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Phase II Study of MEDI4736 Monotherapy in Treatment of Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

A Phase II, Multi-Center, Single-Arm, Global Study of MEDI4736 Monotherapy in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02207530
Enrollment
112
Registered
2014-08-04
Start date
2014-10-23
Completion date
2020-07-06
Last updated
2020-09-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Recurrent or Metastatic PD-L1-positive Squamous Cell Carcinoma of the Head and Neck

Keywords

Head and neck cancer; SCCHN

Brief summary

Primary Objective: To assess the efficacy of MEDI4736 monotherapy in terms of ORR

Detailed description

This is a phase II, multi-center, single-arm, global study of MEDI4736 monotherapy in patients with PD-L1 positive recurrent or metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN), who have progressed during or after treatment with only 1 systemic palliative regimen for recurrent or metastatic disease that must have contained a platinum agent.

Interventions

DRUGMEDI4736

MEDI4736 monotherapy

Sponsors

PRA Health Sciences
CollaboratorINDUSTRY
AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 130 Years
Healthy volunteers
No

Inclusion criteria

* Age ≥18 years * Written informed consent obtained from the patient/legal representative * Histologically confirmed recurrent or metastatic SCCHN * Tumor progression or recurrence during or after treatment with only 1 systemic palliative regimen for recurrent or metastatic disease that must have contained a platinum agent. * Written consent to provide newly acquired tumor tissue (preferred) or archival tissue for the purpose of establishing PD-L1 status. * Confirmed PD-L1-positive SCCHN by Ventana SP263 assay * WHO/ECOG performance status of 0 or 1 * At least 1 measurable lesion at baseline * No prior exposure to immune-mediated therapy * Adequate organ and marrow function * Evidence of post-menopausal status or negative urinary or serum pregnancy test.

Exclusion criteria

* Histologically confirmed squamous cell carcinoma of any other primary anatomic location in the head and neck * Received more than 1 systematic palliative regimen for recurrent or metastatic disease * Any concurrent chemotherapy, Investigational Product, biologic, or hormonal therapy for cancer treatment * Prior randomization or treatment in a previous MEDI4736 and/or tremelimumab clinical study regardless of treatment arm assignment or receipt of any investigational anticancer therapy within 28 days or 5 half-lives * Receipt of last dose of an approved (marketed) anticancer therapy (chemotherapy, targeted therapy, biologic therapy, mAbs, etc) within 21 days prior to the first dose of study treatment * Major surgical procedure within 28 days prior to the first dose of Investigational Product * Any unresolved toxicity NCI CTCAE Grade ≥2 from previous anticancer therapy with the exception of alopecia, vitiligo, and the laboratory values defined in the inclusion criterion * Current or prior use of immunosuppressive medication within 14 days before the first dose of MEDI4736 * History of allogeneic organ transplantation * Active or prior documented autoimmune or inflammatory disorders; * Uncontrolled intercurrent illness * Another primary malignancy * Patients with history of brain metastases, spinal cord compression, or leptomeningeal carcinomatosis * History of active primary immunodeficiency * Known history of previous tuberculosis * Active infection including hepatitis B, hepatitis C or human immunodeficiency virus (HIV) * Receipt of live, attenuated vaccine within 30 days prior to the first dose of MEDI4736 * Pregnant or breast-feeding female patients * Mean QT interval corrected for heart rate (QTc) ≥470 ms calculated from 3 electrocardiograms (ECGs) using Fridericia's Correction * Any condition that, in the opinion of the Investigator, would interfere with evaluation of the IP or interpretation of patient safety or study results

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (ORR)12 monthsObjective response rate (per RECIST 1.1 as assessed by blinded independent central review \[BICR\]) is defined as the number (%) of patients with a confirmed complete response or confirmed partial response and will be based on all treated patients who are PD-L1-positive with measurable disease at baseline per BICR. Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1. criteria are: Complete response \[CR\] = disappearance of all target lesions since baseline; and partial response \[PR\] = at least a 30% decrease in the sum of the diameters of target lesions.

