This single-center, open-label Phase II trial aims to evaluate the efficacy and safety of neoadjuvant combination therapy with Adebrelimab (anti-PD-L1), Dalpiciclib Isethionate (CDK4/6 inhibitor), and cisplatin chemotherapy in patients with resectable locally advanced head and neck squamous cell carcinoma (LA-HNSCC). A total of 32 eligible subjects will receive 2 cycles of triplet neoadjuvant treatment prior to radical surgery. The primary endpoint is the pathological complete response (pCR) rate following neoadjuvant therapy; secondary endpoints include major pathological response (MPR), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), 1-year overall survival (1y-OS), and treatment-related adverse events (TRAEs). The exploratory objectives analyze correlations between biomarkers (oral microbiome, CDKN2A/B deletion, CDK4/6 amplification, and PD-L1 expression) and therapeutic efficacy or prognosis. Subjects will receive long-term tumor and survival follow-up after surgery until disease progression, death, loss to follow-up, or the end of study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Dose: 1200 mg Route: Intravenous Infusion Schedule: Day 1 of each 21-day cycle, every 3 weeks for 2 cycles total Description: Intravenous infusion over 30 minutes (20-60 min window), no dose reduction allowed; suspend or permanently discontinue per immune-related adverse events.
100mg/125mg, Schedule: Days 1-21 of every 28-day cycle, continuous oral administration Description: Dose modification per CTCAE v5.0 toxicity grading; permanent discontinuation for ≥2 grade interstitial lung disease, grade 4 hepatotoxicity.
Dose: 75 mg/m² Route: Intravenous drip Schedule: Day 1 of each 21-day cycle, every 3 weeks for 2 cycles total Description: Dose reduced to 40mg/m² if creatinine clearance 40-50 mL/min; discontinue cisplatin if CrCl \<40 mL/min; 20% dose reduction for grade 3-4 related toxicities.
Timing: 4-6 weeks after completion of 2 neoadjuvant cycles Description: Curative surgical resection of primary tumor and regional lymph nodes per standard head and neck oncology guidelines.
Pathological Complete Response (pCR) Rate
Percentage of subjects achieving pathological complete response in primary tumor and regional lymph nodes after neoadjuvant therapy (no viable tumor cells in surgical specimen)
Time frame: At time of surgical resection (approximately 6 weeks after 2 cycles neoadjuvant treatment)
Major Pathological Response (MPR) Rate
Proportion of patients with ≤10% residual viable tumor cells in surgical specimen
Time frame: At surgical resection
Objective Response Rate (ORR)
Percentage of participants with confirmed Complete Response (CR) or Partial Response (PR) per RECIST 1.1 on post-neoadjuvant contrast-enhanced CT
Time frame: At the end of Cycle 2 (each neoadjuvant cycle is 28 days)
Disease Control Rate (DCR)
Proportion of patients with CR, PR or Stable Disease (SD) per RECIST 1.1
Time frame: At the end of Cycle 2 (each neoadjuvant cycle is 28 days)
Progression-Free Survival (PFS)
Time from first study drug administration to first documentation of disease progression (local/regional/distant) or death from any cause
Time frame: Up to 36 months from enrollment
1-Year Overall Survival (1y-OS) Rate
Percentage of subjects alive 12 months after first dose of neoadjuvant therapy
Time frame: 12 months post first treatment
Incidence and Severity of Treatment-Related Adverse Events (TRAEs)
All adverse events graded per NCI CTCAE v5.0 from informed consent signing to 1 month after last study drug administration; summarize frequency, grade, causality and resolution
Time frame: From screening through 30 days after final study drug dose
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.