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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT04590963
Other study ID # D7310C00001
Secondary ID 2019-004770-25
Status Active, not recruiting
Phase Phase 3
First received
Last updated
Start date October 2, 2020
Est. completion date June 28, 2024

Study information

Verified date February 2024
Source AstraZeneca
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a randomized, double-blind, multicenter, global Phase 3 study to assess the efficacy and safety of monalizumab and cetuximab, compared to placebo and cetuximab, in Participants with recurrent or metastatic head and neck cancer.


Description:

Participants with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) who had prior immune checkpoint inhibitor and platinum-based chemotherapy treatment will be randomized in a 2:1 ratio to monalizumab and cetuximab or placebo and cetuximab. Efficacy and safety assessments will be performed periodically from the time of enrollment and throughout the study. Participants in all arms will continue therapy until progression, unacceptable toxicity, withdrawal of consent, or another discontinuation criterion is met. All Participants will be followed for survival after progression is confirmed.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 370
Est. completion date June 28, 2024
Est. primary completion date May 11, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years to 130 Years
Eligibility Inclusion Criteria: - Are aged 18 years and over - Recurrent or metastatic squamous cell carcinoma of the SCCHN, oral cavity, oropharynx, hypopharynx, or larynx which has progressed on or after previous systemic cancer therapy and is not amenable to curative therapy - Received prior treatment using a programmed cell death ligand-1 (PD-L1) inhibitor - Prior platinum failure - Received 1 or 2 prior systemic regimens for recurrent or metastatic SCCHN - Has measurable disease per RECIST 1.1 - A fresh or recently acquired tumor tissue for the purpose of biomarker testing - World Health Organization (WHO)/ Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 Exclusion Criteria: - Head and neck cancer of any primary anatomic location in the head and neck not specified in the inclusion criteria, including participants with SCCHN of unknown primary or non-squamous histologies - Had prior cetuximab therapy (unless it was administered in curative locally advanced setting with radiotherapy and no disease progression for at least 6 months following the last cetuximab dose) - Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [eg, colitis or Crohn's disease], diverticulitis - Any concurrent anticancer treatment, except for hormonal therapy for non-cancer-related conditions (eg, hormone replacement therapy)

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Monalizumab
Participants will receive IV infusion of monalizumab as stated in arm description.
Cetuximab
Participants will receive IV infusion of cetuximab as stated in arm description.
Other:
Placebo
Participants will receive IV infusion of placebo as stated in arm description.

