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A Phase 3 Study to Evaluate Petosemtamab Plus Pembrolizumab vs Pembrolizumab in First-line Treatment of Head and Neck Cancer (LiGeR - HN1)

Phase 3
Recruiting
Conditions
Head and Neck Squamous Cell Carcinoma
Interventions
Registration Number
NCT06525220
Lead Sponsor
Merus N.V.
Brief Summary

This is a Phase 3 randomized, open-label study to evaluate the efficacy and safety of petosemtamab plus pembrolizumab vs pembrolizumab in first-line treatment of recurrent or metastatic PD-L1+ head and neck squamous cell carcinoma.

Detailed Description

This is a Phase 3 randomized, open-label study to evaluate the efficacy and safety of petosemtamab plus pembrolizumab vs pembrolizumab in first-line treatment of recurrent or metastatic PD-L1+ HNSCC. HNSCC patients should not have had previous systemic therapy administered in the incurable recurrent or metastatic setting, although previous systemic therapy as part of multimodal treatment for locally advanced disease is allowed if PD was ≥6 months after the last platinum-containing therapy dose. Previous treatments with anti PD-(L)1 or anti-EGFR therapies are not allowed. In the case of cetuximab, patients who have received cetuximab with radiotherapy as a local treatment and PD was \>1 year after the last dose of cetuximab are eligible.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
500
Inclusion Criteria
  1. Signed ICF before initiation of any study procedures
  2. Age ≥ 18 years at signing of ICF
  3. Histologically confirmed HNSCC with evidence of metastatic or locally recurrent disease not amenable to local therapy with curative intent.
  4. The eligible HNSCC primary tumor locations are oropharynx, oral cavity, hypopharynx, and larynx.
  5. HNSCC patients eligible to receive pembrolizumab as 1L monotherapy with tumors expressing PD-L1, CPS ≥1.
  6. HNSCC patients should not have had previous systemic therapy administered in the incurable recurrent or metastatic setting
  7. A new tumor biopsy, unless the patient has an available archival tumor sample with sufficient material
  8. Measurable disease per Investigator assessment as defined by RECIST v1.1 by radiologic methods
  9. ECOG Performance Status (PS) of 0-1
  10. Life expectancy ≥ 12 weeks, as per investigator assessment.
  11. Left ventricular ejection fraction (LVEF) ≥50% or ≥ institutional normal limit, whichever is higher, by echocardiogram (ECHO) or multigated acquisition (MUGA) scan
  12. Adequate organ function as defined per protocol.
  13. HIV-positive patients are eligible only if the cluster of differentiation 4 (CD4+) count is ≥ 300/µl, viral load is undetectable, and the patient is currently receiving highly active antiretroviral therapy
Exclusion Criteria
  1. Central nervous system metastases that are untreated or already treated but symptomatic, or require radiation, surgery, or continued steroid therapy to control symptoms within 21 days prior to randomization
  2. Known leptomeningeal involvement
  3. Any systemic anticancer therapy or investigational drug within 4 weeks or 5 half-lives, whichever is shorter, before randomization
  4. Requirement for immunosuppressive medication
  5. Major surgery or radiotherapy within 3 weeks of randomization
  6. Clinically significant toxicities related to prior anticancer therapies that have not returned to ≤ Grade 1 or baseline except for Grade ≤2- myalgia, neuropathy, alopecia, and any prior therapy related endocrinopathies
  7. History of hypersensitivity reaction to any of the excipients of petosemtomab or pembrolizumab.
  8. Unstable angina; history of congestive heart failure of Class II-IV New York Heart Association (NYHA) criteria, or serious cardiac arrhythmia requiring treatment; or history of myocardial infarction within 6 months prior to randomization
  9. History of prior malignancies within the last 5 years, with the exception of excised local cancer
  10. Current dyspnea at rest of any origin, or other diseases requiring continuous oxygen therapy
  11. Current serious illness or medical conditions including, but not limited to, uncontrolled active infection, clinically significant pulmonary, metabolic or psychiatric disorders
  12. Patients with known infectious diseases as per protocol.
  13. Pregnant or breastfeeding patients.
  14. The patient has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy of prednisone >10 mg/day or equivalent, or any other form of immunosuppressive therapy
  15. The patient has an active autoimmune disease that has required systemic immune suppressive treatment in the past 2 years; replacement therapy is not considered immune suppressive treatment
  16. The patient has had an allogeneic tissue/solid organ transplant.
  17. Patient has a primary tumor site of nasopharynx, or sinonasal carcinoma (any histology)

Other protocol defined inclusion/exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Petosemtamab + PembrolizumabPembrolizumabCombination Therapy
PembrolizumabPembrolizumabMonotherapy
Petosemtamab + PembrolizumabPetosemtamabCombination Therapy
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS)Up to approximately 3 years
Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as assessed by blinded independent central review (BICR)Up to approximately 2 years
Secondary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS) per RECIST v1.1 as assessed by BICRUp to approximately 2 years
Duration of Response (DOR) per RECIST v1.1 as assessed by BICRUp to approximately 2 years
Objective response rate per RECIST v1.1 as assessed by investigator reviewUp to approximately 2 years
Progression-free survival per RECIST v1.1 as assessed by investigator reviewUp to approximately 2 years
Duration of response per RECIST v1.1 as assessed by investigator reviewUp to approximately 2 years
Clinical benefit rate per RECIST v1.1 as assessed by BICRUp to approximately 2 years
Clinical benefit rate per RECIST v1.1 as assessed by investigator reviewUp to approximately 2 years
Number of participants who experienced at least one treatment emergent adverse event (TEAE)Up to 30 days post last dose
Number of participants who experienced at least one serious TEAEUp to 30 days post last dose
Number of participants who discontinued study treatment due to TEAEsUp to 30 days post last dose
Number of participants who had dose modification due to TEAEsUp to 30 days post last dose
To evaluate patient reported outcomes for health-related quality of lifeUp to approximately 2 years
Pharmacokinetic parametersUp to first 6 cycles
Incidence of anti-drug antibodies (ADAs)Up to 30 days post last dose

