MedPath

Study of Zanzalintinib (XL092) + Pembrolizumab vs Pembrolizumab in Subjects With PD-L1 Positive Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

Phase 2
Recruiting
Conditions
Head and Neck Squamous Cell Carcinoma
Interventions
Drug: Zanzalintinib-matched Placebo
Registration Number
NCT06082167
Lead Sponsor
Exelixis
Brief Summary

This is a multicenter, randomized, double-blind, controlled Phase 2/3 trial of zanzalintinib in combination with pembrolizumab versus zanzalintinib-matched placebo in combination with pembrolizumab in subjects with PD-L1 positive recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) incurable by local therapies who have not received prior systemic therapy for recurrent or metastatic disease.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
600
Inclusion Criteria
  • Histologically or cytologically-confirmed R/M HNSCC that is considered incurable by local therapy.

    • Subjects should not have had prior systemic therapy administered in the recurrent or metastatic setting. Systemic therapy which was completed more than 6 months prior to randomization if given as part of multimodal treatment for locally advanced disease is allowed.
    • The eligible primary tumor locations are the oropharynx, oral cavity, hypopharynx, and larynx.
  • PD-L1 expression level Combined Positive Score (CPS) ≥ 1.

  • Subjects with oropharyngeal cancer must have HPV status from tumor tissue.

  • Measurable disease according to RECIST 1.1 as determined by the Investigator.

  • Tumor samples (archival or fresh tumor biopsy) are required. If archival tissue is unavailable, must provide fresh tumor tissue biopsy prior to randomization.

  • Recovery to baseline or ≤ Grade 1 severity (CTCAE v5) from adverse events (AEs) related to any prior treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive therapy.

  • Age 18 years (or the legal age of consent in your country, if higher than 18) or older on the day of consent.

  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.

  • Adequate organ and marrow function.

Exclusion Criteria
  • Nasopharynx, salivary gland or occult primary site (regardless of p16 status).
  • Has disease that is suitable for local therapy administered with curative intent.
  • Has received prior therapy with zanzalintinib, any anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137).
  • Life expectancy < 3 months.
  • Had progressive disease within 6 months of completion of curatively intended systemic treatment for locoregionally advanced HNSCC.
  • Radiation therapy for bone metastases within 2 weeks, any other radiation therapy within 4 weeks prior to randomization.
  • Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 4 weeks prior to randomization.
  • Positive hepatitis B surface antigen (HBsAg) test.
  • Positive hepatitis C virus (HCV) antibody test.
  • Major surgery (eg, GI surgery, removal or biopsy of brain metastasis) within 8 weeks prior to randomization. Complete wound healing from major or minor surgery must have occurred at least prior to randomization.
  • Corrected QT interval calculated by the Fridericia formula (QTcF) > 480 ms per electrocardiogram (ECG) within 28 days before randomization.
  • Pregnant or lactating females.
  • Administration of a live, attenuated vaccine within 30 days before randomization.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Zanzalintinib + PembrolizumabPembrolizumabSubjects with R/M HNSCC will receive zanzalintinib + pembrolizumab
Zanzalintinib-Matched Placebo + PembrolizumabZanzalintinib-matched PlaceboSubjects with R/M HNSCC will receive zanzalintinib-matched placebo + pembrolizumab
Zanzalintinib-Matched Placebo + PembrolizumabPembrolizumabSubjects with R/M HNSCC will receive zanzalintinib-matched placebo + pembrolizumab
Zanzalintinib + PembrolizumabZanzalintinibSubjects with R/M HNSCC will receive zanzalintinib + pembrolizumab
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) by Blinded Independent Central Review (BICR)Approximately 33 months after the first subject is randomized

Defined as the time from randomization to the earlier of either radiographic progressive disease (PD) per RECIST 1.1 as determined by the BICR or death from any cause

Overall Survival (OS)Approximately 50 months after the first subject is randomized

Defined as the time from randomization to death due to any cause

Secondary Outcome Measures
NameTimeMethod
PFS per RECIST 1.1 by InvestigatorApproximately 33 months after the first subject is randomized

Defined as the time from randomization to the earlier of either radiographic PD per RECIST 1.1 as determined by the Investigator or death from any cause

Objective Response Rate (ORR) per RECIST 1.1 by the BICR and InvestigatorApproximately 33 months after the first subject is randomized

Defined as the proportion of subjects with the best overall response of complete response (CR) or partial response (PR) per RECIST 1.1 as determined by the BICR and Investigator

Duration of Response (DOR) Per RECIST 1.1 by BICR and InvestigatorApproximately 33 months after the first subject is randomized

Defined as the time from the first documentation of objective response (subsequently confirmed at a visit ≥ 28 days later) to disease progression or death due to any cause

