A Study of Ficlatuzumab in Combination With Cetuximab in Participants With Recurrent or Metastatic (R/M) HPV Negative Head and Neck Squamous Cell Carcinoma

PHASE3RECRUITING

The purpose of this study is to compare the efficacy and safety of ficlatuzumab plus cetuximab compared to placebo plus cetuximab in participants with recurrent/metastatic (R/M) HPV-negative Head and Neck Cancer. The primary hypothesis is that ficlatuzumab combined with cetuximab is superior to cetuximab alone in terms of progression-free survival and/or overall survival.

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Study details:

This multicenter, randomized, double-blind, placebo-controlled Phase 3 study is designed to compare the efficacy and safety of two dose levels of ficlatuzumab combined with cetuximab (Arm 1 or Arm 2) to a control arm of placebo plus cetuximab (Arm 3) in participants with R/M human papilloma virus (HPV)-negative HNSCC. Eligible participants must have failed prior therapy with an anti-PD-1 \[programmed cell death protein 1\] or PD-L1 \[programmed death ligand 1\] immune checkpoint inhibitor (ICI) and with platinum-based chemotherapy, administered in combination or sequentially. Failure of prior treatment may be due to progression of disease or intolerance to treatment.

It is anticipated that the study will enroll approximately 410 participants across 3 arms.

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

  • Male or female and ≥ 18 years of age
  • Histologically and/or cytologically confirmed primary diagnosis of R/M HNSCC
  • Participants with oropharyngeal cancer will be required to be p16 negative and have proof of HPV-negative status submitted on the basis of a pathology report
  • At least 1 measurable lesion by contrast CT or MRI scan according to RECIST v.1.1. Such lesions must not have been previously irradiated; if the measurable lesion(s) has been irradiated, clear progression must be documented
  • Participants must have failed prior therapy with an anti-PD-1/PD-L1 ICI and with platinum-based chemotherapy administered in combination or sequentially, in either the locally advanced or R/M setting. Failure of prior treatment may be due to progression of disease or intolerance to treatment
  • Patient's tumor must be considered inoperable and incurable
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 with a life expectancy of at least 12 weeks
  • For women of childbearing potential (WOCBP), documentation of negative serum pregnancy test within 30 days of randomization
  • For WOCBP and male participants whose sexual partners are of childbearing potential, agreement to use an effective method of contraception during the study and for at least 60 days after the last dose of study treatment. Birth control methods which may be considered highly effective include methods that achieve a failure rate of less than 1% per year when used consistently and correctly.
  • Ability to give written informed consent and comply with protocol requirements
  • Patients with feeding tubes are eligible for the study.
  • Archived tissue sample must be submitted to the Sponsor-designated laboratory within 60 days of randomization for c-Met/HGF analysis
  • Exclusion criteria

  • History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the investigational agent or cetuximab
  • Known or suspected untreated and uncontrolled brain metastases or leptomeningeal carcinomatosis Note: Participants with locally treated brain metastases are eligible provided 2 weeks have elapsed since local therapy. Participants are allowed to continue steroid taper during the start of study treatment.
  • Prior treatment with any other investigational drug or biologic agent or radiation therapy before a washout has been completed (must be completed prior to randomization): 1. 2 weeks (14 days) or 5 half-lives, whichever is shorter, for chemotherapeutic agents, small molecules, and checkpoint inhibitors 2. 3 weeks (21 days) or 5 half-lives, whichever is shorter, for antibody-drug conjugates 3. 4 weeks (28 days) for cell therapies 4. 2 weeks (14 days) for radiation therapy
  • Any unresolved and significant toxicity (National Cancer Institute Common Terminology Criteria for Adverse Events [NCI-CTCAE] version 5.0) Grade > 2 from previous anticancer therapy (including radiation therapy), other than alopecia
  • Significant cardiovascular disease, including: Cardiac failure New York Heart Association class III or IV; Myocardial infarction, severe or unstable angina within 6 months prior to randomization; History of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation)
  • Any other medical condition or psychiatric condition that, in the opinion of the Investigator, might interfere with the participant's involvement in the study or interfere with the interpretation of study results
  • History of prior malignancy within 2 years prior to randomization (except for adequately treated non-melanoma skin cancer, carcinoma in situ of the breast or cervix, superficial bladder cancer, or early-stage prostate cancer, without evidence of recurrence; participants may or may not be on maintenance therapy)
  • Female participants who are pregnant or breastfeeding
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    Eligibility

    Age eligible for study : 18 and older

    Healthy volunteers accepted : No

    Gender eligible for study: All

    Things to know

    Study dates

    Study start: 2024-01-11

    Primary completion: 2027-08-01

    Study completion finish: 2027-11-01

    study type

    Study type

    TREATMENT

    phase

    Phase

      PHASE3

    trial

    Trial ID

    NCT06064877

    Intervention or treatment

    BIOLOGICAL: Ficlatuzumab

    BIOLOGICAL: Cetuximab

    OTHER: Placebo

    Conditions

    • Metastatic Head-and-neck Squamous-cell Carcinoma
    • Recurrent Head and Neck Squamous Cell Carcinoma
    Image related to Metastatic Head-and-neck Squamous-cell Carcinoma
    • Condition: Metastatic Head-and-neck Squamous-cell Carcinoma, Recurrent Head and Neck Squamous Cell Carcinoma

    • BIOLOGICAL: Ficlatuzumab and other drugs

    • Kogarah, New South Wales, Australia and more

    • Sponsor: AVEO Pharmaceuticals, Inc.

