- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание NCT06568172
Тестирование добавления иммунотерапевтического препарата Цемиплимаба (REGN2810) плюс хирургическое вмешательство к обычному хирургическому вмешательству для лечения распространенного рака кожи
Рандомизированное исследование III фазы периоперационной иммунотерапии с адаптированным к ответу лечением в сравнении со стандартным лечением резектабельного плоскоклеточного рака кожи III/IV стадии
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.
Обзор исследования
Статус
Условия
- Стадия IV головы и шея кожного плоскоклеточного рака AJCC V8
- Стадия III голова и шея кожные плоскоклеточные карциномы AJCC V8
- Плоскоклеточный рак века
- Кожная акантолитическая плоскоклеточная карцинома
- Кожный чистый клеточный плоскоклеточный рак
- Кожная лимфоэпителиальная карцинома
- Кожная веретеноклеточная плоскоклеточная карцинома
- Плоскоклеточный рак кожи с саркоматоидной дифференцировкой
- Рецидивирующая плоскоклеточная карцинома века
- Рецидивирующая кожная акантолитическая плоскоклеточная карцинома
- Рецидивирующий кожный плоскоклеточный рак из светлых клеток
- Рецидивирующая кожная лимфоэпителиальная карцинома
- Рецидивирующий веретеноклеточный плоскоклеточный рак кожи
- Рецидивирующий плоскоклеточный рак кожи с саркоматоидной дифференцировкой
- Резектабельный плоскоклеточный рак века
- Резектабельный акантолитический плоскоклеточный рак кожи
- Резектабельный кожный плоскоклеточный рак из светлых клеток
- Резектабельная кожная лимфоэпителиальная карцинома
- Резецируемая веретеноклеточная плоскоклеточная карцинома кожи
- Резецируемая плоскоклеточная карцинома кожи с саркоматоидной дифференцировкой
Вмешательство/лечение
- Процедура: Magnetic Resonance Imaging
- Другой: Questionnaire Administration
- Процедура: Positron Emission Tomography
- Радиация: Intensity-Modulated Radiation Therapy
- Биологический: Cemiplimab
- Процедура: Computed Tomography
- Процедура: Biospecimen Collection
- Радиация: Image Guided Radiation Therapy
- Процедура: Surgical Procedure
- Процедура: Surgical Procedure
Подробное описание
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.
Тип исследования
Регистрация (Оцененный)
Фаза
- Фаза 3
Контакты и местонахождение
Места учебы
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New South Wales
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Camperdown, New South Wales, Австралия, 2050
- Chris O'Brien Lifehouse
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Wollongong, New South Wales, Австралия, 2500
- Wollongong Hospital
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Queensland
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Townsville, Queensland, Австралия, 4814
- Townsville General Hospital
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Woolloongabba, Queensland, Австралия, 4102
- Princess Alexandra Hospital
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Victoria
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Fitzroy, Victoria, Австралия, 3065
- Saint Vincent's Hospital
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Melbourne, Victoria, Австралия, 3000
- Peter MacCallum Cancer Centre
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Western Australia
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Murdoch, Western Australia, Австралия, 6150
- Fiona Stanley Hospital
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British Columbia
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Vancouver, British Columbia, Канада, V5Z 4E6
- BCCA-Vancouver Cancer Centre
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Ontario
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Toronto, Ontario, Канада, M5G 2M9
- University Health Network-Princess Margaret Hospital
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Toronto, Ontario, Канада, M4N 3M5
- Odette Cancer Centre- Sunnybrook Health Sciences Centre
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Alabama
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Birmingham, Alabama, Соединенные Штаты, 35233
- University of Alabama at Birmingham Cancer Center
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Arizona
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Gilbert, Arizona, Соединенные Штаты, 85234
- Banner MD Anderson Cancer Center
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Phoenix, Arizona, Соединенные Штаты, 85054
- Mayo Clinic Hospital in Arizona
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California
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Beverly Hills, California, Соединенные Штаты, 90211
- Tower Cancer Research Foundation
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Duarte, California, Соединенные Штаты, 91010
- City of Hope Comprehensive Cancer Center
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Encinitas, California, Соединенные Штаты, 92024
- UC San Diego Health System - Encinitas
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Irvine, California, Соединенные Штаты, 92618
- City of Hope at Irvine Lennar
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La Jolla, California, Соединенные Штаты, 92093
- UC San Diego Moores Cancer Center
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Lancaster, California, Соединенные Штаты, 93534
- City of Hope Antelope Valley
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Los Angeles, California, Соединенные Штаты, 90033
- USC / Norris Comprehensive Cancer Center
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Los Angeles, California, Соединенные Штаты, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, Соединенные Штаты, 90025
