Testing the Addition of Anti-Cancer Drug, Cetuximab, to Standard of Care Treatment (Pembrolizumab) for Returning or Spreading Head and Neck Cancer After Previous Treatment
Start Date
3/27/2025
Completion Date
11/30/2029
Summary
This phase III trial compares the effect of adding cetuximab to pembrolizumab versus pembrolizumab alone in treating patients with head and neck squamous cell carcinoma (HNSCC) that has come back after a period of improvement (recurrent) and/or that has spread from where it first started (primary site) to other places in the body (metastatic). Cetuximab is in a class of medications called monoclonal antibodies. It binds to a protein called EGFR, which is found on some types of tumor cells. This may help keep tumor cells from growing. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread. Giving cetuximab and pembrolizumab together may be more effective at treating patients with recurrent and/or metastatic HNSCC than pembrolizumab alone.
Detailed Description
PRIMARY OBJECTIVE: I. To assess whether the combination of cetuximab and pembrolizumab (arm 2) compared to pembrolizumab alone (arm 1) results in improved overall survival (OS) in subjects with platinum refractory HNSCC. SECONDARY OBJECTIVES: I. To compare pembrolizumab + cetuximab (arm 2) versus (vs.) pembrolizumab alone (arm 1) with respect to objective response rate per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. II. To compare pembrolizumab + cetuximab (arm 2) vs. pembrolizumab alone (arm 1) with respect to progression free survival (PFS) per RECIST 1.1. III. To evaluate pembrolizumab + cetuximab (arm 2) vs. pembrolizumab alone (arm 1) with respect to duration of response (DOR) per RECIST 1.1. IV. To assess the safety and tolerability of pembrolizumab + cetuximab (arm 2) vs. pembrolizumab alone (arm 1). V. To assess the patient-reported toxicity using Patient Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) of pembrolizumab + cetuximab (arm 2) vs. pembrolizumab alone (arm 1). EXPLORATORY OBJECTIVES: I. To identify specific mutational changes that may be indicative of clinical response to pembrolizumab + cetuximab and pembrolizumab alone. II. To evaluate circulating tumor-derived deoxyribonucleic acid (ctDNA) kinetics over the course of treatment in response to pembrolizumab + cetuximab and pembrolizumab alone. OUTLINE: Patients are randomized to 1 of 2 arms. ARM 1: Patients receive pembrolizumab intravenously (IV) over 30 minutes on day 1 of each cycle. Cycles repeat every 42 days for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT), positron emission tomography (PET)/CT or magnetic resonance imaging (MRI) throughout the trial and optionally undergo blood sample collection on study and at disease progression or end of treatment. ARM 2: Patients receive cetuximab IV over 120 minutes on day -14 prior to cycle 1 and then on days 1, 15 and 29 of each cycle and pembrolizumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 42 days for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, PET/CT or MRI throughout the trial and optionally undergo blood sample collection on study and at disease progression or end of treatment. After completion of study treatment, patients are followed up within 4 weeks and then every 3 and/or 6 months for up to 5 years.