    Find a site

    Closest Location:

    St George Hospital

    Research sites nearby

    Select from list below to view details:

    • St George Hospital

      Kogarah, New South Wales, Australia

    • St. Vincent's Hospital

      Sydney, New South Wales, Australia

    • Princess Alexandra Hospital

      Brisbane, Queensland, Australia

    • St. John of God Murdoch Hospital

      Murdoch, Western Australia, Australia

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    Study Plan

    This section provides details of the study plan, including how the study is designed and what the study is measuring.

    How is the study designed?

    Participant Group/ArmIntervention/Treatment
    EXPERIMENTAL: Arm 1 (Investigational Arm: ficlatuzumab plus cetuximab)
    • Intravenous (IV) ficlatuzumab dose A on Day 1 (D1) and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
    BIOLOGICAL: Ficlatuzumab
    • Ficlatuzumab (AV-299) is a humanized hepatocyte growth factor (HGF) inhibitory immunoglobulin G1 (IgG1) monoclonal antibody (mAb).
    EXPERIMENTAL: Arm 2 (Investigational Arm: ficlatuzumab plus cetuximab)
    • IV ficlatuzumab dose B on D1 and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
    BIOLOGICAL: Ficlatuzumab
    • Ficlatuzumab (AV-299) is a humanized hepatocyte growth factor (HGF) inhibitory immunoglobulin G1 (IgG1) monoclonal antibody (mAb).
    PLACEBO_COMPARATOR: Arm 3 (Comparator Arm: placebo plus cetuximab)
    • IV placebo (saline, ficlatuzumab-matched) on D1 and D15 of each 28-day cycle IV cetuximab on D1 and D15 of each 28-day cycle
    BIOLOGICAL: Cetuximab
    • Cetuximab is an epidermal growth factor receptor (EGFR) antagonist.

    What is the study measuring?

    Primary outcome

    Primary Outcome MeasurePrimary Outcome DescriptionPrimary Outcome Time Frame
    To compare the efficacy by overall survival of ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC)Overall survival (OS), defined as the time from the date of randomization to the date of death for any causeFrom Randomization until death from any cause (Approximately 44 months)

    Secondary outcome

    Secondary Outcome MeasureSecondary Outcome DescriptionSecondary Outcome Time Frame
    To evaluate additional endpoints of efficacy for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCProgression-free survival (PFS), defined as the time from randomization to the first documented progressive disease (PD) per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, or death from any cause, whichever occurs firstFrom Randomization until disease progression or death (Approximately 44 months)
    To evaluate additional endpoints of efficacy for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCObjective response rate (ORR), defined as the percentage of participants who have a complete response (CR) or a partial response (PR) per RECIST v1.1From Cycle 1 Day 1 until last response assessment (response assessments are every 8 weeks for the first year, every 12 weeks for years 2 and 3 and then every 6 months)
    To evaluate additional endpoints of efficacy for ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCDuration of response (DOR), defined as the time from first documented evidence of a confirmed CR or PR per RECIST v1.1From Cycle 1 Day 1 until last response assessment (response assessments are every 8 weeks for the first year, every 12 weeks for years 2 and 3 and then every 6 months)
    To compare the safety and tolerability of ficlatuzumab plus cetuximab vs placebo plus cetuximab in participants with R/M HNSCCNumber of times participants experience Adverse Events (AE) or abnormal laboratory values.From Screening until 30 days after last dose
    To evaluate the pharmacokinetics (Pk) of ficlatuzumab and cetuximabSerum samples will be assessed for concentrations of ficlatuzumab and cetuximabFrom Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)
    To assess the immunogenicity of ficlatuzumab via antidrug antibodies (ADAs)Serum samples will be assessed for the presence of ADA to ficlatuzumab.From Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)
    To assess the immunogenicity of ficlatuzumab via neutralizing antibodies (nAB)Serum samples that test positive for the presence of ADA to ficlatuzumab will be further tested for the presence of nAB.From Baseline (Cycle 1 Day 1 pre-dose) until End of Treatment (Approximately 44 months)

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    References

    Clinical Trials Gov: A Study of Ficlatuzumab in Combination With Cetuximab in Participants With Recurrent or Metastatic (R/M) HPV Negative Head and Neck Squamous Cell Carcinoma

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