| Eligibility |
Inclusion Criteria:
- Capable of giving signed informed consent which includes compliance with the
requirements and restrictions listed in the informed consent and in this protocol
- Age = 18 years old
- Newly diagnosed HPV-related oropharynx squamous cell carcinoma, either confirmed or
suspected. Patients with a primary oropharynx cancer consistent with squamous cell
carcinoma based on clinical presentation and radiological features AND that are
interested in participating in this study can have histological confirmation at the
same time as the research biopsy. Patient can only participate in the study if
squamous cell carcinoma histology AND HPV is confirmed.
- Disease stage I per the TNM AJCC 8th Edition
- Patients must be amenable to TORS in the opinion of the treating head and neck surgeon
- Patients must be willing to undergo baseline biopsy to obtain tumor material
- Disease must be measurable by RECIST 1.1
- Performance status ECOG 0 or 1
- Baseline pulse oximetry > 92%
- Patients must have adequate normal organ and marrow function. Abnormal organ and
marrow function is defined as:
neutrophils <1500/mm3, platelet count <100,000/mm3, hemoglobin <9 g/dL, total bilirubin
>1.5 upper limit of normal (ULN) (except known Gilbert's syndrome), aspartate
aminotransferase (AST) and alanine aminotransferase (ALT) >2.5 of upper limit of normality
(ULN) Glomerular Filtration Rate (GFR) <40 mL/min/1.73 m2 (GFR will be calculated using the
CKD-EPI equation per institutional standard)
- Female patients with reproductive potential must practice two effective contraceptive
measures for the duration of study drug therapy and for at least 120 days after completion
of study therapy. The two birth control methods can be either two barrier methods or a
barrier method plus a hormonal method to prevent pregnancy. The following are considered
adequate barrier methods of contraception: diaphragm, condom, copper intrauterine device,
sponge,
or spermicide. Appropriate hormonal contraceptives will include any registered and marketed
contraceptive agent that contains an estrogen and/or a progestational agent (including
oral, subcutaneous, intrauterine, or intramuscular agents).
- Male participants with female partners of childbearing potential are eligible to
participate if they agree to either be abstinent from penile-vaginal intercourse or
use a male condom plus partner use of a hormonal contraceptive method during the
treatment period and for at least 120 days after the last dose of study treatment. Men
with a pregnant or breastfeeding partner must agree to remain abstinent from
penile-vaginal intercourse or use a male condom during each episode of penile
penetration.
- Patient weight must be at least 50 Kg
Exclusion Criteria:
- History of previous malignancy other than malignancy treated with curative intent and
with no evidence of active disease =3 years before the first dose of the study drugs
and of low potential risk for recurrence. Patients with the following diagnoses
represents an exception and may enroll:
1. Non-melanoma skin cancers with no current evidence of disease
2. Melanoma in situ with no current evidence of disease
3. Localized cancer of the prostate with prostate-specific antigen of <1 ng/mL
4. Treated or localized well-differentiated thyroid cancer
5. Treated cervical carcinoma in situ
6. Treated ductal/lobular carcinoma in situ of the breast
- International Normalized Ratio (INR) or Prothrombin Time (PT) or Activated Partial
Thromboplastin Time (aPTT) >1.5 × ULN unless the participant is receiving
anticoagulant therapy as long as PT or aPTT is within therapeutic range of intended
use of anticoagulants.
- Participants under anti-hypertensive treatment who cannot temporarily (for at least 36
hours) withhold antihypertensive medications prior to each IMP dosing.
- Evidence of uncontrolled, active infection, requiring systemic anti-bacterial,
anti-viral or anti-fungal therapy =14 days prior to administration of investigational
product. Patients with known hepatitis B, hepatitis C (HCV), or HIV infection could go
on study provided the viral load is undetectable at Screening.
- Unstable or severe uncontrolled medical condition (e.g., unstable cardiac or pulmonary
function or uncontrolled diabetes) or any important medical illness or abnormal
laboratory finding that would, in the investigator's judgment, increase the risk to
the patient associated with his or her participation in the study.
- Female subjects who are pregnant or breast-feeding
- Known hypersensitivity (= Grade 3) to or contraindication for the use of any study
intervention or components thereof, including premedication to be administered in this
study, as well as PEG or any pegylated drug and E. coli-derived protein".
- Patient with active, known, or suspected autoimmune disease that has required systemic
therapy. Exceptions: patients with vitiligo, type I diabetes mellitus, and
endocrinopathies.
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