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進行性皮膚がんの治療における通常の単独手術に免疫療法薬セミプリマブ (REGN2810) と手術を追加する試験

2026年10月31日 更新者：National Cancer Institute (NCI)

切除可能なステージ III/IV 皮膚扁平上皮癌に対する反応適応型治療と標準治療による周術期免疫療法のランダム化第 III 相試験

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.

調査の概要

状態

一時停止

条件

介入・治療

詳細な説明

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.

研究の種類

介入

入学 (推定)

420

段階

  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

  • アメリカ
    • Alabama
      • Birmingham、Alabama、アメリカ、35233
        • University of Alabama at Birmingham Cancer Center
    • Arizona
      • Gilbert、Arizona、アメリカ、85234
        • Banner MD Anderson Cancer Center
      • Phoenix、Arizona、アメリカ、85054
        • Mayo Clinic Hospital in Arizona
    • California
      • Beverly Hills、California、アメリカ、90211
        • Tower Cancer Research Foundation
      • Duarte、California、アメリカ、91010
        • City of Hope Comprehensive Cancer Center
      • Encinitas、California、アメリカ、92024
        • UC San Diego Health System - Encinitas
      • Irvine、California、アメリカ、92618
        • City of Hope at Irvine Lennar
      • La Jolla、California、アメリカ、92093
        • UC San Diego Moores Cancer Center
      • Lancaster、California、アメリカ、93534
        • City of Hope Antelope Valley
      • Los Angeles、California、アメリカ、90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles、California、アメリカ、90048
        • Cedars-Sinai Medical Center
      • Los Angeles、California、アメリカ、90025
        • The Angeles Clinic and Research Institute - West Los Angeles Office
      • Oakland、California、アメリカ、94611
        • Kaiser Permanente-Oakland
      • Palo Alto、California、アメリカ、94304
        • Stanford Cancer Institute Palo Alto
      • Sacramento、California、アメリカ、95817
        • University of California Davis Comprehensive Cancer Center
      • Sacramento、California、アメリカ、95823
        • Kaiser Permanente-South Sacramento
      • San Diego、California、アメリカ、92103
        • UC San Diego Medical Center - Hillcrest
      • San Francisco、California、アメリカ、94115
        • Kaiser Permanente-San Francisco
      • South Pasadena、California、アメリカ、91030
        • City of Hope South Pasadena
      • Torrance、California、アメリカ、90505
        • Torrance Memorial Physician Network - Cancer Care
      • Upland、California、アメリカ、91786
        • City of Hope Upland
      • Walnut Creek、California、アメリカ、94596
        • Kaiser Permanente-Walnut Creek
    • Colorado
      • Aurora、Colorado、アメリカ、80045
        • UCHealth University of Colorado Hospital
      • Colorado Springs、Colorado、アメリカ、80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs、Colorado、アメリカ、80920
        • Memorial Hospital North
    • Connecticut
      • Greenwich、Connecticut、アメリカ、06830
        • Smilow Cancer Hospital Care Center at Greenwich
      • Guilford、Connecticut、アメリカ、06437
        • Smilow Cancer Hospital Care Center - Guilford
      • New Haven、Connecticut、アメリカ、06520
        • Yale University
      • Trumbull、Connecticut、アメリカ、06611
        • Smilow Cancer Hospital Care Center-Trumbull
      • Waterbury、Connecticut、アメリカ、06708
        • Smilow Cancer Hospital-Waterbury Care Center
      • Waterford、Connecticut、アメリカ、06385
        • Smilow Cancer Hospital Care Center - Waterford
    • Delaware
      • Newark、Delaware、アメリカ、19713
        • Helen F Graham Cancer Center
      • Newark、Delaware、アメリカ、19713
        • Medical Oncology Hematology Consultants PA
    • Florida
      • Aventura、Florida、アメリカ、33180
        • UM Sylvester Comprehensive Cancer Center at Aventura
      • Coral Gables、Florida、アメリカ、33146
        • UM Sylvester Comprehensive Cancer Center at Coral Gables
      • Deerfield Beach、Florida、アメリカ、33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Doral、Florida、アメリカ、33166
