Proton Spatially Fractionated Radiotherapy or Photon Stereotactic Body Radiotherapy in Combination With Pembrolizumab Before Surgery for the Treatment of Locally Advanced and Radiation-Naive Locoregionally Recurrent Oral Cavity Cancer, OSPRI Trial
20. august 2026 oppdatert av: Mayo Clinic
Phase II: Randomized Neoadjuvant Treatment of Oral Cavity Cancer With Spatially Fractionated Proton Radiotherapy and Immunotherapy (OSPRI)
This phase II trial compares the effect of adding proton spatially fractionated radiotherapy (SFRT) or photon stereotactic body radiotherapy (SBRT) to standard immunotherapy pembrolizumab before surgery (neoadjuvant) in treating patients with oral cavity squamous cell cancer that has spread to nearby tissue or lymph nodes (locally advanced) or that has come back where it first started (primary site) or near it (locoregionally recurrent) and have not had (naive) prior radiation.
Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill tumor cells and shrink tumors.
Proton SFRT is a type of external beam radiation treatment that uses streams of protons (tiny particles with a positive charge) to deliver different doses of radiation to different parts of the tumor in a grid like pattern.
This type of radiation kills tumor cells but does not damage nearby tissues.
SBRT is a type of external radiation therapy that uses special equipment to position a patient and precisely deliver radiation to tumors in the body (except the brain).
The total dose of radiation is divided into smaller doses given over several days.
This type of radiation therapy helps spare normal tissue.
Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread.
Giving neoadjuvant proton SFRT or SBRT in combination with pembrolizumab may be safe and tolerable and may be an effective approach to shrink the tumor, reduce the extent of surgery and/or the need for further treatment in patients with locally advanced or locoregionally recurrent oral cavity squamous cell cancer.
Studieoversikt
Status
Har ikke rekruttert ennå
Forhold
Intervensjon / Behandling
- Biologisk: Pembrolizumab
- Fremgangsmåte: Bioprøvesamling
- Fremgangsmåte: Magnetisk resonansavbildning
- Fremgangsmåte: Kirurgisk prosedyre
- Fremgangsmåte: Computertomografi
- Fremgangsmåte: Positron-utslippstomografi
- Fremgangsmåte: Biopsiprosedyre
- Stråling: Spatially-fractionated Radiation Therapy
- Stråling: Photon Stereotactic Body Radiation Therapy
Studietype
Intervensjonell
Registrering (Antatt)
30
Fase
- Fase 2
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiekontakt
- Navn: Clinical Trials Referral Office
- Telefonnummer: 855-776-0015
- E-post: mayocliniccancerstudies@mayo.edu
Studiesteder
-
-
Minnesota
-
Rochester, Minnesota, Forente stater, 55905
- Mayo Clinic in Rochester
-
Ta kontakt med:
- Clinical Trials Referral Office
- Telefonnummer: 855-776-0015
- E-post: mayocliniccancerstudies@mayo.edu
-
Hovedetterforsker:
- Daniel K. Ebner, MD, MPH
-
-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Nei
Beskrivelse
Inclusion Criteria:
Patients with histologically confirmed human papillomavirus (HPV)/p16-unrelated squamous cell carcinoma of the oral cavity and:
- Either locally advanced (T3-T4) non-metastatic disease, or
- Radiation-naïve locoregionally recurrent disease (prior radiation to a site outside of the treatment fields is permitted)
- Age ≥ 18 years old
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 2
- Eligible to receive immunotherapy on multidisciplinary evaluation
- Ability to complete questionnaire(s) by themselves or with assistance
- Provide signed written informed consent in accordance with ethical, regulatory, and institutional requirements
- Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study)
- Willing to consent to and provide tissue and blood samples for correlative research purposes (not the optional Riskguard and OncoExtra testing)
- PD-L1 combined positive score ≥ 1
Exclusion Criteria:
Participation in another clinical study with an investigational product during the last 3 months (12 weeks)
- Exception: Unless it is an observational (non-interventional) clinical study during the follow-up period of the study
- Contraindications to pembrolizumab
- Prior radiation therapy to the head and neck
- Previous anticancer therapeutic received ≤ 30 days prior to registration, or adequate washout period on a per-agent basis, or concurrent anti-cancer therapeutic not specified by this protocol
- Uncontrolled pre-existing condition(s), such as infection, congestive heart failure, hypertension, angina, arrhythmia, chronic diarrhea, psychiatric conditions, or others, that in the opinion of the treating investigator limits the ability to provide consent or longitudinal participation in this study
- Inability to place 2 or more SFRT spheres within the tumor target
- Prophylactic placement of feeding tubes is not allowed
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Arm A (proton SFRT, pembrolizumab, surgery)
Patients receive proton SFRT QOD for up to 3 treatment fractions over 1 week.
