- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT06568172
Tester tillegg av et immunterapilegemiddel, Cemiplimab (REGN2810), pluss kirurgi til vanlig kirurgi alene for behandling av avansert hudkreft
Randomisert fase III-studie av perioperativ immunterapi med responstilpasset behandling versus standardbehandling for resektabelt stadium III/IV kutant plateepitelkarsinom
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.
Studieoversikt
Status
Forhold
- Fase IV Hode og nakke Kutan plateepitelkarsinom AJCC V8
- Fase III hode og nakke kutan plateepitelkarsinom AJCC V8
- Øyelokkskvamøscellekarcinom
- Hud akantolytisk planocellulært karcinom
- Hudklar celle skivepitelcarcinom
- Hud lymfoepitelialt karcinom
- Hud Spindelcelle Plattencellekarsinom
- Hud spinocellulært karsinom med sarkomatoïd differensiering
- Tilbakevendende øyelokkskvamøscellekarsinom
- Reseptiv hudacantolytisk spinalcellekarsinom
- Reseptiv Hud Klarcelle Plattencellekarsinom
- Reseptiv hudlymfoepitelial karsinom
- Recidiverende hudspindelcelle skivepitelcarcinom
- Recidiv hudplatteneccarcinom med sarcomatoid differensiering
- Resekterbart øyelokkskvamøscellekarcinom
- Resekterbar hud akantolytisk plateepitelkreft
- Resekterbar hud klar celle skvamøscellekarsinom
- Resekabelt hudlymfoepitelialt karsinom
- Resekabelt hudspindelcelle spinocellulært karcinom
- Resektabel hudcancer med sarkomatoid differensiering
Intervensjon / Behandling
- Fremgangsmåte: Magnetic Resonance Imaging
- Annen: Questionnaire Administration
- Fremgangsmåte: Positron Emission Tomography
- Stråling: Intensity-Modulated Radiation Therapy
- Biologisk: Cemiplimab
- Fremgangsmåte: Computed Tomography
- Fremgangsmåte: Biospecimen Collection
- Stråling: Image Guided Radiation Therapy
- Fremgangsmåte: Surgical Procedure
- Fremgangsmåte: Surgical Procedure
Detaljert beskrivelse
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.
Studietype
Registrering (Antatt)
Fase
- Fase 3
Kontakter og plasseringer
Studiesteder
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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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-
-
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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, Forente stater, 35233
- University of Alabama at Birmingham Cancer Center
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Arizona
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Gilbert, Arizona, Forente stater, 85234
- Banner MD Anderson Cancer Center
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Phoenix, Arizona, Forente stater, 85054
- Mayo Clinic Hospital in Arizona
-
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California
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Beverly Hills, California, Forente stater, 90211
- Tower Cancer Research Foundation
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Duarte, California, Forente stater, 91010
- City of Hope Comprehensive Cancer Center
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Encinitas, California, Forente stater, 92024
- UC San Diego Health System - Encinitas
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Irvine, California, Forente stater, 92618
- City of Hope at Irvine Lennar
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La Jolla, California, Forente stater, 92093
- UC San Diego Moores Cancer Center
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Lancaster, California, Forente stater, 93534
- City of Hope Antelope Valley
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Los Angeles, California, Forente stater, 90033
- USC / Norris Comprehensive Cancer Center
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Los Angeles, California, Forente stater, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, Forente stater, 90025
- The Angeles Clinic and Research Institute - West Los Angeles Office
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Oakland, California, Forente stater, 94611
- Kaiser Permanente-Oakland
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Palo Alto, California, Forente stater, 94304
- Stanford Cancer Institute Palo Alto
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Sacramento, California, Forente stater, 95817
- University of California Davis Comprehensive Cancer Center
-
Sacramento, California, Forente stater, 95823
- Kaiser Permanente-South Sacramento
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San Diego, California, Forente stater, 92103
- UC San Diego Medical Center - Hillcrest
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San Francisco, California, Forente stater, 94115
- Kaiser Permanente-San Francisco
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South Pasadena, California, Forente stater, 91030
- City of Hope South Pasadena