Trial Locations

Locations (121)

Site 80

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Barcelona, Spain

Site 75

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Madrid, Spain

Site 67

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Madrid, Spain

Site 73

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Marbella, Spain

Site 61

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Pamplona, Spain

Site 62

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Pamplona, Spain

Site 74

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Valencia, Spain

Site 41

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Changhua, Taiwan

Site 4

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Kaohsiung, Taiwan

Site 103

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Kaohsiung, Taiwan

Site 114

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Bangkok Noi, Bangkok, Thailand

Site 36

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La Jolla, California, United States

Site 27

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Los Angeles, California, United States

Site 16

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Palo Alto, California, United States

Site 19

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Newark, Delaware, United States

Site 108

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Washington, District of Columbia, United States

Site 14

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Fort Myers, Florida, United States

Site 48

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Orlando, Florida, United States

Site 8

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Orlando, Florida, United States

Site 76

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Rosario, Argentina

Site 46

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Viedma, Argentina

Site 11

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Blacktown, New South Wales, Australia

Site 24

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St Leonards, New South Wales, Australia

Site 53

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Brussels, Belgium

Site 98

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Edegem, Belgium

Site 99

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Gent, Belgium

Site 63

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Namur, Belgium

Site 26

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Providencia, Chile

Site 71

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Leuven, Belgium

Site 109

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Liège, Belgium

Site 100

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Dresden, Germany

Site 64

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Vandœuvre-lès-Nancy, France

Site 112

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Villejuif, France

Site 60

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Greifswald, Germany

Site 68

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Utrecht, Netherlands

Site 106

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Gliwice, Poland

Site 116

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Kraków, Poland

Site 120

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Badalona, Spain

Site 13

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Goyang-si, Korea, Republic of

Site 51

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Hwasun, Korea, Republic of

Site 28

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Seoul, Korea, Republic of

Site 42

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Suwon-si, Korea, Republic of

Site 84

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Amsterdam, Netherlands

Site 58

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Nijmegen, Netherlands

Site 77

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Hat Yai, Songkhla, Thailand

Site 52

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Taichung, Taiwan

Site 33

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Taipei City, Taiwan

Site 39

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Taipei City, Taiwan

Site 49

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Taoyuan City, Taiwan

Site 65

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Ratchathewi, Bangkok, Thailand

Site 83

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Northwood, United Kingdom

Site 107

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Pathum Wan, Bangkok, Thailand

Site 102

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Cambridge, United Kingdom

Site 90

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London, United Kingdom

Site 69

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London, United Kingdom

Site 70

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Sutton, United Kingdom

Site 21

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Saint Petersburg, Florida, United States

Site 20

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West Palm Beach, Florida, United States

Site 50

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Chicago, Illinois, United States

Site 2

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Louisville, Kentucky, United States

Site 94

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Hackensack, New Jersey, United States

Site 6

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Albuquerque, New Mexico, United States

Site 113

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Durham, North Carolina, United States

Site 118

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Winston-Salem, North Carolina, United States

Site 43

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Philadelphia, Pennsylvania, United States

Site 89

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Chattanooga, Tennessee, United States

Site 115

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Memphis, Tennessee, United States

Site 88

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Nashville, Tennessee, United States

Site 22

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Austin, Texas, United States

Site 1

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Houston, Texas, United States

Site 18

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Plano, Texas, United States

Site 17

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Sugarland, Texas, United States

Site 15

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Tyler, Texas, United States

Site 10

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Salt Lake City, Utah, United States

Site 12

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Blacksburg, Virginia, United States

Site 23

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Norfolk, Virginia, United States

Site 96

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Caba, Argentina

Site 37

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Caba, Argentina

Site 31

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Córdoba, Argentina

Site 30

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La Rioja, Argentina

Site 44

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Toronto, Canada

Site 111

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Winnipeg, Canada

Site 38

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Antofagasta, Chile

Site 82

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Hamburg, Germany

Site 91

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Hamburg, Germany

Site 54

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Rouen, France

Site 59

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Toulouse, France

Site 25

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Temuco, Chile

Site 29

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Recoleta, Chile

Site 40

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Santiago, Chile

Site 32

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Santiago, Chile

Site 101

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Le Mans, France

Site 34

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Santiago, Chile

Site 56

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Bordeaux, France

Site 79

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Lille, France

Site 72

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Lyon, France

Site 57

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Marseille, France

Site 55

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Montpellier, France

Site 66

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Nice, France

Site 105

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Paris, France

Site 87

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Poitiers, France

Site 104

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Hannover, Germany

Site 121

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Münster, Germany

Site 78

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Tübingen, Germany

Site 110

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Würzburg, Germany

Site 119

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Patras, Achaia, Greece

Site 117

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Heraklion, Crete, Greece

Site 97

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Brescia, Italy

Site 35

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Seoul, Korea, Republic of

Site 95

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Chaïdári, Greece

Site 92

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Panórama, Greece

Site 9

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Haifa, Israel

Site 5

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Jerusalem, Israel

Site 3

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Ramat Gan, Israel

Site 7

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Tel Aviv, Israel

Site 86

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Ancona, Italy

Site 81

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Milan, Italy

Site 93

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Naples, Italy

Site 85

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Rozzano, Italy

Site 47

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Gyeonggi-do, Korea, Republic of

Site 45

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Seoul, Korea, Republic of

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