Starting within 7 days of initiating SFRT, patients receive pembrolizumab IV on day 1 of each cycle.
Cycles repeat every 3 weeks for up to 2 cycles in the absence of disease progression or unacceptable toxicity.
Within 8 weeks of completing pembrolizumab, patients undergo surgical resection per standard of care.
Patients also undergo blood sample collection, CT, and PET/MRI or PET/CT throughout the study.
Additionally, patients may also undergo tissue biopsy at baseline and/or on study.
|
Gitt IV
Andre navn:
Gjennomgå blodprøvetaking
Andre navn:
Gjennomgå PET/MR
Andre navn:
Gjennomgå kirurgisk reseksjon
Andre navn:
Gjennomgå CT eller PET/CT
Andre navn:
Gjennomgå PET/CT eller PET/MR
Andre navn:
Gjennomgå vevsbiopsi
Andre navn:
Receive proton SFRT
Andre navn:
|
|
Eksperimentell: Arm B (photon SBRT, pembrolizumab, surgery)
Patients receive photon SBRT QOD for up to 3 treatment fractions over 1 week.
Starting within 7 days of initiating SBRT, patients receive pembrolizumab IV on day 1 of each cycle.
Cycles repeat every 3 weeks for up to 2 cycles in the absence of disease progression or unacceptable toxicity.
Within 8 weeks of completing pembrolizumab, patients undergo surgical resection per standard of care.
Patients also undergo blood sample collection, CT, and PET/MRI or PET/CT throughout the study.
Additionally, patients may also undergo tissue biopsy at baseline and/or on study.
|
Gitt IV
Andre navn:
Gjennomgå blodprøvetaking
Andre navn:
Gjennomgå PET/MR
Andre navn:
Gjennomgå kirurgisk reseksjon
Andre navn:
Gjennomgå CT eller PET/CT
Andre navn:
Gjennomgå PET/CT eller PET/MR
Andre navn:
Gjennomgå vevsbiopsi
Andre navn:
Receive photon SBRT
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Improvement in major pathologic response rate (MPR)
Tidsramme: At the time of surgical resection
|
MPR is defined from pathologic evaluation of the surgically resected tumor, demonstrating less than 10% of residual tumor in the resection sample (≥90% disease reduction).
Will be assessed using a Bayesian pick-the-winner randomized phase-II clinical trial design.
|
At the time of surgical resection
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Pathologic complete response rate
Tidsramme: At the time of surgical resection
|
Pathologic complete response rate is defined from pathologic evaluation of the surgically resected tumor, demonstrating no signs of residual disease following immuno-radiation.
This will be calculated separately for Arm A and for Arm B.
|
At the time of surgical resection
|
|
Percent of patients receiving the prescribed therapy
Tidsramme: Up to 1 year
|
Will be defined as the number of patients who received the prescribed therapy divided by the number of evaluable patients who signed a consent form and began treatment.
This will be calculated separately for Arm A and Arm B.
|
Up to 1 year
|
|
Incidence of Adverse Events (AEs) Prior to Surgery:
Tidsramme: From the time of registration until surgery
|
Overall AEs, overall toxicities, and by maximum grade per type of AE per patient of the AEs that occur before surgery will be explored and summarized descriptively, mainly through the use of frequency tables.
Toxicity is defined as an adverse event that is classified as possibly, probably, or definitely related to study treatment.
AEs are graded per National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 6.0.
|
From the time of registration until surgery
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Daniel K. Ebner, MD, MPH, Mayo Clinic in Rochester
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Hjelpsomme linker
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Antatt)
7. september 2026
Primær fullføring (Antatt)
1. april 2030
Studiet fullført (Antatt)
1. april 2030
Datoer for studieregistrering
Først innsendt
20. august 2026
Først innsendt som oppfylte QC-kriteriene
20. august 2026
Først lagt ut (Faktiske)
25. august 2026
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
25. august 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
20. august 2026
Sist bekreftet
1. august 2026
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Neoplasmer etter nettsted
- Neoplasmer
- Neoplasmer etter histologisk type
- Neoplasmer i hode og nakke
- Neoplasmer, kjertel og epitel
- Karsinom
- Karsinom, plateepitel
- Plateepitelkarsinom i hode og nakke
- Undersøkelsesteknikker
- Kliniske laboratorieteknikker
- Diagnostiske teknikker og prosedyrer
- Diagnose
- Cytologiske teknikker
- Cytodiagnose
- Diagnostiske teknikker, kirurgisk
- Kjemisteknikker, analytisk
- Spektrumanalyse
- Biopsi
- Prøvehåndtering
- pembrolizumab
- Magnetisk resonansspektroskopi
- Kirurgiske prosedyrer, operativ
Andre studie-ID-numre
- GMROR2472
- NCI-2026-05918 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
- 24-011038 (Annen identifikator: Mayo Clinic Institutional Review Board)
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Ja
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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