- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT06568172
Testowanie dodania leku immunoterapeutycznego, cemiplimabu (REGN2810), operacji plus operacji do zwykłej operacji w leczeniu zaawansowanego raka skóry
Randomizowane badanie III fazy dotyczące okołooperacyjnej immunoterapii z leczeniem dostosowanym do odpowiedzi w porównaniu ze standardowym leczeniem resekcyjnego raka płaskonabłonkowego skóry w stadium III/IV
This phase III trial compares the effect of adding cemiplimab to standard therapy (surgery with or without radiation) versus standard therapy alone in treating patients with stage III/IV squamous cell skin cancer that is able to be removed by surgery (resectable) and that may have come back after a period of improvement (recurrent). The usual treatment for patients with resectable squamous cell skin cancer is the removal of the cancerous tissue (surgery) with or without radiation, which uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. Immunotherapy with monoclonal antibodies, such as cemiplimab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cemiplimab has been approved for the treatment of skin cancer that has spread or that cannot be removed by surgery, but it has not been approved for the treatment of skin cancer than can be removed by surgery. Adding cemiplimab to the usual treatment of surgery with or without radiation may be more effective in treating patients with stage III/IV resectable squamous cell skin cancer than the usual treatment alone.
Przegląd badań
Status
Warunki
- STAPOWA IV Głowa i szyja rak płaskonabłonkowy AJCC V8
- STAPII III Głowa i szyja rak płaskonabłonkowy AJCC V8
- Rak płaskonabłonkowy powieki
- Skórzasty rak płaskonabłonkowy z akantolizą
- Rak kolczystokomórkowy skóry z komórkami jasnymi
- Rak limfoepitelialny skóry
- Skórzasty rak płaskonabłonkowy wrzecionowatokomórkowy
- Rak płaskonabłonkowy skóry z różnicowaniem mięsakowatym
- Nawrotowy Rak Płaskonabłonkowy Powieki
- Nawracający skórny akantolityczny rak płaskonabłonkowy
- Nawrotowy raka skóry z jasnokomórkowego raka płaskonabłonkowego
- Nawracający skórny chłoniako-nabłoniak
- Nawrotowy skórny płaskonabłonkowy rak wrzecionowatokomórkowy
- Nawrotowy raka płaskonabłonkowego skóry ze zróżnicowaniem mięsakowatym
- Resekowalny Płaskonabłonkowy Rak Powieki
- Resekowalny rak płaskonabłonkowy skóry z akantolizą
- Resekowalny Skórny Czerniak Komórek Płaskich
- Resekowalny limfoepitelialny rak skóry
- Resekowalny skórny wrzecionowatokomórkowy rak płaskonabłonkowy
- Resekowalny Płaskonabłonkowy Rak Skóry z Różnicowaniem Sarkomatoidalnym
Interwencja / Leczenie
- Procedura: Magnetic Resonance Imaging
- Inny: Questionnaire Administration
- Procedura: Positron Emission Tomography
- Promieniowanie: Intensity-Modulated Radiation Therapy
- Biologiczny: Cemiplimab
- Procedura: Computed Tomography
- Procedura: Biospecimen Collection
- Promieniowanie: Image Guided Radiation Therapy
- Procedura: Surgical Procedure
- Procedura: Surgical Procedure
Szczegółowy opis
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.
