Open-label, Phase II, randomized, controlled study evaluating the efficacy and safety of danvatirsen in combination with pembrolizumab compared with pembrolizumab alone as first-line treatment of patients with recurrent/metastatic (R/M) HNSCC. Two-thirds of patients will be randomized to receive danvatirsen and pembrolizumab and one-third will be randomized to receive pembrolizumab alone.
This is a multicenter, open-label, Phase II, randomized, controlled study to determine the efficacy, safety, and other indicators of clinical and biological activity of the combination of danvatirsen and pembrolizumab as first-line treatment for R/M HNSCC. After providing informed consent, patients will be assessed for eligibility during the screening phase of the study. All patients must be willing and able to provide a formalin fixed paraffin-embedded (FFPE) archival or fresh tumor sample collected during the screening period; a fresh biopsy is preferred if safe and feasible to obtain and consented to by the patient. Following the screening period, eligible patients will be randomized in a 2:1 ratio to danvatirsen + pembrolizumab or pembrolizumab monotherapy, respectively. Patients will receive treatment in 21-day cycles. Patients assigned to the pembrolizumab monotherapy arm will receive treatment until a criterion for discontinuation is met or a maximum of 24 months of treatment. Patients assigned to combination therapy will receive both treatments until a criterion for discontinuation is met or the patient has received a maximum of 24 months of treatment, after which they may remain on danvatirsen monotherapy. Patients in both treatment arms will have radiologic tumor assessments every 6 weeks (±1 week), regardless of treatment delays, until objective disease progression, initiation of new anticancer treatment, death, withdrawal of consent, or end of study, whichever occurs first. All patients who discontinue study treatment for any reason will have a safety follow-up visit 30 days (+7 days) after the last dose of study treatment and a follow-up for AEs 90 days (+7 days) after the last dose of pembrolizumab. Patients will be followed for survival at 12 week (±7 days) intervals until death or withdrawal of consent, whichever occurs first. Survival follow-up will continue until at least 15 months after the last patient is randomized in the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
69
Danvatirsen is a STAT3 targeting drug.
Pembrolizumab is a monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2
Confirmed ORR
Determine the ORR (Partial response \[PR\] + CR defined according to RECIST v1.1) as determined by the Investigator for the combination of danvatirsen and pembrolizumab compared with pembrolizumab alone
Time frame: Up to 18 months
Number of Participants With Adverse Events as Assessed by CTCAE v5.0
Adverse Events are assessed and graded according to Common Toxicity Criteria for Adverse Events (CTCAE) Version 5.0.
Time frame: Up to 18 months
DOR
Duration of Response by RECIST v1.1
Time frame: Up to 18months
DCR & CR Rate
Disease control rate and complete response rate by RECIST v1.1
Time frame: Up to 18months
ORR in Tumors With CPS ≥20 and ≥ 50
Overall response rate per RECIST v1.1 in tumors with CPS\< 20, CPS ≥ 20 and CPS ≥ 50
Time frame: Up to 18months
DOR in Tumors With CPS ≥20 and ≥50
Duration of response by RECIST v1.1 in tumors with CPS ≥ 20 and ≥50
Time frame: Up to 18months
PFS
Progression-free survival by RECIST v1.1, defined as the time from randomization to the first documentation of progressive disease (PD) or death from any cause, whichever comes first
Time frame: Up to 18months
OS
Overall survival, defined as time from randomization to death from any cause
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The University of Arizona Cancer Center
Tucson, Arizona, United States
University of California Irvine (UCI)
Irvine, California, United States
TMPN Hunt Cancer Care
Torrance, California, United States
University of California Los Angeles
Westwood, Los Angeles, California, United States
University of Colorado Hospital (UCH) Anschutz Cancer Pavilion
Aurora, Colorado, United States
Miami Cancer Institute
Miami, Florida, United States
Emory University Hospital Midtown
Atlanta, Georgia, United States
University of Illinois Cancer Center
Chicago, Illinois, United States
AMR Kansas City Oncology
Merriam, Kansas, United States
University of Kansas Medical Center
Westwood, Kansas, United States
...and 22 more locations
Time frame: Up to 30months
Maximum Plasma Concentration
Maximum concentration recorded \[Cmax\]of danvatirsen at defined timepoints in the combination regimen
Time frame: Up to 18 months
Trough Concentration
Trough concentration \[Ctrough\] of danvatirsen at defined timepoints in the combination regimen
Time frame: Up to 18 months
Area Under the Plasma Concentration-time Curve
Area under the plasma concentration-time curve over the dosing interval \[AUCtau\] of danvatirsen at defined timepoints in the combination regimen
Time frame: Up to 18 months
Time to Maximum Plasma Concentration
Time to maximum plasma concentration \[Tmax\]) after single and multiple doses at defined timepoints in the combination regimen
Time frame: Up to 18 months
Immunogenicity of Danvatirsen
Anti-danvatirsen antibody titers at defined timepoints in the combination regimen
Time frame: Up to 18 months