- The Angeles Clinic and Research Institute - West Los Angeles Office
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Oakland, California, Соединенные Штаты, 94611
- Kaiser Permanente-Oakland
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Palo Alto, California, Соединенные Штаты, 94304
- Stanford Cancer Institute Palo Alto
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Sacramento, California, Соединенные Штаты, 95817
- University of California Davis Comprehensive Cancer Center
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Sacramento, California, Соединенные Штаты, 95823
- Kaiser Permanente-South Sacramento
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San Diego, California, Соединенные Штаты, 92103
- UC San Diego Medical Center - Hillcrest
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San Francisco, California, Соединенные Штаты, 94115
- Kaiser Permanente-San Francisco
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South Pasadena, California, Соединенные Штаты, 91030
- City of Hope South Pasadena
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Torrance, California, Соединенные Штаты, 90505
- Torrance Memorial Physician Network - Cancer Care
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Upland, California, Соединенные Штаты, 91786
- City of Hope Upland
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Walnut Creek, California, Соединенные Штаты, 94596
- Kaiser Permanente-Walnut Creek
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Colorado
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Aurora, Colorado, Соединенные Штаты, 80045
- UCHealth University of Colorado Hospital
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Colorado Springs, Colorado, Соединенные Штаты, 80909
- UCHealth Memorial Hospital Central
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Colorado Springs, Colorado, Соединенные Штаты, 80920
- Memorial Hospital North
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Connecticut
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Greenwich, Connecticut, Соединенные Штаты, 06830
- Smilow Cancer Hospital Care Center at Greenwich
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Guilford, Connecticut, Соединенные Штаты, 06437
- Smilow Cancer Hospital Care Center - Guilford
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New Haven, Connecticut, Соединенные Штаты, 06520
- Yale University
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Trumbull, Connecticut, Соединенные Штаты, 06611
- Smilow Cancer Hospital Care Center-Trumbull
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Waterbury, Connecticut, Соединенные Штаты, 06708
- Smilow Cancer Hospital-Waterbury Care Center
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Waterford, Connecticut, Соединенные Штаты, 06385
- Smilow Cancer Hospital Care Center - Waterford
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Delaware
-
Newark, Delaware, Соединенные Штаты, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Соединенные Штаты, 19713
- Medical Oncology Hematology Consultants PA
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Florida
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Aventura, Florida, Соединенные Штаты, 33180
- UM Sylvester Comprehensive Cancer Center at Aventura
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Coral Gables, Florida, Соединенные Штаты, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
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Deerfield Beach, Florida, Соединенные Штаты, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Doral, Florida, Соединенные Штаты, 33166
- UM Sylvester Comprehensive Cancer Center at Doral
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Jacksonville, Florida, Соединенные Штаты, 32224-9980
- Mayo Clinic in Florida
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Miami, Florida, Соединенные Штаты, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Соединенные Штаты, 33176
- Miami Cancer Institute
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Miami, Florida, Соединенные Штаты, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
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N. Venice, Florida, Соединенные Штаты, 34275
- Sarasota Memorial Hospital-Venice
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Plantation, Florida, Соединенные Штаты, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
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Sarasota, Florida, Соединенные Штаты, 34239
- Sarasota Memorial Hospital
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Sarasota, Florida, Соединенные Штаты, 34232
- Florida Cancer Specialists - Sarasota
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Sarasota, Florida, Соединенные Штаты, 34243
- Sarasota Memorial Health Care Center at University Parkway
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Sarasota, Florida, Соединенные Штаты, 34239
- First Physicians Group - Silverstein Institute at Floyd Street
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Sarasota, Florida, Соединенные Штаты, 34239
- Florida Cancer Specialists - Sarasota Downtown
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Tampa, Florida, Соединенные Штаты, 33612
- Moffitt Cancer Center
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Tampa, Florida, Соединенные Штаты, 33607
- Moffitt Cancer Center-International Plaza
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Tampa, Florida, Соединенные Штаты, 33612
- Moffitt Cancer Center - McKinley Campus