Typ studiów
Zapisy (Szacowany)
Faza
- Faza 3
Kontakty i lokalizacje
Lokalizacje studiów
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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
-
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, Kanada, V5Z 4E6
- BCCA-Vancouver Cancer Centre
-
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Ontario
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Toronto, Ontario, Kanada, M5G 2M9
- University Health Network-Princess Margaret Hospital
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Toronto, Ontario, Kanada, M4N 3M5
- Odette Cancer Centre- Sunnybrook Health Sciences Centre
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-
-
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Alabama
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Birmingham, Alabama, Stany Zjednoczone, 35233
- University of Alabama at Birmingham Cancer Center
-
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Arizona
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Gilbert, Arizona, Stany Zjednoczone, 85234
- Banner MD Anderson Cancer Center
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Phoenix, Arizona, Stany Zjednoczone, 85054
- Mayo Clinic Hospital in Arizona
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California
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Beverly Hills, California, Stany Zjednoczone, 90211
- Tower Cancer Research Foundation
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Duarte, California, Stany Zjednoczone, 91010
- City of Hope Comprehensive Cancer Center
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Encinitas, California, Stany Zjednoczone, 92024
- UC San Diego Health System - Encinitas
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Irvine, California, Stany Zjednoczone, 92618
- City of Hope at Irvine Lennar
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La Jolla, California, Stany Zjednoczone, 92093
- UC San Diego Moores Cancer Center
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Lancaster, California, Stany Zjednoczone, 93534
- City of Hope Antelope Valley
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Los Angeles, California, Stany Zjednoczone, 90033
- USC / Norris Comprehensive Cancer Center
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Los Angeles, California, Stany Zjednoczone, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, Stany Zjednoczone, 90025
- The Angeles Clinic and Research Institute - West Los Angeles Office
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Oakland, California, Stany Zjednoczone, 94611
- Kaiser Permanente-Oakland
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Palo Alto, California, Stany Zjednoczone, 94304
- Stanford Cancer Institute Palo Alto
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Sacramento, California, Stany Zjednoczone, 95817
- University of California Davis Comprehensive Cancer Center
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Sacramento, California, Stany Zjednoczone, 95823
- Kaiser Permanente-South Sacramento
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San Diego, California, Stany Zjednoczone, 92103
- UC San Diego Medical Center - Hillcrest
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San Francisco, California, Stany Zjednoczone, 94115
- Kaiser Permanente-San Francisco
-
South Pasadena, California, Stany Zjednoczone, 91030
- City of Hope South Pasadena
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Torrance, California, Stany Zjednoczone, 90505
- Torrance Memorial Physician Network - Cancer Care
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Upland, California, Stany Zjednoczone, 91786
- City of Hope Upland
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Walnut Creek, California, Stany Zjednoczone, 94596
- Kaiser Permanente-Walnut Creek
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Colorado
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Aurora, Colorado, Stany Zjednoczone, 80045
- UCHealth University of Colorado Hospital
-
Colorado Springs, Colorado, Stany Zjednoczone, 80909
- UCHealth Memorial Hospital Central
-
Colorado Springs, Colorado, Stany Zjednoczone, 80920
- Memorial Hospital North
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Connecticut
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Greenwich, Connecticut, Stany Zjednoczone, 06830
- Smilow Cancer Hospital Care Center at Greenwich
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Guilford, Connecticut, Stany Zjednoczone, 06437
- Smilow Cancer Hospital Care Center - Guilford
-
New Haven, Connecticut, Stany Zjednoczone, 06520
- Yale University
-
Trumbull, Connecticut, Stany Zjednoczone, 06611
- Smilow Cancer Hospital Care Center-Trumbull
-
Waterbury, Connecticut, Stany Zjednoczone, 06708
- Smilow Cancer Hospital-Waterbury Care Center
-
Waterford, Connecticut, Stany Zjednoczone, 06385
- Smilow Cancer Hospital Care Center - Waterford
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-
Delaware
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Newark, Delaware, Stany Zjednoczone, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, Stany Zjednoczone, 19713
- Medical Oncology Hematology Consultants PA
-
-
Florida
-
Aventura, Florida, Stany Zjednoczone, 33180
