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Neoadjuvant Tislelizumab With Afatinib for Resectable Head and Neck Squamous Cell Carcinoma (neoCHANCE-1)

Primary Purpose

Head and Neck Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Tislelizumab
Afatinib
Sponsored by
West China Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Cancer focused on measuring Head and Neck Cancer, Neoadjuvant therapy, Immunotherapy, EGFR-TKI

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18 years or above.
  2. Patients with pathologically confirmed HNSCC (except for nasopharyngeal carcinoma) and meet the following conditions:

    • were newly diagnosed and without distant metastasis;
    • were deemed surgically resectable evaluated by a head and neck surgeon;
    • were willing to undergo surgery.
  3. Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
  4. Adequate organ and bone marrow function:

    • absolute neutrophil count ≥ 1.5 × 10^9/L, hemoglobin ≥ 80 g/L, platelets ≥ 80 × 10^9/L;
    • ALT, AST and ALP < 2.5× upper limit of normal (ULN), total bilirubin ≤ 2×ULN; albumin≥ 2.8 g/dL;
    • creatinine clearance ≥ 60 ml/min;
    • INR≤ 1.5, APTT≤ 1.5×ULN.
  5. Written informed consent.

Exclusion Criteria:

  1. History of other malignancies (except for the history of malignant tumors that have been cured and have not recurred within 5 years, such as skin basal cell carcinoma, skin squamous cell carcinoma, superficial bladder cancer, in situ cervical cancer, and gastrointestinal mucosal cancer, etc.)
  2. Have an active autoimmune disease requiring systemic treatment or a documented history of clinically severe autoimmune disease.
  3. Any history of allergic disease, or a sever hypersensitivity reaction to drugs, or allergy to the study drug components.
  4. Any of prior therapy with:

    • anti-PD-1, anti-PD-L1/2, anti-CTLA-4 antibody, anti-EGFR antibody or EGFR-TKIs;
    • antitumor vaccine;
    • any active vaccine against an infectious disease within 4 weeks prior to the first dose or planned during the study period;
    • major surgery or serious trauma within 4 weeks before the first dose;
    • toxicity from prior antitumor therapy has not recovered to ≤ CTCAE Version 5.0 Grade 1 or the level specified by the inclusion/exclusion criteria.
  5. With serious medical diseases, such as grade II and above cardiac dysfunction (NYHA criteria), ischemic heart disease, supraventricular or ventricular arrhythmia, poorly controlled diabetes mellitus, poorly controlled hypertension, echocardiographic ejection fraction < 50%, etc.
  6. With interstitial pneumonitis, non-infectious pneumonitis, active pulmonary tuberculosis, or history of pulmonary tuberculosis infection that were not controlled by treatment.
  7. With hyperthyroidism, or organic thyroid disease.
  8. With active infection, or unexplained fever during the screening period or 48 hours before the first dose.
  9. With active hepatitis B or C, or known history of positive HIV test, or acquired immunodeficiency syndrome.
  10. History of a clear neurological or psychiatric disorder.
  11. History of drug abuse or alcohol abuse.
  12. Women who are pregnant or breastfeeding, or have a reproductive plan from the screening period to 3 months after the end of the study, or have sex without contraceptive measures, or are unwilling to take appropriate contraceptive measures.
  13. Received any investigational drug within 4 weeks prior to the first dose, or concurrently enrolled in another clinical trial.
  14. Any other factors that are not suitable for inclusion in this study judged by investigators.

Sites / Locations

  • Xingchen Peng

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Cohort

Arm Description

Tislelizumab administration on days 1 and 22, and afatinib continuous administration from days 1 to 42 Standard of care surgery

Outcomes

Primary Outcome Measures

Major Pathologic Response
Major Pathologic Response (MPR) was defined as fewer than 10% viable tumor cells.

Secondary Outcome Measures

Pathologic Complete Response
Pathologic Complete Response (pCR) was defined as the absence of viable tumor cells.
Objective Response Rate
Objective Response Rate (ORR) was defined as the percentage of participants with a best overall response of CR or PR using RECIST Criteria.
Adverse events
Adverse events were defined as the number of participants with adverse events using CTCAE Criteria or with an unplanned surgery delay.
Disease-free Survival
Disease-free Survival (DFS) was defined as the time from the administration of the first dose to first disease progression or death.

Full Information

First Posted
August 19, 2022
Last Updated
August 23, 2022
Sponsor
West China Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05517330
Brief Title
Neoadjuvant Tislelizumab With Afatinib for Resectable Head and Neck Squamous Cell Carcinoma
Acronym
neoCHANCE-1
Official Title
Neoadjuvant Tislelizumab With Afatinib for the Treatment of Resectable Head and Neck Squamous Cell Carcinoma: A Single-Arm Phase 2 Trial (neoCHANCE-1 Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
August 20, 2022 (Anticipated)
Primary Completion Date
August 19, 2023 (Anticipated)
Study Completion Date
August 19, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
West China Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to explore the efficiency and safety of anti-Programmed death-1 (PD-1) immunotherapy, tislelizumab, combined with EGFR-tyrosine kinase inhibitor (TKI), afatinib as a new neoadjuvant treatment regimen for patients with resectable head and neck squamous cell carcinoma (HNSCC).
Detailed Description
Head and neck squamous cell carcinoma (HNSCC) is the most common malignancy of the head and neck. More than 60% of patients with HNSCC have locally advanced or metastatic disease at the time of diagnosis, with a 5-year overall survival rate of less than 60%. The clinical outcomes of those patients still need to be improved. Neoadjuvant therapy theoretically can reduce tumor volume, increase organ retention rate, and reduce distant metastasis rate. However, in addition to nasopharyngeal carcinoma, results from several phase III clinical trials have not proved a significant survival benefit of neoadjuvant chemotherapy for patients with resectable HNSCC. It is urgent to explore new neoadjuvant treatment options to improve the prognosis of patients with HNSCC. Immunotherapy such as PD-1/PD-L1 inhibitors have shown excellent efficiency in the treatment of malignancies. Anti-PD-1 therapy is approved as the first-line treatment of recurrent/metastatic HNSCC. Neoadjuvant immunotherapy for the treatment of locally advanced and resectable HNSCC has been demonstrated to be feasible in some trials. Afatinib, as an irreversible ErbB tyrosine kinase inhibitor (TKI), has been used as the second-line treatment for recurrent and/or metastatic HNSCC. However, there is a lack of high-level evidence-based medical evidence for the use of afatinib in preoperative therapy for HNSCC. A previous study published in 2018 confirmed that afatinib can be administered safely before surgery. In summary, the investigators designed this study to explore the efficiency and safety of anti-PD1 immunotherapy, tislelizumab, combined with EGFR-TKI, afatinib as a new neoadjuvant treatment regimen for patients with resectable HNSCC, aiming to provide a new treatment option for those patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Cancer
Keywords
Head and Neck Cancer, Neoadjuvant therapy, Immunotherapy, EGFR-TKI