Eligibility Criteria
Age Range: 18 years to No maximum
Interventions
Biospecimen Collection
Cetuximab
Computed Tomography
Magnetic Resonance Imaging
Pembrolizumab
Positron Emission Tomography
Conditions
Locations
University of Arkansas for Medical Sciences
Little Rock, Arkansas 72205
United States
Fremont - Rideout Cancer Center
Marysville, California 95901
United States
VA Palo Alto Health Care System
Palo Alto, California 94304
United States
UCHealth Memorial Hospital Central
Colorado Springs, Colorado 80909
United States
Memorial Hospital North
Colorado Springs, Colorado 80920
United States
Poudre Valley Hospital
Fort Collins, Colorado 80524
United States
Cancer Care and Hematology-Fort Collins
Fort Collins, Colorado 80528
United States
Lutheran Hospital - Cancer Centers of Colorado
Golden, Colorado 80401
United States
UCHealth Greeley Hospital
Greeley, Colorado 80631
United States
Medical Center of the Rockies
Loveland, Colorado 80538
United States
Mount Sinai Medical Center
Miami Beach, Florida 33140
United States
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho 83706
United States
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho 83605
United States
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho 83814
United States
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho 83687
United States
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho 83854
United States
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho 83864
United States
Advocate Good Shepherd Hospital
Barrington, Illinois 60010
United States
University of Chicago Comprehensive Cancer Center
Chicago, Illinois 60637
United States
Advocate Illinois Masonic Medical Center
Chicago, Illinois 60657
United States
AMG Crystal Lake - Oncology
Crystal Lake, Illinois 60014
United States
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois 62526
United States
Decatur Memorial Hospital
Decatur, Illinois 62526
United States
Advocate Good Samaritan Hospital
Downers Grove, Illinois 60515
United States
Crossroads Cancer Center
Effingham, Illinois 62401
United States
Advocate Sherman Hospital
Elgin, Illinois 60123
United States
Advocate South Suburban Hospital
Hazel Crest, Illinois 60429
United States
AMG Libertyville - Oncology
Libertyville, Illinois 60048
United States
Condell Memorial Hospital
Libertyville, Illinois 60048
United States
Illinois CancerCare-Macomb
Macomb, Illinois 61455
United States
UC Comprehensive Cancer Center at Silver Cross
New Lenox, Illinois 60451
United States
Cancer Care Center of O'Fallon
O'Fallon, Illinois 62269
United States
Advocate Christ Medical Center
Oak Lawn, Illinois 60453-2699
United States
Advocate Outpatient Center - Oak Lawn
Oak Lawn, Illinois 60453
United States
University of Chicago Medicine-Orland Park
Orland Park, Illinois 60462
United States
Advocate High Tech Medical Park
Palos Heights, Illinois 60463
United States
Advocate Lutheran General Hospital
Park Ridge, Illinois 60068
United States
Illinois CancerCare-Peoria
Peoria, Illinois 61615
United States
UW Health Carbone Cancer Center Rockford
Rockford, Illinois 61114
United States
Memorial Hospital East
Shiloh, Illinois 62269
United States
Southern Illinois University School of Medicine
Springfield, Illinois 62702
United States
Springfield Clinic
Springfield, Illinois 62702
United States
Springfield Memorial Hospital
Springfield, Illinois 62781
United States
UChicago Medicine Northwest Indiana
Crown Point, Indiana 46307
United States
Mary Greeley Medical Center
Ames, Iowa 50010
United States
McFarland Clinic - Ames
Ames, Iowa 50010
United States
McFarland Clinic - Boone
Boone, Iowa 50036
United States
Mercy Hospital
Cedar Rapids, Iowa 52403
United States
Oncology Associates at Mercy Medical Center
Cedar Rapids, Iowa 52403
United States
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa 50501
United States
McFarland Clinic - Jefferson
Jefferson, Iowa 50129
United States
McFarland Clinic - Marshalltown
Marshalltown, Iowa 50158
United States
HaysMed
Hays, Kansas 67601
United States
University of Kansas Cancer Center
Kansas City, Kansas 66160
United States
Lawrence Memorial Hospital
Lawrence, Kansas 66044
United States
The University of Kansas Cancer Center - Olathe
Olathe, Kansas 66061
United States
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas 66210
United States
University of Kansas Hospital-Indian Creek Campus
Overland Park, Kansas 66211
United States
Salina Regional Health Center
Salina, Kansas 67401
United States
University of Kansas Health System Saint Francis Campus
Topeka, Kansas 66606
United States
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas 66205
United States
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland 21201
United States
Boston Medical Center
Boston, Massachusetts 02118
United States
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan 48106