- UM Sylvester Comprehensive Cancer Center at Aventura
-
Coral Gables, Florida, Stany Zjednoczone, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
-
Deerfield Beach, Florida, Stany Zjednoczone, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
-
Doral, Florida, Stany Zjednoczone, 33166
- UM Sylvester Comprehensive Cancer Center at Doral
-
Jacksonville, Florida, Stany Zjednoczone, 32224-9980
- Mayo Clinic in Florida
-
Miami, Florida, Stany Zjednoczone, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
Miami, Florida, Stany Zjednoczone, 33176
- Miami Cancer Institute
-
Miami, Florida, Stany Zjednoczone, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
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N. Venice, Florida, Stany Zjednoczone, 34275
- Sarasota Memorial Hospital-Venice
-
Plantation, Florida, Stany Zjednoczone, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
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Sarasota, Florida, Stany Zjednoczone, 34239
- Sarasota Memorial Hospital
-
Sarasota, Florida, Stany Zjednoczone, 34232
- Florida Cancer Specialists - Sarasota
-
Sarasota, Florida, Stany Zjednoczone, 34243
- Sarasota Memorial Health Care Center at University Parkway
-
Sarasota, Florida, Stany Zjednoczone, 34239
- First Physicians Group - Silverstein Institute at Floyd Street
-
Sarasota, Florida, Stany Zjednoczone, 34239
- Florida Cancer Specialists - Sarasota Downtown
-
Tampa, Florida, Stany Zjednoczone, 33612
- Moffitt Cancer Center
-
Tampa, Florida, Stany Zjednoczone, 33607
- Moffitt Cancer Center-International Plaza
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Tampa, Florida, Stany Zjednoczone, 33612
- Moffitt Cancer Center - McKinley Campus
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Venice, Florida, Stany Zjednoczone, 34285
- Florida Cancer Specialists - Venice Island
-
Venice, Florida, Stany Zjednoczone, 34275
- Florida Cancer Specialists - Venice Pinebrook
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Georgia
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Atlanta, Georgia, Stany Zjednoczone, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Stany Zjednoczone, 30322
- Emory University Hospital/Winship Cancer Institute
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Illinois
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Alton, Illinois, Stany Zjednoczone, 62002
- Alton Memorial Hospital
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Chicago, Illinois, Stany Zjednoczone, 60611
- Northwestern University
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Chicago, Illinois, Stany Zjednoczone, 60612
- University of Illinois
-
Chicago, Illinois, Stany Zjednoczone, 60612
- Rush MD Anderson Cancer Center
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DeKalb, Illinois, Stany Zjednoczone, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Stany Zjednoczone, 62526
- Decatur Memorial Hospital
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Geneva, Illinois, Stany Zjednoczone, 60134
- Northwestern Medicine Cancer Center Delnor
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Orland Park, Illinois, Stany Zjednoczone, 60462
- Northwestern Medicine Orland Park
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Shiloh, Illinois, Stany Zjednoczone, 62269
- Memorial Hospital East
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Warrenville, Illinois, Stany Zjednoczone, 60555
- Northwestern Medicine Cancer Center Warrenville
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Indiana
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Carmel, Indiana, Stany Zjednoczone, 46032
- IU Health North Hospital
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Goshen, Indiana, Stany Zjednoczone, 46526
- Goshen Center for Cancer Care
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Indianapolis, Indiana, Stany Zjednoczone, 46237
- Franciscan Health Indianapolis
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Indianapolis, Indiana, Stany Zjednoczone, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
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Iowa
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Council Bluffs, Iowa, Stany Zjednoczone, 51503
- Heartland Oncology and Hematology LLP
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Council Bluffs, Iowa, Stany Zjednoczone, 51503
- Methodist Jennie Edmundson Hospital
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Kansas
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Kansas City, Kansas, Stany Zjednoczone, 66160
- University of Kansas Cancer Center
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Overland Park, Kansas, Stany Zjednoczone, 66210
- University of Kansas Cancer Center-Overland Park
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Overland Park, Kansas, Stany Zjednoczone, 66211
- University of Kansas Hospital-Indian Creek Campus
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Westwood, Kansas, Stany Zjednoczone, 66205
- University of Kansas Hospital-Westwood Cancer Center
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Kentucky
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Lexington, Kentucky, Stany Zjednoczone, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, Stany Zjednoczone, 40202