Secondary

MeasureTime frameDescription
Duration of Response- Participants Remaining in Response12 monthsParticipants remaining in response - based on BICR assessments according to RECIST v1.1. An ongoing response was defined as a patient who had documented objective response and was still alive and progression-free at the time of the data cut-off.
Duration of Response12 monthsDuration of objective response in patients with objective response based on BICR assessments according to RECIST v1.1. Duration of response was the time from the first documentation of complete or partial response until the date of progression (which was subsequently confirmed), death, or the last evaluable RECIST assessment for patients that did not progress. An ongoing response was defined as a patient who had documented objective response and was still alive and progression-free at the time of the data cut-off.
Time to Onset of Response From First Dose12 monthsTime to onset of response in patients with objective response based on BICR assessments according to RECIST 1.1
Best Objective Response12 monthsBest objective response based on BICR assessments according to RECIST v1.1. Response required confirmation after 4 weeks. Unconfirmed complete (CR) or partial response (PR) refers to CR or PR achieved but either no confirmation assessment was performed or a confirmation assessment was performed but response was not confirmed.
Progression-free Survival12 monthsProgression status based on BICR assessments according to RECIST v1.1 at time of PFS analysis. Progression was defined as the time from the date of first dose until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient withdrew from therapy or received another anti-cancer therapy prior to progression.
Overall Survival (OS)12 monthsSurvival status at time of overall survival analysis. 'Still in survival follow-up' includes patients known to be alive at data cut-off. 'Terminated prior to death' includes patients with unknown survival status, or who were lost to follow-up.
Quality of Life12 monthsImprovement in quality of life was assessed using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires: * The impact of treatment on Health-Related Quality of Life, functioning, and symptoms was evaluated using the EORTC QLQ-C30 v3. * Head and neck cancer-specific symptoms were evaluated using the EORTC QLQ-H&N35. Function or global health status/quality of life improvement was defined as patients with 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (an increase from baseline score ≥10). Symptom improvement was defined as 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (a decrease from baseline score ≥10). Scale improvement was defined as patients with 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (a decrease from baseline score ≥10).
Disease Control at 6 Months6 monthsDisease control (DCR) at 6 months based on BICR assessments according to RECIST v1.1. DCR at 6 months was evaluated using 2 different approaches to the length of stable disease (SD): * Method 1: Patients who had a best objective response of complete response (CR) or partial response (PR) within 24 weeks or had demonstrated SD for a minimum interval of 24 weeks following the start of study treatment. * Method 2: Patients who had a best objective response of CR or PR within 24 weeks or had demonstrated SD for a minimum interval of 16 weeks following the start of study treatment.

Countries

Belgium, Canada, Czechia, France, Georgia, Germany, Hungary, Israel, Malaysia, South Korea, Spain, Taiwan, United Kingdom, United States

Participant flow

Recruitment details

110 sites in 14 countries enrolled and screened patients. The study was conducted and managed by PRA, a contract research organization.

Participants by arm

ArmCount
MEDI4736 10 mg/kg
MEDI4736 monotherapy: Durvalumab was provided at a dose of 10 mg/kg using an intravenous solution every 2 weeks until 12 months, disease progression, toxicity, or patient decision to stop therapy
112
Total112

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event8
Overall StudyPatient decision to stop study treatment5
Overall StudyWorsening condition under investigation78

Baseline characteristics

CharacteristicMEDI4736 10 mg/kg
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
29 Participants
Age, Categorical
Between 18 and 65 years
83 Participants
Age, Continuous60.0 Years
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
109 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
2 Participants
HPV status
Negative
65 Participants
HPV status
Positive
34 Participants
HPV status
Unknown/ Not reported
3 Participants
Nicotine Use
Current
10 Participants
Nicotine Use
Former
59 Participants
Nicotine Use
Never
43 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
4 Participants
Race (NIH/OMB)
Black or African American
5 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
Race (NIH/OMB)
White
100 Participants
Sex: Female, Male
Female
32 Participants
Sex: Female, Male
Male
80 Participants
Smoking/ Nicotine status
<=10 pack years
53 Participants
Smoking/ Nicotine status
>10 Pack years
49 Participants
Smoking/ Nicotine status
Unknown/ Not reported
10 Participants
WHO/ECOG performance status
(0) Normal activity
34 Participants
WHO/ECOG performance status
(1) Restricted activity
77 Participants
WHO/ECOG performance status
Missing
1 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
78 / 112
other
Total, other adverse events
93 / 112
serious
Total, serious adverse events
43 / 112

Outcome results

Primary

Objective Response Rate (ORR)

Objective response rate (per RECIST 1.1 as assessed by blinded independent central review \[BICR\]) is defined as the number (%) of patients with a confirmed complete response or confirmed partial response and will be based on all treated patients who are PD-L1-positive with measurable disease at baseline per BICR. Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1. criteria are: Complete response \[CR\] = disappearance of all target lesions since baseline; and partial response \[PR\] = at least a 30% decrease in the sum of the diameters of target lesions.

