This phase II trial compares the effect of amivantamab and hyaluronidase to cetuximab for the treatment of skin (cutaneous) squamous cell carcinoma that has come back after a period of improvement and has not spread to other parts of the body (locally recurrent) or that has spread from where it first started (primary site) to other places in the body (metastatic). Amivantamab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Hyaluronidase is an endoglycosidase. It helps to keep amivantamab in the body longer, so that the medications will have a greater effect. Cetuximab is in a class of medications called monoclonal antibodies. It binds to a protein called EGFR, which is found on some types of cancer cells. This may help keep cancer cells from growing. Giving amivantamab and hyaluronidase may be as effective as cetuximab for the treatment of locally recurrent or metastatic cutaneous squamous cell carcinoma.
PRIMARY OBJECTIVES: I. To evaluate the safety and preliminary efficacy of amivantamab monotherapy in patients with locoregionally incurable or metastatic cutaneous squamous cell carcinoma and an active immunosuppressed condition. (Cohort A) II. To compare progression-free survival (PFS) of amivantamab monotherapy versus cetuximab monotherapy in patients with locoregionally incurable or metastatic cutaneous squamous cell carcinoma and an active immunosuppressed condition. (Cohort B) SECONDARY OBJECTIVES: I. To estimate the frequency and severity of toxicities in each cohort and treatment arm. II. To estimate confirmed objective response rate (ORR) (ORR, confirmed complete and partial responses by Response Evaluation Criteria in Solid Tumors \[RECIST\] version \[v\] 1.1) in each cohort and treatment arm. III. To estimate duration of objective response, time to progression, time to next treatment, and overall survival in each cohort and treatment arm. IV. To estimate ORR and progression free survival (PFS) in each cohort and treatment arm in subgroups defined by reason for immunosuppression: transplant, autoimmune disease, hematologic malignancy, or other reason. BANKING OBJECTIVE: I. To bank specimens for future correlative studies. OUTLINE: Patients in cohort A are assigned to arm I, patients in cohort B are randomized to arm I or II. ARM I: Patients receive amivantamab and hyaluronidase subcutaneously (SC) over at least 5 minutes on days 1, 8, 15 and 22 of cycle 1 and day 1 of subsequent cycles. Cycles repeat every 28 days for 24 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo blood sample collection on study and computed tomography (CT) and/or magnetic resonance imaging (MRI) throughout the study. ARM II: Patients receive cetuximab intravenously (IV) over 60-120 minutes on days 1 and 15 of each cycle. Cycles repeat every 28 days for 24 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo blood sample collection on study and CT and/or MRI throughout the study. After completion of study treatment, patients are followed up, per the treating investigator, for up 3 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
86
Given SC
Undergo blood sample collection
Given IV
Undergo CT scan
Undergo MRI
Banner MD Anderson Cancer Center
Gilbert, Arizona, United States
RECRUITINGUC San Diego Moores Cancer Center
La Jolla, California, United States
RECRUITINGYale University
New Haven, Connecticut, United States
RECRUITINGCarle at The Riverfront
Danville, Illinois, United States
RECRUITINGCarle Physician Group-Effingham
Effingham, Illinois, United States
RECRUITINGCarle Physician Group-Mattoon/Charleston
Mattoon, Illinois, United States
RECRUITINGCarle BroMenn Medical Center
Normal, Illinois, United States
RECRUITINGCarle Cancer Institute Normal
Normal, Illinois, United States
RECRUITINGCarle Cancer Center
Urbana, Illinois, United States
RECRUITINGUniversity of Michigan Rogel Cancer Center
Ann Arbor, Michigan, United States
RECRUITING...and 10 more locations
Incidence of toxicity of interest (cohort A)
Defined as grade 3 or 4 skin rash that does not recover within 14 days, grade 3 or 4 non-hematologic toxicity that does not recover within 7 days, grade 4 hematologic toxicity including febrile neutropenia or organ transplant failure (for transplant patients only).
Time frame: Up to completion of the first cycle (cycle length = 28 days)
Progression free survival (PFS) (cohort B)
Time frame: From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause, up to 3 years
Organ rejection
Will be monitored for participants with prior organ transplants.
Time frame: Up to 5 years
Overall survival (OS)
Will estimate OS by cohort and treatment arm and within subgroups using the method of Kaplan-Meier. OS will be compared between arms using an un-stratified log-rank test. The hazard ratio and 95% confidence interval from an un-stratified Cox regression model with treatment as the only covariate will be descriptively reported for OS.
Time frame: From date of registration to date of death due to any cause, up to 5 years
PFS
Will estimate PFS by cohort and treatment arm and within subgroups using the method of Kaplan-Meier.
Time frame: From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause, up to 5 years
Time to next treatment
will be estimated using cumulative incidence curves with death before event accounted for as a competing event.
Time frame: Up to 3 years
Time to progression
will be estimated using cumulative incidence curves with death before event accounted for as a competing event.
Time frame: Up to 3 years
Duration of objective response
Will be estimated using cumulative incidence curves with death before event accounted for as a competing event.
Time frame: Up to 5 years
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