Study of Xevinapant With Radiation and Chemotherapy for Patients With Head and Neck Cancer

Trial Title: Study of Xevinapant With Radiation and Chemotherapy for Patients With Head and Neck Cancer

NCT ID: NCT06110195

Condition: Head and Neck Cancer
Head and Neck Neoplasms
Squamous Cell Carcinoma of Head and Neck

Conditions: Official terms:
Carcinoma
Carcinoma, Squamous Cell
Head and Neck Neoplasms
Squamous Cell Carcinoma of Head and Neck
Paclitaxel
Carboplatin

Study type: Interventional

Study phase: Phase 1

Overall status: Active, not recruiting

Study design:

Allocation: Non-Randomized

Intervention model: Sequential Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Drug
Intervention name: Xevinapant
Description: Given orally during study treatment on days 1-14 of a 21-day treatment cycles. It will be given continuously during treatment with carboplatin, paclitaxel, and radiation (chemoRT). After completely of the chemoRT dosing, an additional 3 cycles of Xevinapant along will be given.
Arm group label: Dose Expansion
Arm group label: Escalation Group Dose Level -1
Arm group label: Escalation Group Dose Level 0
Arm group label: Escalation Group Dose Level 1
Arm group label: Escalation Group Dose Level 2

Intervention type: Drug
Intervention name: Carboplatin
Description: Given with radiation weekly for 7 doses.
Arm group label: Dose Expansion
Arm group label: Escalation Group Dose Level -1
Arm group label: Escalation Group Dose Level 0
Arm group label: Escalation Group Dose Level 1
Arm group label: Escalation Group Dose Level 2

Intervention type: Drug
Intervention name: Paclitaxel
Description: Given with radiation weekly for 7 doses.
Arm group label: Dose Expansion
Arm group label: Escalation Group Dose Level -1
Arm group label: Escalation Group Dose Level 0
Arm group label: Escalation Group Dose Level 1
Arm group label: Escalation Group Dose Level 2

Intervention type: Radiation
Intervention name: Radiation Therapy
Description: Radiation will be given together with paclitaxel and carboplatin for 7 weeks.
Arm group label: Dose Expansion
Arm group label: Escalation Group Dose Level -1
Arm group label: Escalation Group Dose Level 0
Arm group label: Escalation Group Dose Level 1
Arm group label: Escalation Group Dose Level 2

Summary: The goal of this clinical trial is to determine the best safe dose of xevinapant that can be given in combination with chemotherapy and radiation in patients with head and neck cancer. Up to 4 doses of xevinapant will be tested in the dose escalation portion of the study. After the best safe dose is found during escalation, an additional group of participants will be enrolled at that dose to learn more about the treatment combination (dose expansion). The main question[s] it aims to answer are: - what is the maximum safe dose that can be given - what dose should be used in subsequent (phase 2) trials Participants will receive xevinapant in combination with paclitaxel and carboplatin chemotherapy and radiation. Treatment will be given in 3-week cycles for 3 cycles.

Criteria for eligibility:
Criteria:
Inclusion Criteria: 1. Pathologically proven diagnosis of squamous cell carcinoma of the head and neck (HNSCC) of the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, or sinuses. - Patients with oropharynx cancer need p16 determination by immunohistochemistry (where positive is defined as greater than 70% strong nuclear or nuclear and cytoplasmic staining of tumor cells). - Oral cavity, larynx, hypopharynx, or p16-negative oropharynx cancer must be stages T1-2N1-3 or T3-4N0-3 (AJCC 8th edition). Sinus primary must be T4bN0-3 not amenable to surgical resection. - P16-positive oropharynx cancer patients, stages T1-2N1-3 or T3-4N0-3 (AJCC 8th edition staging). 2. The patient has unresected, measurable disease as defined by the presence of at least one measurable lesion per RECIST 1.1. 3. Age >= 18 years of age 4. Patients must have a contraindication to cisplatin 5. Performance Status of 0-2 6. Adequate hematologic function - White Blood Cell Count (WBC) >= 2000 cells/mm3 - Absolute neutrophil count (ANC) >= 1,500 cells/mm3 - Platelets >= 100,000 cells/mm3 - Hemoglobin >= 9.0 g/dL 7. Adequate renal function was defined as follows: Creatinine clearance (CrCl) > 30 mL/min 8. Adequate hepatic function - Total bilirubin <= 1.5 x upper limit of normal (ULN) (except patients with Gilbert Syndrome who can have total bilirubin < 3.0 mg/dL) - aspartate aminotransferase (AST) and alanine transaminase (ALT) <= 2.5 x upper limit of normal (ULN) 9. For women of childbearing potential (e.g. uterus present and menstruating), a negative serum pregnancy test within 14 days prior to registration. 10. Willingness to agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) from time of joining the study until 6 months after completing chemotherapy treatment or 3 months after last dose of xevinapant, whichever is the latest. 11. Patients with a history of hepatitis B or C infection are eligible if they have an undetectable viral load. 12. Ability to understand and the willingness to sign a written informed consent document. 13. Availability of tumor tissue for research analysis. Patients who do not have adequate tissue available will need to undergo a new biopsy prior to enrollment on study. Exclusion Criteria: 1. Definitive clinical or radiologic evidence of distant (beyond cervical lymph node and neck tissue) metastatic disease. 2. Carcinoma of the neck of unknown primary site of origin 3. Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable if not within < 3 years 4. Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields; 5. Severe, active co-morbidity defined as follows: - History of bone marrow transplant and organ transplant, including allogeneic stem cell transplantation. - Unstable angina requiring hospitalization in the last 6 months. - New York Heart Association Functional Classification III/IV. - Myocardial infarction within the last 6 months. - Persistent Grade 3-4 electrolyte abnormalities that cannot be reversed despite as indicated by repeat testing. - Ongoing active infection associated with symptoms and/or requires antibiotic therapy at the time of initiation of treatment. 6. Pregnancy and nursing females, if applicable. 7. Receipt of live vaccinations within 28 days prior to study start. 8. Patients who are receiving any other investigational agents. 9. Patients with a "currently active" second malignancy other than non-melanoma skin cancers. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥ 3 years. 10. History of allergic reactions attributed to compounds of similar chemical or biologic composition to xevinapant, carboplatin, or paclitaxel. 11. Patients taking prohibited medications and those requiring close monitoring.

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: University of Chicago Medicine Comprehensive Cancer Center

Address:
City: Chicago
Zip: 60637
Country: United States

Start date: January 24, 2024

Completion date: October 2027

Lead sponsor:
Agency: University of Chicago
Agency class: Other

Collaborator:
Agency: EMD Serono
Agency class: Industry

Source: University of Chicago

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06110195