United States
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan 48114
United States
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan 48188
United States
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan 48118
United States
Cancer Hematology Centers - Flint
Flint, Michigan 48503
United States
Genesee Hematology Oncology PC
Flint, Michigan 48503
United States
Genesys Hurley Cancer Institute
Flint, Michigan 48503
United States
Hurley Medical Center
Flint, Michigan 48503
United States
University of Michigan Health - Sparrow Lansing
Lansing, Michigan 48912
United States
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan 48154
United States
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan 48341
United States
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan 48197
United States
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota 56601
United States
Minnesota Oncology - Burnsville
Burnsville, Minnesota 55337
United States
Mercy Hospital
Coon Rapids, Minnesota 55433
United States
Fairview Southdale Hospital
Edina, Minnesota 55435
United States
Saint John's Hospital - Healtheast
Maplewood, Minnesota 55109
United States
Abbott-Northwestern Hospital
Minneapolis, Minnesota 55407
United States
Hennepin County Medical Center
Minneapolis, Minnesota 55415
United States
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota 55416
United States
Regions Hospital
Saint Paul, Minnesota 55101
United States
United Hospital
Saint Paul, Minnesota 55102
United States
Saint Francis Medical Center
Cape Girardeau, Missouri 63703
United States
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri 63376
United States
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri 63141
United States
University Health Truman Medical Center
Kansas City, Missouri 64108
United States
University of Kansas Cancer Center - Briarcliff
Kansas City, Missouri 64116
United States
University of Kansas Cancer Center - North
Kansas City, Missouri 64154
United States
University of Kansas Cancer Center - Lee's Summit
Lee's Summit, Missouri 64064
United States
Lake Regional Hospital
Osage Beach, Missouri 65065
United States
Washington University School of Medicine
St Louis, Missouri 63110
United States
Mercy Hospital South
St Louis, Missouri 63128
United States
Siteman Cancer Center-South County
St Louis, Missouri 63129
United States
Siteman Cancer Center at Christian Hospital
St Louis, Missouri 63136
United States
Community Hospital of Anaconda
Anaconda, Montana 59711
United States
Billings Clinic Cancer Center
Billings, Montana 59101
United States
Bozeman Health Deaconess Hospital
Bozeman, Montana 59715
United States
Benefis Sletten Cancer Institute
Great Falls, Montana 59405
United States
Logan Health Medical Center
Kalispell, Montana 59901
United States
Community Medical Center
Missoula, Montana 59804
United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire 03756
United States
Memorial Sloan Kettering Basking Ridge
Basking Ridge, New Jersey 07920
United States
Jefferson Cherry Hill Hospital
Cherry Hill, New Jersey 08002
United States
Memorial Sloan Kettering Monmouth
Middletown, New Jersey 07748
United States
Memorial Sloan Kettering Bergen
Montvale, New Jersey 07645
United States
Sidney Kimmel Cancer Center Washington Township
Sewell, New Jersey 08080
United States
Memorial Sloan Kettering Commack
Commack, New York 11725
United States
Glens Falls Hospital
Glens Falls, New York 12801
United States
Memorial Sloan Kettering Westchester
Harrison, New York 10604
United States
Memorial Sloan Kettering Cancer Center
New York, New York 10065
United States
State University of New York Upstate Medical University
Syracuse, New York 13210
United States
SUNY Upstate Medical Center-Community Campus
Syracuse, New York 13215
United States
Memorial Sloan Kettering Nassau
Uniondale, New York 11553
United States
Upstate Cancer Center at Verona
Verona, New York 13478
United States
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina 27599
United States
Margaret R Pardee Memorial Hospital
Hendersonville, North Carolina 28791
United States
FirstHealth of the Carolinas-Moore Regional Hospital
Pinehurst, North Carolina 28374
United States
Sanford Bismarck Medical Center
Bismarck, North Dakota 58501
United States
Sanford Broadway Medical Center
Fargo, North Dakota 58122
United States
Sanford Roger Maris Cancer Center
Fargo, North Dakota 58122
United States
Miami Valley Hospital South
Centerville, Ohio 45459
United States
Miami Valley Hospital
Dayton, Ohio 45409
United States
Miami Valley Hospital North
Dayton, Ohio 45415
United States
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio 45005-1066
United States
Miami Valley Cancer Care and Infusion
Greenville, Ohio 45331
United States
ProMedica Flower Hospital
Sylvania, Ohio 43560