        • UM Sylvester Comprehensive Cancer Center at Doral
      • Jacksonville、Florida、アメリカ、32224-9980
        • Mayo Clinic in Florida
      • Miami、Florida、アメリカ、33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Miami、Florida、アメリカ、33176
        • Miami Cancer Institute
      • Miami、Florida、アメリカ、33176
        • UM Sylvester Comprehensive Cancer Center at Kendall
      • N. Venice、Florida、アメリカ、34275
        • Sarasota Memorial Hospital-Venice
      • Plantation、Florida、アメリカ、33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
      • Sarasota、Florida、アメリカ、34239
        • Sarasota Memorial Hospital
      • Sarasota、Florida、アメリカ、34232
        • Florida Cancer Specialists - Sarasota
      • Sarasota、Florida、アメリカ、34243
        • Sarasota Memorial Health Care Center at University Parkway
      • Sarasota、Florida、アメリカ、34239
        • First Physicians Group - Silverstein Institute at Floyd Street
      • Sarasota、Florida、アメリカ、34239
        • Florida Cancer Specialists - Sarasota Downtown
      • Tampa、Florida、アメリカ、33612
        • Moffitt Cancer Center
      • Tampa、Florida、アメリカ、33607
        • Moffitt Cancer Center-International Plaza
      • Tampa、Florida、アメリカ、33612
        • Moffitt Cancer Center - McKinley Campus
      • Venice、Florida、アメリカ、34285
        • Florida Cancer Specialists - Venice Island
      • Venice、Florida、アメリカ、34275
        • Florida Cancer Specialists - Venice Pinebrook
    • Georgia
      • Atlanta、Georgia、アメリカ、30308
        • Emory University Hospital Midtown
      • Atlanta、Georgia、アメリカ、30322
        • Emory University Hospital/Winship Cancer Institute
    • Illinois
      • Alton、Illinois、アメリカ、62002
        • Alton Memorial Hospital
      • Chicago、Illinois、アメリカ、60611
        • Northwestern University
      • Chicago、Illinois、アメリカ、60612
        • University of Illinois
      • Chicago、Illinois、アメリカ、60612
        • Rush MD Anderson Cancer Center
      • DeKalb、Illinois、アメリカ、60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Decatur、Illinois、アメリカ、62526
        • Decatur Memorial Hospital
      • Geneva、Illinois、アメリカ、60134
        • Northwestern Medicine Cancer Center Delnor
      • Orland Park、Illinois、アメリカ、60462
        • Northwestern Medicine Orland Park
      • Shiloh、Illinois、アメリカ、62269
        • Memorial Hospital East
      • Warrenville、Illinois、アメリカ、60555
        • Northwestern Medicine Cancer Center Warrenville
    • Indiana
      • Carmel、Indiana、アメリカ、46032
        • IU Health North Hospital
      • Goshen、Indiana、アメリカ、46526
        • Goshen Center for Cancer Care
      • Indianapolis、Indiana、アメリカ、46237
        • Franciscan Health Indianapolis
      • Indianapolis、Indiana、アメリカ、46202
        • Indiana University/Melvin and Bren Simon Cancer Center
    • Iowa
      • Council Bluffs、Iowa、アメリカ、51503
        • Heartland Oncology and Hematology LLP
      • Council Bluffs、Iowa、アメリカ、51503
        • Methodist Jennie Edmundson Hospital
    • Kansas
      • Kansas City、Kansas、アメリカ、66160
        • University of Kansas Cancer Center
      • Overland Park、Kansas、アメリカ、66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park、Kansas、アメリカ、66211
        • University of Kansas Hospital-Indian Creek Campus
      • Westwood、Kansas、アメリカ、66205
        • University of Kansas Hospital-Westwood Cancer Center
    • Kentucky
      • Lexington、Kentucky、アメリカ、40536
        • University of Kentucky/Markey Cancer Center
      • Louisville、Kentucky、アメリカ、40202
        • The James Graham Brown Cancer Center at University of Louisville
      • Louisville、Kentucky、アメリカ、40245
        • UofL Health Medical Center Northeast
    • Louisiana
      • Baton Rouge、Louisiana、アメリカ、70805
        • LSU Health Baton Rouge-North Clinic
      • Baton Rouge、Louisiana、アメリカ、70808
