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Study of Nivolumab in Combination With Ipilimumab Compared to the Standard of Care (Extreme Regimen) as First Line Treatment in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

Phase 3
Completed
Conditions
Head and Neck Cancer
Interventions
Biological: Nivolumab
Drug: Cetuximab/Erbitux
Biological: Ipilimumab
Drug: Cisplatin/Platinol
Drug: Carboplatin/Paraplatin
Drug: Fluorouracil/Adrucil
Registration Number
NCT02741570
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The main purpose of this study is to compare nivolumab and ipilimumab with the extreme regimen as first line treatment in patients with recurrent or metastatic squamous cell of the head and neck cancer

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
947
Inclusion Criteria
  • Histologically confirmed metastatic or recurrent squamous cell carcinoma of the head and neck (oral cavity, oropharynx, hypopharynx & larynx) that is not amenable to curative therapy.
  • No prior systemic cancer therapy for recurrent or metastatic disease (except if chemotherapy was part of multimodal treatment completed 6 months prior to enrolment).
  • Measurable disease detected by imaging exam (CT or MRI).
  • Have tumor tissue for PD L1 expression testing, and for oropharyngeal cancer have results from testing of HPV p16 status.
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Exclusion Criteria
  • Metastatic or recurrent carcinoma of the nasopharynx, squamous cell carcinoma of unknown primary, squamous cell carcinoma originating from skin and salivary glands or non squamous histologies (eg. mucosal melanoma).
  • No prior treatment with anti PD1, anti PD L1, anti CTLA 4 antibody or any other antibody or drugs targeting T cell costimulation or checkpoint pathways, or cetuximab or EGFR inhibitors in any treatment setting.
  • Participants with certain diseases such as active autoimmune disease, type I diabetes, hypothyroidism that needs hormone replacement, active infection, psychiatric disorder.
  • Inadequate hematologic, renal or hepatic function.

Other protocol defined inclusion/exclusion criteria could apply

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Extreme RegimenCarboplatin/ParaplatinSpecified dose on specified days
Nivolumab and IpilimumabNivolumabSpecified dose on specified days
Nivolumab and IpilimumabIpilimumabSpecified dose on specified days
Extreme RegimenCetuximab/ErbituxSpecified dose on specified days
Extreme RegimenCisplatin/PlatinolSpecified dose on specified days
Extreme RegimenFluorouracil/AdrucilSpecified dose on specified days
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS) in Participants With Programmed Death-Ligand 1 (PD-L1) With a Combined Positive Score (CPS) ≥20From randomization to date of death or date the participant was last known to be alive (Up to approximately 55 months)

Overall survival (OS) is defined as the time between randomization and death. For participants without documentation of death, OS will be censored on the last date the participant was known to be alive. Overall survival will be censored at the date of randomization for participants who were randomized but had no follow-up. Survival follow-up will be conducted every 3 months after participants off-treatment date. (Based on Kaplan-Meier estimates)

Overall Survival (OS) in All Randomized ParticipantsFrom randomization to date of death or date the participant was last known to be alive (Up to approximately 55 months)

Overall survival (OS) is defined as the time between randomization and death. For participants without documentation of death, OS will be censored on the last date the participant was known to be alive. Overall survival will be censored at the date of randomization for participants who were randomized but had no follow-up. Survival follow-up will be conducted every 3 months after participants off-treatment date. (Based on Kaplan-Meier estimates)

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS) in Randomized Participants With Programmed Death-Ligand 1 (PD-L1) With a Combined Positive Score (CPS) ≥ 1From randomization to date of death or date the participant was last known to be alive (Up to approximately 65 months)

Overall survival (OS) is defined as the time between randomization and death. For participants without documentation of death, OS will be censored on the last date the participant was known to be alive. Overall survival will be censored at the date of randomization for participants who were randomized but had no follow-up. Survival follow-up will be conducted every 3 months after participants off-treatment date. (Based on Kaplan-Meier estimates)

Progression Free Survival (PFS)From randomization to disease progression or death (Up to approximately 65 months)

PFS is defined as the time between the date of randomization and the date of first documented tumor progression, based on Blinded Independent Central Review (BICR) assessments (per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria), or death due to any cause, whichever occurs first. Participants who neither progress nor die will be censored on the date of their last tumor assessment. Participants who receive subsequent anti-cancer therapy prior to documented progression, will be censored on the date of their last tumor assessment prior to subsequent therapy. (Based on Kaplan-Meier Estimates)

Progression is defined as at least a 20% increase in the sum of diameters of target lesions, in addition the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).