Locations

Country Name City State
Argentina Research Site Caba
Argentina Research Site Caba
Argentina Research Site Caba
Australia Research Site Camperdown
Australia Research Site Elizabeth Vale
Australia Research Site Heidelberg
Australia Research Site Melbourne
Austria Research Site Linz
Belgium Research Site Bruxelles
Belgium Research Site Leuven
Belgium Research Site Namur
Belgium Research Site Roeselare
Brazil Research Site Belo Horizonte
Brazil Research Site Porto Alegre
Brazil Research Site Rio de Janeiro
Brazil Research Site Sao Paulo
Brazil Research Site Sao Paulo
Brazil Research Site Sao Paulo
Brazil Research Site Sao Paulo
Bulgaria Research Site Panagyurishte
Bulgaria Research Site Plovdiv
Bulgaria Research Site Sofia
Canada Research Site Hamilton Ontario
Canada Research Site Montreal Quebec
Canada Research Site Toronto Ontario
Canada Research Site Toronto Ontario
Canada Research Site Victoria British Columbia
France Research Site Avignon
France Research Site Bordeaux
France Research Site Clermont Ferrand cedex 01
France Research Site Dijon
France Research Site Lyon Cedex 08
France Research Site Marseille
France Research Site Montpellier Cedex 05
France Research Site Strasbourg
Germany Research Site Berlin
Germany Research Site Essen
Germany Research Site Freiburg
Germany Research Site Hannover
Germany Research Site Leipzig
Germany Research Site Ulm
Germany Research Site Würzburg
Greece Research Site Athens
Greece Research Site Chaidari
Greece Research Site Thessaloniki
Italy Research Site Brescia
Italy Research Site Candiolo
Italy Research Site Firenze
Italy Research Site Milano
Italy Research Site Milano
Italy Research Site Modena
Italy Research Site Napoli
Italy Research Site Padova
Japan Research Site Chuo-ku
Japan Research Site Fukuoka-shi
Japan Research Site Hiroshima-shi
Japan Research Site Isehara-shi
Japan Research Site Kashiwa
Japan Research Site Kobe-shi
Japan Research Site Koto-ku
Japan Research Site Okayama
Japan Research Site Osakasayama
Japan Research Site Sunto-gun
Japan Research Site Yokohama-shi
Japan Research Site Yokohama-shi
Korea, Republic of Research Site Busan
Korea, Republic of Research Site Cheongju-si
Korea, Republic of Research Site Goyang-si
Korea, Republic of Research Site Seongnam-si
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Netherlands Research Site Amsterdam
Netherlands Research Site Maastricht
Netherlands Research Site Nijmegen
Philippines Research Site Manila
Philippines Research Site Pasig City
Philippines Research Site Quezon City
Poland Research Site Bialystok
Poland Research Site Bydgoszcz
Poland Research Site Poznan
Portugal Research Site Coimbra
Portugal Research Site Porto
Portugal Research Site Porto
Portugal Research Site Vila Nova de Gaia
Russian Federation Research Site Moscow
Russian Federation Research Site Moscow region
Russian Federation Research Site Obninsk
Russian Federation Research Site Saint Petersburg
Russian Federation Research Site Saint-Petersburg
Russian Federation Research Site Saint-Petersburg
Russian Federation Research Site St.Petersburg
Spain Research Site Barcelona
Spain Research Site Madrid
Spain Research Site Madrid
Spain Research Site Madrid
Spain Research Site Valencia
Switzerland Research Site Basel
Switzerland Research Site Bern
Switzerland Research Site Lausanne
Taiwan Research Site Changhua
Taiwan Research Site Taichung
Taiwan Research Site Taichung
Taiwan Research Site Tainan City
Taiwan Research Site Taipei
Taiwan Research Site Taipei
United Kingdom Research Site London
United Kingdom Research Site Manchester
United Kingdom Research Site Newcastle upon Tyne
United Kingdom Research Site Sutton
United States Research Site Ann Arbor Michigan
United States Research Site Boston Massachusetts
United States Research Site Charlotte North Carolina
United States Research Site Chicago Illinois
United States Research Site Columbus Ohio
United States Research Site Dallas Texas
United States Research Site Houston Texas
United States Research Site Las Vegas Nevada
United States Research Site New York New York
United States Research Site Philadelphia Pennsylvania
United States Research Site Philadelphia Pennsylvania
United States Research Site Pittsburgh Pennsylvania
United States Research Site Rochester Minnesota
United States Research Site Saint Louis Missouri
United States Research Site Tucson Arizona
United States Research Site Westwood Kansas
United States Research Site Winston-Salem North Carolina

Sponsors (2)