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Venice, Florida, Соединенные Штаты, 34285
- Florida Cancer Specialists - Venice Island
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Venice, Florida, Соединенные Штаты, 34275
- Florida Cancer Specialists - Venice Pinebrook
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Georgia
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Atlanta, Georgia, Соединенные Штаты, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Соединенные Штаты, 30322
- Emory University Hospital/Winship Cancer Institute
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Illinois
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Alton, Illinois, Соединенные Штаты, 62002
- Alton Memorial Hospital
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Chicago, Illinois, Соединенные Штаты, 60611
- Northwestern University
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Chicago, Illinois, Соединенные Штаты, 60612
- University of Illinois
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Chicago, Illinois, Соединенные Штаты, 60612
- Rush MD Anderson Cancer Center
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DeKalb, Illinois, Соединенные Штаты, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Соединенные Штаты, 62526
- Decatur Memorial Hospital
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Geneva, Illinois, Соединенные Штаты, 60134
- Northwestern Medicine Cancer Center Delnor
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Orland Park, Illinois, Соединенные Штаты, 60462
- Northwestern Medicine Orland Park
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Shiloh, Illinois, Соединенные Штаты, 62269
- Memorial Hospital East
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Warrenville, Illinois, Соединенные Штаты, 60555
- Northwestern Medicine Cancer Center Warrenville
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Indiana
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Carmel, Indiana, Соединенные Штаты, 46032
- IU Health North Hospital
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Goshen, Indiana, Соединенные Штаты, 46526
- Goshen Center for Cancer Care
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Indianapolis, Indiana, Соединенные Штаты, 46237
- Franciscan Health Indianapolis
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Indianapolis, Indiana, Соединенные Штаты, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
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Iowa
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Council Bluffs, Iowa, Соединенные Штаты, 51503
- Heartland Oncology and Hematology LLP
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Council Bluffs, Iowa, Соединенные Штаты, 51503
- Methodist Jennie Edmundson Hospital
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Kansas
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Kansas City, Kansas, Соединенные Штаты, 66160
- University of Kansas Cancer Center
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Overland Park, Kansas, Соединенные Штаты, 66210
- University of Kansas Cancer Center-Overland Park
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Overland Park, Kansas, Соединенные Штаты, 66211
- University of Kansas Hospital-Indian Creek Campus
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Westwood, Kansas, Соединенные Штаты, 66205
- University of Kansas Hospital-Westwood Cancer Center
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Kentucky
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Lexington, Kentucky, Соединенные Штаты, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, Соединенные Штаты, 40202
- The James Graham Brown Cancer Center at University of Louisville
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Louisville, Kentucky, Соединенные Штаты, 40245
- UofL Health Medical Center Northeast
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Louisiana
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Baton Rouge, Louisiana, Соединенные Штаты, 70805
- LSU Health Baton Rouge-North Clinic
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Baton Rouge, Louisiana, Соединенные Штаты, 70808
- Our Lady of the Lake Physician Group
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New Orleans, Louisiana, Соединенные Штаты, 70112
- University Medical Center New Orleans
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Michigan
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Ann Arbor, Michigan, Соединенные Штаты, 48109
- University of Michigan Rogel Cancer Center
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Brighton, Michigan, Соединенные Штаты, 48116
- University of Michigan - Brighton Center for Specialty Care
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Detroit, Michigan, Соединенные Штаты, 48202
- Henry Ford Hospital
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Grand Rapids, Michigan, Соединенные Штаты, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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West Bloomfield, Michigan, Соединенные Штаты, 48322
- Henry Ford West Bloomfield Hospital
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Wyoming, Michigan, Соединенные Штаты, 49519
- University of Michigan Health - West
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Minnesota
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Minneapolis, Minnesota, Соединенные Штаты, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, Соединенные Штаты, 55905
- Mayo Clinic in Rochester
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Missouri