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Torrance, California, Forente stater, 90505
- Torrance Memorial Physician Network - Cancer Care
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Upland, California, Forente stater, 91786
- City of Hope Upland
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Walnut Creek, California, Forente stater, 94596
- Kaiser Permanente-Walnut Creek
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Colorado
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Aurora, Colorado, Forente stater, 80045
- UCHealth University of Colorado Hospital
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Colorado Springs, Colorado, Forente stater, 80909
- UCHealth Memorial Hospital Central
-
Colorado Springs, Colorado, Forente stater, 80920
- Memorial Hospital North
-
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Connecticut
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Greenwich, Connecticut, Forente stater, 06830
- Smilow Cancer Hospital Care Center at Greenwich
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Guilford, Connecticut, Forente stater, 06437
- Smilow Cancer Hospital Care Center - Guilford
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New Haven, Connecticut, Forente stater, 06520
- Yale University
-
Trumbull, Connecticut, Forente stater, 06611
- Smilow Cancer Hospital Care Center-Trumbull
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Waterbury, Connecticut, Forente stater, 06708
- Smilow Cancer Hospital-Waterbury Care Center
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Waterford, Connecticut, Forente stater, 06385
- Smilow Cancer Hospital Care Center - Waterford
-
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Delaware
-
Newark, Delaware, Forente stater, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, Forente stater, 19713
- Medical Oncology Hematology Consultants PA
-
-
Florida
-
Aventura, Florida, Forente stater, 33180
- UM Sylvester Comprehensive Cancer Center at Aventura
-
Coral Gables, Florida, Forente stater, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
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Deerfield Beach, Florida, Forente stater, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
-
Doral, Florida, Forente stater, 33166
- UM Sylvester Comprehensive Cancer Center at Doral
-
Jacksonville, Florida, Forente stater, 32224-9980
- Mayo Clinic in Florida
-
Miami, Florida, Forente stater, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
Miami, Florida, Forente stater, 33176
- Miami Cancer Institute
-
Miami, Florida, Forente stater, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
-
N. Venice, Florida, Forente stater, 34275
- Sarasota Memorial Hospital-Venice
-
Plantation, Florida, Forente stater, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
-
Sarasota, Florida, Forente stater, 34239
- Sarasota Memorial Hospital
-
Sarasota, Florida, Forente stater, 34232
- Florida Cancer Specialists - Sarasota
-
Sarasota, Florida, Forente stater, 34243
- Sarasota Memorial Health Care Center at University Parkway
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Sarasota, Florida, Forente stater, 34239
- First Physicians Group - Silverstein Institute at Floyd Street
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Sarasota, Florida, Forente stater, 34239
- Florida Cancer Specialists - Sarasota Downtown
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Tampa, Florida, Forente stater, 33612
- Moffitt Cancer Center
-
Tampa, Florida, Forente stater, 33607
- Moffitt Cancer Center-International Plaza
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Tampa, Florida, Forente stater, 33612
- Moffitt Cancer Center - McKinley Campus
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Venice, Florida, Forente stater, 34285
- Florida Cancer Specialists - Venice Island
-
Venice, Florida, Forente stater, 34275
- Florida Cancer Specialists - Venice Pinebrook
-
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Georgia
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Atlanta, Georgia, Forente stater, 30308
- Emory University Hospital Midtown
-
Atlanta, Georgia, Forente stater, 30322
- Emory University Hospital/Winship Cancer Institute
-
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Illinois
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Alton, Illinois, Forente stater, 62002
- Alton Memorial Hospital
-
Chicago, Illinois, Forente stater, 60611
- Northwestern University
-
Chicago, Illinois, Forente stater, 60612
- University of Illinois
-
Chicago, Illinois, Forente stater, 60612
- Rush MD Anderson Cancer Center
-
DeKalb, Illinois, Forente stater, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Forente stater, 62526
- Decatur Memorial Hospital
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Geneva, Illinois, Forente stater, 60134