        • Our Lady of the Lake Physician Group
      • New Orleans、Louisiana、アメリカ、70112
        • University Medical Center New Orleans
    • Michigan
      • Ann Arbor、Michigan、アメリカ、48109
        • University of Michigan Rogel Cancer Center
      • Brighton、Michigan、アメリカ、48116
        • University of Michigan - Brighton Center for Specialty Care
      • Detroit、Michigan、アメリカ、48202
        • Henry Ford Hospital
      • Grand Rapids、Michigan、アメリカ、49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • West Bloomfield、Michigan、アメリカ、48322
        • Henry Ford West Bloomfield Hospital
      • Wyoming、Michigan、アメリカ、49519
        • University of Michigan Health - West
    • Minnesota
      • Minneapolis、Minnesota、アメリカ、55455
        • University of Minnesota/Masonic Cancer Center
      • Rochester、Minnesota、アメリカ、55905
        • Mayo Clinic in Rochester
    • Missouri
      • City of Saint Peters、Missouri、アメリカ、63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Columbia、Missouri、アメリカ、65212
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Creve Coeur、Missouri、アメリカ、63141
        • Siteman Cancer Center at West County Hospital
      • Kansas City、Missouri、アメリカ、64154
        • University of Kansas Cancer Center - North
      • Lee's Summit、Missouri、アメリカ、64064
        • University of Kansas Cancer Center - Lee's Summit
      • St Louis、Missouri、アメリカ、63110
        • Washington University School of Medicine
      • St Louis、Missouri、アメリカ、63129
        • Siteman Cancer Center-South County
      • St Louis、Missouri、アメリカ、63136
        • Siteman Cancer Center at Christian Hospital
    • Nebraska
      • Bellevue、Nebraska、アメリカ、68123
        • Nebraska Medicine-Bellevue
      • Omaha、Nebraska、アメリカ、68114
        • Nebraska Methodist Hospital
      • Omaha、Nebraska、アメリカ、68198
        • University of Nebraska Medical Center
      • Omaha、Nebraska、アメリカ、68118
        • Nebraska Medicine-Village Pointe
      • Omaha、Nebraska、アメリカ、68114
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
    • New Hampshire
      • Lebanon、New Hampshire、アメリカ、03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Basking Ridge、New Jersey、アメリカ、07920
        • Memorial Sloan Kettering Basking Ridge
      • Middletown、New Jersey、アメリカ、07748
        • Memorial Sloan Kettering Monmouth
      • Montvale、New Jersey、アメリカ、07645
        • Memorial Sloan Kettering Bergen
    • New Mexico
      • Albuquerque、New Mexico、アメリカ、87106
        • University of New Mexico Cancer Center
    • New York
      • Commack、New York、アメリカ、11725
        • Memorial Sloan Kettering Commack
      • Harrison、New York、アメリカ、10604
        • Memorial Sloan Kettering Westchester
      • Lake Success、New York、アメリカ、11042
        • Northwell Health/Center for Advanced Medicine
      • Mineola、New York、アメリカ、11501
        • NYU Langone Hospital - Long Island
      • New York、New York、アメリカ、10065
        • Memorial Sloan Kettering Cancer Center
      • New York、New York、アメリカ、10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • New York、New York、アメリカ、10075
        • Lenox Hill Hospital
      • New York、New York、アメリカ、10065
        • Manhattan Eye Ear and Throat Hospital
      • Rochester、New York、アメリカ、14642
        • University of Rochester
      • Stony Brook、New York、アメリカ、11794
        • Stony Brook University Medical Center
      • Syracuse、New York、アメリカ、13210
        • State University of New York Upstate Medical University
      • Syracuse、New York、アメリカ、13215
        • SUNY Upstate Medical Center-Community Campus
      • The Bronx、New York、アメリカ、10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx、New York、アメリカ、10467
        • Montefiore Medical Center - Moses Campus
      • The Bronx、New York、アメリカ、10461
        • Montefiore Medical Center-Weiler Hospital