Time frame: 12 months

Population: Evaluable analysis set - all patients who received at least one dose of study treatment, who had a baseline tumor assessment, and had measurable disease at baseline according to BICR

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgObjective Response Rate (ORR)Smoking/nicotine status >10 pack years14.6 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)Smoking/nicotine status <=10 pack years18.9 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)Substance user-Former15.3 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)HPV status-Positive29.4 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)Overall16.2 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)Smoking/nicotine status - Missing10.0 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)Substance user-Current11.1 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)Substance user-Never18.6 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)HPV status-Negative10.9 % of participants
MEDI4736 10 mg/kgObjective Response Rate (ORR)HPV status-Missing7.7 % of participants
Secondary

Best Objective Response

Best objective response based on BICR assessments according to RECIST v1.1. Response required confirmation after 4 weeks. Unconfirmed complete (CR) or partial response (PR) refers to CR or PR achieved but either no confirmation assessment was performed or a confirmation assessment was performed but response was not confirmed.

Time frame: 12 months

Population: Evaluable analysis set - included all patients who received at least one dose of study treatment who had a baseline tumor assessment and had measurable disease at baseline according to BICR.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgBest Objective ResponseResponse-Partial response (PR)15.3 % of participants
MEDI4736 10 mg/kgBest Objective ResponseResponse-Complete response (CR)0.9 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-SD≥8 weeks-Unconfirmed CR or PR2.7 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Stable disease (SD) ≥8 weeks-SD6.3 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Progression-Total52.3 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Progression-RECIST 1.1 progression25.2 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Progression-Death27.0 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Not evaluable-SD<8 weeks19.8 % of participants
MEDI4736 10 mg/kgBest Objective ResponseResponse-Total16.2 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNon-response (NR)-Total83.8 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Stable disease (SD)≥8 weeks-Total9.0 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Not evaluable-Total22.5 % of participants
MEDI4736 10 mg/kgBest Objective ResponseNR-Not evaluable-Incomplete post-baseline tests2.7 % of participants
Secondary

Disease Control at 6 Months

Disease control (DCR) at 6 months based on BICR assessments according to RECIST v1.1. DCR at 6 months was evaluated using 2 different approaches to the length of stable disease (SD): * Method 1: Patients who had a best objective response of complete response (CR) or partial response (PR) within 24 weeks or had demonstrated SD for a minimum interval of 24 weeks following the start of study treatment. * Method 2: Patients who had a best objective response of CR or PR within 24 weeks or had demonstrated SD for a minimum interval of 16 weeks following the start of study treatment.

Time frame: 6 months

Population: Evaluable analysis set - included all patients who received at least one dose of study treatment who had a baseline tumor assessment and had measurable disease at baseline according to BICR.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgDisease Control at 6 MonthsMETHOD 1: Disease control at 6 months23.4 % of participants
MEDI4736 10 mg/kgDisease Control at 6 MonthsMETHOD 1: No disease control at 6 months76.6 % of participants
MEDI4736 10 mg/kgDisease Control at 6 MonthsMETHOD 1: No disease control:Not evaluable/missing27.0 % of participants
MEDI4736 10 mg/kgDisease Control at 6 MonthsMETHOD 2: Disease control at 6 months33.3 % of participants
MEDI4736 10 mg/kgDisease Control at 6 MonthsMETHOD 2: No disease control at 6 months66.7 % of participants
MEDI4736 10 mg/kgDisease Control at 6 MonthsMETHOD 2: No disease control:Not evaluable/missing27.0 % of participants
Secondary

Duration of Response

Duration of objective response in patients with objective response based on BICR assessments according to RECIST v1.1. Duration of response was the time from the first documentation of complete or partial response until the date of progression (which was subsequently confirmed), death, or the last evaluable RECIST assessment for patients that did not progress. An ongoing response was defined as a patient who had documented objective response and was still alive and progression-free at the time of the data cut-off.

Time frame: 12 months

Population: Evaluable analysis set - included all patients who received at least one dose of study treatment who had a baseline tumor assessment and had measurable disease at baseline according to BICR.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgDuration of ResponseNo. progressed or died within 12 months6 Participants
MEDI4736 10 mg/kgDuration of ResponseNo. progressed or died after 12 months2 Participants
Secondary

Duration of Response- Participants Remaining in Response

Participants remaining in response - based on BICR assessments according to RECIST v1.1. An ongoing response was defined as a patient who had documented objective response and was still alive and progression-free at the time of the data cut-off.