- Northwestern Medicine Cancer Center Delnor
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Orland Park, Illinois, Forente stater, 60462
- Northwestern Medicine Orland Park
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Shiloh, Illinois, Forente stater, 62269
- Memorial Hospital East
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Warrenville, Illinois, Forente stater, 60555
- Northwestern Medicine Cancer Center Warrenville
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Indiana
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Carmel, Indiana, Forente stater, 46032
- IU Health North Hospital
-
Goshen, Indiana, Forente stater, 46526
- Goshen Center for Cancer Care
-
Indianapolis, Indiana, Forente stater, 46237
- Franciscan Health Indianapolis
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Indianapolis, Indiana, Forente stater, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
-
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Iowa
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Council Bluffs, Iowa, Forente stater, 51503
- Heartland Oncology and Hematology LLP
-
Council Bluffs, Iowa, Forente stater, 51503
- Methodist Jennie Edmundson Hospital
-
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Kansas
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Kansas City, Kansas, Forente stater, 66160
- University of Kansas Cancer Center
-
Overland Park, Kansas, Forente stater, 66210
- University of Kansas Cancer Center-Overland Park
-
Overland Park, Kansas, Forente stater, 66211
- University of Kansas Hospital-Indian Creek Campus
-
Westwood, Kansas, Forente stater, 66205
- University of Kansas Hospital-Westwood Cancer Center
-
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Kentucky
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Lexington, Kentucky, Forente stater, 40536
- University of Kentucky/Markey Cancer Center
-
Louisville, Kentucky, Forente stater, 40202
- The James Graham Brown Cancer Center at University of Louisville
-
Louisville, Kentucky, Forente stater, 40245
- UofL Health Medical Center Northeast
-
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Louisiana
-
Baton Rouge, Louisiana, Forente stater, 70805
- LSU Health Baton Rouge-North Clinic
-
Baton Rouge, Louisiana, Forente stater, 70808
- Our Lady of the Lake Physician Group
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New Orleans, Louisiana, Forente stater, 70112
- University Medical Center New Orleans
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Michigan
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Ann Arbor, Michigan, Forente stater, 48109
- University of Michigan Rogel Cancer Center
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Brighton, Michigan, Forente stater, 48116
- University of Michigan - Brighton Center for Specialty Care
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Detroit, Michigan, Forente stater, 48202
- Henry Ford Hospital
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Grand Rapids, Michigan, Forente stater, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
West Bloomfield, Michigan, Forente stater, 48322
- Henry Ford West Bloomfield Hospital
-
Wyoming, Michigan, Forente stater, 49519
- University of Michigan Health - West
-
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Minnesota
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Minneapolis, Minnesota, Forente stater, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, Forente stater, 55905
- Mayo Clinic in Rochester
-
-
Missouri
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City of Saint Peters, Missouri, Forente stater, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Columbia, Missouri, Forente stater, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
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Creve Coeur, Missouri, Forente stater, 63141
- Siteman Cancer Center at West County Hospital
-
Kansas City, Missouri, Forente stater, 64154
- University of Kansas Cancer Center - North
-
Lee's Summit, Missouri, Forente stater, 64064
- University of Kansas Cancer Center - Lee's Summit
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St Louis, Missouri, Forente stater, 63110
- Washington University School of Medicine
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St Louis, Missouri, Forente stater, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Forente stater, 63136
- Siteman Cancer Center at Christian Hospital
-
-
Nebraska
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Bellevue, Nebraska, Forente stater, 68123
- Nebraska Medicine-Bellevue
-
Omaha, Nebraska, Forente stater, 68114
- Nebraska Methodist Hospital
-
Omaha, Nebraska, Forente stater, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, Forente stater, 68118
- Nebraska Medicine-Village Pointe
-
