Phase II trial evaluating to assess the feasibility and efficacy as first-line therapy for patients with non-resectable locally advanced HPV negative HNSCC of Durvalumab a PDL1-Inhibitor plus Tremelimumab a CTLA-4- Inhibitor in combination with radiotherapy and Durvalumab in combination with radiotherapy as first-line therapy. 2-arm, randomized, multicenter, phase II. Step 1 is Registration. All patients need to sign the informed consent form for registration. Tumor tissue then be send to the central lab for defining the HPV status. If the patient is HPV negative the site will be notified if they can further proceed to patient randomization. Step 2 is Randomization of all eligible patients with a centrally diagnosed, HPV negative tumor in one of the two arms (Durvalumab plus Tremelimumab + radiotherapy; Durvalumab + radiotherapy) after signing the informed consent form for step 2.
The primary objective is to explore the feasibility and efficacy in terms of treatment discontinuation due to toxicity and in terms of 1-year progression free survival of a PDL1-Inhibitor plus a CTLA-4 Inhibitor in combination with radiotherapy and a PDL1-Inhibitor in combination with radiotherapy as first-line therapy for patients with non-resectable locally advanced HNSCC in the poor prognostic subgroup. Secondary objectives are to investigate the benefit of the addition of a CTLA-4 Inhibitor and/or a PDL1-Inhibitor to radiotherapy in terms of overall progression free survival, overall survival and to investigate the approach in terms of safety, chronic toxicity and quality of life.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Durvalumab (1500 mg) starting on week 1 to complete a total of 12 months
Tremelimumab (75 mg) for up to 4 doses/cycles
Radiotherapy with 35 fractions (administered as daily fractions of 2 Gy given 5 days every week for 7 weeks)
Universitätsklinikum Essen
Essen, North Rhine-Westphalia, Germany
Vivantes Klinikum Neukölln
Berlin, Germany
Charité Comprehensive Cancer Center
Berlin, Germany
Efficacy- 1-year progression free survival (PFS)
1-year progression free survival (PFS) depicted as the 1-year in-field-progression-free survival and 1-year distant metastasis free survival
Time frame: 1 year
Feasibility - Number of treatment discontinuations due to toxicity
number of treatment discontinuations due to toxicity
Time frame: During treatment
Overall Survival (OS)
defined as the time from patient inclusion to the date of death or date of last follow-up news
Time frame: From date of randomization until the date of death, assessed up to 3 years
Safety - Number of participants with treatment-related adverse events as assessed by CTCAE v4.03
defined as event possibly related to study treatment and fulfills the criteria using CTCAE Version 4.03
Time frame: From date of randomization until the date of study assessed up to 3 years
Chronic toxicity -Number of participants with treatment-related adverse Events Lasting longer than 3 months as assessed by CTCAE v4.03 and/or RTOG/EORTC Late Radiation Morbidity Scoring Schema
defined as event lasting longer than 3 months and possibly related to study treatment and fulfills the criteria using CTCAE Version 4.03 and/or and/or RTOG/EORTC Late Radiation Morbidity Scoring Schema
Time frame: From date of randomization until the date of study assessed up to 3 years
Quality of life (QoL) - measured by EORTC QLQ-H&N35 and EORTC QLQ-C30)
defined as assessment for evaluation of medical and psychosocial interventions
Time frame: From date of randomization until the date of study assessed up to 3 years
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