Lead Sponsor Collaborator
AstraZeneca Innate Pharma

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Austria,  Belgium,  Brazil,  Bulgaria,  Canada,  France,  Germany,  Greece,  Italy,  Japan,  Korea, Republic of,  Netherlands,  Philippines,  Poland,  Portugal,  Russian Federation,  Spain,  Switzerland,  Taiwan,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Overall Survival (OS) in Human Papillomavirus (HPV)-Unrelated Analysis Set The OS is defined as time from the date of randomization until death due to any cause regardless of whether the participant withdraws from randomized therapy or receives another anti-cancer therapy (i.e. date of death or censoring - date of randomization + 1). The OS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from a stratified log-rank test and hazard ratio (HR) and confidence intervals (CIs) from a stratified Cox proportional hazards model. Analyses were stratified on World Health Organization/ Eastern Cooperative Oncology Group performance status (WHO/ECOG PS) (0 or 1) and number of prior lines of therapy in recurrent or metastatic (R/M) setting (1 or 2). Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Overall Survival in Full Analysis Set (FAS) The OS is defined as time from the date of randomization until death due to any cause regardless of whether the participant withdraws from randomized therapy or receives another anti-cancer therapy (i.e. date of death or censoring - date of randomization + 1). The OS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from a stratified log-rank test and HR and CIs from a stratified Cox proportional hazards model. Analyses were stratified on HPV status (OPC HPV positive or HPV-unrelated), WHO/ECOG PS (0 or 1) and number of prior lines of therapy in R/M setting (1 or 2). Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Progression-Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by Investigator Assessment in HPV-unrelated Analysis Set PFS per RECIST 1.1 as assessed by the investigator is defined as time from randomization until date of RECIST 1.1-defined radiological progressive disease (PD) or death regardless of whether participant withdraws from therapy or received subsequent anticancer therapy prior to progression. PD: at least 20% increase in sum of diameters of target lesions (TLs), taking as reference the smallest sum on study (nadir) and sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing non-TLs (NTLs) or appearance of new lesions. PFS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from stratified log-rank test and HR and CIs from a stratified Cox proportional hazards model. Analyses were stratified on WHO/ECOG PS (0/1) and no. of prior lines of therapy in R/M setting. Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Progression-Free Survival Per RECIST 1.1 by Investigator Assessment in FAS PFS per RECIST 1.1 as assessed by the investigator is defined as time from randomization until date of RECIST 1.1-defined radiological progressive disease (PD) or death regardless of whether participant withdraws from therapy or received subsequent anticancer therapy prior to progression. PD: at least 20% increase in sum of diameters of target lesions (TLs), taking as reference the smallest sum on study (nadir) and sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing NTLs or appearance of new lesions. PFS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from a stratified log-rank test and HR and CIs from a stratified Cox proportional hazards model. Analyses were stratified on HPV status, WHO/ECOG PS (0/1) and no. of prior lines of therapy in R/M setting. Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Percentage of Participants With Objective Response (OR) Per RECIST 1.1 in HPV-unrelated Analysis Set The OR is defined as the percentage of participants with at least one confirmed investigator-assessed response of complete response (CR) or partial response (PR) as assessed by RECIST 1.1 guidelines. The CR is defined as disappearance of all TLs and NTLs, any pathological lymph nodes (target and non-target) must have reduction in short axis < 10 mm, and no new lesions. The PR is defined as at least a 30% decrease in the sum of the diameters (SoD) of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. Percentage of participants with OR is reported. Participants who had measurable disease at baseline per the site investigator were analyzed for this outcome. Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Percentage of Participants With OR Per RECIST 1.1 in FAS The OR is defined as the percentage of participants with at least one confirmed investigator-assessed response of CR or PR as assessed by RECIST 1.1 guidelines. The CR is defined as disappearance of all TLs and NTLs, any pathological lymph nodes (target and non-target) must have reduction in short axis < 10 mm, and no new lesions. The PR is defined as at least a 30% decrease in the SoD of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. Percentage of participants with OR is reported. Participants who had measurable disease at baseline per the site investigator were analyzed for this outcome. Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Duration of Response (DoR) Per RECIST 1.1 in HPV-unrelated Analysis Set The DoR is defined as the time from the date of first documented confirmed response until date of documented progression or death in the absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1). The CR is defined as disappearance of all target and non-target lesions, no new lesions, and normalization of tumor marker level. The PR is defined as at least a 30% decrease in the SoDs of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. The PD is defined as at least a 20% increase in the SoDs of TLs, taking as reference the smallest previous SoDs (nadir) and the sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing NTLs or appearance of new lesions. The DoR was analyzed using Kaplan-Meier technique. Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Duration of Response Per RECIST 1.1 in FAS The DoR is defined as the time from the date of first documented confirmed response until date of documented progression or death in the absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1). The CR is defined as disappearance of all target and non-target lesions, no new lesions, and normalization of tumor marker level. The PR is defined as at least a 30% decrease in the SoDs of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. The PD is defined as at least a 20% increase in the SoDs of TLs, taking as reference the smallest previous SoDs (nadir) and the sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing NTLs or appearance of new lesions. The DoR was analyzed using Kaplan-Meier technique. Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary Number of Participants With Treatment-emergent Adverse Events (TEAEs) An adverse event (AE) is any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first. Day 1 through 21.4 months (maximum observed duration)
Secondary Number of Participants With Abnormal Clinical Laboratory Parameters Reported as TEAEs Participants with abnormal laboratory parameters reported as TEAEs are reported. Laboratory analysis included hematology and clinical chemistry. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first. Day 1 through 21.4 months (maximum observed duration)
Secondary Number of Participants With Abnormal Vital Signs Reported as TEAEs Participants with abnormal vital signs (heart rate, blood pressure, temperature, and respiratory rate) reported as TEAEs are reported. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first. Day 1 through 21.4 months (maximum observed duration)
Secondary Number of Participants With Electrocardiograms (ECGs) Reported as TEAEs Participants with Abnormal ECGs reported as TEAEs are reported. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first. Day 1 through 21.4 months (maximum observed duration)
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