Omaha, Nebraska, Forente stater, 68114
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
-
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New Hampshire
-
Lebanon, New Hampshire, Forente stater, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
-
Basking Ridge, New Jersey, Forente stater, 07920
- Memorial Sloan Kettering Basking Ridge
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Middletown, New Jersey, Forente stater, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, Forente stater, 07645
- Memorial Sloan Kettering Bergen
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New Mexico
-
Albuquerque, New Mexico, Forente stater, 87106
- University of New Mexico Cancer Center
-
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New York
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Commack, New York, Forente stater, 11725
- Memorial Sloan Kettering Commack
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Harrison, New York, Forente stater, 10604
- Memorial Sloan Kettering Westchester
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Lake Success, New York, Forente stater, 11042
- Northwell Health/Center for Advanced Medicine
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Mineola, New York, Forente stater, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Forente stater, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, Forente stater, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
New York, New York, Forente stater, 10075
- Lenox Hill Hospital
-
New York, New York, Forente stater, 10065
- Manhattan Eye Ear and Throat Hospital
-
Rochester, New York, Forente stater, 14642
- University of Rochester
-
Stony Brook, New York, Forente stater, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Forente stater, 13210
- State University of New York Upstate Medical University
-
Syracuse, New York, Forente stater, 13215
- SUNY Upstate Medical Center-Community Campus
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The Bronx, New York, Forente stater, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Forente stater, 10467
- Montefiore Medical Center - Moses Campus
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The Bronx, New York, Forente stater, 10461
- Montefiore Medical Center-Weiler Hospital
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Uniondale, New York, Forente stater, 11553
- Memorial Sloan Kettering Nassau
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Webster, New York, Forente stater, 14580
- Wilmot Cancer Institute at Webster
-
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North Carolina
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Albemarle, North Carolina, Forente stater, 28002
- Atrium Health Stanly/LCI-Albemarle
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Chapel Hill, North Carolina, Forente stater, 27599
- UNC Lineberger Comprehensive Cancer Center
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Charlotte, North Carolina, Forente stater, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, Forente stater, 28210
- Atrium Health Pineville/LCI-Pineville
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Charlotte, North Carolina, Forente stater, 28262
- Atrium Health University City/LCI-University
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Concord, North Carolina, Forente stater, 28025
- Atrium Health Cabarrus/LCI-Concord
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Durham, North Carolina, Forente stater, 27710
- Duke University Medical Center
-
Gastonia, North Carolina, Forente stater, 28054
- Levine Cancer Institute-Gaston
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Monroe, North Carolina, Forente stater, 28112
- Atrium Health Union/LCI-Union
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Raleigh, North Carolina, Forente stater, 27609
- Duke Cancer Center Raleigh
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Shelby, North Carolina, Forente stater, 28150
- Atrium Health Cleveland/LCI-Cleveland
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Winston-Salem, North Carolina, Forente stater, 27157
- Wake Forest University Health Sciences
-
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Ohio
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Avon, Ohio, Forente stater, 44011
- UH Seidman Cancer Center at UH Avon Health Center
-
Beachwood, Ohio, Forente stater, 44122
- UHHS-Chagrin Highlands Medical Center
-
Centerville, Ohio, Forente stater, 45459
- Miami Valley Hospital South
-
Cincinnati, Ohio, Forente stater, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cleveland, Ohio, Forente stater, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Forente stater, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Forente stater, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Forente stater, 45415
