HFHS-1801-A Pilot Study of Immunotherapy As Consolidation Therapy for Patients with Recurrent Head and Neck Cancer

Early Phase 1CompletedNCT04188951

Henry Ford Health System10 enrolled

Overview

The study is a pilot study to explore the feasibility and efficacy of immunotherapy following salvage surgery for recurrent head and neck cancer.

Approximately 30-40% of patients treated with a curative intent for locally advanced squamous cell carcinoma of the head and neck cancer will experience an isolated loco-regional recurrence or a second primary tumor in the previously radiated tissues1-5. Patients with recurrent head and neck cancer frequently recur locally and are still amenable for curative interventions. The current recommendations for treatment of these recurrent and second primary tumors includes surgical resection whenever possible as this has been shown to have a significantly better outcome as compared to patients treated non-surgically with radiation therapy with or without concurrent chemotherapy. Immunotherapy is expected to be more effective with smaller amounts of disease and application of therapy when disease burden is minimal is expected to yield improved outcomes. Many trials underway at the present time explore the use of immunotherapy in earlier stages of head and neck cancer than the ones already studied. However, patients undergoing salvage therapy are understudied and no major cooperative group or industry trial is addressing this group of patients.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Head and Neck Neoplasms

Interventions

Pembrolizumab 25 MG/1 ML Intravenous Solution [KEYTRUDA]DRUG

Patients will receive 17 cycles of pembrolizumab via IV infusion of 200 mg over a period of 30 minutes, every 3 weeks starting no later than 90 days from the date of salvage head and neck therapy.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients must be 18 years or older, of either gender, with the ability to consent to participation in the study. * Patients must have a history of squamous cell carcinoma of the head and neck involving any sub-site in the head and neck area except nasopharynx, paranasal sinuses, and salivary gland tumors. * All patients must have recurred following definitive therapy with any combination of surgery, radiation, and/or chemotherapy. * All patients must have undergone salvage surgery in an attempt to excise all recurrent disease. * Salvage radiation therapy must not be an option available to the patient. * Patients must have high risk features such extra nodal invasion, positive margins, perineural invasion or vascular embolism. Exclusion Criteria: * Patients with macroscopic residual disease * Patient is eligible for radiation therapy. * Performance status more than 2. * Contraindications for immunotherapy, autoimmune disease, allergy to medication, steroid use at baseline. * Patients with other previous cancers excluding CIN, DCIS, non-melanoma skin cancers * Patients previously treated with immunotherapy \<12months prior * Patients with synchronous cancers "not included in the inclusion criteria"

Locations (1)

Henry Ford Health System

Detroit, Michigan, United States

Outcomes

Primary Outcomes

Rate of recurrence at 1 year, will be measured by RECIST 1.1 as the primary measure for assessment of tumor, date of disease progression, and as a basis for all protocol guidelines related to disease status (e.g., discontinuation of study treatment).

Primary objective

Time frame: 1 year

Secondary Outcomes

Determine the feasibility of immunotherapy for head and neck cancer following salvage surgery to produce preliminary data for 15 patients regarding efficacy. All side effects and symptoms will be assessed by CTCAE v5.0.

Study endpoint

Time frame: 1 year

Rate of completion of all planned therapy. All drug related toxicities will be graded by CTCAE v5.0.

Study endpoint

Time frame: through study completion, an average of 1 year

Toxicity rates measured by laboratory assessments and all adverse events and serious adverse events will be assessed by CTCAE v5.0.

Study endpoint

Time frame: through study completion, an average of 1 year

Data from ClinicalTrials.gov

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