Time frame: 12 months

Population: Evaluable analysis set - included all patients who received at least one dose of study treatment who had a baseline tumor assessment and had measurable disease at baseline according to BICR.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgDuration of Response- Participants Remaining in ResponseRemaining in response-12 months37.1 % of participants
MEDI4736 10 mg/kgDuration of Response- Participants Remaining in ResponseRemaining in response-3 months100 % of participants
MEDI4736 10 mg/kgDuration of Response- Participants Remaining in ResponseRemaining in response-6 months76.5 % of participants
MEDI4736 10 mg/kgDuration of Response- Participants Remaining in ResponseRemaining in response-9 months61.8 % of participants
MEDI4736 10 mg/kgDuration of Response- Participants Remaining in ResponseOngoing response55.6 % of participants
Secondary

Overall Survival (OS)

Survival status at time of overall survival analysis. 'Still in survival follow-up' includes patients known to be alive at data cut-off. 'Terminated prior to death' includes patients with unknown survival status, or who were lost to follow-up.

Time frame: 12 months

Population: Full analysis set - included all treated patients who had a baseline tumor assessment and had measurable disease at baseline according to the Investigator site assessment.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgOverall Survival (OS)Death69.6 % of participants
MEDI4736 10 mg/kgOverall Survival (OS)Still in survival follow-up24.1 % of participants
MEDI4736 10 mg/kgOverall Survival (OS)Terminated prior to death6.3 % of participants
MEDI4736 10 mg/kgOverall Survival (OS)Voluntary discontinuation by subject6.3 % of participants
Secondary

Progression-free Survival

Progression status based on BICR assessments according to RECIST v1.1 at time of PFS analysis. Progression was defined as the time from the date of first dose until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient withdrew from therapy or received another anti-cancer therapy prior to progression.

Time frame: 12 months

Population: Full analysis set - included all treated patients who had a baseline tumor assessment and had measurable disease at baseline according to the Investigator site assessment.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgProgression-free SurvivalDeath in absence of RECIST 1.1 progression33.0 % of participants
MEDI4736 10 mg/kgProgression-free SurvivalNo progression + under follow-up12.5 % of participants
MEDI4736 10 mg/kgProgression-free SurvivalNo progression17.0 % of participants
MEDI4736 10 mg/kgProgression-free SurvivalProgression-Total83.0 % of participants
MEDI4736 10 mg/kgProgression-free SurvivalRECIST 1.1 progression50.0 % of participants
Secondary

Quality of Life

Improvement in quality of life was assessed using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires: * The impact of treatment on Health-Related Quality of Life, functioning, and symptoms was evaluated using the EORTC QLQ-C30 v3. * Head and neck cancer-specific symptoms were evaluated using the EORTC QLQ-H&N35. Function or global health status/quality of life improvement was defined as patients with 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (an increase from baseline score ≥10). Symptom improvement was defined as 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (a decrease from baseline score ≥10). Scale improvement was defined as patients with 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (a decrease from baseline score ≥10).

Time frame: 12 months

Population: Full analysis set - included all treated patients who had a baseline tumor assessment and had measurable disease at baseline according to the Investigator site assessment.

ArmMeasureGroupValue (NUMBER)
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Function-Physical17.1 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Function-Cognitive21.0 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Pain in the mouth24.6 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Function-Role22.9 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Function-Emotional15.9 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Function-Social34.7 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Symptom-Fatigue21.3 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Symptom-Pain26.8 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Symptom-Nausea/vomiting32.3 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-C30 Global health status/QoL13.5 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Swallowing19.4 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Senses34.3 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Speech28.4 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Social eating22.4 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Social contact17.2 % of participants
MEDI4736 10 mg/kgQuality of LifeEORTC QLQ-H&N35 Scale-Sexuality25.7 % of participants
Secondary

Time to Onset of Response From First Dose

Time to onset of response in patients with objective response based on BICR assessments according to RECIST 1.1

Time frame: 12 months

Population: Evaluable analysis set - included all patients who received at least one dose of study treatment who had a baseline tumor assessment and had measurable disease at baseline according to BICR.

ArmMeasureValue (MEDIAN)
MEDI4736 10 mg/kgTime to Onset of Response From First Dose2.00 Months

Source: ClinicalTrials.gov · Data processed: Mar 4, 2026