Duration of Objective Response (DOR)From randomization to the first documented response (CR or PR) and progression (up to approximately 65 months)

The time between the first documented response (Complete response (CR) or partial response (PR)) and progression or death, per RECIST 1.1 by blinded independent central review (BICR) assessment. (Based on Kaplan-Meier Estimates)

Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.

Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Objective Response Rate (ORR)From randomization up to approximately 65 months

Objective Response Rate (ORR) is defined as the number of participants with a best overall response (BOR) of complete response (CR) or partial response (PR). Based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria by blinded independent central review (BICR) assessment.

Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.

Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Trial Locations

Locations (132)

Local Institution - 0111

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Atlanta, Georgia, United States

Local Institution - 0006

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Chicago, Illinois, United States

Local Institution - 0013

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Pittsburgh, Pennsylvania, United States

Local Institution - 0001

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Boston, Massachusetts, United States

Local Institution - 0093

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Boston, Massachusetts, United States

Local Institution - 0014

🇺🇸

Houston, Texas, United States

Local Institution - 0080

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Boston, Massachusetts, United States

Local Institution - 0009

🇺🇸

Houston, Texas, United States

Local Institution - 0142

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Blacktown, New South Wales, Australia

Local Institution - 0118

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Sao Paulo, Brazil

Local Institution - 0135

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Duarte, California, United States

Local Institution - 0010

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Langhorne, Pennsylvania, United States

Local Institution - 0028

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Jacksonville, Florida, United States

Local Institution - 0139

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Dallas, Texas, United States

Local Institution - 0015

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Philadelphia, Pennsylvania, United States

Local Institution - 0007

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Columbus, Ohio, United States

Local Institution - 0134

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Tucson, Arizona, United States

Local Institution - 0005

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Stanford, California, United States

Local Institution - 0003

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Charlottesville, Virginia, United States

Local Institution - 0125

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Morgantown, West Virginia, United States

Local Institution - 0021

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Elizabeth Vale, South Australia, Australia

Local Institution - 0044

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Cuneo, Italy

IRST Meldola

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Meldola (fc), Italy

Local Institution - 0068

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Bonn, Germany

Local Institution - 0079

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Heidelberg, Germany

Local Institution - 0108

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Sendai-shi, Miyagi, Japan

Local Institution - 0152

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Isehara, Kanagawa, Japan

Local Institution - 0066

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Wuerzburg, Germany

Local Institution

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Shimotsuke-shi, Tochigi, Japan

Local Institution - 0022

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Clayton, Victoria, Australia

Local Institution - 0018

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Athens, Greece

Local Institution - 0107

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Akashi-shi, Hyogo, Japan

Local Institution - 0042

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Milano, MI, Italy

Local Institution - 0092

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Hannover, Germany

Local Institution - 0102

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Kobe-shi, Hyogo, Japan

Local Institution - 0089

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Strasbourg, France

Local Institution - 0017

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Nea Kifissia, Greece

Local Institution - 0147

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Dublin 8, Dublin, Ireland

Local Institution - 0075

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Linz, Austria

Local Institution - 0133

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Amiens, Somme, France

Local Institution - 0138

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Lyon, France

Local Institution - 0060

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Jerusalem, Israel

Local Institution - 0140

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La Tronche, France

Local Institution - 0069

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Ulm, Germany

Local Institution - 0036

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Douglas, Queensland, Australia

Local Institution - 0074

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Leipzig, Germany

Local Institution - 0054

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Lyon, France

Local Institution - 0146

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Osakasayaha, Osaka, Japan

Local Institution - 0065

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Muenchen, Germany

Local Institution - 0062

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Haifa, Israel

Local Institution - 0106

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Nagoya, Aichi, Japan

Local Institution - 0063

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Petah-tikva, Israel

Local Institution - 0071

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Wien, Austria

Local Institution - 0131

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Melbourne, Victoria, Australia

Local Institution - 0124

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Sao Paulo, Brazil

Local Institution - 0067

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Hamburg, Germany

Local Institution - 0094

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Bordeaux, France

Local Institution - 0117

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Barretos, Sao Paulo, Brazil

Local Institution - 0051

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Thessaloniki, Greece

Local Institution - 0153

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Bunkyo-ku, Tokyo, Japan

Azienda Ospedaliera Universitaria Di Modena

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Modena, Italy

Aorn Dei Colli

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Napoli, Italy

Azienda Ospedaliera Di Perugia

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Perugia, Italy

Local Institution - 0099

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Takatsuki-shi, Osaka, Japan

Local Institution - 0114

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Sunto-gun, Shizuoka, Japan

Local Institution - 0105

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Sapporo-shi, Hokkaido, Japan