United States
Upper Valley Medical Center
Troy, Ohio 45373
United States
Cancer Centers of Southwest Oklahoma Research
Lawton, Oklahoma 73505
United States
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma 73104
United States
Saint Alphonsus Cancer Care Center-Ontario
Ontario, Oregon 97914
United States
Providence Willamette Falls Medical Center
Oregon City, Oregon 97045
United States
Providence Portland Medical Center
Portland, Oregon 97213
United States
Providence Saint Vincent Medical Center
Portland, Oregon 97225
United States
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania 18103
United States
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania 18017
United States
Carlisle Regional Cancer Center
Carlisle, Pennsylvania 17015
United States
Pocono Medical Center
East Stroudsburg, Pennsylvania 18301
United States
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania 16505
United States
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania 15601
United States
UPMC Pinnacle Cancer Center/Community Osteopathic Campus
Harrisburg, Pennsylvania 17109
United States
IRMC Cancer Center
Indiana, Pennsylvania 15701
United States
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania 15901
United States
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania 17050
United States
UPMC Hillman Cancer Center - Monroeville
Monroeville, Pennsylvania 15146
United States
Jefferson Torresdale Hospital
Philadelphia, Pennsylvania 19114
United States
UPMC-Saint Margaret
Pittsburgh, Pennsylvania 15215
United States
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania 15232
United States
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania 15237
United States
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh, Pennsylvania 15243
United States
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania 16346
United States
UPMC Cancer Center-Uniontown
Uniontown, Pennsylvania 15401
United States
UPMC Cancer Center-Washington
Washington, Pennsylvania 15301
United States
Medical University of South Carolina
Charleston, South Carolina 29425
United States
Avera Cancer Institute - Mitchell
Mitchell, South Dakota 57301
United States
Avera Cancer Institute at Pierre
Pierre, South Dakota 57501
United States
Sanford Cancer Center Oncology Clinic
Sioux Falls, South Dakota 57104
United States
Avera Cancer Institute
Sioux Falls, South Dakota 57105
United States
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota 57117-5134
United States
Avera Cancer Institute at Yankton
Yankton, South Dakota 57078
United States
Dartmouth Cancer Center - North
Saint Johnsbury, Vermont 05819
United States
VCU Massey Cancer Center at Stony Point
Richmond, Virginia 23235
United States
VCU Massey Comprehensive Cancer Center
Richmond, Virginia 23298
United States
West Virginia University Charleston Division
Charleston, West Virginia 25304
United States
Aurora Cancer Care-Southern Lakes VLCC
Burlington, Wisconsin 53105
United States
Aurora Saint Luke's South Shore
Cudahy, Wisconsin 53110
United States
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin 54701
United States
Aurora Health Care Germantown Health Center
Germantown, Wisconsin 53022
United States
Aurora Cancer Care-Grafton
Grafton, Wisconsin 53024
United States
Aurora BayCare Medical Center
Green Bay, Wisconsin 54311
United States
Aurora Cancer Care-Kenosha South
Kenosha, Wisconsin 53142
United States
Gundersen Lutheran Medical Center
La Crosse, Wisconsin 54601
United States
Aurora Bay Area Medical Group-Marinette
Marinette, Wisconsin 54143
United States
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin 54449
United States
Aurora Cancer Care-Milwaukee
Milwaukee, Wisconsin 53209
United States
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin 53215
United States
Aurora Sinai Medical Center
Milwaukee, Wisconsin 53233
United States
ProHealth D N Greenwald Center
Mukwonago, Wisconsin 53149
United States
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin 53066
United States
Vince Lombardi Cancer Clinic - Oshkosh
Oshkosh, Wisconsin 54904
United States
Aurora Cancer Care-Racine
Racine, Wisconsin 53406
United States
Vince Lombardi Cancer Clinic-Sheboygan
Sheboygan, Wisconsin 53081
United States
Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin 54482
United States
Aurora Medical Center in Summit
Summit, Wisconsin 53066
United States
Vince Lombardi Cancer Clinic-Two Rivers
Two Rivers, Wisconsin 54241
United States
ProHealth Waukesha Memorial Hospital
Waukesha, Wisconsin 53188
United States
UW Cancer Center at ProHealth Care
Waukesha, Wisconsin 53188
United States
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin 53226
United States
Aurora West Allis Medical Center
West Allis, Wisconsin 53227
United States
Marshfield Medical Center - Weston
Weston, Wisconsin 54476
United States