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A Study of Xevinapant (Debio 1143) in Combination With Platinum-Based Chemotherapy and Standard Fractionation Intensity-Modulated Radiotherapy in Participants With Locally Advanced Squamous Cell Carcinoma of the Head and Neck, Suitable for Definitive Chemoradiotherapy (TrilynX)

Phase 3
Terminated
Conditions
Squamous Cell Carcinoma of the Head and Neck
Interventions
Radiation: Intensity Modulation Radiation Therapy (IMRT)
Drug: Placebo
Registration Number
NCT04459715
Lead Sponsor
EMD Serono Research & Development Institute, Inc.
Brief Summary

The primary objective of the study is to demonstrate superior efficacy of Xevinapant (Debio 1143) vs placebo when added to chemoradiotherapy (CRT) in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN).

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
730
Inclusion Criteria
  • Eastern Cooperative Oncology Group performance status (ECOG PS) 0 or 1
  • Histologically confirmed diagnosis of previously untreated Locally Advanced Squamous Cell Carcinoma of the Head and Neck (LA-SCCHN) participant (stage III, IVa or IVb according to the American Joint Committee on Cancer(AJCC))/Classification of malignant tumors: T=size of the primary tumor, N=regional lymph node involvement, M=distant metastasis (TNM) Staging System, 8th Edition.) suitable for definitive ChemoRadiotherapy (CRT), of at least one of the following sites: oropharynx, hypopharynx and larynx
  • For OroPharyngeal Cancer (OPC) participants, primary tumors must be human papillomavirus (HPV)-negative as determined by p16 expression using immunohistochemistry
  • Evaluable tumor burden (measurable and/or non-measurable tumor lesions) assessed by computed tomography scan (CT-scan) or magnetic resonance imaging (MRI), based on Response evaluation criteria in solid tumors (RECIST) version 1.1
  • Peripheral neuropathy less than (<) grade 2
  • Adequate hematologic, renal and hepatic function
  • Other protocol defined inclusion criteria may apply
Exclusion Criteria
  • Primary tumor of nasopharynx, paranasal sinuses, nasal or oral cavity, salivary, thyroid or parathyroid gland pathologies, skin or unknown primary site
  • Metastatic disease (stage IVc as per AJCC/TNM, 8th Ed.)
  • Prior definitive or adjuvant Radiotherapy (RT) and/or radical surgery to the head and neck region which may jeopardize the primary tumor irradiation plan, or any other prior SCCHN systemic treatment, including investigational agents
  • Documented weight loss of >10% during the last 4 weeks prior to randomization (unless adequate measures are undertaken for nutritional support), OR plasmatic albumin < 3.0 g/dL. No albumin transfusions are allowed within 2 weeks before randomization
  • Known allergy to Xevinapant (Debio 1143), cisplatin, carboplatin, other platinum-based agent or any excipient known to be present in any of these products or in the placebo formulation
  • other protocol defined exclusion criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Xevinapant (Debio 1143)Xevinapant (Debio 1143)Participants will receive: Concomitant chemo-radiation therapy period (Cycles 1-3): * Radiotherapy * Cisplatin * Xevinapant (Debio 1143) Monotherapy period (Cycles 4-6): • Xevinapant (Debio 1143)
Xevinapant (Debio 1143)CisplatinParticipants will receive: Concomitant chemo-radiation therapy period (Cycles 1-3): * Radiotherapy * Cisplatin * Xevinapant (Debio 1143) Monotherapy period (Cycles 4-6): • Xevinapant (Debio 1143)
Xevinapant (Debio 1143)Intensity Modulation Radiation Therapy (IMRT)Participants will receive: Concomitant chemo-radiation therapy period (Cycles 1-3): * Radiotherapy * Cisplatin * Xevinapant (Debio 1143) Monotherapy period (Cycles 4-6): • Xevinapant (Debio 1143)
PlaceboCisplatinParticipants will receive: Concomitant chemo-radiation therapy period (Cycles 1-3): * Radiotherapy * Cisplatin * Matched placebo Monotherapy period (Cycles 4-6): • Matched placebo
PlaceboIntensity Modulation Radiation Therapy (IMRT)Participants will receive: Concomitant chemo-radiation therapy period (Cycles 1-3): * Radiotherapy * Cisplatin * Matched placebo Monotherapy period (Cycles 4-6): • Matched placebo
PlaceboPlaceboParticipants will receive: Concomitant chemo-radiation therapy period (Cycles 1-3): * Radiotherapy * Cisplatin * Matched placebo Monotherapy period (Cycles 4-6): • Matched placebo
Primary Outcome Measures
NameTimeMethod
Event-Free Survival (EFS)Up to 5 years

