Multicenter randomized controlled phase III study of nivolumab alone or in combination with ipilimumab as immunotherapy vs standard follow-up in surgical resectable HNSCC after adjuvant therapy
Surgically treated locally advanced head and neck squamous cell carcinoma often requires postoperative chemoradiation with high risk of acute and late toxicity. DFS after 2 years is approximately 70%. Combining anti-PD-1 and anti-CTLA4 as a maintenance therapy may improve DFS due to anti-tumor effects of immunotherapy by enhancing cross-presentation of tumor antigens.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
276
Surgical resection of primary tumor including neck dissection according to standard of care
Risk-adapted adjuvant radio(-chemo)therapy 56-66 Gy (chemotherapy Cisplatin 100 mg/m2 on days 1, 22, 43, or Cisplatin once weekly (40mg/m2) for high risk patients only)
Neoadjuvant dose with Nivolumab 3mg/kg after randomization within 2 weeks before surgery
Universitätsklinikum Ulm
Ulm, Baden-Wurttemberg, Germany
Technische Universität München, Klinikum rechts der Isar
München, Bavaria, Germany
Universitätsklinikum Gießen
Giessen, Hesse, Germany
Klinikum Bielefeld
Bielefeld, North Rhine-Westphalia, Germany
Disease Free Survival
disease free survival (DFS) at 3 years of nivolumab alone or in combination with ipilimumab as adjuvant immunotherapy after adjuvant radio(chemo)therapy in locally advanced resected HNSCC
Time frame: approximately 71 months
Local regional control (LRC)
Disease assessment (CT/ MRI) and Panendoscopy and FFPE in case of suspicion or recurrence
Time frame: Time from randomization to date of first observed histologically proven or death, up to 36 month
Distant metastasis free survival (DMFS)
Disease assessment (CT/ MRI)
Time frame: Time from randomization to date of first observed histologically proven or death, up to 36 month
Overall survival (OS)
Follow Up- Visits after end of treatment every 3 months until month 36 after randomization, afterwards every 6 months
Time frame: until end of study (36 months after end of therapy of the last patient), approximately 71 months
Acute toxicity and late morbidity
Adverse Events Assessment
Time frame: AEs/SAEs should be collected continuously until 12 months after randomization
Quality of life (QoL): QLQ-C30
Questionaire EORTC QLQ-C30
Time frame: through study completion, an average of 3 years
Quality of life (QoL): Questionnaire H&N43
Questionnaire H\&N43
Time frame: through study completion, an average of 3 years
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Administration of Nivolumab 3mg/kg i.v. d1 every 2 weeks within 6 weeks after end of radiotherapy until progression or up to 6 months
Administration of Nivolumab 3mg/kg i.v. d1 every 2 weeks and Ipilimumab 1mg/kg i.v. d1 every 6 weeks within 6 weeks after end of radiotherapy until progression or up to 6 months
HELIOS Klinikum Erfurt GmbH
Erfurt, Thuringia, Germany
Universitätsklinikum Hamburg Eppendorf
Hamburg, Germany
Katholisches Marienkrankenhaus Hamburg
Hamburg, Germany
Comparison of nivolumab alone group vs control and nivolumab & ipilimumab group vs control in terms of DFS
We compare disease free survival, defined as time from randomization to date of first observed either histologically proven recurrence (local, locoregional or distant), or death from any cause whatever occurs first, of arm Ia to arm II and of arm Ib to arm II
Time frame: assessed up to 36 month
Survival depending on PD-L1 Status
Assessment of PD-L1 Status
Time frame: after surgery, up to 4 weeks after surgery