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City of Saint Peters, Missouri, Соединенные Штаты, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Columbia, Missouri, Соединенные Штаты, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
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Creve Coeur, Missouri, Соединенные Штаты, 63141
- Siteman Cancer Center at West County Hospital
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Kansas City, Missouri, Соединенные Штаты, 64154
- University of Kansas Cancer Center - North
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Lee's Summit, Missouri, Соединенные Штаты, 64064
- University of Kansas Cancer Center - Lee's Summit
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St Louis, Missouri, Соединенные Штаты, 63110
- Washington University School of Medicine
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St Louis, Missouri, Соединенные Штаты, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Соединенные Штаты, 63136
- Siteman Cancer Center at Christian Hospital
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Nebraska
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Bellevue, Nebraska, Соединенные Штаты, 68123
- Nebraska Medicine-Bellevue
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Omaha, Nebraska, Соединенные Штаты, 68114
- Nebraska Methodist Hospital
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Omaha, Nebraska, Соединенные Штаты, 68198
- University of Nebraska Medical Center
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Omaha, Nebraska, Соединенные Штаты, 68118
- Nebraska Medicine-Village Pointe
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Omaha, Nebraska, Соединенные Штаты, 68114
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
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New Hampshire
-
Lebanon, New Hampshire, Соединенные Штаты, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
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New Jersey
-
Basking Ridge, New Jersey, Соединенные Штаты, 07920
- Memorial Sloan Kettering Basking Ridge
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Middletown, New Jersey, Соединенные Штаты, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, Соединенные Штаты, 07645
- Memorial Sloan Kettering Bergen
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New Mexico
-
Albuquerque, New Mexico, Соединенные Штаты, 87106
- University of New Mexico Cancer Center
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New York
-
Commack, New York, Соединенные Штаты, 11725
- Memorial Sloan Kettering Commack
-
Harrison, New York, Соединенные Штаты, 10604
- Memorial Sloan Kettering Westchester
-
Lake Success, New York, Соединенные Штаты, 11042
- Northwell Health/Center for Advanced Medicine
-
Mineola, New York, Соединенные Штаты, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Соединенные Штаты, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, Соединенные Штаты, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
New York, New York, Соединенные Штаты, 10075
- Lenox Hill Hospital
-
New York, New York, Соединенные Штаты, 10065
- Manhattan Eye Ear and Throat Hospital
-
Rochester, New York, Соединенные Штаты, 14642
- University of Rochester
-
Stony Brook, New York, Соединенные Штаты, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Соединенные Штаты, 13210
- State University of New York Upstate Medical University
-
Syracuse, New York, Соединенные Штаты, 13215
- SUNY Upstate Medical Center-Community Campus
-
The Bronx, New York, Соединенные Штаты, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Соединенные Штаты, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Соединенные Штаты, 10461
- Montefiore Medical Center-Weiler Hospital
-
Uniondale, New York, Соединенные Штаты, 11553
- Memorial Sloan Kettering Nassau
-
Webster, New York, Соединенные Штаты, 14580
- Wilmot Cancer Institute at Webster
-
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North Carolina
-
Albemarle, North Carolina, Соединенные Штаты, 28002
- Atrium Health Stanly/LCI-Albemarle
-
Chapel Hill, North Carolina, Соединенные Штаты, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Charlotte, North Carolina, Соединенные Штаты, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, Соединенные Штаты, 28210
- Atrium Health Pineville/LCI-Pineville
-
Charlotte, North Carolina, Соединенные Штаты, 28262
- Atrium Health University City/LCI-University
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Concord, North Carolina, Соединенные Штаты, 28025
- Atrium Health Cabarrus/LCI-Concord
-
Durham, North Carolina, Соединенные Штаты, 27710
- Duke University Medical Center
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Gastonia, North Carolina, Соединенные Штаты, 28054
- Levine Cancer Institute-Gaston
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Monroe, North Carolina, Соединенные Штаты, 28112
- Atrium Health Union/LCI-Union
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Raleigh, North Carolina, Соединенные Штаты, 27609
- Duke Cancer Center Raleigh
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Shelby, North Carolina, Соединенные Штаты, 28150
- Atrium Health Cleveland/LCI-Cleveland
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Winston-Salem, North Carolina, Соединенные Штаты, 27157
- Wake Forest University Health Sciences
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Ohio
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Avon, Ohio, Соединенные Штаты, 44011
- UH Seidman Cancer Center at UH Avon Health Center
-
Beachwood, Ohio, Соединенные Штаты, 44122
