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Head and Neck CancerPhase 2NCT04058145

AMD3100 Plus Pembrolizumab in Immune Checkpoint Blockade Refractory Head and Neck Squamous Cell Carcinoma

A Phase 2 study testing AMD3100 and Pembrolizumab in people with Head and Neck Cancer, run by Massachusetts General Hospital at 2 sites in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This research is studying the safety and effectiveness of AMD3100 and pembrolizumab in participants with metastatic head and neck squamous cell carcinoma. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Head and Neck Cancer
What is being tested?
AMD3100 and Pembrolizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
2 sitesUnited States
Study dates
30 Sep 2019to 11 Oct 2019
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Have histologically or cytologically confirmed diagnosis of squamous cell carcinoma of the recurrent or metastatic head and neck. For oropharyngeal cancer, tumor HPV status must be known.
  • Have measurable disease based on RECIST 1.1. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions
  • Have progressed on or after immune checkpoint therapy (anti-PD-1 or anti-PD-L1, as a monotherapy or in combination with other agents). Anti-PD-1/PD-L1 immune checkpoint therapy does not have to be the most immediate prior therapy before the study enrollment.
  • Have provided archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated. Formalin-fixed, paraffin embedded (FFPE) tissue blocks are preferred to slides. If slides are to be submitted, 10-20 unstained slides are required. Newly obtained biopsies are preferred to archived tissue. At a minimum, 3 core biopsies will be obtained and 1 core will be formalin fixed and the other 2 cores will be flash frozen.
  • Have a lesion that is accessible for biopsy for subjects in the Run-In phase. An exception can be granted for those patients who do not have a lesion that can be safely biopsied based upon review with the Principal Investigator. The tumor biopsy is optional in the Phase II portion of the study
  • Be >18 years of age on the day of signing informed consent.
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  • ECOG performance status ≤ 1 (Karnofsky ≥70%, see Appendix A).
  • Have normal organ and marrow function as defined below. Specimens must be collected within 28 days prior to study registration.
  • leukocytes ≥3,000/mcL
  • absolute neutrophil count ≥1,500/mcL
  • platelets ≥100,000/mcL
  • total bilirubin ≤1.5 ×ULN
  • AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal
  • creatinine Within normal institutional limits, OR
  • creatinine clearance ≥60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
  • Ability to understand and the willingness to sign a written informed consent document.
  • Male participants:
  • A male participant must agree to use a contraception as detailed in Appendix C of this protocol during the treatment period and for at least 120 days after the last dose of study treatment and refrain from donating sperm during this period.
  • -Female participants:
  • A female participant is eligible to participate if she is not pregnant (see Appendix C), not breastfeeding, and at least one of the following conditions applies:
  • Not a woman of childbearing potential (WOCBP) as defined in Appendix C, OR
  • A WOCBP who agrees to follow the contraceptive guidance in Appendix C during the treatment period and for at least 120 days plus 30 days (a menstruation cycle) after the last dose of study treatment.

Who cannot join

  • Has received prior systemic anti-cancer therapy including investigational agents within 2 weeks prior to registration with the exception of receiving immune checkpoint blockade therapy.
  • Participants must have recovered from all AEs due to previous therapies to ≤ Grade 1 or baseline. Participants with ≤ Grade 2 neuropathy may be eligible after discussion with PI.
  • Has received prior radiotherapy within 2 weeks of first dose of study drug.
  • Participants must have recovered from all radiation-related toxicities to ≤Grade 1 or baseline, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease.
  • Has received a live vaccine within 30 days prior to the first dose of study drug. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (eg, FluMist®) are live attenuated vaccines and are not allowed.
  • Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 2 weeks prior to the first dose of study drug. Note: Participants who have entered the follow-up phase of an investigational study may participate as long as it has been >2 weeks since the last dose of the previous investigational agent.
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  • Has a known diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug.
  • Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.
  • Has known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, i.e. without evidence of progression for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study treatment.
  • Has severe hypersensitivity (≥Grade 3) to pembrolizumab, AMD3100, and/or any of its excipients.
  • Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.
  • Has an active infection requiring systemic therapy.
  • Has a known history of Human Immunodeficiency Virus (HIV).
  • No HIV testing is required unless mandated by local health authority.
  • Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection. Note: No testing for Hepatitis B and Hepatitis C is required unless mandated by local health authority.
  • Has a known history of active TB (Bacillus Tuberculosis).
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  • Has known uncontrolled psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
  • Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of trial treatment.
  • A WOCBP who has a positive serum pregnancy test within 72 hours prior to registration (see Appendix C). Note: In the event that 72 hours have elapsed between the screening pregnancy test and the first dose of study treatment, another pregnancy test (urine or serum) must be performed and must be negative in order for subject to start receiving study medication.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Massachusetts General Hospital Cancer Center

    Boston, Massachusetts, 02062

  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02115

Other trials in United States

About this study

Official title: A Phase II Study of AMD3100 in Combination With Pembrolizumab in Head and Neck Squamous Cell Carcinoma Patients Who Have Progressed on Immune Checkpoint Blockade Therapy

This research is studying the safety and effectiveness of AMD3100 and pembrolizumab in participants with metastatic head and neck squamous cell carcinoma.

Read the detailed description

This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational drug to learn whether the drug combination works in treating a specific disease. "Investigational" means that the drug is being studied.