      • Uniondale、New York、アメリカ、11553
        • Memorial Sloan Kettering Nassau
      • Webster、New York、アメリカ、14580
        • Wilmot Cancer Institute at Webster
    • North Carolina
      • Albemarle、North Carolina、アメリカ、28002
        • Atrium Health Stanly/LCI-Albemarle
      • Chapel Hill、North Carolina、アメリカ、27599
        • UNC Lineberger Comprehensive Cancer Center
      • Charlotte、North Carolina、アメリカ、28203
        • Carolinas Medical Center/Levine Cancer Institute
      • Charlotte、North Carolina、アメリカ、28210
        • Atrium Health Pineville/LCI-Pineville
      • Charlotte、North Carolina、アメリカ、28262
        • Atrium Health University City/LCI-University
      • Concord、North Carolina、アメリカ、28025
        • Atrium Health Cabarrus/LCI-Concord
      • Durham、North Carolina、アメリカ、27710
        • Duke University Medical Center
      • Gastonia、North Carolina、アメリカ、28054
        • Levine Cancer Institute-Gaston
      • Monroe、North Carolina、アメリカ、28112
        • Atrium Health Union/LCI-Union
      • Raleigh、North Carolina、アメリカ、27609
        • Duke Cancer Center Raleigh
      • Shelby、North Carolina、アメリカ、28150
        • Atrium Health Cleveland/LCI-Cleveland
      • Winston-Salem、North Carolina、アメリカ、27157
        • Wake Forest University Health Sciences
    • Ohio
      • Avon、Ohio、アメリカ、44011
        • UH Seidman Cancer Center at UH Avon Health Center
      • Beachwood、Ohio、アメリカ、44122
        • UHHS-Chagrin Highlands Medical Center
      • Centerville、Ohio、アメリカ、45459
        • Miami Valley Hospital South
      • Cincinnati、Ohio、アメリカ、45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cleveland、Ohio、アメリカ、44106
        • Case Western Reserve University
      • Cleveland、Ohio、アメリカ、44109
        • MetroHealth Medical Center
      • Columbus、Ohio、アメリカ、43210
        • Ohio State University Comprehensive Cancer Center
      • Dayton、Ohio、アメリカ、45415
        • Miami Valley Hospital North
      • Franklin、Ohio、アメリカ、45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Greenville、Ohio、アメリカ、45331
        • Miami Valley Cancer Care and Infusion
      • Mentor、Ohio、アメリカ、44060
        • UH Seidman Cancer Center at Lake Health Mentor Campus
      • Troy、Ohio、アメリカ、45373
        • Upper Valley Medical Center
      • West Chester、Ohio、アメリカ、45069
        • University of Cincinnati Cancer Center-West Chester
    • Oklahoma
      • Oklahoma City、Oklahoma、アメリカ、73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Portland、Oregon、アメリカ、97213
        • Providence Portland Medical Center
    • Pennsylvania
      • Chadds Ford、Pennsylvania、アメリカ、19317
        • Christiana Care Health System-Concord Health Center
      • Erie、Pennsylvania、アメリカ、16505
        • UPMC Hillman Cancer Center Erie
      • Erie、Pennsylvania、アメリカ、16544
        • Saint Vincent Hospital
      • Hershey、Pennsylvania、アメリカ、17033-0850
        • Penn State Milton S Hershey Medical Center
      • Johnstown、Pennsylvania、アメリカ、15901
        • UPMC-Johnstown/John P. Murtha Regional Cancer Center
      • Monroeville、Pennsylvania、アメリカ、15146
        • Forbes Hospital
      • Philadelphia、Pennsylvania、アメリカ、19111
        • Fox Chase Cancer Center
      • Philadelphia、Pennsylvania、アメリカ、19107
        • Thomas Jefferson University Hospital
      • Pittsburgh、Pennsylvania、アメリカ、15212
        • Allegheny General Hospital
      • Pittsburgh、Pennsylvania、アメリカ、15224
        • West Penn Hospital
      • Pittsburgh、Pennsylvania、アメリカ、15232
        • UPMC Hillman Cancer Center
      • Wexford、Pennsylvania、アメリカ、15090
        • Wexford Health and Wellness Pavilion
    • South Carolina
      • Charleston、South Carolina、アメリカ、29425
        • Medical University of South Carolina
      • Rock Hill、South Carolina、アメリカ、29732
        • Levine Cancer Institute-Rock Hill