- UHHS-Chagrin Highlands Medical Center
-
Centerville, Ohio, Соединенные Штаты, 45459
- Miami Valley Hospital South
-
Cincinnati, Ohio, Соединенные Штаты, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cleveland, Ohio, Соединенные Штаты, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Соединенные Штаты, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Соединенные Штаты, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Соединенные Штаты, 45415
- Miami Valley Hospital North
-
Franklin, Ohio, Соединенные Штаты, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Greenville, Ohio, Соединенные Штаты, 45331
- Miami Valley Cancer Care and Infusion
-
Mentor, Ohio, Соединенные Штаты, 44060
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Troy, Ohio, Соединенные Штаты, 45373
- Upper Valley Medical Center
-
West Chester, Ohio, Соединенные Штаты, 45069
- University of Cincinnati Cancer Center-West Chester
-
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Oklahoma
-
Oklahoma City, Oklahoma, Соединенные Штаты, 73104
- University of Oklahoma Health Sciences Center
-
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Oregon
-
Portland, Oregon, Соединенные Штаты, 97213
- Providence Portland Medical Center
-
-
Pennsylvania
-
Chadds Ford, Pennsylvania, Соединенные Штаты, 19317
- Christiana Care Health System-Concord Health Center
-
Erie, Pennsylvania, Соединенные Штаты, 16505
- UPMC Hillman Cancer Center Erie
-
Erie, Pennsylvania, Соединенные Штаты, 16544
- Saint Vincent Hospital
-
Hershey, Pennsylvania, Соединенные Штаты, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Johnstown, Pennsylvania, Соединенные Штаты, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
Monroeville, Pennsylvania, Соединенные Штаты, 15146
- Forbes Hospital
-
Philadelphia, Pennsylvania, Соединенные Штаты, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Соединенные Штаты, 19107
- Thomas Jefferson University Hospital
-
Pittsburgh, Pennsylvania, Соединенные Штаты, 15212
- Allegheny General Hospital
-
Pittsburgh, Pennsylvania, Соединенные Штаты, 15224
- West Penn Hospital
-
Pittsburgh, Pennsylvania, Соединенные Штаты, 15232
- UPMC Hillman Cancer Center
-
Wexford, Pennsylvania, Соединенные Штаты, 15090
- Wexford Health and Wellness Pavilion
-
-
South Carolina
-
Charleston, South Carolina, Соединенные Штаты, 29425
- Medical University of South Carolina
-
Rock Hill, South Carolina, Соединенные Штаты, 29732
- Levine Cancer Institute-Rock Hill
-
Rock Hill, South Carolina, Соединенные Штаты, 29730
- Rock Hill Radiation Therapy Center
-
-
Tennessee
-
Nashville, Tennessee, Соединенные Штаты, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Conroe, Texas, Соединенные Штаты, 77384
- UT MD Anderson - The Woodlands
-
Dallas, Texas, Соединенные Штаты, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Соединенные Штаты, 75237
- UT Southwestern Simmons Cancer Center - RedBird
-
Fort Worth, Texas, Соединенные Штаты, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Houston, Texas, Соединенные Штаты, 77030
- UT MD Anderson Cancer Center
-
Houston, Texas, Соединенные Штаты, 77079
- UT MD Anderson - West Houston
-
League City, Texas, Соединенные Штаты, 77573
- UT MD Anderson - League City
-
Richardson, Texas, Соединенные Штаты, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
San Antonio, Texas, Соединенные Штаты, 78229
- University of Texas Health Science Center at San Antonio
-
Sugar Land, Texas, Соединенные Штаты, 77478
- UT MD Anderson - Sugar Land
-
-
Utah
-
Salt Lake City, Utah, Соединенные Штаты, 84112
- Huntsman Cancer Institute/University of Utah
-
-
Vermont
-
Berlin Corners, Vermont, Соединенные Штаты, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, Соединенные Штаты, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, Соединенные Штаты, 05405
- University of Vermont and State Agricultural College
-
Saint Johnsbury, Vermont, Соединенные Штаты, 05819
- Dartmouth Cancer Center - North
-
-
Virginia
-
Charlottesville, Virginia, Соединенные Штаты, 22908
- University of Virginia Cancer Center
-
Fairfax, Virginia, Соединенные Штаты, 22031
- Inova Schar Cancer Institute
-
Richmond, Virginia, Соединенные Штаты, 23298
- VCU Massey Comprehensive Cancer Center
-
-
Washington
-
Seattle, Washington, Соединенные Штаты, 98101
- Virginia Mason Medical Center
-
-
Wisconsin
-
La Crosse, Wisconsin, Соединенные Штаты, 54601
- Gundersen Lutheran Medical Center
-
Madison, Wisconsin, Соединенные Штаты, 53705
- William S Middleton VA Medical Center
-
Madison, Wisconsin, Соединенные Штаты, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Соединенные Штаты, 53718
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
Marshfield, Wisconsin, Соединенные Штаты, 54449
- Marshfield Medical Center-Marshfield
-
Menomonee Falls, Wisconsin, Соединенные Штаты, 53051
- Froedtert Menomonee Falls Hospital
-
Milwaukee, Wisconsin, Соединенные Штаты, 53226
- Medical College of Wisconsin
-
Oak Creek, Wisconsin, Соединенные Штаты, 53154
- Drexel Town Square Health Center
-
West Bend, Wisconsin, Соединенные Штаты, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
-
Weston, Wisconsin, Соединенные Штаты, 54476
- Marshfield Medical Center - Weston
-
-
Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
Inclusion Criteria:
-
Pathologically (histologically or cytologically) proven diagnosis of invasive cutaneous squamous cell carcinoma (CSCC) or regional lymph node or in-transit metastasis of CSCC
-
The following CSCC subtypes are eligible according to World Health Organization (WHO) classification if the predominant histology is confirmed CSCC.