- The James Graham Brown Cancer Center at University of Louisville
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Louisville, Kentucky, Stany Zjednoczone, 40245
- UofL Health Medical Center Northeast
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Louisiana
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Baton Rouge, Louisiana, Stany Zjednoczone, 70805
- LSU Health Baton Rouge-North Clinic
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Baton Rouge, Louisiana, Stany Zjednoczone, 70808
- Our Lady of the Lake Physician Group
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New Orleans, Louisiana, Stany Zjednoczone, 70112
- University Medical Center New Orleans
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Michigan
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Ann Arbor, Michigan, Stany Zjednoczone, 48109
- University of Michigan Rogel Cancer Center
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Brighton, Michigan, Stany Zjednoczone, 48116
- University of Michigan - Brighton Center for Specialty Care
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Detroit, Michigan, Stany Zjednoczone, 48202
- Henry Ford Hospital
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Grand Rapids, Michigan, Stany Zjednoczone, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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West Bloomfield, Michigan, Stany Zjednoczone, 48322
- Henry Ford West Bloomfield Hospital
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Wyoming, Michigan, Stany Zjednoczone, 49519
- University of Michigan Health - West
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Minnesota
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Minneapolis, Minnesota, Stany Zjednoczone, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, Stany Zjednoczone, 55905
- Mayo Clinic in Rochester
-
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Missouri
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City of Saint Peters, Missouri, Stany Zjednoczone, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Columbia, Missouri, Stany Zjednoczone, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
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Creve Coeur, Missouri, Stany Zjednoczone, 63141
- Siteman Cancer Center at West County Hospital
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Kansas City, Missouri, Stany Zjednoczone, 64154
- University of Kansas Cancer Center - North
-
Lee's Summit, Missouri, Stany Zjednoczone, 64064
- University of Kansas Cancer Center - Lee's Summit
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St Louis, Missouri, Stany Zjednoczone, 63110
- Washington University School of Medicine
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St Louis, Missouri, Stany Zjednoczone, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Stany Zjednoczone, 63136
- Siteman Cancer Center at Christian Hospital
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Nebraska
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Bellevue, Nebraska, Stany Zjednoczone, 68123
- Nebraska Medicine-Bellevue
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Omaha, Nebraska, Stany Zjednoczone, 68114
- Nebraska Methodist Hospital
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Omaha, Nebraska, Stany Zjednoczone, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, Stany Zjednoczone, 68118
- Nebraska Medicine-Village Pointe
-
Omaha, Nebraska, Stany Zjednoczone, 68114
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
-
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New Hampshire
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Lebanon, New Hampshire, Stany Zjednoczone, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
-
Basking Ridge, New Jersey, Stany Zjednoczone, 07920
- Memorial Sloan Kettering Basking Ridge
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Middletown, New Jersey, Stany Zjednoczone, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, Stany Zjednoczone, 07645
- Memorial Sloan Kettering Bergen
-
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New Mexico
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Albuquerque, New Mexico, Stany Zjednoczone, 87106
- University of New Mexico Cancer Center
-
-
New York
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Commack, New York, Stany Zjednoczone, 11725
- Memorial Sloan Kettering Commack
-
Harrison, New York, Stany Zjednoczone, 10604
- Memorial Sloan Kettering Westchester
-
Lake Success, New York, Stany Zjednoczone, 11042
- Northwell Health/Center for Advanced Medicine
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Mineola, New York, Stany Zjednoczone, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Stany Zjednoczone, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, Stany Zjednoczone, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
New York, New York, Stany Zjednoczone, 10075
- Lenox Hill Hospital
-
New York, New York, Stany Zjednoczone, 10065
- Manhattan Eye Ear and Throat Hospital
-
Rochester, New York, Stany Zjednoczone, 14642
- University of Rochester
-
Stony Brook, New York, Stany Zjednoczone, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Stany Zjednoczone, 13210
- State University of New York Upstate Medical University
