The goal of this trial is to test the ability of MK-3475 (pembrolizumab) to improve locoregional recurrence and distant metastatic rates in high-risk patients with locally advanced head and neck squamous cell carcinomas (HNSCCs) that are treated with current standard of care surgical approaches.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
67
Standard of care
Recommended, standard of care
Recommended, standard of care
Standard of care
-Baseline, time of surgery (between day 14-24 inclusive), 3 months post surgery, 6 months post surgery, 9 months post surgery, 12 months post surgery
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Washington University School of Medicine
St Louis, Missouri, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Locoregional Recurrence Rates in Cohorts 1 and 2
-The percentage of participants who developed local-regional recurrence within one year of surgery
Time frame: Within 1 year of surgery (surgery occurred within 13-22 days after neoadjuvant MK-3475 dose)
Distant Failure Rate in Cohorts 1 and 2
-The percentage of participants who developed distant failure within one year of surgery. Distant disease is cancer that is found in another part of the body that is far away from where the original (primary) tumor first formed.
Time frame: Within 1 year of surgery (surgery occurred within 13-22 days after neoadjuvant MK-3475 dose)
Rate of Major Pathologic Treatment Effect in Cohort 1
* Major pathologic treatment effect=pathologic tumor response (pTR). * pTR was defined as the presence of tumor cell necrosis and keratinous debris with giant cell/histiocytic reaction, quantified as a percentage of the overall tumor bed (area pathologic response/area pathologic response plus viable tumor): pTR-0 (\>10%), pTR-1 (10-49%), and pTR-2 (≥50%).
Time frame: At the time of surgery (surgery occurred within 13-22 days after neoadjuvant MK-3475 dose)
Rate of Major Pathologic Treatment Effect in Cohort 2
* Major pathologic treatment effect=pathologic tumor response (pTR). * pTR was defined as the presence of tumor cell necrosis and keratinous debris with giant cell/histiocytic reaction, quantified as a percentage of the overall tumor bed (area pathologic response/area pathologic response plus viable tumor): pTR-0 (\>10%), pTR-1 (10-49%), and pTR-2 (≥50%).
Time frame: At the time of surgery (surgery occurred within 13-22 days after last neoadjuvant MK-3475 dose)
Number of Participants in Cohort 1 and 2 Who Experienced Reportable Adverse Events
Reportable adverse events will be tracked for 30 days following the last day of study treatment. For the purposes of this protocol, reportable adverse events are events thought to be possibly, probably, or definitely related to MK-3475. Events thought to be probably or definitely related to surgery, adjuvant chemotherapy, or radiotherapy need not be recorded.
Time frame: Through 30 days after last dose of MK-3475
Number of Surgical Complications and/or Delays in Cohorts 1 and 2
Time frame: At the time of surgery (approximately 2-3 weeks after registration)
Number of Participants With Locoregional Recurrence Rates in Cohorts 1 and 2
Time frame: Through completion of follow-up (median total time 58.7 months (IQR 23.2-61.4))
Number of Participants With Distant Metastases (DM) in Cohorts 1 and 2
Time frame: Through completion of follow-up (median total time 58.7 months (IQR 23.2-61.4))
Kaplan-Meier Estimate of Median 5-year Event-free Survival (EFS) in Cohorts 1 and 2
Event-free survival will be defined as time from surgery to time to disease recurrence, distant metastasis, new primary, or death due to any cause, whichever occurred first.
Time frame: Through completion of follow-up (median total time 58.8 months (IQR 25.1-61.4))
Kaplan-Meier Estimate of Median 5-year Event-free Survival (EFS) Differences by Presence Versus Absence and by Predicted Impact of Recurrent Genomic Alterations, Specifically in TP53, in Cohort 1
Event-free survival will be defined as time from surgery to time to disease recurrence, distant metastasis, new primary, or death due to any cause, whichever occurred first.
Time frame: Through completion of follow-up (median total time 60.9 months (IQR: 21.2-63.9))
Kaplan-Meier Estimate of Median 5-year Overall Survival (OS) Differences by Presence Versus Absence and by Predicted Impact of Recurrent Genomic Alterations, Specifically in TP53, in Cohort 1
Overall survival will be defined as time from surgery to death from any cause.
Time frame: Through completion of follow-up (median total time 60.9 months (IQR: 25.1 - 63.9 months))
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