      • Rock Hill、South Carolina、アメリカ、29730
        • Rock Hill Radiation Therapy Center
    • Tennessee
      • Nashville、Tennessee、アメリカ、37232
        • Vanderbilt University/Ingram Cancer Center
    • Texas
      • Conroe、Texas、アメリカ、77384
        • UT MD Anderson - The Woodlands
      • Dallas、Texas、アメリカ、75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Dallas、Texas、アメリカ、75237
        • UT Southwestern Simmons Cancer Center - RedBird
      • Fort Worth、Texas、アメリカ、76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Houston、Texas、アメリカ、77030
        • UT MD Anderson Cancer Center
      • Houston、Texas、アメリカ、77079
        • UT MD Anderson - West Houston
      • League City、Texas、アメリカ、77573
        • UT MD Anderson - League City
      • Richardson、Texas、アメリカ、75080
        • UT Southwestern Clinical Center at Richardson/Plano
      • San Antonio、Texas、アメリカ、78229
        • University of Texas Health Science Center at San Antonio
      • Sugar Land、Texas、アメリカ、77478
        • UT MD Anderson - Sugar Land
    • Utah
      • Salt Lake City、Utah、アメリカ、84112
        • Huntsman Cancer Institute/University of Utah
    • Vermont
      • Berlin Corners、Vermont、アメリカ、05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington、Vermont、アメリカ、05401
        • University of Vermont Medical Center
      • Burlington、Vermont、アメリカ、05405
        • University of Vermont and State Agricultural College
      • Saint Johnsbury、Vermont、アメリカ、05819
        • Dartmouth Cancer Center - North
    • Virginia
      • Charlottesville、Virginia、アメリカ、22908
        • University of Virginia Cancer Center
      • Fairfax、Virginia、アメリカ、22031
        • Inova Schar Cancer Institute
      • Richmond、Virginia、アメリカ、23298
        • VCU Massey Comprehensive Cancer Center
    • Washington
      • Seattle、Washington、アメリカ、98101
        • Virginia Mason Medical Center
    • Wisconsin
      • La Crosse、Wisconsin、アメリカ、54601
        • Gundersen Lutheran Medical Center
      • Madison、Wisconsin、アメリカ、53705
        • William S Middleton VA Medical Center
      • Madison、Wisconsin、アメリカ、53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Madison、Wisconsin、アメリカ、53718
        • University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
      • Marshfield、Wisconsin、アメリカ、54449
        • Marshfield Medical Center-Marshfield
      • Menomonee Falls、Wisconsin、アメリカ、53051
        • Froedtert Menomonee Falls Hospital
      • Milwaukee、Wisconsin、アメリカ、53226
        • Medical College of Wisconsin
      • Oak Creek、Wisconsin、アメリカ、53154
        • Drexel Town Square Health Center
      • West Bend、Wisconsin、アメリカ、53095
        • Froedtert West Bend Hospital/Kraemer Cancer Center
      • Weston、Wisconsin、アメリカ、54476
        • Marshfield Medical Center - Weston
  • オーストラリア
    • New South Wales
      • Camperdown、New South Wales、オーストラリア、2050
        • Chris O'Brien Lifehouse
      • Wollongong、New South Wales、オーストラリア、2500
        • Wollongong Hospital
    • Queensland
      • Townsville、Queensland、オーストラリア、4814
        • Townsville General Hospital
      • Woolloongabba、Queensland、オーストラリア、4102
        • Princess Alexandra Hospital
    • Victoria
      • Fitzroy、Victoria、オーストラリア、3065
        • Saint Vincent's Hospital
      • Melbourne、Victoria、オーストラリア、3000
        • Peter MacCallum Cancer Centre
    • Western Australia
      • Murdoch、Western Australia、オーストラリア、6150
        • Fiona Stanley Hospital
  • カナダ
    • British Columbia
      • Vancouver、British Columbia、カナダ、V5Z 4E6
        • BCCA-Vancouver Cancer Centre
    • Ontario
      • Toronto、Ontario、カナダ、M5G 2M9
        • University Health Network-Princess Margaret Hospital
      • Toronto、Ontario、カナダ、M4N 3M5
        • Odette Cancer Centre- Sunnybrook Health Sciences Centre

