arm. The proportion of patients with at least one grade 3 or higher AE, serious AEs, AEs leading to discontinuation or death will be reported for each treatment arm. These analyses will be descriptive. |
At 30 days and then up to 6 years
|
|
Pathologic complete response
Lasso di tempo: At 1 and 2 years
|
Site-reported pathologic response will be assessed using the following categories: pathological complete, major, and partial response, no pathological response (i.e., no complete, major, or partial response), and no pathological evaluation. Pathological responses at 1 and 2 years will be summarized using frequencies and percentages and tested using a chi-square test at a two-sided 5% significance level. |
At 1 and 2 years
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Quality of life
Lasso di tempo: From baseline up to 12 months after surgery
|
The primary patient-reported outcome (PRO) is the global health status score as measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. For all PRO scheduled assessment visits, patient disposition will be summarized. PRO completion rate and available data rate will be computed and reported at each timepoint. Mixed effects model with repeated measures (MMRM) will be performed for the global health status score incorporating all PRO assessment timepoints. The adjusted means for each treatment and the estimated treatment differences for the treatment comparisons will be presented together with 95% CIs. |
From baseline up to 12 months after surgery
|
|
Validation and scoring of Cutaneous Squamous Cell Carcinoma NeoAdjuvant, Adjuvant and Perioperative 32 question scale (CSCC NAAP-32)
Lasso di tempo: From baseline up to 12 months after surgery
|
Item response distributions, inter-item correlations, factor analysis and internal consistency will be assessed. Confirmatory factor analyses will be used to confirm the underlying structure hypothesized by the conceptual framework. Items capturing perceptions and effect of treatments will be evaluated with single-item scores. Completion rate and available data rate will be computed and reported at each timepoint. CSCC-NAAP-32 item responses will be described at baseline to evaluate floor/ceiling effects, missingness, outliers, and multi-modal distributions. Internal consistency reliability for multi-item scales will be evaluated at baseline using both Cronbach's alpha and McDonald Omega coefficients. Test-retest reliability will be assessed using intraclass correlation coefficients between two time points. Construct validity and ability to detect change over time will be assessed. |
From baseline up to 12 months after surgery
|
|
Change in patient-reported symptoms, functioning, and quality of life
Lasso di tempo: From baseline up to 12 months after surgery
|
PRO instruments will be scored based on their respective scoring algorithms. Descriptive statistics, MMRMs, and assessment of missing data will be performed. |
From baseline up to 12 months after surgery
|
|
Disease-specific survival (DSS)
Lasso di tempo: From randomization to death due to study cancer, date of precluding event, or last follow up, assessed up to 6 years
|
The cause-specific log-rank test and cause-specific Cox models will also be used to compare cause-specific HRs between treatment arms and estimate cause-specific treatment-effect HRs, respectively. The cumulative incidence method will be used to estimate the incidence of cancer-specific mortality with between-arm differences tested using the stratified Gray's test. Stratified sub-distribution HR and 95% CI for treatment effect from Fine-Gray models will be computed to supplement the DSS analysis. |
From randomization to death due to study cancer, date of precluding event, or last follow up, assessed up to 6 years
|
|
Pathologic response
Lasso di tempo: Up to 6 years
|
Will evaluate the association of pathologic response with DFS in the experimental arm. Will compare EFS between patients with complete response versus others (major/partial/no response/not evaluable) using a log-rank test. DFS rates for each pathological response subgroup will be estimated using the Kaplan-Meier method. Furthermore, DFS rates for each pathological response subgroup will be calculated using the Kaplan-Meier method as an exploratory analysis. |
Up to 6 years
|
|
Overall response rate
Lasso di tempo: Up to 6 years
|
Will be assessed using Response Evaluation Criteria in Solid Tumors v. 1.1 and summarized by time-point using frequencies and relative frequencies. The best objective response (complete response + partial response) rate will be estimated using a 95% confidence interval obtained using the normal approximation for a binomial proportion. |
Up to 6 years
|
|
Failure patterns
Lasso di tempo: Up to 6 years
|
Failure patterns (local, regional, and distant metastasis) for EFS will be summarized for each treatment arm. |
Up to 6 years
|
|
Lymph node yield
Lasso di tempo: At time of surgery
|
The pathologic measurements of lymph node yield (i.e., number of lymph nodes) will be compared between arms using the Mann-Whitney test. |
At time of surgery
|
|
Primary tumor specimen dimensions
Lasso di tempo: At time of surgery
|
The pathologic measurements of the primary tumor specimens' length, width, and volume will be compared between arms using the t-test for independent samples. A Mann-Whitney test will be used if the distribution of a variable does not pass the normality test. |
At time of surgery
|
|
Treatment effect HR estimates
Lasso di tempo: Up to 6 years
|
Treatment effect HR estimates and 95% CIs for the primary and secondary endpoints (EFS, DFS, DSS, OS) will be calculated using a (cause-specific) Cox model with treatment by factor interaction for the following subgroups:
|
Up to 6 years
|
|
Treatment effect estimates by sex
Lasso di tempo: Up to 6 years
|
Estimates of the primary outcome treatment effect and the corresponding 95% CIs by sex will be provided. |
Up to 6 years
|
|
Treatment effect estimates by race
Lasso di tempo: Up to 6 years
|
Estimates of the primary outcome treatment effect and the corresponding 95% CIs by race will be provided. |
Up to 6 years
|
|
Treatment effect estimates by ethnicity
Lasso di tempo: Up to 6 years
|
Estimates of the primary outcome treatment effect and the corresponding 95% CIs by ethnicity will be provided. |
Up to 6 years
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Neil D Gross, NRG Oncology
Pubblicazioni e link utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Tecniche investigative
- Terapie
- Tecniche di laboratorio clinico
- Tecniche e procedure diagnostiche
- Diagnosi
- Tecniche di chimica, analitiche
- Analisi dello spettro
- Radioterapia
- Radioterapia, conforme
- Radioterapia, assistita da computer
- Gestione dei campioni
- Spettroscopia di risonanza magnetica
- Procedure chirurgiche, operative
- Radioterapia, modulata intensità
- Cemiplimab
- Radioterapia, guidata dall'immagine
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- NCI-2024-03425
- U10CA180868 (Sovvenzione/contratto NIH degli Stati Uniti)
- NCI-2024-03425 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
- NRG-HN014 (Altro identificatore: CTEP)
- NRG-HN014 (Altro identificatore: NRG Oncology)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
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Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
prodotto fabbricato ed esportato dagli Stati Uniti
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