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
23 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Cohort
Arm Type
Experimental
Arm Description
Tislelizumab administration on days 1 and 22, and afatinib continuous administration from days 1 to 42 Standard of care surgery
Intervention Type
Biological
Intervention Name(s)
Tislelizumab
Other Intervention Name(s)
BGB-A317
Intervention Description
200mg IV Q3W
Intervention Type
Drug
Intervention Name(s)
Afatinib
Intervention Description
30mg PO QD
Primary Outcome Measure Information:
Title
Major Pathologic Response
Description
Major Pathologic Response (MPR) was defined as fewer than 10% viable tumor cells.
Time Frame
Time of surgery
Secondary Outcome Measure Information:
Title
Pathologic Complete Response
Description
Pathologic Complete Response (pCR) was defined as the absence of viable tumor cells.
Time Frame
Time of surgery
Title
Objective Response Rate
Description
Objective Response Rate (ORR) was defined as the percentage of participants with a best overall response of CR or PR using RECIST Criteria.
Time Frame
Up to 8 weeks
Title
Adverse events
Description
Adverse events were defined as the number of participants with adverse events using CTCAE Criteria or with an unplanned surgery delay.
Time Frame
Up to 12 weeks
Title
Disease-free Survival
Description
Disease-free Survival (DFS) was defined as the time from the administration of the first dose to first disease progression or death.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 years or above. Patients with pathologically confirmed HNSCC (except for nasopharyngeal carcinoma) and meet the following conditions: were newly diagnosed and without distant metastasis; were deemed surgically resectable evaluated by a head and neck surgeon; were willing to undergo surgery. Eastern Cooperative Oncology Group (ECOG) performance status 0-1. Adequate organ and bone marrow function: absolute neutrophil count ≥ 1.5 × 10^9/L, hemoglobin ≥ 80 g/L, platelets ≥ 80 × 10^9/L; ALT, AST and ALP < 2.5× upper limit of normal (ULN), total bilirubin ≤ 2×ULN; albumin≥ 2.8 g/dL; creatinine clearance ≥ 60 ml/min; INR≤ 1.5, APTT≤ 1.5×ULN. Written informed consent. Exclusion Criteria: History of other malignancies (except for the history of malignant tumors that have been cured and have not recurred within 5 years, such as skin basal cell carcinoma, skin squamous cell carcinoma, superficial bladder cancer, in situ cervical cancer, and gastrointestinal mucosal cancer, etc.) Have an active autoimmune disease requiring systemic treatment or a documented history of clinically severe autoimmune disease. Any history of allergic disease, or a sever hypersensitivity reaction to drugs, or allergy to the study drug components. Any of prior therapy with: anti-PD-1, anti-PD-L1/2, anti-CTLA-4 antibody, anti-EGFR antibody or EGFR-TKIs; antitumor vaccine; any active vaccine against an infectious disease within 4 weeks prior to the first dose or planned during the study period; major surgery or serious trauma within 4 weeks before the first dose; toxicity from prior antitumor therapy has not recovered to ≤ CTCAE Version 5.0 Grade 1 or the level specified by the inclusion/exclusion criteria. With serious medical diseases, such as grade II and above cardiac dysfunction (NYHA criteria), ischemic heart disease, supraventricular or ventricular arrhythmia, poorly controlled diabetes mellitus, poorly controlled hypertension, echocardiographic ejection fraction < 50%, etc. With interstitial pneumonitis, non-infectious pneumonitis, active pulmonary tuberculosis, or history of pulmonary tuberculosis infection that were not controlled by treatment. With hyperthyroidism, or organic thyroid disease. With active infection, or unexplained fever during the screening period or 48 hours before the first dose. With active hepatitis B or C, or known history of positive HIV test, or acquired immunodeficiency syndrome. History of a clear neurological or psychiatric disorder. History of drug abuse or alcohol abuse. Women who are pregnant or breastfeeding, or have a reproductive plan from the screening period to 3 months after the end of the study, or have sex without contraceptive measures, or are unwilling to take appropriate contraceptive measures. Received any investigational drug within 4 weeks prior to the first dose, or concurrently enrolled in another clinical trial. Any other factors that are not suitable for inclusion in this study judged by investigators.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xingchen Peng, Professor
Phone
+86 18980606753
Email
pxx2014@scu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xingchen Peng, Professor
Organizational Affiliation
West China Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Xingchen Peng
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610041
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No
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Neoadjuvant Tislelizumab With Afatinib for Resectable Head and Neck Squamous Cell Carcinoma

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