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • 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)

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：ランダム化
  • 介入モデル：並列代入
  • マスキング：独身

武器と介入

参加者グループ / アーム
介入・治療
アクティブコンパレータ：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.
手順：Magnetic Resonance Imaging

Undergo MRI

他の名前：
  • MRI
  • 磁気共鳴
  • 磁気共鳴画像スキャン
  • 医用画像、磁気共鳴 / 核磁気共鳴
  • 氏
  • MRイメージング
  • MRI スキャン
  • NMRイメージング
  • NMRI
  • 核磁気共鳴イメージング
  • 磁気共鳴画像法 (MRI)
  • sMRI
  • 磁気共鳴画像法（手順）
  • 構造MRI
他の：Questionnaire Administration

Ancillary studies

手順：Positron Emission Tomography

Undergo PET/CT

他の名前：
  • 医用画像、陽電子放出断層撮影
  • ペット
  • PETスキャン
  • 陽電子放出断層撮影スキャン
  • 陽電子放出断層撮影
  • PT
  • 陽電子放出断層撮影（手順）
放射線：Intensity-Modulated Radiation Therapy

Undergo IMRT

他の名前：
  • IMRT
  • 強度変調 RT
  • 強度変調放射線治療
  • 放射線、強度変調放射線治療
  • 強度変調放射線療法（手順）
手順：Computed Tomography

Undergo CT and/or PET/CT

他の名前：
  • CT
  • 猫
  • CATスキャン
  • コンピューター断層撮影
  • コンピュータ化されたアキシャルトモグラフィー
  • CTスキャン
  • トモグラフィー
  • コンピューター断層撮影 (手順)
  • コンピューター断層撮影 (CT) スキャン
  • 診断CATスキャン
  • 診断CATスキャンサービスタイプ
手順：Biospecimen Collection

Undergo collection of blood and/or plasma

他の名前：
  • 生物学的サンプルの収集
  • 採取された生体試料
  • 標本収集
  • サンプル収集
放射線：Image Guided Radiation Therapy

Undergo IGRT

他の名前：
  • IGRT
  • 画像誘導放射線治療
  • 画像ガイド付き放射線療法
手順：Surgical Procedure

Undergo surgery per SOC

他の名前：
  • 手術
  • 手術の種類
  • 外科的
  • 外科的介入
  • 外科処置
  • 手術、NOS
手順：Surgical Procedure

Undergo response-adaptive surgery

他の名前：
  • 手術
  • 手術の種類
  • 外科的
  • 外科的介入
  • 外科処置
  • 手術、NOS
実験的：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.
手順：Magnetic Resonance Imaging

Undergo MRI

他の名前：
  • MRI
  • 磁気共鳴
  • 磁気共鳴画像スキャン
  • 医用画像、磁気共鳴 / 核磁気共鳴
  • 氏
  • MRイメージング
  • MRI スキャン
  • NMRイメージング
  • NMRI
  • 核磁気共鳴イメージング
  • 磁気共鳴画像法 (MRI)
  • sMRI
  • 磁気共鳴画像法（手順）
  • 構造MRI
他の：Questionnaire Administration