Local Institution - 0064

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Tel-Aviv, Israel

Local Institution - 0097

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Taichung, Taiwan

Local Institution - 0113

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Fukuoka-shi, Fukuoka, Japan

Local Institution - 0023

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Gdansk, Poland

Local Institution - 0026

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Krakow, Poland

Local Institution - 0095

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Seoul, Korea, Republic of

Local Institution - 0149

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Kitaadachi-gun, Saitama, Japan

Fondazione Policlinico Universitario A. Gemelli

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Roma, Italy

Local Institution - 0049

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Newcastle Upon Tyne, Durham, United Kingdom

Local Institution - 0073

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Zuerich, Switzerland

Local Institution - 0091

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Sutton, Surrey, United Kingdom

Local Institution - 0025

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Warszawa, Poland

Local Institution - 0082

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Madrid, Spain

Local Institution - 0098

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Taipei, Taiwan

Local Institution - 0035

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Oaxaca, Mexico

Local Institution - 0037

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Bydgoszcz, Poland

Local Institution - 0129

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Gliwice, Poland

Local Institution - 0130

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L'Hospitalet Del Llobregat, Spain

Local Institution - 0109

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Kita-gun, Japan

Local Institution - 0081

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Valencia, Spain

Local Institution - 0083

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Barcelona, Spain

Local Institution - 0085

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Madrid, Spain

Local Institution - 0046

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Manchester, Greater Manchester, United Kingdom

Local Institution - 0020

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Nedlands, Western Australia, Australia

Local Institution - 0148

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Belo Horizonte, Minas Gerais, Brazil

Local Institution - 0032

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Leon de los Aldama, Guanajuato, Mexico

Local Institution - 0121

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Ijui, RIO Grande DO SUL, Brazil

Local Institution - 0120

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Porto Alegre, RIO Grande DO SUL, Brazil

Local Institution - 0122

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Porto Alegre, RIO Grande DO SUL, Brazil

Local Institution - 0031

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Morelia, Michoacan, Mexico

Local Institution - 0072

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Basel, Switzerland

Local Institution - 0047

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Southampton, Hampshire, United Kingdom

Local Institution - 0090

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Lille, France

Local Institution - 0040

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Villejuif Cedex, France

Local Institution - 0132

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Sheffield, United Kingdom

Local Institution - 0011

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Fairfax, Virginia, United States

Local Institution - 0127

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Darlinghurst, New South Wales, Australia

Local Institution - 0077

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Brisbane, Queensland, Australia

Local Institution - 0019

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St. Leonards, New South Wales, Australia

Local Institution - 0088

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Paris, France

Local Institution - 0123

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Sao Jose De Rio Preto, Sao Paulo, Brazil

Local Institution - 0126

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Marseille, France

Local Institution - 0055

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Nice Cedex 2, France

Local Institution - 0039

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Paris, France

Local Institution - 0078

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Freiburg, Germany

Local Institution - 0070

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Mainz, Germany

Local Institution - 0061

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Ramat-gan, Israel

Local Institution - 0043

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Torino, TO, Italy

Istituto Nazionale Tumori Fondazione Pascale

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Napoli, Italy

Local Institution - 0100

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Kashiwa, Chiba, Japan

Local Institution - 0150

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Yokohama-shi, Kanagawa, Japan

Local Institution - 0151

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Natori-shi, Miyagi, Japan

Local Institution - 0110

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Seoul, Korea, Republic of

Local Institution - 0104

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Koto-ku, Tokyo, Japan

Local Institution - 0034

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Mexico City, Distrito Federal, Mexico

Local Institution - 0033

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Monterrey, Nuevo LEON, Mexico

Local Institution - 0096

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Gangnam-gu, Korea, Republic of

Local Institution - 0101

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Chuo-ku, Tokyo, Japan

Local Institution - 0030

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Mexico, Distrito Federal, Mexico

Local Institution - 0084

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Sevilla, Spain

Local Institution - 0045

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London, Greater London, United Kingdom

Local Institution - 0050

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Birmingham, West Midlands, United Kingdom

Local Institution - 0012

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Charlotte, North Carolina, United States

Local Institution - 0128

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Gosford, New South Wales, Australia

Local Institution - 0008

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Tampa, Florida, United States

Local Institution - 0004

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Ann Arbor, Michigan, United States

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