-
Spindle cell squamous cell carcinoma (SCC)
-
Squamous cell carcinoma with sarcomatoid differentiation
-
Acantholytic SCC
-
Clear cell SCC
-
Lymphoepithelial carcinoma
- Note: Keratoacanthoma SCC and Verrucous SCC subtypes are not eligible.
-
-
For patients with regional metastasis without a primary tumor at screening: a clinical history of CSCC that drains to the involved regional lymph nodes or in-transit metastases in question is required
- For example, a parotid mass shown to be SCC by cytologic analysis of a fine needle aspirate in a patient with a clinical history of CSCC on the ipsilateral scalp would be eligible
-
For patients with regional metastases without a primary tumor and an ambiguous clinical history: tumor genomic sequencing suggesting a primary tumor of cutaneous origin would be acceptable evidence to establish eligibility
-
NOTE: Tumor genomic sequencing is not required to determine eligibility, but may be part of the routine evaluation of patients with cancers of unknown primary at some institutions. For example, a parotid mass shown to be SCC by cytologic analysis of fine needle aspirate without a primary tumor and an ambiguous clinical history, but with a tumor genomic sequencing assay demonstrating a high tumor mutation burden (≥ 10 mutations/Mb) and/or a high fraction of ultraviolet (UV) related mutations (> 50% of mutations [cytosine (C)/thymine (T)]C > T or CC > TT) and/or the presence of "signature 7" mutations would be eligible (Chang 2021)
-
-
Previously untreated or recurrent CSCC
-
Clinical American Joint Committee on Cancer (AJCC) 8th Edition (eyelid, head and neck sites) or Union for International Cancer Control (UICC) (non-head and neck sites) stage III or IV
-
Primary tumor site must be in the head and neck cutaneous region, other non-head and neck cutaneous regions, or eyelid cutaneous region
-
No mucosal squamous cell carcinoma (vermillion lip, nasal, oral, sinonasal, conjunctival, anogenital)
-
Tumor must be resectable with curative intent. Note: Tumor with bony skull base invasion and/or skull base foramen involvement (T4b) is not eligible. (Patients with T4b eyelid tumors using UICC Staging, and not involving the brain, are eligible.)
-
At least 1 lesion that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
-
No definitive clinical or radiologic evidence of distant metastatic disease (M1), visceral and/or distant nodal disease
-
Age ≥ 18
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
-
Not pregnant and not nursing
- Negative urine or serum pregnancy test (in persons of childbearing potential) within 14 days prior to registration. Childbearing potential is defined as any person who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal
-
Absolute neutrophil count (ANC) ≥ 1,000 cells/mm^3
-
Platelets ≥ 75,000 cells/mm^3
-
Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin [Hgb] ≥ 8.0 g/dl is acceptable)
-
Creatinine clearance (CrCL) > 30mL/min by the Cockcroft-Gault formula
-
Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (NOTE: For patients with Gilbert's syndrome, total bilirubin ≤ 3 x ULN. Gilbert's syndrome must be documented appropriately as past medical history.)