Trial Locations

Locations (168)

Exelixis Clinical Site #168

🇲🇽

Guadalajara, Mexico

Exelixis Clinical Site #2

🇺🇸

Fullerton, California, United States

Exelixis Clinical Site #1

🇺🇸

Orange City, Florida, United States

Exelixis Clinical Site #42

🇦🇹

Salzburg, Austria

Exelixis Clinical Site #22

🇧🇪

Bruxelles, Belgium

Exelixis Clinical Site #106

🇧🇪

Charleroi, Belgium

Exelixis Clinical Site #14

🇧🇪

Libramont, Belgium

Exelixis Clinical Site #37

🇧🇪

Sint-Niklaas, Belgium

Exelixis Clinical Site #68

🇧🇷

Passo Fundo, Rio Grande Do Sul, Brazil

Exelixis Clinical Site #90

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Exelixis Clinical Site #110

🇧🇷

Jau, Sao Paulo, Brazil

Exelixis Clinical Site #65

🇧🇷

Santo André, Sao Paulo, Brazil

Exelixis Clinical Site #83

🇧🇷

São José Do Rio Preto, Sao Paulo, Brazil

Exelixis Clinical Site #116

🇧🇷

Barretos, Brazil

Exelixis Clinical Site #75

🇧🇷

Curitiba, Brazil

Exelixis Clinical Site #101

🇧🇷

Curitiba, Brazil

Exelixis Clinical Site #97

🇧🇷

Porto Alegre, Brazil

Exelixis Clinical Site #102

🇧🇷

Recife, Brazil

Exelixis Clinical Site #87

🇧🇷

Rio de Janeiro, Brazil

Exelixis Clinical Site #88

🇧🇷

Sao Paulo, Brazil

Exelixis Clinical Site #76

🇧🇷

São Paulo, Brazil

Exelixis Clinical Site #77

🇧🇷

São Paulo, Brazil

Exelixis Clinical Site #67

🇧🇷

São Paulo, Brazil

Exelixis Clinical Site #98

🇧🇷

São Paulo, Brazil

Exelixis Clinical Site #25

🇧🇬

Plovdiv, Bulgaria

Exelixis Clinical Site #94

🇧🇬

Ruse, Bulgaria

Exelixis Clinical Site #15

🇧🇬

Sofia, Bulgaria

Exelixis Clinical Site #11

🇧🇬

Sofia, Bulgaria

Exelixis Clinical Site #54

🇧🇬

Sofia, Bulgaria

Exelixis Clinical Site #33

🇨🇱

Santiago, Chile

Exelixis Clinical Site #52

🇨🇱

Santiago, Chile

Exelixis Clinical Site #38

🇨🇱

Santiago, Chile

Exelixis Clinical Site #109

🇨🇱

Santiago, Chile

Exelixis Clinical Site #50

🇨🇱

Talca, Chile

Exelixis Clinical Site #51

🇨🇱

Valdivia, Chile

Exelixis Clinical Site #40

🇨🇱

Viña Del Mar, Chile

Exelixis Clinical Site #96

🇨🇴

Barranquilla, Colombia

Exelixis Clinical Site #152

🇨🇴

Bogota, Colombia

Exelixis Clinical Site #103

🇨🇴

Floridablanca, Colombia

Exelixis Clinical Site #99

🇭🇺

Kecskemet, Hungary

Exelixis Clinical Site #131

🇭🇺

Salgotarjan, Hungary

Exelixis Clinical Site #147

🇭🇺

Szekszard, Hungary

Exelixis Clinical Site #132

🇮🇱

Haifa, Israel

Exelixis Clinical Site #85

🇮🇱

Haifa, Israel

Exelixis Clinical Site #74

🇮🇱

Jerusalem, Israel

Exelixis Clinical Site #122

🇮🇱

Ramat Gan, Israel

Exelixis Clinical Site #86

🇮🇱

Tel Aviv, Israel

Exelixis Clinical Site #21

🇮🇹

Candiolo, Torino, Italy

Exelixis Clinical Site #35

🇮🇹

Brescia, Italy

Exelixis Clinical Site #45

🇮🇹

Catania, Italy

Exelixis Clinical Site #81

🇮🇹

Milano, Italy

Exelixis Clinical Site #55

🇮🇹

Milano, Italy

Exelixis Clinical Site #18

🇮🇹

Napoli, Italy

Exelixis Clinical Site #78

🇮🇹

Rome, Italy

Exelixis Clinical Site #124

🇮🇹

Rozzano, Italy

Exelixis Clinical Site #10

🇮🇹

Verona, Italy

Exelixis Clinical Site #121

🇸🇰

Zilina, Slovakia

Exelixis Clinical Site #115

🇪🇸

Barcelona, Spain

Exelixis Clinical Site #113

🇪🇸

Girona, Spain

Exelixis Clinical Site #130

🇪🇸

La Coruna, Spain

Exelixis Clinical Site #134

🇪🇸

Madrid, Spain

Exelixis Clinical Site #111

🇪🇸

Madrid, Spain

Exelixis Clinical Site #32

🇪🇸

Madrid, Spain

Exelixis Clinical Site #59

🇪🇸

Madrid, Spain

Exelixis Clinical Site #31

🇪🇸

Madrid, Spain

Exelixis Clinical Site #136

🇪🇸

Pamplona, Spain

Exelixis Clinical Site #126

🇪🇸

Sevilla, Spain

Exelixis Clinical Site #153

🇪🇸

Valencia, Spain

Exelixis Clinical Site #41

🇪🇸

Zaragoza, Spain

Exelixis Clinical Site #145

🇨🇳

Kaohsiung, Taiwan

Exelixis Clinical Site #164

🇨🇳

Taichung, Taiwan

Exelixis Clinical Site #142

🇨🇳

Taipei City, Taiwan

Exelixis Clinical Site #118

🇨🇳

Taipei, Taiwan

Exelixis Clinical Site #165

🇨🇳

Taoyuan, Taiwan

Exelixis Clinical Site #71

🇹🇭

Bangkoknoi, Bangkok, Thailand

Exelixis Clinical Site #167

🇩🇪

Giessen, Germany

Exelixis Clinical Site #166

🇦🇹

Vienna, Austria

Exelixis Clinical Site #163

🇺🇸

Tampa, Florida, United States

Exelixis Clinical Site #123

🇺🇸

Athens, Georgia, United States

Exelixis Clinical Site #82

🇺🇸

Atlanta, Georgia, United States

Exelixis Clinical Site #19

🇺🇸

Chicago, Illinois, United States

Exelixis Clinical Site #62

🇺🇸

Des Moines, Iowa, United States

Exelixis Clinical Site #100

🇺🇸

Iowa City, Iowa, United States

Exelixis Clinical Site #4

🇺🇸

Saint Louis, Missouri, United States

Exelixis Clinical Site #148

🇺🇸

Lebanon, New Hampshire, United States

Exelixis Clinical Site #158

🇺🇸

Camden, New Jersey, United States

Exelixis Clinical Site #3

🇺🇸

Shirley, New York, United States

Exelixis Clinical Site #95

🇺🇸

Durham, North Carolina, United States

Exelixis Clinical Site #117

🇺🇸

Wilson, North Carolina, United States

Exelixis Clinical Site #43

🇺🇸

Roanoke, Virginia, United States

Exelixis Clinical Site #73

🇦🇷

Rosario, Santa Fe, Argentina

Exelixis Clinical Site #91

🇦🇷

Buenos Aires, Argentina

Exelixis Clinical Site # 47

🇦🇷

Ciudad Autonoma de Buenos Aire, Argentina

Exelixis Clinical Site #53

🇦🇷

Ciudad Autonoma de Buenos Aire, Argentina

Exelixis Clinical Site #93

🇦🇷

Cordoba, Argentina

Exelixis Clinical Site #64

🇦🇷

Córdoba, Argentina

Exelixis Clinical Site #157

🇦🇷

Pergamino, Argentina

Exelixis Clinical Site #92

🇦🇷

Santa Fe, Argentina

Exelixis Clinical Site #57

🇦🇺

Port Macquarie, New South Wales, Australia

Exelixis Clinical Site # 46

🇦🇺

Adelaide, Australia

Exelixis Clinical Site #154

🇦🇺

Bedford Park, Australia

Exelixis Clinical Site #137

🇦🇺

Camperdown, Australia

Exelixis Clinical Site #39

🇦🇺

Murdoch, Australia

Exelixis Clinical Site #156

🇦🇹

Linz, Austria

Exelixis Clinical Site #146

🇨🇴

Pasto, Colombia

Exelixis Clinical Site #149

🇨🇴

Pereira, Colombia

Exelixis Clinical Site #49

🇨🇿

Nový Jičín, Czechia

Exelixis Clinical Site #58

🇨🇿

Olomouc, Czechia

Exelixis Clinical Site #34

🇨🇿

Prague, Czechia

Exelixis Clinical Site #151

🇨🇿

Praha, Czechia

Exelixis Clinical Site #48

🇨🇿

Praha, Czechia

Exelixis Clinical Site #36

🇨🇿

Praha, Czechia

Exelixis Clinical Site #28

🇫🇷

Marseille, Bouches-du-Rhône, France

Exelixis Clinical Site #16

🇫🇷

Bordeaux, Gironde, France

Exelixis Clinical Site #44

🇫🇷

Rennes, Ille Et Vilaine, France

Exelixis Clinical Site #108

🇫🇷

Saint Priest en Jarez, Loire, France

Exelixis Clinical Site #70

🇫🇷

Lyon, Rhone, France

Exelixis Clinical Site #107

🇫🇷

Le Mans, Sarthe, France

Exelixis Clinical Site #66

🇫🇷

Villejuif, Val De Marne, France

Exelixis Clinical Site #144

🇫🇷

Dijon Cedex, France

Exelixis Clinical Site #141

🇫🇷

Grenoble Cedex, France

Exelixis Clinical Site #140

🇫🇷

Lille cedex, France

Exelixis Clinical Site #26

🇫🇷

Paris, France

Exelixis Clinical Site #112

🇫🇷

Pierre Benite Cedex, France

Exelixis Clinical Site #105

🇫🇷

Poitiers, France

Exelixis Clinical Site #155

🇬🇷

Athens, Greece

Exelixis Clinical Site #129

🇬🇷

Athens, Greece

Exelixis Clinical Site #159

🇬🇷

Larissa, Greece

Exelixis Clinical Site #120

🇬🇷

Thessaloniki, Greece

Exelixis Clinical Site #150

🇬🇷

Thessaloniki, Greece

Exelixis Clinical Site #128

🇬🇷

Thessaloniki, Greece

Exelixis Clinical Site #125

🇭🇺

Budapest, Hungary

Exelixis Clinical Site #7

🇰🇷

Busan, Gangwon-do, Korea, Republic of

Exelixis Clinical Site #30

🇰🇷

Suwon-si, Gyeonggi-do, Korea, Republic of

Exelixis Clinical Site #17

🇰🇷

Suwon, Gyeonggi-do, Korea, Republic of

Exelixis Clinical Site #9

🇰🇷

Yangsan, Gyeongsangnam-do, Korea, Republic of

Exelixis Clinical Site #69

🇰🇷

Jeonju, Jeollabuk Do, Korea, Republic of

Exelixis Clinical Site #8

🇰🇷

Jeonju, Jeollabuk-do, Korea, Republic of

Exelixis Clinical Site #13

🇰🇷

Busan, Korea, Republic of

Exelixis Clinical Site #5

🇰🇷

Seoul, Korea, Republic of

Exelixis Clinical Site #63

🇰🇷

Seoul, Korea, Republic of

Exelixis Clinical Site #12

🇰🇷

Seoul, Korea, Republic of

Exelixis Clinical Site #6

🇰🇷

Seoul, Korea, Republic of

Exelixis Clinical Site #29

🇰🇷

Seoul, Korea, Republic of

Exelixis Clinical Site #61

🇲🇾

Putrajaya, Kuala Lumpur, Malaysia

Exelixis Clinical Site #60

🇲🇾

Kuala Lumpur, Malaysia

Exelixis Clinical Site #72

🇲🇾

Kuala Lumpur, Malaysia

Exelixis Clinical Site #114

🇲🇽

Guadalajara, Jalisco, Mexico

Exelixis Clinical Site #119

🇲🇽

San Juan del Rio, Queretaro, Mexico

Exelixis Clinical Site #89

🇵🇱

Piotrkow, Trybunalski, Poland

Exelixis Clinical Site #139

🇵🇱

Gliwice, Poland

Exelixis Clinical Site #162

🇵🇱

Torun, Poland

Exelixis Clinical Site #160

🇷🇴

Bucuresti, Romania

Exelixis Clinical Site #24

🇷🇴

Cluj-Napoca, Romania

Exelixis Clinical Site #20

🇷🇴

Craiova, Romania

Exelixis Clinical Site #104

🇷🇴

Floreşti, Romania

Exelixis Clinical Site #127

🇷🇴

Ploiesti, Romania

Exelixis Clinical Site #143

🇷🇴

Timisoara, Romania

Exelixis Clinical Site #23

🇸🇰

Košice, Slovakia

Exelixis Clinical Site #27

🇸🇰

Trnava, Slovakia

Exelixis Clinical Site #56

🇹🇭

Chiangmai, Chiang Mai, Thailand

Exelixis Clinical Site #79

🇹🇭

Hat Yai, Songkhla, Thailand

Exelixis Clinical Site #80

🇹🇭

Bangkok, Thailand

Exelixis Clinical Site #135

🇬🇧

London, England, United Kingdom

Exelixis Clinical Site #84

🇬🇧

Romford, Essex, United Kingdom

Exelixis Clinical Site #138

🇬🇧

Manchester, United Kingdom

Exelixis Clinical Site #133

🇬🇧

Sutton, United Kingdom

Exelixis Clinical Site #161

🇬🇧

Torquay, United Kingdom

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