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Neoadjuvant Anti-PD-1 Immunotherapy With Chemotherapy in Resectable Locally Advanced Oral Squamous Cell Carcinoma (NEOPCOSCC)

Primary Purpose

Oral Squamous Cell Carcinoma

Status
Not yet recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Camrelizumab plus TP
TP
Sponsored by
Hospital of Stomatology, Wuhan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Oral Squamous Cell Carcinoma focused on measuring Neoadjuvant, Oral squamous cell carcinoma, Anti-PD-1 immunotherapy, Camrelizumab, TP chemotherapy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically documented oral squamous cell carcinoma (biopsy required). Local advanced oral squamous cell carcinoma (clinical stage T1-2N1-3M0, T3-4aN0-3M0) with resection option for potential cure, as assessed by a faculty surgeon at Hospital of Stomatology, Wuhan University. Distant metastasis is excluded by chest CT and emission computed tomograph. Adequate organ function as follows: 1) Leukocyte count ≥ 2,000/mm3; 2) Absolute neutrophil count ≥ 1,000/mm3; 3) Platelet count ≥ 100,000/mm3; 4) Hemoglobin ≥ 90 g/L; 5) Serum albumin ≥30 g/L; 6) Total bilirubin ≤ 1.5 × upper limit of normal (ULN); 7) AST (SGOT) and ALT (SGPT) < 2.5 × ULN; 8) ALP ≤ 2.5 × ULN; 9) Prothrombin time-international normalized ratio ≤ 1.5; 10) Serum creatinine ≤ 1.5 × ULN; 11) INR/PT≤ 1.5; 12) TSH ≤ ULN. ECOG performance status 0-1. Female patient tested HCG negative in serum or urine within 7 days prior to the start of investigational product. Both patient and partner must agree to use contraception prior to study entry and for the duration of study participation and for up to 120 days after the last dose of PD-1 blockade. Patient understands the study regimen, its requirements, risks and discomforts and is able and willing to sign the informed consent form. Exclusion Criteria: History of ≥ 3 grade immune related adverse events (irAEs) or have not recovered to ≤ 1 grade irAEs from previous treatment. History of other treatments for cancer, including surgery, chemotherapy, radiotherapy or molecular targeted therapy within past 5 years. Previous therapy with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 or any other antibody targeting T cell co-regulatory pathways. Active autoimmune disease or history of refractory autoimmune disease. Active systemic infection requiring therapy. Patients who are receiving psychotropic drug or alcohol/drug abuse. Subjects with concurrent other active malignancies. HIV or untreated active HBV or HCV infections, or vaccinated (HBV, flu, varicella, etc) within 4 weeks before recruitment. Uncontrollable systemic diseases, including diabetes, hypertension, etc. History of stroke or transient ischemic attack within past 6 months. Distant metastases or inability to resect after physician evaluation. Serious cardiovascular, respiratory, immune system critical disease or other conditions that the researchers thought might increase the subjects' risk.

Sites / Locations

  • Hospital of Stomatology, Wuhan University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

No Intervention

Experimental

Experimental

Arm Label

Surgery followed by postoperative RT

Neoadjuvant TP chemotherapy

Neoadjuvant anti-PD-1 immunotherapy plus TP chemotherapy

Arm Description

The participants will take a radical surgery followed by radiotherapy or chemoradiotherapy if necessary.

The participants will receive 2 courses of TP chemotherapy. Then the participants will take a radical surgery followed by radiotherapy or chemoradiotherapy if necessary.

The participants will receive 3 doses of PD-1 blockade and 2 courses of TP chemotherapy. Then the participants will take a radical surgery followed by radiotherapy or chemoradiotherapy if necessary.

Outcomes

Primary Outcome Measures

Event-free Survival (EFS) Rate on Each Treatment Arm.
EFS is the time from the date of randomization to the date of first record of disease progression as defined by RECIST 1.1.