-
Syracuse, New York, Stany Zjednoczone, 13215
- SUNY Upstate Medical Center-Community Campus
-
The Bronx, New York, Stany Zjednoczone, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Stany Zjednoczone, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Stany Zjednoczone, 10461
- Montefiore Medical Center-Weiler Hospital
-
Uniondale, New York, Stany Zjednoczone, 11553
- Memorial Sloan Kettering Nassau
-
Webster, New York, Stany Zjednoczone, 14580
- Wilmot Cancer Institute at Webster
-
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North Carolina
-
Albemarle, North Carolina, Stany Zjednoczone, 28002
- Atrium Health Stanly/LCI-Albemarle
-
Chapel Hill, North Carolina, Stany Zjednoczone, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Charlotte, North Carolina, Stany Zjednoczone, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, Stany Zjednoczone, 28210
- Atrium Health Pineville/LCI-Pineville
-
Charlotte, North Carolina, Stany Zjednoczone, 28262
- Atrium Health University City/LCI-University
-
Concord, North Carolina, Stany Zjednoczone, 28025
- Atrium Health Cabarrus/LCI-Concord
-
Durham, North Carolina, Stany Zjednoczone, 27710
- Duke University Medical Center
-
Gastonia, North Carolina, Stany Zjednoczone, 28054
- Levine Cancer Institute-Gaston
-
Monroe, North Carolina, Stany Zjednoczone, 28112
- Atrium Health Union/LCI-Union
-
Raleigh, North Carolina, Stany Zjednoczone, 27609
- Duke Cancer Center Raleigh
-
Shelby, North Carolina, Stany Zjednoczone, 28150
- Atrium Health Cleveland/LCI-Cleveland
-
Winston-Salem, North Carolina, Stany Zjednoczone, 27157
- Wake Forest University Health Sciences
-
-
Ohio
-
Avon, Ohio, Stany Zjednoczone, 44011
- UH Seidman Cancer Center at UH Avon Health Center
-
Beachwood, Ohio, Stany Zjednoczone, 44122
- UHHS-Chagrin Highlands Medical Center
-
Centerville, Ohio, Stany Zjednoczone, 45459
- Miami Valley Hospital South
-
Cincinnati, Ohio, Stany Zjednoczone, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cleveland, Ohio, Stany Zjednoczone, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Stany Zjednoczone, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Stany Zjednoczone, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Stany Zjednoczone, 45415
- Miami Valley Hospital North
-
Franklin, Ohio, Stany Zjednoczone, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Greenville, Ohio, Stany Zjednoczone, 45331
- Miami Valley Cancer Care and Infusion
-
Mentor, Ohio, Stany Zjednoczone, 44060
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Troy, Ohio, Stany Zjednoczone, 45373
- Upper Valley Medical Center
-
West Chester, Ohio, Stany Zjednoczone, 45069
- University of Cincinnati Cancer Center-West Chester
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Stany Zjednoczone, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Portland, Oregon, Stany Zjednoczone, 97213
- Providence Portland Medical Center
-
-
Pennsylvania
-
Chadds Ford, Pennsylvania, Stany Zjednoczone, 19317
- Christiana Care Health System-Concord Health Center
-
Erie, Pennsylvania, Stany Zjednoczone, 16505
- UPMC Hillman Cancer Center Erie
-
Erie, Pennsylvania, Stany Zjednoczone, 16544
- Saint Vincent Hospital
-
Hershey, Pennsylvania, Stany Zjednoczone, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Johnstown, Pennsylvania, Stany Zjednoczone, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
Monroeville, Pennsylvania, Stany Zjednoczone, 15146
- Forbes Hospital
-
Philadelphia, Pennsylvania, Stany Zjednoczone, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Stany Zjednoczone, 19107
- Thomas Jefferson University Hospital
-
Pittsburgh, Pennsylvania, Stany Zjednoczone, 15212
- Allegheny General Hospital
-
Pittsburgh, Pennsylvania, Stany Zjednoczone, 15224
- West Penn Hospital
-
Pittsburgh, Pennsylvania, Stany Zjednoczone, 15232
- UPMC Hillman Cancer Center
-
Wexford, Pennsylvania, Stany Zjednoczone, 15090
- Wexford Health and Wellness Pavilion
-
-
South Carolina
-
Charleston, South Carolina, Stany Zjednoczone, 29425
- Medical University of South Carolina
-
Rock Hill, South Carolina, Stany Zjednoczone, 29732
- Levine Cancer Institute-Rock Hill
-
Rock Hill, South Carolina, Stany Zjednoczone, 29730
- Rock Hill Radiation Therapy Center
-
-
Tennessee
-
Nashville, Tennessee, Stany Zjednoczone, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Conroe, Texas, Stany Zjednoczone, 77384
- UT MD Anderson - The Woodlands
-
Dallas, Texas, Stany Zjednoczone, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Stany Zjednoczone, 75237
- UT Southwestern Simmons Cancer Center - RedBird
-
Fort Worth, Texas, Stany Zjednoczone, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Houston, Texas, Stany Zjednoczone, 77030
- UT MD Anderson Cancer Center
-
Houston, Texas, Stany Zjednoczone, 77079
- UT MD Anderson - West Houston
-
League City, Texas, Stany Zjednoczone, 77573
- UT MD Anderson - League City
-
Richardson, Texas, Stany Zjednoczone, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
San Antonio, Texas, Stany Zjednoczone, 78229
- University of Texas Health Science Center at San Antonio
-
Sugar Land, Texas, Stany Zjednoczone, 77478
- UT MD Anderson - Sugar Land
-
-
Utah
-
Salt Lake City, Utah, Stany Zjednoczone, 84112
- Huntsman Cancer Institute/University of Utah