- Miami Valley Hospital North
-
Franklin, Ohio, Forente stater, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Greenville, Ohio, Forente stater, 45331
- Miami Valley Cancer Care and Infusion
-
Mentor, Ohio, Forente stater, 44060
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Troy, Ohio, Forente stater, 45373
- Upper Valley Medical Center
-
West Chester, Ohio, Forente stater, 45069
- University of Cincinnati Cancer Center-West Chester
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Forente stater, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Portland, Oregon, Forente stater, 97213
- Providence Portland Medical Center
-
-
Pennsylvania
-
Chadds Ford, Pennsylvania, Forente stater, 19317
- Christiana Care Health System-Concord Health Center
-
Erie, Pennsylvania, Forente stater, 16505
- UPMC Hillman Cancer Center Erie
-
Erie, Pennsylvania, Forente stater, 16544
- Saint Vincent Hospital
-
Hershey, Pennsylvania, Forente stater, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Johnstown, Pennsylvania, Forente stater, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
Monroeville, Pennsylvania, Forente stater, 15146
- Forbes Hospital
-
Philadelphia, Pennsylvania, Forente stater, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Forente stater, 19107
- Thomas Jefferson University Hospital
-
Pittsburgh, Pennsylvania, Forente stater, 15212
- Allegheny General Hospital
-
Pittsburgh, Pennsylvania, Forente stater, 15224
- West Penn Hospital
-
Pittsburgh, Pennsylvania, Forente stater, 15232
- UPMC Hillman Cancer Center
-
Wexford, Pennsylvania, Forente stater, 15090
- Wexford Health and Wellness Pavilion
-
-
South Carolina
-
Charleston, South Carolina, Forente stater, 29425
- Medical University of South Carolina
-
Rock Hill, South Carolina, Forente stater, 29732
- Levine Cancer Institute-Rock Hill
-
Rock Hill, South Carolina, Forente stater, 29730
- Rock Hill Radiation Therapy Center
-
-
Tennessee
-
Nashville, Tennessee, Forente stater, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Conroe, Texas, Forente stater, 77384
- UT MD Anderson - The Woodlands
-
Dallas, Texas, Forente stater, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Forente stater, 75237
- UT Southwestern Simmons Cancer Center - RedBird
-
Fort Worth, Texas, Forente stater, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Houston, Texas, Forente stater, 77030
- UT MD Anderson Cancer Center
-
Houston, Texas, Forente stater, 77079
- UT MD Anderson - West Houston
-
League City, Texas, Forente stater, 77573
- UT MD Anderson - League City
-
Richardson, Texas, Forente stater, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
San Antonio, Texas, Forente stater, 78229
- University of Texas Health Science Center at San Antonio
-
Sugar Land, Texas, Forente stater, 77478
- UT MD Anderson - Sugar Land
-
-
Utah
-
Salt Lake City, Utah, Forente stater, 84112
- Huntsman Cancer Institute/University of Utah
-
-
Vermont
-
Berlin Corners, Vermont, Forente stater, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, Forente stater, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, Forente stater, 05405
- University of Vermont and State Agricultural College
-
Saint Johnsbury, Vermont, Forente stater, 05819
- Dartmouth Cancer Center - North
-
-
Virginia
-
Charlottesville, Virginia, Forente stater, 22908
- University of Virginia Cancer Center
-
Fairfax, Virginia, Forente stater, 22031
- Inova Schar Cancer Institute
-
Richmond, Virginia, Forente stater, 23298
- VCU Massey Comprehensive Cancer Center
-
-
Washington
-
Seattle, Washington, Forente stater, 98101
- Virginia Mason Medical Center
-
-
Wisconsin
-
La Crosse, Wisconsin, Forente stater, 54601
- Gundersen Lutheran Medical Center
-
Madison, Wisconsin, Forente stater, 53705
- William S Middleton VA Medical Center
-
Madison, Wisconsin, Forente stater, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Forente stater, 53718
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
Marshfield, Wisconsin, Forente stater, 54449
- Marshfield Medical Center-Marshfield
-
Menomonee Falls, Wisconsin, Forente stater, 53051
- Froedtert Menomonee Falls Hospital
-
Milwaukee, Wisconsin, Forente stater, 53226
- Medical College of Wisconsin
-
Oak Creek, Wisconsin, Forente stater, 53154
- Drexel Town Square Health Center
-
West Bend, Wisconsin, Forente stater, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
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Weston, Wisconsin, Forente stater, 54476
- Marshfield Medical Center - Weston
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
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
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The following CSCC subtypes are eligible according to World Health Organization (WHO) classification if the predominant histology is confirmed CSCC.
