This study is a prospective clinical study. The purpose is to explore the efficacy and safety of Envafolimab combined with chemotherapy for neoadjuvant treatment or conversion treatment of locally advanced head and neck squamous cell carcinoma, and to observe the correlation between the immune microenvironment and the efficacy of immune checkpoint inhibitors, genetic changes and the efficacy in head and neck squamous cell carcinoma .
This study is a prospective clinical study. The purpose is to explore the efficacy and safety of Envafolimab combined with chemotherapy for neoadjuvant treatment or conversion treatment of locally advanced head and neck squamous cell carcinoma, and to observe the correlation between the immune microenvironment and the efficacy of immune checkpoint inhibitors, genetic changes and the efficacy in head and neck squamous cell carcinoma . After the patient signed the informed consent form, he was screened to meet the enrollment criteria and received envafolimab combined with chemotherapy according to the patient's condition. For the first imaging evaluation, if surgical treatment can be performed, neoadjuvant therapy is required to be enrolled in group A, and 3 cycles of chemotherapy combined with envafolimab are given for re-imaging after treatment. The iRECIST criteria were used to evaluate and observe the ORR and PRO (University of Washington Head and Neck Tumor Quality of Life Scale 4th Edition (UW-QOL V4.0)), if the clinical status of the subjects is stable and the investigator evaluates that surgical treatment is feasible, the subjects can be treated with surgery, and the MPR and pCR rates are observed in postoperative pathology. After the operation, the next treatment plan (adjuvant therapy or observation) is decided according to the patient's pathological condition. If the patient develops PD during the treatment period, the subject should discontinue the study treatment. If the imaging evaluation cannot be surgically treated, conversion therapy can be used to enroll in group B, and 3 cycles of chemotherapy combined with envafolimab can be given for re-imaging after treatment. The iRECIST criteria were used to evaluate and observe the ORR and PRO (University of Washington Head and Neck Tumor Quality of Life Scale 4th Edition (UW-QOL V4.0)), if the clinical status of the subjects is stable and the investigator evaluates that surgical treatment is feasible, the subjects can be treated with surgery, and the MPR and pCR rates are observed in postoperative pathology. After the operation, the next treatment plan (adjuvant therapy or observation) is decided according to the patient's pathological condition. If the patient develops PD during the follow-up period, the subject should discontinue the study treatment.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
envafolimab: 150 mg once every 1 week for 8 doses subcutaneously on day 1 Chemotherapy: nab-paclitaxel + cisplatin/carboplatin 3 cycles; Albumin paclitaxel 260 mg/m2, cisplatin 75 mg/m2 divided into 3 days, carboplatin AUC 5 applied on the first day.
ORR(Objective response rate)
Proportion of patients whose tumors have shrunk to a prespecified value and are able to maintain the minimum time limit
Time frame: 12 months
pCR
It is defined as the absence of residual infiltrates in the tissues after neoadjuvant therapy induction and surgical treatment, and no lesions can be detected in lymph node samples.The proportion of pathological complete response was achieved .
Time frame: immediately after the surgery
MPR
Defined as tumor regression with pathologic residual tumor ≤ 10% in neoadjuvant therapy induction and surgical treatment.The proportion of pathologic residual tumor ≤ 10% was achieved .
Time frame: immediately after the surgery
Safety of treatment
This includes the incidence of adverse events (AEs) and serious adverse events (SAEs), and the incidence of AEs/SAEs leading to treatment discontinuation
Time frame: 12 months
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