-
-
Vermont
-
Berlin Corners, Vermont, Stany Zjednoczone, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, Stany Zjednoczone, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, Stany Zjednoczone, 05405
- University of Vermont and State Agricultural College
-
Saint Johnsbury, Vermont, Stany Zjednoczone, 05819
- Dartmouth Cancer Center - North
-
-
Virginia
-
Charlottesville, Virginia, Stany Zjednoczone, 22908
- University of Virginia Cancer Center
-
Fairfax, Virginia, Stany Zjednoczone, 22031
- Inova Schar Cancer Institute
-
Richmond, Virginia, Stany Zjednoczone, 23298
- VCU Massey Comprehensive Cancer Center
-
-
Washington
-
Seattle, Washington, Stany Zjednoczone, 98101
- Virginia Mason Medical Center
-
-
Wisconsin
-
La Crosse, Wisconsin, Stany Zjednoczone, 54601
- Gundersen Lutheran Medical Center
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Madison, Wisconsin, Stany Zjednoczone, 53705
- William S Middleton VA Medical Center
-
Madison, Wisconsin, Stany Zjednoczone, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Stany Zjednoczone, 53718
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
Marshfield, Wisconsin, Stany Zjednoczone, 54449
- Marshfield Medical Center-Marshfield
-
Menomonee Falls, Wisconsin, Stany Zjednoczone, 53051
- Froedtert Menomonee Falls Hospital
-
Milwaukee, Wisconsin, Stany Zjednoczone, 53226
- Medical College of Wisconsin
-
Oak Creek, Wisconsin, Stany Zjednoczone, 53154
- Drexel Town Square Health Center
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West Bend, Wisconsin, Stany Zjednoczone, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
-
Weston, Wisconsin, Stany Zjednoczone, 54476
- Marshfield Medical Center - Weston
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
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)
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Squamous cell carcinoma with sarcomatoid differentiation
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Acantholytic SCC
-
Clear cell SCC
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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
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Age ≥ 18
-
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
-
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
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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)
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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
-
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
-
-
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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
-
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)
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Pojedynczy
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Aktywny 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
Inne nazwy:
Ancillary studies Undergo PET/CT
Inne nazwy:
Undergo IMRT
Inne nazwy:
Undergo CT and/or PET/CT
Inne nazwy:
Undergo collection of blood and/or plasma
Inne nazwy:
Undergo IGRT
Inne nazwy:
Undergo surgery per SOC
Inne nazwy:
Undergo response-adaptive surgery
Inne nazwy:
|
|
Eksperymentalny: 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
Inne nazwy:
Ancillary studies Undergo PET/CT
Inne nazwy:
Undergo IMRT
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT and/or PET/CT
Inne nazwy:
Undergo collection of blood and/or plasma
Inne nazwy:
Undergo IGRT
Inne nazwy:
Undergo surgery per SOC
Inne nazwy:
Undergo response-adaptive surgery
Inne nazwy:
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Event-free survival (EFS)
Ramy czasowe: 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
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Utilization of adjuvant radiation
Ramy czasowe: 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)
Ramy czasowe: 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)
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
|
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Quality of life
Ramy czasowe: 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)
Ramy czasowe: 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
Ramy czasowe: 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)
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
|
Współpracownicy i badacze
Sponsor
Śledczy
- Główny śledczy: Neil D Gross, NRG Oncology
Publikacje i pomocne linki
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
- Techniki śledcze
- Lecznictwo
- Techniki laboratoryjne kliniczne
- Techniki i procedury diagnostyczne
- Diagnoza
- Techniki chemii, analityczne
- Analiza widma
- Radioterapia
- Radioterapia, zgodna
- Radioterapia, wspomagana komputerowo
- Prowadzenie okazów
- Spektroskopia rezonansu magnetycznego
- Procedury chirurgiczne, operacyjny
- Radioterapia, modulowana intensywnością
- Cemiplimab
- Radioterapia, kierowana obrazem
Inne numery identyfikacyjne badania
- NCI-2024-03425
- U10CA180868 (Grant/umowa NIH USA)
- NCI-2024-03425 (Identyfikator rejestru: CTRP (Clinical Trial Reporting Program))
- NRG-HN014 (Inny identyfikator: CTEP)
- NRG-HN014 (Inny identyfikator: NRG Oncology)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
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