Head and Neck Squamous Cell Carcinoma, Head and Neck Squamous Cell Carcinoma (HNSCC), Head & Neck Cancer, Neoadjuvant Therapy
Conditions
Brief summary
This is a randomized controlled, phase II clinical study designed to explore the efficacy and safety of nimotuzumab combined with immunotherapy and chemotherapy as neoadjuvant treatment for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). The primary endpoint of the study is the 2-year event-free survival (EFS) rate. Enrollment is expected to be completed within 2 years; all patients will be followed up for at least 2 years after the last patient is enrolled.
Interventions
Nimotuzumab 400mg，d3，Q3W，for two cycles。
DRUGTislelizumab
tislelizumab (or pembrolizumab) 200mg，d1，Q3W，for two cycles。
Albumin-bound paclitaxel 180 mg/m² (or docetaxel 75 mg/m²), administered on day 3, every 3 weeks (Q3W);for two cycles。
Cisplatin 75 mg/m² (carboplatin AUC=5 may be substituted if cisplatin is not tolerated), administered on day 3, every 3 weeks (Q3W).for two cycles。
PROCEDURERadical surgery of tumor
Standard radical surgery of tumor
RADIATIONConcurrent chemoradiotherapy
Concurrent chemoradiotherapy： Radiotherapy: intensity modulated conformal radiotherapy (IMRT) was used with a total dose of 60-66gy (2gy/f, 30-33f). Chemotherapy: Cisplatin 40 mg/m2, QW, 6-7 times in total; Targeting: nimotuzumab 200mg, QW, 6-7 times in total.
Sponsors
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18 to 75 years inclusive. 2. Histologically or cytologically confirmed squamous cell carcinoma of the head and neck (HNSCC) (oral cavity, oropharynx, larynx, hypopharynx), stage III-IVB per AJCC 8th edition. 3. Resectable disease assessed by a multidisciplinary team (MDT) including surgical, radiological, and pathological specialists. 4. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1. 5. For oropharyngeal carcinoma: mandatory p16 immunohistochemistry (testing within standard of care is acceptable; repeat testing not required). p16 testing is not required for other tumor locations. 6. Availability of tumor tissue (archived or newly obtained) for PD-L1 testing (prior testing is acceptable; repeat testing not required). 7. At least one measurable lesion per RECIST 1.1. 8. Life expectancy ≥ 6 months. 9. Adequate hematologic function: White blood cell count ≥ 4.0 × 10⁹/L Absolute neutrophil count ≥ 1.5 × 10⁹/L Platelet count ≥ 100 × 10⁹/L Hemoglobin ≥ 90 g/L 10. Adequate renal function: Serum creatinine ≤ 1.5 × upper limit of normal (ULN) OR Creatinine clearance (CrCl) ≥ 60 mL/min calculated by Cockcroft-Gault formula: Female: CrCl (mL/min) = (140 - age) × body weight (kg) × 0.85 / (72 × serum creatinine (mg/dL)) Male: CrCl (mL/min) = (140 - age) × body weight (kg) × 1.00 / (72 × serum creatinine (mg/dL)) 11. Adequate hepatic function: Total bilirubin ≤ 1.5 × ULN Aspartate aminotransferase (AST) ≤ 2.5 × ULN Alanine aminotransferase (ALT) ≤ 2.5 × ULN 12. Female subjects: negative pregnancy test within 2 weeks before first study drug, non-lactating. Females: highly effective contraception required during study and for 6 months after last study drug. Males: highly effective contraception required during study and for 6 months after last study drug. 13. Written informed consent obtained prior to any study-specific procedures, and willingness to comply with all study visits and protocol requirements.
Exclusion criteria
1. Received PD-1 inhibitors, EGFR monoclonal antibodies, EGFR-TKIs, or anti-angiogenic agents within 4 weeks prior to enrollment. 2. Participation in another interventional clinical trial within 30 days prior to screening. 3. In the investigator's judgment, the patient cannot tolerate or has contraindications to platinum-based chemotherapy (cisplatin or carboplatin) as specified in the protocol. 4. Unresectable disease, poor medical condition for surgery, refusal of surgery for any reason, or excessive tumor burden precluding resection. 5. History of other malignancy within the past 5 years (except cured basal cell carcinoma of the skin). 6. History of primary immunodeficiency disease. 7. Presence of uncontrolled comorbidities, including heart failure, severe pulmonary disease, severe hepatic disease, psychiatric disorders, etc. 8. Known HIV infection, active viral hepatitis, or active tuberculosis. 9. Underwent major surgery within 90 days prior to the first study drug, or planning major surgery unrelated to this cancer treatment. 10. Hypersensitivity to any study drug or their components. 11. Pregnant (confirmed by serum or urine HCG test) or lactating woman; or subject of childbearing potential unwilling or unable to use effective contraception during study treatment and for at least 6 months after the last dose of study treatment (applicable to both males and females). 12. Investigator considers the subject not suitable for study participation. 13. Unwilling to participate or unable to provide written informed consent. 14. Receipt of a live vaccine within 30 days before the first study drug administration.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 2-Year Event-Free Survival (EFS) Rate | From first study treatment up to 2 years after the last patient randomized. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Major Pathologic Response (MPR) | Within 4 weeks after surgery. | — |
| Pathological Complete Response (pCR) | Within 4 weeks after surgery. | — |
| Objective Response Rate (ORR) | After 2 cycles (each cycle is 21 days） of neoadjuvant treatment. | — |
| 2-Year Overall Survival (OS) Rate | From first study treatment up to 2 years after the last patient randomized. | — |
| Quality of Life (QoL) | Baseline（Screening） After neoadjuvant chemotherapy：Study Group（S）Week6 /Control Group（C）NA Post-surgery：S Week 9/C Week 3 After adjuvant radiotherapy（S Week 21/C Week 15） End of treatment（Week 24） Follow-up: Month 6, Month 12, Month 24 | Assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires QLQ-C30 (V3.0). EORTC QLQ-C30 V3.0：The scale consists of general domain items and global health and quality of life items. General domain items are further divided into functional domains and symptom domains. The raw scores of general items range from 1 (minimum) to 4 (maximum), while those of global health and quality of life items range from 1 (minimum) to 7 (maximum). All raw scores are finally standardized to scores ranging from 0 to 100. In functional domains including PF, RF, EF, CF, SF and QL, higher scores indicate better functional status. In symptom domains including FA, NV, PA, DY, SL, AP, CO, DI and FI, higher scores stand for more severe symptoms. For the global health and quality of life domain, higher scores reflect better general health condition and quality of life. |
Countries
China
Contacts
CONTACTxin wei chen
Outcome results
None listed