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Spindle cell squamous cell carcinoma (SCC)
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Squamous cell carcinoma with sarcomatoid differentiation
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Acantholytic SCC
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Clear cell SCC
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Lymphoepithelial carcinoma
- Note: Keratoacanthoma SCC and Verrucous SCC subtypes are not eligible.
-
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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
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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
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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)
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Previously untreated or recurrent CSCC
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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
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Primary tumor site must be in the head and neck cutaneous region, other non-head and neck cutaneous regions, or eyelid cutaneous region
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No mucosal squamous cell carcinoma (vermillion lip, nasal, oral, sinonasal, conjunctival, anogenital)
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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.)
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At least 1 lesion that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
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No definitive clinical or radiologic evidence of distant metastatic disease (M1), visceral and/or distant nodal disease
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Age ≥ 18
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Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
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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
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Absolute neutrophil count (ANC) ≥ 1,000 cells/mm^3
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Platelets ≥ 75,000 cells/mm^3
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Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin [Hgb] ≥ 8.0 g/dl is acceptable)
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Creatinine clearance (CrCL) > 30mL/min by the Cockcroft-Gault formula
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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.)
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Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x institutional ULN
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No prior systemic therapy for the study cancer (including patients currently receiving immunotherapy for a separate malignancy)
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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
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No history of myocardial infarction/unstable angina within the last 6 months
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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)
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No active infection requiring systemic antibiotics, antiviral, or antifungal treatments
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No history of allogeneic stem cell transplantation, or autologous stem cell transplantation
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No history of a solid organ transplant (other than corneal transplant)
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No active, known, or suspected autoimmune disease
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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)
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NOTES:
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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
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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
-
-
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No history of interstitial lung disease (eg, idiopathic pulmonary fibrosis, organizing pneumonia)
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No active, noninfectious pneumonitis requiring immune-suppressive therapy
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No active tuberculosis
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No live vaccines within 28 days prior to registration
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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)
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Aktiv komparator: 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
Andre navn:
Ancillary studies Undergo PET/CT
Andre navn:
Undergo IMRT
Andre navn:
Undergo CT and/or PET/CT
Andre navn:
Undergo collection of blood and/or plasma
Andre navn:
Undergo IGRT
Andre navn:
Undergo surgery per SOC
Andre navn:
Undergo response-adaptive surgery
Andre navn:
|
|
Eksperimentell: 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
Andre navn:
Ancillary studies Undergo PET/CT
Andre navn:
Undergo IMRT
Andre navn:
Given IV
Andre navn:
Undergo CT and/or PET/CT
Andre navn:
Undergo collection of blood and/or plasma
Andre navn:
Undergo IGRT
Andre navn:
Undergo surgery per SOC
Andre navn:
Undergo response-adaptive surgery
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Event-free survival (EFS)
Tidsramme: 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
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Utilization of adjuvant radiation
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Quality of life
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Neil D Gross, NRG Oncology
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Undersøkelsesteknikker
- Terapeutikk
- Kliniske laboratorieteknikker
- Diagnostiske teknikker og prosedyrer
- Diagnose
- Kjemisteknikker, analytisk
- Spektrumanalyse
- Strålebehandling
- Strålebehandling, konform
- Strålebehandling, datamaskinassistert
- Prøvehåndtering
- Magnetisk resonansspektroskopi
- Kirurgiske prosedyrer, operativ
- Strålebehandling, intensitetsmodulert
- Cemiplimab
- Strålebehandling, bildestyrt
Andre studie-ID-numre
- NCI-2024-03425
- U10CA180868 (U.S. NIH-stipend/kontrakt)
- NCI-2024-03425 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
- NRG-HN014 (Annen identifikator: CTEP)
- NRG-HN014 (Annen identifikator: NRG Oncology)
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
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.
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
produkt produsert i og eksportert fra USA
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