Actively Recruiting
Cetuximab Plus Platinum and Taxane-based Chemotherapy, Followed by Avelumab and Cetuximab, as First-line Treatment for Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (HNSCC) Patients With a PD-L1 Combined Positive Score (CPS)≥1≤19.
Led by Gruppo Oncologico del Nord-Ovest · Updated on 2025-03-14
67
Participants Needed
8
Research Sites
156 weeks
Total Duration
On this page
Sponsors
G
Gruppo Oncologico del Nord-Ovest
Lead Sponsor
M
Merck Serono S.P.A., Italy
Collaborating Sponsor
AI-Summary
What this Trial Is About
This phase II interventional clinical trial aims to evaluate whether combining cetuximab and avelumab, after three cycles of platinum and taxane-based chemotherapy, can improve treatment outcomes for patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) with a PD-L1 combined positive score (CPS) between 1 and 19. Specifically, the study seeks to determine if this approach can increase the 6-month progression-free survival (PFS) rate from 40% to 55%. The trial will include adult patients with confirmed R/M HNSCC, who have not previously received systemic therapy for their advanced disease. By testing this sequential treatment strategy, researchers hope to improve outcomes for this specific patient population, which has shown poorer responses to existing immunotherapy options compared to those with higher PD-L1 expression levels. Participants will first undergo an induction phase, consisting of three cycles of chemotherapy with paclitaxel, platinum (cisplatin or carboplatin), and cetuximab. After this initial treatment, they will move to a maintenance phase, where they will receive avelumab and cetuximab every two weeks until disease progression or the occurrence of unacceptable side effects. The study aims to answer several key questions: Can this treatment approach improve progression-free survival at 6 months? What impact does it have on overall survival, response rates, and the duration of response? Is this combination therapy safe and well-tolerated? In addition to the treatment itself, participants will be asked to provide blood and tumor tissue samples for translational research, helping scientists better understand how biomarkers influence treatment response. Regular follow-up assessments will also be conducted to monitor disease progression and overall health. By testing this innovative treatment sequence, researchers hope to bridge the gap between different PD-L1 subgroups, potentially offering a more effective and personalized approach for patients with R/M HNSCC.
CONDITIONS
Official Title
Cetuximab Plus Platinum and Taxane-based Chemotherapy, Followed by Avelumab and Cetuximab, as First-line Treatment for Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (HNSCC) Patients With a PD-L1 Combined Positive Score (CPS)≥1≤19.
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Able to sign informed consent and aged 18 years or older
- Histologically or cytologically confirmed diagnosis of head and neck squamous cell carcinoma (HNSCC)
- Recurrent or metastatic HNSCC not suitable for curative local therapy
- PD-L1 combined positive score (CPS) between 1 and 19
- Measurable disease per RECIST 1.1 criteria
- No prior systemic therapy for recurrent or metastatic HNSCC
- Prior systemic therapy more than 6 months ago for locally advanced disease allowed if part of curative treatment
- ECOG performance status of 0 or 1
- Adequate bone marrow function: neutrophils ≥ 1.5 x 10^9/L, platelets ≥ 100 x 10^9/L, hemoglobin ≥ 9 g/dL
- Adequate liver function: total bilirubin < 1.5 x ULN (except Gilbert syndrome), AP and GGT < 3 x ULN, AST and ALT ≤ 2.5 x ULN
- Adequate renal function: creatinine clearance ≥ 30 mL/min
- Available archival or fresh tumor tissue before treatment
- Willing to provide peripheral blood samples as required
- Palliative radiotherapy or surgery within 4 weeks before study entry allowed
- Peripheral neuropathy or ototoxicity grade ≥ 2 acceptable with carboplatin substitution if needed
You will not qualify if you...
- Nasopharyngeal, salivary gland, nasal sinus, and non-melanoma skin cancers
- Life expectancy less than 3 months
- Prior chemotherapy, biological therapy, or immunotherapy for recurrent/metastatic HNSCC
- Immunodeficiency or systemic steroid use > 10 mg/day prednisone or equivalent within 30 days before treatment that cannot be stopped
- Known allergy or hypersensitivity to study drugs or components
- Active autoimmune disease requiring systemic treatment in past 2 years
- Active autoimmune disease that may worsen with immunostimulatory agents (except some stable conditions)
- Additional malignancy diagnosed or treated within 5 years except certain treated skin, prostate, cervical, or breast cancers
- Conditions or therapies that could interfere with trial participation or results
- Significant neurological, psychiatric, or substance abuse disorders
- Clinically significant cardiovascular disease within last 6 months
- Prior organ transplantation
- Active uncontrolled infection requiring systemic therapy
- Known HIV infection or AIDS
- Hepatitis B or C infection at screening
- Live vaccination within 30 days before study start
- Pregnancy or breastfeeding; women of childbearing potential must use effective contraception during and 30 days post-study
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 8 locations
1
Ospedale Oncologico "A. Businco" ARNAS BROTSU
Cagliari, CAGLIARI, Italy, 09121
Not Yet Recruiting
2
Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico-S. Marco
Catania, CATANIA, Italy, 95123
Not Yet Recruiting
3
Azienda Ospedaliero-Universitaria Careggi
Florence, FIRENZE, Italy, 50134
Actively Recruiting
4
Fondazione IRCCS Istituto Nazionale dei Tumori (INT) di Milano
Milan, Milano, Italy, 20133
Actively Recruiting
5
Irccs Humanitas Research Hospital
Rozzano, Milano, Italy, 20089
Not Yet Recruiting
6
Irccs Fondazione G. Pascale
Naples, Napoli, Italy, 80131
Actively Recruiting
7
AOU Luigi Vanvitelli
Naples, NAPOLI, Italy, 80138
Not Yet Recruiting
8
Azienda Ospedaliero-Universitaria Sant'Andrea
Roma, roma, Italy, 00189
Not Yet Recruiting
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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