Ancillary studies

手順：Positron Emission Tomography

Undergo PET/CT

他の名前：
  • 医用画像、陽電子放出断層撮影
  • ペット
  • PETスキャン
  • 陽電子放出断層撮影スキャン
  • 陽電子放出断層撮影
  • PT
  • 陽電子放出断層撮影（手順）
放射線：Intensity-Modulated Radiation Therapy

Undergo IMRT

他の名前：
  • IMRT
  • 強度変調 RT
  • 強度変調放射線治療
  • 放射線、強度変調放射線治療
  • 強度変調放射線療法（手順）
生物学的：Cemiplimab

Given IV

他の名前：
  • REGN2810
  • セミプリマブ RWLC
  • セミプリマブ-rwlc
  • リブタヨ
  • レグノ 2810
  • REGN-2810
手順：Computed Tomography

Undergo CT and/or PET/CT

他の名前：
  • CT
  • 猫
  • CATスキャン
  • コンピューター断層撮影
  • コンピュータ化されたアキシャルトモグラフィー
  • CTスキャン
  • トモグラフィー
  • コンピューター断層撮影 (手順)
  • コンピューター断層撮影 (CT) スキャン
  • 診断CATスキャン
  • 診断CATスキャンサービスタイプ
手順：Biospecimen Collection

Undergo collection of blood and/or plasma

他の名前：
  • 生物学的サンプルの収集
  • 採取された生体試料
  • 標本収集
  • サンプル収集
放射線：Image Guided Radiation Therapy

Undergo IGRT

他の名前：
  • IGRT
  • 画像誘導放射線治療
  • 画像ガイド付き放射線療法
手順：Surgical Procedure

Undergo surgery per SOC

他の名前：
  • 手術
  • 手術の種類
  • 外科的
  • 外科的介入
  • 外科処置
  • 手術、NOS
手順：Surgical Procedure

Undergo response-adaptive surgery

他の名前：
  • 手術
  • 手術の種類
  • 外科的
  • 外科的介入
  • 外科処置
  • 手術、NOS

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Event-free survival (EFS)
時間枠：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

二次結果の測定

結果測定
メジャーの説明
時間枠
Utilization of adjuvant radiation
時間枠：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)
時間枠：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)
時間枠：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
時間枠：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
時間枠：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

その他の成果指標

結果測定
メジャーの説明
時間枠
Quality of life
時間枠：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)
時間枠：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
時間枠：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)
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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:

  • Immunosuppressed (Yes versus [vs.] no)
  • Advanced nodal disease (N3 or in-transit metastases vs. other).
  • Clinical Union for International Cancer Control or American Joint Committee on Cancer 8th Edition stage III vs. IV
  • Female vs. male
  • Age < 70 vs. ≥ 70 years
  • Eastern Cooperative Oncology Group performance status (0 vs. 1-2)
  • Females vs. males
  • White vs. other race
  • Head and neck vs. trunk/extremities
  • T stage (Tx-2 vs. > T2)
  • N stage (N0-1 vs. > N1)
  • Country A forest plot with these treatment effect HR estimates will be provided.
Up to 6 years
Treatment effect estimates by sex
時間枠：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
時間枠：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
時間枠：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

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

National Cancer Institute (NCI)

捜査官

  • 主任研究者：Neil D Gross、NRG Oncology

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2025年2月18日

一次修了 (推定)

2031年8月14日

研究の完了 (推定)

2031年8月14日

試験登録日

最初に提出

2024年8月22日

QC基準を満たした最初の提出物

2024年8月22日

最初の投稿 (実際)

2024年8月23日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月3日

QC基準を満たした最後の更新が送信されました

2026年10月31日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • NCI-2024-03425
  • U10CA180868 (米国 NIH グラント/契約)
  • NCI-2024-03425 (レジストリ識別子：CTRP (Clinical Trial Reporting Program))
  • NRG-HN014 (その他の識別子：CTEP)
  • NRG-HN014 (その他の識別子：NRG Oncology)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

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.

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

はい

米国FDA規制機器製品の研究

いいえ

米国で製造され、米国から輸出された製品。

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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