This is a phase III randomized blind placebo-controlled study, designed to show the superiority of the experimental arm to the control arm. After surgery and checking eligibility criteria, patients will be randomized between the control and the experimental arms with a 1:1 ratio (randomization will take place at a maximum 4 weeks after surgery): * Experimental Arm: Durvalumab (one dose) before chemoradiotherapy (CRT) and for 6 months every 4 weeks (Q4W) after CRT * Control Arm: placebo (one dose) before CRT and for 6 months Q4W after CRT Radiotherapy planning will take place after randomization. The primary endpoint of this trial is disease free survival (DFS), measured from the date of randomization to the date of first occurrence of any loco-regional recurrence, metastatic progression, or death due to any cause.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Durvalumab (one dose) before CRT and for 6 months Q4W after CRT
radiotherapy is administered in 33 fractions over 6.5 weeks fro a total of 66 Gy
placebo (one dose) before CRT and for 6 months Q4W after CRT
disease free survival
The main study objective is to test whether treatment with Durvalumab, given before and after completion of standard adjuvant chemoradiation, significantly prolongs disease free survival in macroscopically completely resected HPV negative advanced head and neck cancer at high risk of recurrence.
Time frame: 3 years and half after last pateint in
overall survival
To assess the impact of postoperative Durvalumab on the overall survival
Time frame: 5 years after last patients in
Cumulative incidence of distant metastases
Time to distant metastases is defined as the time interval between the date of randomization and the first date when distant disease is detected. Cumulative incidence of distant metastases is estimated considering death or diagnosis of loco-regional recurrence in absence of distant disease is considered as a competing risk event. If a recurrence is detected at the same time at both loco-regional and distant sites, this is considered as a competing risk for this endpoint.
Time frame: 5 years after last patients in
Cumulative incidence of loco-regional recurrence
Time to loco-regional recurrence is the time interval between the date of randomization and the date where local or regional recurrence is first detected. Cumulative incidence of loco-regional recurrence is estimated considering death or diagnosis of distant metastases in absence of loca l or regional recurrence is considered as a competing risk event. If a recurrence is detected at the same time at both loco-regional and distant sites, this is considered as an event of interest for this endpoint.
Time frame: 5 years after last patients in
Cumulative incidence of second cancers (all sites)
first diagnosis of any second cancer in the head and neck region or outside the head and neck region. Cumulative incidence of second cancer is estimated considering death without a second cancer is considered as a competing risk.
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Cisplatin (100mg/m2) is administered at day 1, 22, 43 of radiotherapy
Time frame: 5 years after last patients in
Rate of toxicity assessed by clinicians
All adverse events will be recorded; the investigator will assess whether those events are drug related (reasonable possibility, no reasonable possibility) and this assessment will be recorded in the database for all adverse events. Adverse events will be recorded according to NCI-CTCAE
Time frame: 5 years after last patients in
Health-related quality of Life questionnaires: QLQ-C30
To compare the addition of immunotherapy to chemo-radiation therapy on health-related quality of life. Quality of life will be assessed with the EORTC Quality of Life Questionnaire (QLQ-C30) version 3. The EORTC Quality of Life Questionnaire (QLQ-C30) version 3 is patient questionnaire composed of 30 single questions which form 15 multi-item and single-item scales. These include five functional scales (physical, role, emotional, social, and cognitive), three multi-item symptom scales (fatigue, nausea and vomiting and pain), six single item symptom scales (dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) and a global health status/QoL scale. The scoring algorithm for the scales results in a score from 0 to 100 where a high score for a functional scale represents a healthy level of functioning, but a high score for a symptom scale represents a high level of problems.
Time frame: 5 years after last patients in