-
Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x institutional ULN
-
No prior systemic therapy for the study cancer (including patients currently receiving immunotherapy for a separate malignancy)
-
No prior radiotherapy to the region of the study cancer that would result in cumulative doses of radiation to organs at risk for radiation injury that exceed protocol limitations
-
No history of myocardial infarction/unstable angina within the last 6 months
-
New York Heart Association functional classification IIb or better (New York Heart Association [NYHA] functional classification III/IV are not eligible) (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association functional classification)
-
No active infection requiring systemic antibiotics, antiviral, or antifungal treatments
-
No history of allogeneic stem cell transplantation, or autologous stem cell transplantation
-
No history of a solid organ transplant (other than corneal transplant)
-
No active, known, or suspected autoimmune disease
-
Active or known disease is defined as:
- Requiring higher than physiologic steroid levels (> 10mg prednisone/day or equivalent) or
- Requiring disease-modifying agents or
- Ongoing or recent (within 5 years prior to registration) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk for immune-related adverse events (irAEs)
-
NOTES:
-
Patients meeting the following criteria are not considered immunosuppressed and are eligible to enroll:
- Patients who require a brief course of steroids (eg, prophylaxis for imaging assessments due to hypersensitivity to contrast agents) are not excluded
- Patients with type I diabetes mellitus, and endocrinopathies (including hypothyroidism due to autoimmune thyroiditis) only requiring hormone replacement, or skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll
- Physiologic replacement doses ≤ 10 mg prednisone/day or equivalent allowed, as long as they are not being administered for immunosuppressive intent. Inhaled or topical steroids are permitted
-
Patients with the following immunosuppressed conditions are eligible to enroll:
- Patients with HIV infection on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible
- Patients with chronic lymphocytic leukemia (CLL) with no history of anti-CLL therapy within 6 months prior to registration are eligible
-
-
-
No history of interstitial lung disease (eg, idiopathic pulmonary fibrosis, organizing pneumonia)
-
No active, noninfectious pneumonitis requiring immune-suppressive therapy
-
No active tuberculosis
-
No live vaccines within 28 days prior to registration
-
No history of allergic reaction to the study agent, compounds of similar chemical or biologic composition to the study agent (or any of its excipients)
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Одинокий
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
|---|---|
|
Активный компаратор: 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
Другие имена:
Ancillary studies Undergo PET/CT
Другие имена:
Undergo IMRT
Другие имена:
Undergo CT and/or PET/CT
Другие имена:
Undergo collection of blood and/or plasma
Другие имена:
Undergo IGRT
Другие имена:
Undergo surgery per SOC
Другие имена:
Undergo response-adaptive surgery
Другие имена:
|
|
Экспериментальный: 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
Другие имена:
Ancillary studies Undergo PET/CT
Другие имена:
Undergo IMRT
Другие имена:
Given IV
Другие имена:
Undergo CT and/or PET/CT
Другие имена:
Undergo collection of blood and/or plasma
Другие имена:
Undergo IGRT
Другие имена:
Undergo surgery per SOC
Другие имена:
Undergo response-adaptive surgery
Другие имена:
|
Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Event-free survival (EFS)
Временное ограничение: 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
|
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Utilization of adjuvant radiation
Временное ограничение: 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)
Временное ограничение: 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)
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
|
Другие показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Quality of life
Временное ограничение: 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)
Временное ограничение: 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
Временное ограничение: 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)
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
|
Соавторы и исследователи
Спонсор
Следователи
- Главный следователь: Neil D Gross, NRG Oncology
Публикации и полезные ссылки
Даты записи исследования
Изучение основных дат
Начало исследования (Действительный)
Первичное завершение (Оцененный)
Завершение исследования (Оцененный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Дополнительные соответствующие термины MeSH
- Следственные методы
- Терапия
- Клинические лабораторные методы
- Диагностические методы и процедуры
- Диагноз
- Химические методы, аналитические
- Анализ спектра
- Лучевая терапия
- Лучевая терапия, конформная
- Лучевая терапия, компьютерная помощь
- Обработка образца
- Магнитно -резонансная спектроскопия
- Хирургические процедуры, оперативные
- Лучевая терапия, модулированная интенсивностью
- Cemiplimab
- Лучевая терапия, с изображением
Другие идентификационные номера исследования
- NCI-2024-03425
- U10CA180868 (Грант/контракт NIH США)
- NCI-2024-03425 (Идентификатор реестра: CTRP (Clinical Trial Reporting Program))
- NRG-HN014 (Другой идентификатор: CTEP)
- NRG-HN014 (Другой идентификатор: NRG Oncology)
Планирование данных отдельных участников (IPD)
Планируете делиться данными об отдельных участниках (IPD)?
Описание плана IPD
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Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
продукт, произведенный в США и экспортированный из США.
Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .