MedPath

A Study of Ficlatuzumab in Combination With Cetuximab in Participants With Recurrent or Metastatic (R/M) HPV Negative Head and Neck Squamous Cell Carcinoma

Phase 3
Recruiting
Conditions
Metastatic Head-and-neck Squamous-cell Carcinoma
Recurrent Head and Neck Squamous Cell Carcinoma
Interventions
Registration Number
NCT06064877
Lead Sponsor
AVEO Pharmaceuticals, Inc.
Brief Summary

The purpose of this study is to compare the efficacy and safety of ficlatuzumab plus cetuximab compared to placebo plus cetuximab in participants with recurrent/metastatic (R/M) HPV-negative Head and Neck Cancer.

The primary hypothesis is that ficlatuzumab combined with cetuximab is superior to cetuximab alone in terms of progression-free survival and/or overall survival.

Detailed Description

This multicenter, randomized, double-blind, placebo-controlled Phase 3 study is designed to compare the efficacy and safety of two dose levels of ficlatuzumab combined with cetuximab (Arm 1 or Arm 2) to a control arm of placebo plus cetuximab (Arm 3) in participants with R/M human papilloma virus (HPV)-negative HNSCC. Eligible participants must have failed prior therapy with an anti-PD-1 \[programmed cell death protein 1\] or PD-L1 \[programmed death ligand 1\] immune checkpoint inhibitor (ICI) and with platinum-based chemotherapy, administered in combination or sequentially. Failure of prior treatment may be due to progression of disease or intolerance to treatment. It is anticipated that the study will enroll approximately 410 participants across 3 arms.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
410
Inclusion Criteria
  • Male or female and ≥ 18 years of age
  • Histologically and/or cytologically confirmed primary diagnosis of R/M HNSCC
  • Participants with oropharyngeal cancer will be required to have proof of p16 negative status submitted on the basis of a pathology report
  • At least 1 measurable lesion by contrast CT or MRI scan according to RECIST v.1.1. Such lesions must not have been previously irradiated; if the measurable lesion(s) has been irradiated, clear progression must be documented
  • Participants must have failed prior therapy with an anti-PD-1/PD-L1 ICI and with platinum-based chemotherapy administered in combination or sequentially, in either the locally advanced or R/M setting. Failure of prior treatment may be due to progression of disease or intolerance to treatment
  • Patient's tumor must be considered inoperable and incurable
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 with a life expectancy of at least 12 weeks
  • For women of childbearing potential (WOCBP), documentation of negative serum pregnancy test within 30 days of randomization
  • For WOCBP and male participants whose sexual partners are of childbearing potential, agreement to use an effective method of contraception during the study and for at least 5 months after the last dose of study treatment. Birth control methods which may be considered highly effective include methods that achieve a failure rate of less than 1% per year when used consistently and correctly.
  • Ability to give written informed consent and comply with protocol requirements
  • Patients with feeding tubes are eligible for the study.
  • Archived tissue sample must be submitted to the Sponsor-designated laboratory within 60 days of randomization for c-Met analysis (if a tissue sample is not available, a fresh biopsy may be required prior to enrollment)
Exclusion Criteria
  • Participants who have received > 2 prior lines of anticancer therapy or prior treatment with cetuximab/alternative EGFR inhibitors for the treatment of R/M HNSCC

  • History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the investigational agent or cetuximab

  • Known or suspected untreated and uncontrolled brain metastases or leptomeningeal carcinomatosis Note: Participants with locally treated brain metastases are eligible provided 2 weeks have elapsed since local therapy. Participants are allowed to continue steroid taper during the start of study treatment.

  • Prior treatment with any other investigational drug or biologic agent or radiation therapy before a washout has been completed (must be completed prior to randomization):

    1. 2 weeks (14 days) or 5 half-lives, whichever is shorter, for chemotherapeutic agents, small molecules, and checkpoint inhibitors
    2. 3 weeks (21 days) or 5 half-lives, whichever is shorter, for antibody-drug conjugates
    3. 4 weeks (28 days) for cell therapies
    4. 2 weeks (14 days) for radiation therapy
  • Any unresolved and significant toxicity (National Cancer Institute Common Terminology Criteria for Adverse Events [NCI-CTCAE] version 5.0) Grade > 2 from previous anticancer therapy (including radiation therapy), other than alopecia

  • Significant cardiovascular disease, including: Cardiac failure New York Heart Association class III or IV; Myocardial infarction, severe or unstable angina within 6 months prior to randomization; History of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation)

  • Any other medical condition or psychiatric condition that, in the opinion of the Investigator, might interfere with the participant's involvement in the study or interfere with the interpretation of study results

  • History of prior malignancy within 2 years prior to randomization (except for adequately treated non-melanoma skin cancer, carcinoma in situ of the breast or cervix, superficial bladder cancer, or early-stage prostate cancer, without evidence of recurrence; participants may or may not be on maintenance therapy)

  • Participants who are positive for HBV or HCV with indication of acute or chronic hepatitis (as defined in protocol)

  • Radiographic evidence (historical or at screening) of interstitial lung disease or idiopathic pulmonary fibrosis

  • Female participants who are pregnant or breastfeeding

A full list of inclusion and exclusion criteria can be found in the protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 2 (Investigational Arm: ficlatuzumab plus cetuximab)FiclatuzumabIV ficlatuzumab dose B on D1 and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
Arm 1 (Investigational Arm: ficlatuzumab plus cetuximab)FiclatuzumabIntravenous (IV) ficlatuzumab dose A on Day 1 (D1) and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
Arm 3 (Comparator Arm: placebo plus cetuximab)CetuximabIV placebo (saline, ficlatuzumab-matched) on D1 and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
Arm 3 (Comparator Arm: placebo plus cetuximab)PlaceboIV placebo (saline, ficlatuzumab-matched) on D1 and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
Arm 1 (Investigational Arm: ficlatuzumab plus cetuximab)CetuximabIntravenous (IV) ficlatuzumab dose A on Day 1 (D1) and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
Arm 2 (Investigational Arm: ficlatuzumab plus cetuximab)CetuximabIV ficlatuzumab dose B on D1 and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
Primary Outcome Measures
NameTimeMethod
To compare the efficacy by overall survival of ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC)From Randomization until death from any cause (Approximately 44 months)

Overall survival (OS), defined as the time from the date of randomization to the date of death for any cause

Secondary Outcome Measures
NameTimeMethod
To assess the immunogenicity of ficlatuzumab via antidrug antibodies (ADAs)From Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)

Serum samples will be assessed for the presence of ADA to ficlatuzumab.

To evaluate progression-free survival (PFS) for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCFrom Randomization until disease progression or death (Approximately 44 months)

Progression-free survival (PFS), defined as the time from randomization to the first documented progressive disease (PD) per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, or death from any cause, whichever occurs first

To evaluate additional objective response rate for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCFrom Cycle 1 Day 1 until last response assessment (response assessments are every 8 weeks for the first year, every 12 weeks for years 2 and 3 and then every 6 months)

Objective response rate (ORR), defined as the percentage of participants who have a complete response (CR) or a partial response (PR) per RECIST v1.1

To evaluate disease control rate (DCR) for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCFrom Cycle 1 Day 1 until last response assessment (response assessments are every 8 weeks for the first year, every 12 weeks for years 2 and 3 and then every 6 months)

Disease control rate (DCR), defined for participants who have achieved a CR, PR or stable disease for at least 8 weeks per RECIST v1.1

To evaluate duration of response (DOR) for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCFrom Cycle 1 Day 1 until last response assessment (response assessments are every 8 weeks for the first year, every 12 weeks for years 2 and 3 and then every 6 months)

Duration of response (DOR), defined as the time from first documented evidence of a confirmed CR or PR per RECIST v1.1

To compare the safety and tolerability of ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCFrom Screening until 30 days after last dose

Number of times participants experience Adverse Events (AE) or abnormal laboratory values.

To evaluate the pharmacokinetics (PK) of ficlatuzumabFrom Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)

Serum samples will be assessed for concentrations of ficlatuzumab

To assess the immunogenicity of ficlatuzumab via neutralizing antibodies (nAB)From Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)

Serum samples that test positive for the presence of ADA to ficlatuzumab will be further tested for the presence of nAB.

To evaluate the quality of life (QOL) of ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCFrom Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)

Change from baseline in overall health status and time to clinically meaningful deterioration based on scoring of standardized participant questionnaires

Trial Locations

Locations (110)

Banner MD Anderson Cancer Center

🇺🇸

Gilbert, Arizona, United States

The University of Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

University of California Los Angeles

🇺🇸

Westwood, California, United States

Yale School of Medicine - Smilow Cancer Hospital

🇺🇸

New Haven, Connecticut, United States

The George Washington University

🇺🇸

Washington, District of Columbia, United States

AdventHealth Medical Group Oncology & Hematology at Orlando

🇺🇸

Orlando, Florida, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

University of Illinois Cancer Center

🇺🇸

Chicago, Illinois, United States

University of Kansas Cancer Center

🇺🇸

Westwood, Kansas, United States

Mary Bird Perkins Cancer Center

🇺🇸

Baton Rouge, Louisiana, United States

MaineHealth Institute for Research

🇺🇸

South Portland, Maine, United States

University of Maryland

🇺🇸

Baltimore, Maryland, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Siteman Cancer Center - Washington University

🇺🇸

Saint Louis, Missouri, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

Northwell Health Cancer Institute

🇺🇸

Lake Success, New York, United States

Hospital Universitario Marques de Valdecilla

🇪🇸

Santander, Spain

Manhattan Eye, Ear & Throat Hospital

🇺🇸

New York, New York, United States

University of Cincinnati - UC Health Barrett Cancer Center

🇺🇸

Cincinnati, Ohio, United States

Ohio State University, James Cancer Hospital and Solove Research Institute

🇺🇸

Columbus, Ohio, United States

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

University of Pittsburgh Medical Center - Hillman Cancer Center

🇺🇸

Pittsburg, Pennsylvania, United States

St George Hospital

🇦🇺

Kogarah, New South Wales, Australia

St. Vincent's Hospital

🇦🇺

Sydney, New South Wales, Australia

Princess Alexandra Hospital

🇦🇺

Brisbane, Queensland, Australia

St. John of God Murdoch Hospital

🇦🇺

Murdoch, Western Australia, Australia

CHU Liège

🇧🇪

Liège, Belgium

CHU Universite Catholique de Louvain

🇧🇪

Namur, Belgium

Vitaz-Sint-Niklaas Moerland

🇧🇪

Sint-Niklaas, Belgium

University Hospital

🇧🇬

Panagyurishte, Bulgaria

Tom Baker Cancer Centre (Alberta Health Services)

🇨🇦

Calgary, Alberta, Canada

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

The Ottawa Hospital Cancer Centre

🇨🇦

Ottawa, Ontario, Canada

Princess Margaret Cancer Center - University Health Network

🇨🇦

Toronto, Ontario, Canada

McGill University Health Centre (MUHC)

🇨🇦

Montréal, Quebec, Canada

Fakultni nemocnice Brno

🇨🇿

Brno, Czechia

Medical University of South Carolina (MUSC)

🇺🇸

Charleston, South Carolina, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Oncology Consultants

🇺🇸

Houston, Texas, United States

VCU Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

Medical College of Wisconsin - Froedtert Hospital Cancer Center

🇺🇸

Milwaukee, Wisconsin, United States

Hospital Clinico Universitario de Valencia (CHUV)

🇪🇸

Valencia, Spain

Masaryk Memorial Cancer Institute

🇨🇿

Brno, Czechia

Fakultni Nemocnice Olomouc

🇨🇿

Olomouc, Czechia

Fakultni Nemocnice Kralovske Vinohrady

🇨🇿

Prague, Czechia

Fakultni nemocnice Bulovka

🇨🇿

Prague, Czechia

Clinique Pasteur - Lanroze- Centre Finistérien de Radiothérapie et d'Oncologie

🇫🇷

Brest, France

Pôle Santé Léonard de Vinci

🇫🇷

Chambray-lès-Tours, France

Centre Léon Bérard

🇫🇷

Lyon, France

Assistance Publique Hopitaux de Marseille (APHM)-Hôpital La Timone

🇫🇷

Marseille, France

Institut Curie

🇫🇷

Paris, France

Hôpital Privé des Côtes d'Armor

🇫🇷

Plérin, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

Charite-Universitaetsmedizin Berlin - Campus Virchow-Klinikum (CVK) - Medizinische Klinik mit Schwerpunkt Haematologie, Onkologie und Tumorimmunologie

🇩🇪

Berlin, Germany

UNIVERSITÄTSKLINIKUM FREIBURG, Klinik für Innere Medizin I, Schwerpunkt Hämatologie, Onkologie und Stammzelltransplantation

🇩🇪

Freiburg, Germany

Ludwig-Maximilians University

🇩🇪

Munich, Germany

Orszagos Onkologiai Intezet

🇭🇺

Budapest, Hungary

Petz Aladar Country Teaching Hospital

🇭🇺

Győr, Hungary

Josa Andras Oktatokorhaz

🇭🇺

Nyíregyháza, Hungary

University of Pecs - Oncology

🇭🇺

Pécs, Hungary

Szent Lázár Megyei Kórház

🇭🇺

Salgótarján, Hungary

IRCCS Istituto Scienze Neurologiche

🇮🇹

Bologna, Italy

AOU Careggi

🇮🇹

Firenze, Italy

IRCCS Istituto Clinico Humanitas - Cancer center

🇮🇹

Milano, Italy

IRCCS Ospedale San Raffaele Milano

🇮🇹

Milano, Italy

Fondazione IRCCS - Istituto Nazionale Tumori - Oncologia

🇮🇹

Milano, Italy

Azienda Ospedaliera Universitaria Maggiore Della Carita Novara

🇮🇹

Novara, Italy

Istituto Oncologico Veneto

🇮🇹

Padua, Italy

IRCCS - ICS Maugeri

🇮🇹

Pavia, Italy

Universita degli Studi di Pavia - Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

🇮🇹

Roma, Italy

Keimyung University Dongsan Hospital

🇰🇷

Daegu, Korea, Republic of

Korea University Anam Hospital

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

The Catholic University of Korea, Eunpyeong St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Ajou University Hospital

🇰🇷

Suwon, Korea, Republic of

Antoni van Leeuwenhoek

🇳🇱

Amsterdam, Netherlands

Radboud University Medical Center

🇳🇱

Nijmegen, Netherlands

Centrum Onkologii im. prof. F. Lukaszczyka w Bydgoszczy

🇵🇱

Bydgoszcz, Poland

National Research Institute of Oncology

🇵🇱

Gliwice, Poland

Medisprof Cancer Center

🇷🇴

Cluj-Napoca, Romania

Centrul radioterapie Amethyst Cluj-Napoca

🇷🇴

Floreşti, Romania

Institute of Oncology and Radiology of Serbia

🇷🇸

Belgrade, Serbia

University Clinical Center Kragujevac

🇷🇸

Kragujevac, Serbia

Institute for Oncology Vojvodina

🇷🇸

Sremska Kamenica, Serbia

Hospital Universitario Vinalopo

🇪🇸

Alicante, Spain

Institut Catala d'Oncologia - Hospital Duran i Reynals

🇪🇸

Badalona, Spain

UOMI Cancer Center-Clinica Tres Torres

🇪🇸

Barcelona, Spain

Institut Catala d'Oncologia (ICO) - Hospitalet

🇪🇸

Barcelona, Spain

Vall d'Hebron Institut d'Oncologia (VHIO)

🇪🇸

Barcelona, Spain

Hospital universitario Jerez

🇪🇸

Cadiz, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Grupo Hospital de Madrid (HM) - Hospital Universitario Madrid Sanchinarro - Centro Integral Oncologico Clara Campal (CIOCC)

🇪🇸

Madrid, Spain

Hospital Universitario de Torrejón

🇪🇸

Madrid, Spain

Hospital Quironsalud Malaga

🇪🇸

Málaga, Spain

Changhua Christian Hospital

🇨🇳

Changhua, Taiwan

Chang Gung Memorial Hospital - Kaohsiung

🇨🇳

Kaohsiung, Taiwan

China Medical University Hospital (CMUH)

🇨🇳

Taichung, Taiwan

National Cheng-Kung University Hospital

🇨🇳

Tainan, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Chang Gung Memorial Hospital - Linkou

🇨🇳

Taoyuan, Taiwan

NHS Grampian - Aberdeen Royal Infirmary

🇬🇧

Aberdeen, United Kingdom

The Royal Marsden NHS Foundation Trust

🇬🇧

London, United Kingdom

Sarah Cannon Research Institute

🇬🇧

London, United Kingdom

City Hospital Nottingham

🇬🇧

Nottingham, United Kingdom

The Royal Marden Hospital, Surrey

🇬🇧

Sutton, United Kingdom

Torbay Hospital

🇬🇧

Torquay, United Kingdom

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