EFS is the time from the date of randomization to the date of first record of disease progression or death.

Secondary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)Up to 5 years

ORR defined as proportion of participants with complete response (CR) or partial response (PR) by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, as assessed by Blinded Independent Review Committee (BIRC).

Complete Response Rate (CRR)Up to 5 years

CRR defined as proportion of participants with complete response (CR) as assessed by Blinded Independent Review Committee (BIRC).

Overall survival (OS)Up to 5 years

OS is the time from randomization to death due to any cause.

Changes from Baseline in Global Health Status/Quality of Life (GHS/QoL) and Fatigue SymptomPrior to the first dose of study treatment (Baseline) and at the time of last follow-up (Up to 5 years)

Change from baseline in GHS/QoL and Fatigue Symptom using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (EORTC QLQ-C30)

Changes from Baseline in Swallowing and Pain SymptomsPrior to the first dose of study treatment (Baseline) and at the time of last follow-up (Up to 5 years)

Change from baseline in swallowing, and pain symptoms using the EORTC Head and Neck Questionnaire (EORTC QLQ-H\&N35)

Progression-Free Survival (PFS)Up to 5 years

PFS is the time from randomization to the earliest between PFS event or End of Study (EOS)

Locoregional Control (LRC)From randomization to the earliest between PFS event (progression at the site of the primary tumor or the locoregional lymph nodes) or EOS (Up to 5 years)
Duration of Response (DOR)Up to 5 years

Duration of response (DoR) defined as the time from the first evidence of response (partial or complete, as assessed by the BIRC according to RECIST v1.1) to the first occurrence of progression (radiological or clinical, as assessed by the BIRC) or death from any cause.

Number of Participants with Radical Salvage SurgeryUp to 5 years
Time to Subsequent Systemic Cancer TreatmentsUp to 5 years
Safety and Tolerability as assessed by incidence and severity of Adverse Events (AEs), Serious Adverse Events (SAEs), AEs of Special Interest (AESIs), Changes in Laboratory Values, Vital Signs, Electrocardiogram (ECGs) and Extent of ExposureFrom signed informed consent to EOS (within 6.8 years)

Trial Locations

Locations (285)

The University of Alabama at Birmingham - Hazelrig-Salter Radiation Oncology Center (HSROC)

🇺🇸

Birmingham, Alabama, United States

Banner MD Anderson Cancer Center

🇺🇸

Gilbert, Arizona, United States

University of Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

UC San Diego Moores Cancer Center

🇺🇸

La Jolla, California, United States

Regents of the University of California

🇺🇸

San Francisco, California, United States

UCSF

🇺🇸

San Francisco, California, United States

The Oncology Institute of Hope & Innovation

🇺🇸

Whittier, California, United States

University of Colorado at Denver and Health Sciences Center

🇺🇸

Aurora, Colorado, United States

Yale Cancer Center

🇺🇸

New Haven, Connecticut, United States

Lombardi Comprehensive Cancer Center, Georgetown University Medical Center

🇺🇸

Washington, District of Columbia, United States

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The University of Alabama at Birmingham - Hazelrig-Salter Radiation Oncology Center (HSROC)
🇺🇸Birmingham, Alabama, United States
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