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Study of Cetuximab Plus/Minus Weekly Paclitaxel After Progression To First-Line Pembrolizumab Plus Platinum-5FU in Subjects With Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck.

RecruitingPhase 2Ages 18 Years - anyAllGrupo Español de Tratamiento de Tumores de Cabeza…
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In plain words

What the trial is, and whether it could suit you

Squamous cell carcinoma of the head and neck (SCCHN) arises from epithelial cells and occurs in the oral cavity, pharynx and larynx. SCCHN is the seventh most common cancer worldwide with an annual incidence of approximately 90.000 cases per year in Europe. Recurrent / metastatic SCCHN remains a grievous diagnosis and optimal treatment options after progression to first-line ICI treatment are not determined yet. Previous reports showed that cetuximab plus paclitaxel after progression to ICI therapy may have an enhanced activity as second line after ICI therapy ERBIOTAX is multi-center, open-label, randomized, non-comparative two-arm, phase 2 trial Investigator Initiated Study. The primary study aims is to evaluate the efficacy of weekly cetuximab combined with paclitaxel (Arm A) or cetuximab monotherapy (Arm B) after progression to pembrolizumab plus platinum / 5-FU. The efficacy of tr

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📋 Eligibility rules (as published)
Inclusion Criteria: \- Informed consent 1. Signed written and voluntary informed consent. 2. Patients must be willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedures. 3. Age \> 18 years old. Disease characteristics 4. Have histologically confirmed diagnosis of head and neck squamous cell carcinoma. 5. The eligible primary tumor locations are oropharynx, oral cavity, hypopharynx, and larynx. 6. Known Human papillomavirus (HPV) status in oropharyngeal primaries and tested by p16 and/or HPV DNA testing by ISH or PCR. Local testing is acceptable. 7. Have confirmed disease progression per RECIST 1.1 on or after receiving platinum / 5-FU and pembrolizumab as first-line therapy for recurrent/metastatic disease. Patients must have measurable disease assessed by computed tomography (CT) scan or magnetic resonance imaging (MRI) based on RECIST 1.1 as assessed by the local site investigator/radiology. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. 8. All patients should provide a tumor biopsy obtained prior to the start of cetuximab +/- paclitaxel. A newly obtained biopsy -after progression to pembrolizumab + platinum-based chemotherapy - of a tumor lesion not previously irradiated for central biomarker analysis prior to start of study treatment is strongly recommended, but an archival tumor biopsy sample may be acceptable upon discussion with the sponsor. A second tumor block (FFPE) sample will be strongly recommended to be collected between C2D1 and before C2D15 . Note: Fine needle aspirate \[FNA\] is not adequate. Repeat samples may be required if adequate (quality and quantity) tissue is not provided. Formalin-fixed, paraffin embedded tissue blocks are preferred to slides Patient characteristics 9. Have a performance status of 0 or 1 on the ECOG Performance Scale 10. Patients must have adequate organ function as determined by the following. Screening labs should be performed within -7 days of treatment initiation: a. Hematology * Absolute neutrophils \> 1.5 x 109/L * Platelets \> 100 x 109/L * Hemoglobin \> 90 g/L * Biochemistry * Bilirubin \< 1.5 x upper limit of normal (ULN) * AST and ALT \< 2.5 x ULN * Creatinine or measured or calculated creatinine clearance (GFR can also be used in place of creatinine or CrCl) ≤ 1.5xULN or ≥ 60 mL/min, respectively. 11. Evidence of post-menopausal status, or negative urinary or serum pregnancy test for female pre-menopausal patients. Women will be considered post-menopausal if they have been amenorrheic for 12 months without an alternative medical cause. The following age-specific requirements apply: 1. Women \<50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy, or hysterectomy). 2. Women ≥50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses \>1 year ago, had chemotherapy-induced menopause with last menses \>1 year ago, or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy, or hysterectomy). 12. Female subjects of childbearing potential should have a negative blood pregnancy test within 72 hours prior to receiving the first dose of study medication. A urine test can be considered if a blood test is not appropriate. 13. Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile or abstain from heterosexual activity for the course of the study through 180 days after the last dose of study medication (6 months for paclitaxel). Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for \>1 year. Note: Abstinence is acceptable if this is the usual lifestyle and preferred method of contraception for the subject. 14. Male subjects should agree to use an adequate method of contraception starting with the first dose of study therapy through 180 days after the last dose of study therapy (6 months for paclitaxel). Note: Abstinence is acceptable if this is the usual lifestyle and preferred method of contraception for the subject. Exclusion Criteria: 1. Patients with tumors of the head and neck region, arising from the nasopharynx, nasal cavity, paranasal sinuses, salivary glands, skin, unknown primary site. 2. Patients not treated or not progressing to pembrolizumab + platinum / 5-FU as the first line prior to their enrollment in the study. Progression to platinum / 5-FU plus pembrolizumab or other antiPD-(L)1 agents in combination with other immunotherapies including but not limited to other checkpoint regulatory monoclonal/bispecific antibodies such as anti CTLA-4, anti LAG-3 , anti TIGIT or anti TIM-3 may be allowed upon discussion with the sponsor. 3. Any previous treatment with paclitaxel and/or cetuximab in the recurrent or metastatic setting. 4. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Note: Subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging (using the identical imaging modality for each assessment, either MRI or CT scan) for at least 4 weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomat
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What it tests

  • Cetuximab
  • Paclitaxel
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Where

17 sites
Hospital Clínico Universitario de Santiago de Compostela
Santiago de Compostela, Spain
Instituto Catalán de Oncología - Badalona
Badalona, Spain
Instituto Catalán de Oncología - Hospital Duran i Reynals
Barcelona, Spain
Hospital Universitario Marqués de Valdecilla (Santander)
Santander, Spain
Hospital Universitario Virgen de las Nieves
Granada, Spain
Centro Oncológico de Galicia (La Coruña)
A Coruña, Spain
Hospital Universitario Lucus Augusti
Lugo, Spain
Hospital Clínico San Carlos
Madrid, Spain

…and 9 more on ClinicalTrials.gov.

🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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