Because AMD3100 and Pembrolizumab have not been administered together to individuals before, there will be a Run-In phase prior to the beginning of Phase II. This Run-In Phase is designed to identify what dosing schedule is best for participants on this study. Participants will be participating in the Run-In Phase.

The U.S. Food and Drug Administration (FDA) has approved Pembrolizumab as a treatment option for this disease.

The FDA has not approved AMD3100 as a treatment option for this disease, however it has approved the drug for use in individuals who have recently had bone marrow transplants.

Pembrolizumab is thought to block a receptor called PD-1. This receptor usually acts as a "brake" to prevent the body's immune system from attacking cancer cells. The antibody "removes the brake" to allow parts of the body's immune system (usually T cells) to attack the tumor

AMD3100 is a drug that inhibits CXCR4, which is a biological mechanism called a chemokine. CXCR4 is over-expressed in cancer cells and promotes cancer cell growth, spread, and survival and controls immune cell trafficking. Researchers believe that inhibiting CXCR4 expels the immune-suppressive cells out of the tumor and attract the cancer-killing immune cells into the tumor environment so that the body's immune system may be able to better attack the cancer cells.

In this research study, the investigators are assessing the safety and effectiveness of AMD3100 and pembrolizumab in participants with aggressive head and neck squamous cell carcinoma.

Being tested
AMD3100, Pembrolizumab
Keywords
Head and Neck Cancer
Medical subject headings
Head and Neck Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AMD3100Drug

    Also called Plerixafor

    AMD3100 is a drug that inhibits a chemokine CXCR4 which promotes cancer cell growth, spread, and survival and controls immune cell trafficking. Inhibiting CXCR4 expels the immune-suppressive cells out of the tumor and attract the cancer-killing immune cells into the tumor environment so that the body's immune system may be able to better attack the cancer cells.

  • PembrolizumabDrug

    Also called Keytruda

    Pembrolizumab is thought to block a receptor called PD-1. This receptor usually acts as a "brake" to prevent the body's immune system from attacking cancer cells. The antibody "removes the brake" to allow parts of the body's immune system (usually T cells) to attack the tumor.

Study groups in NCT04058145
Study groupRoleWhat they receive
Pembrolizumab+AMD3100 q3wExperimental* Pembrolizumab is administered intravenously on day 1 of each cycle * AMD3 100 is administered via injection subcutaneously on day 1 of each cycle
Receives: Drug: AMD3100; Drug: Pembrolizumab
Pembrolizumab+AMD3100 weeklyExperimental* Pembrolizumab is administered intravenously on day 1 of each cycle * AMD3 100 is administered via injection subcutaneously on a weekly basis
Receives: Drug: AMD3100; Drug: Pembrolizumab
Pembrolizumab+AMD3100Experimental* Pembrolizumab is administered intravenously * AMD3 100 is administered via injection subcutaneously
Receives: Drug: AMD3100; Drug: Pembrolizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants That Experience a Dose Limiting Toxicity

    A safety run in will be conducted with AMD3100 administered weekly or every three weeks, both in combination with pembrolizumab administered every three weeks. The number of participants that experience dose limiting toxicities will be reported for each arm.

    Measured: From the start of treatment up to 24 months, or until disease progression or intolerable toxicity, whichever occurs first

  2. Overall Response Rate

    Overall response rate will be evaluated using Response Evaluation Criteria in Solid Tumors (RECIST). A participant is considered to have achieved a response if the achieve either of the following:

    • Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm
    • Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters

    Measured: From the start of treatment up to 24 months, or until disease progression or intolerable toxicity, whichever occurs first

Secondary outcomes (4)
  1. Progression Free Survival

    The duration of time from randomization until disease progression or death. Disease progression is assessed using RECIST criteria.

    Confirmed Progressive Disease(CPD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression). Disease progression must be confirmed on a subsequent scan.

    Measured: From the time of randomization until disease progression or death, up to approximately 5 years

  2. Overall Survival

    The median duration of time from the time of randomization until death.

    Measured: From the time of randomization until death, up to approximately 5 years

  3. The Number of Participants With Treatment-Related Serious Adverse Events

    Adverse events are assessed using the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. A treatment-related adverse event is an adverse event deemed to be possibly, probably, or definitely related to study treatment by the investigator.

    Measured: From the start of treatment until 30 days after the end of treatment, up to 25 months

  4. Duration of Response

    Duration of response is measured from the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented (taking as reference for progressive disease the smallest measurements recorded since the treatment started, or death due to any cause. Participants without events reported are censored at the last disease evaluation).

    Measured: From the time of first response until disease progression, up to 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Aug 2019
  2. Study start30 Sep 2019 (estimated)
  3. Primary completion11 Oct 2019
  4. Study completion11 Oct 2019

Why it stopped: Funding Withdrawn

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04058145
Sponsor's protocol ID
19-189
Status last verified
Sep 2020
First submitted
14 Aug 2019
Last updated
7 Sep 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: \[contact information for Sponsor Investigator or designee\]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing AMD3100 and Pembrolizumab in people with Head and Neck Cancer, run by Massachusetts General Hospital at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 22 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 7 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants That Experience a Dose Limiting Toxicity (time frame: From the start of treatment up to 24 months, or until disease progression or intolerable toxicity, whichever occurs first). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Sep 2020.

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