Secondary Outcome Measures

Overall Survival (OS) on Each Treatment Arm.
OS is the time from randomization to death due to any cause.
Radiographic Response.
Clinical response of tumors and lymph nodes to neoadjuvant PD-1 blockade alone or neoadjuvant PD-1 blockade plus TPF induction chemotherapy, as evaluated by radiographic examinations and defined by RECIST 1.1. Clinical response of tumors and lymph nodes to neoadjuvant PD-1 blockade alone or neoadjuvant PD-1 blockade plus TPF induction chemotherapy, as evaluated by radiographic examinations and defined by RECIST 1.1.
Pathologic Response.
Pathologic response of resected tumors and lymph nodes to neoadjuvant PD-1 blockade alone or neoadjuvant PD-1 blockade plus TPF induction chemotherapy. Pathologic response is defined as sum of pathologic complete response and major pathologic response. Pathologic complete response is defined as the absence of viable residual tumor in resected specimen. The rate of major pathologic response, defined as <10% residual viable tumor cells in the resected specimen.
Adverse Events (AEs).
Number of participants experiencing any sign, symptom, disease, or worsening of preexisting conditions temporally associated with the experimental interventions or irrespective of the experimental interventions.

Full Information

First Posted
March 22, 2023
Last Updated
October 21, 2023
Sponsor
Hospital of Stomatology, Wuhan University
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05798793
Brief Title
Neoadjuvant Anti-PD-1 Immunotherapy With Chemotherapy in Resectable Locally Advanced Oral Squamous Cell Carcinoma
Acronym
NEOPCOSCC
Official Title
A Multi-Center, Randomized Phase III Study of Neoadjuvant Anti-PD-1 Immunotherapy Plus TP Chemotherapy Versus TP Chemotherapy or Up-Front Surgery in Resectable Locally Advanced Oral Squamous Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 20, 2023 (Anticipated)
Primary Completion Date
July 1, 2026 (Anticipated)
Study Completion Date
October 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hospital of Stomatology, Wuhan University
Collaborators
Jiangsu HengRui Medicine Co., Ltd.

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 investigate the survival benefit of neoadjuvant anti-PD-1 immunotherapy plus TP chemotherapy compared with TP chemotherapy or up-front surgery in resectable locally advanced oral squamous cell carcinoma.
Detailed Description
On the basis of preliminary study, this study is to further verify the efficacy and safety of neoadjuvant anti-PD-1 immunotherapy plus chemotherapy. The further purpose of this study is to investigate the survival benefit of neoadjuvant anti-PD-1 immunotherapy plus TP chemotherapy compared with TP chemotherapy or up-front surgery in resectable locally advanced oral squamous cell carcinoma. And on this basis, the investigators will explore the changes of the profiles and functions of immune cells within tumors, lymph nodes and peripheral blood after the experimental interventions, as well as their correlation with the patients' response and prognosis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Oral Squamous Cell Carcinoma
Keywords
Neoadjuvant, Oral squamous cell carcinoma, Anti-PD-1 immunotherapy, Camrelizumab, TP chemotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
309 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Surgery followed by postoperative RT
Arm Type
No Intervention
Arm Description
The participants will take a radical surgery followed by radiotherapy or chemoradiotherapy if necessary.
Arm Title
Neoadjuvant TP chemotherapy
Arm Type
Experimental
Arm Description
The participants will receive 2 courses of TP chemotherapy. Then the participants will take a radical surgery followed by radiotherapy or chemoradiotherapy if necessary.
Arm Title
Neoadjuvant anti-PD-1 immunotherapy plus TP chemotherapy
Arm Type
Experimental
Arm Description
The participants will receive 3 doses of PD-1 blockade and 2 courses of TP chemotherapy. Then the participants will take a radical surgery followed by radiotherapy or chemoradiotherapy if necessary.
Intervention Type
Drug
Intervention Name(s)
Camrelizumab plus TP
Other Intervention Name(s)
SHR-1210 plus Docetaxel, Cisplatin
Intervention Description
The participants will receive camrelizumab (200 mg) through intravenous infusion each 2-week cycle, and docetaxel (T) 75 mg/m2, cisplatin (P) 75 mg/m2 through intravenous infusion each 3-week cycle for 2 cycles.
Intervention Type
Drug
Intervention Name(s)
TP
Other Intervention Name(s)
Docetaxel, Cisplatin
Intervention Description
The participants will receive docetaxel (T) 75 mg/m2, cisplatin (P) 75 mg/m2 through intravenous infusion each 3-week cycle for 2 cycles.
Primary Outcome Measure Information:
Title
Event-free Survival (EFS) Rate on Each Treatment Arm.
Description
EFS is the time from the date of randomization to the date of first record of disease progression as defined by RECIST 1.1.
Time Frame
24 months.
Secondary Outcome Measure Information:
Title
Overall Survival (OS) on Each Treatment Arm.
Description
OS is the time from randomization to death due to any cause.
Time Frame
24 months.
Title
Radiographic Response.
Description
Clinical response of tumors and lymph nodes to neoadjuvant PD-1 blockade alone or neoadjuvant PD-1 blockade plus TPF induction chemotherapy, as evaluated by radiographic examinations and defined by RECIST 1.1. Clinical response of tumors and lymph nodes to neoadjuvant PD-1 blockade alone or neoadjuvant PD-1 blockade plus TPF induction chemotherapy, as evaluated by radiographic examinations and defined by RECIST 1.1.
Time Frame
8 weeks.
Title
Pathologic Response.
Description
Pathologic response of resected tumors and lymph nodes to neoadjuvant PD-1 blockade alone or neoadjuvant PD-1 blockade plus TPF induction chemotherapy. Pathologic response is defined as sum of pathologic complete response and major pathologic response. Pathologic complete response is defined as the absence of viable residual tumor in resected specimen. The rate of major pathologic response, defined as <10% residual viable tumor cells in the resected specimen.
Time Frame
8 weeks.
Title
Adverse Events (AEs).
Description
Number of participants experiencing any sign, symptom, disease, or worsening of preexisting conditions temporally associated with the experimental interventions or irrespective of the experimental interventions.
Time Frame
24 months.
Other Pre-specified Outcome Measures:
Title
Changes in the Level of Circualting Exosomal PD-L1.
Description
The level of circulating exosomal PD-L1 at serial time points pre- and on-treatment, as detected by enzyme-linked immunosorbent assay (ELISA).
Time Frame
24 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically documented oral squamous cell carcinoma (biopsy required). Local advanced oral squamous cell carcinoma (clinical stage T1-2N1-3M0, T3-4aN0-3M0) with resection option for potential cure, as assessed by a faculty surgeon at Hospital of Stomatology, Wuhan University. Distant metastasis is excluded by chest CT and emission computed tomograph. Adequate organ function as follows: 1) Leukocyte count ≥ 2,000/mm3; 2) Absolute neutrophil count ≥ 1,000/mm3; 3) Platelet count ≥ 100,000/mm3; 4) Hemoglobin ≥ 90 g/L; 5) Serum albumin ≥30 g/L; 6) Total bilirubin ≤ 1.5 × upper limit of normal (ULN); 7) AST (SGOT) and ALT (SGPT) < 2.5 × ULN; 8) ALP ≤ 2.5 × ULN; 9) Prothrombin time-international normalized ratio ≤ 1.5; 10) Serum creatinine ≤ 1.5 × ULN; 11) INR/PT≤ 1.5; 12) TSH ≤ ULN. ECOG performance status 0-1. Female patient tested HCG negative in serum or urine within 7 days prior to the start of investigational product. Both patient and partner must agree to use contraception prior to study entry and for the duration of study participation and for up to 120 days after the last dose of PD-1 blockade. Patient understands the study regimen, its requirements, risks and discomforts and is able and willing to sign the informed consent form. Exclusion Criteria: History of ≥ 3 grade immune related adverse events (irAEs) or have not recovered to ≤ 1 grade irAEs from previous treatment. History of other treatments for cancer, including surgery, chemotherapy, radiotherapy or molecular targeted therapy within past 5 years. Previous therapy with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 or any other antibody targeting T cell co-regulatory pathways. Active autoimmune disease or history of refractory autoimmune disease. Active systemic infection requiring therapy. Patients who are receiving psychotropic drug or alcohol/drug abuse. Subjects with concurrent other active malignancies. HIV or untreated active HBV or HCV infections, or vaccinated (HBV, flu, varicella, etc) within 4 weeks before recruitment. Uncontrollable systemic diseases, including diabetes, hypertension, etc. History of stroke or transient ischemic attack within past 6 months. Distant metastases or inability to resect after physician evaluation. Serious cardiovascular, respiratory, immune system critical disease or other conditions that the researchers thought might increase the subjects' risk.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gang Chen, M.D.
Phone
+86 02787686215
Email
geraldchan@whu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gang Chen, M.D.
Organizational Affiliation
Hospital of Stomatology, Wuhan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital of Stomatology, Wuhan University
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430079
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Neoadjuvant Anti-PD-1 Immunotherapy With Chemotherapy in Resectable Locally Advanced Oral Squamous Cell Carcinoma

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