Squamous Cell Carcinoma of the Head and NeckPhase 3INTERLINK-1NCT04590963
Assessment of Efficacy and Safety of Monalizumab Plus Cetuximab Compared to Placebo Plus Cetuximab in Recurrent or Metastatic Head and Neck Cancer
A Phase 3 study testing Monalizumab and Cetuximab in people with Squamous Cell Carcinoma of the Head and Neck, run by AstraZeneca at 127 sites in 23 countries.
Trial summary
This is a randomized, double-blind, multicenter, global Phase 3 study to assess the efficacy and safety of monalizumab and cetuximab, compared to placebo and cetuximab, in Participants with recurrent or metastatic head and neck cancer Read more about this study
- Who is it for?
- Ages 18 to 130 years
- Conditions the study is for
- Squamous Cell Carcinoma of the Head and Neck
- What is being tested?
- Monalizumab and Cetuximab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 370 participants
- Where
- 127 sitesin 23 countries
- Study dates
- 2 Oct 2020to 24 Sep 2026
- Phase
- Phase 3
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 to 130 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Are aged 18 years and over
- Recurrent or metastatic squamous cell carcinoma of the SCCHN, oral cavity, oropharynx, hypopharynx, or larynx which has progressed on or after previous systemic cancer therapy and is not amenable to curative therapy
- Received prior treatment using a programmed cell death ligand-1 (PD-L1) inhibitor
- Prior platinum failure
- Received 1 or 2 prior systemic regimens for recurrent or metastatic SCCHN
- Has measurable disease per RECIST 1.1
- A fresh or recently acquired tumor tissue for the purpose of biomarker testing
- World Health Organization (WHO)/ Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
Who cannot join
- Head and neck cancer of any primary anatomic location in the head and neck not specified in the inclusion criteria, including participants with SCCHN of unknown primary or non-squamous histologies
- Had prior cetuximab therapy (unless it was administered in curative locally advanced setting with radiotherapy and no disease progression for at least 6 months following the last cetuximab dose)
- Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [eg, colitis or Crohn's disease], diverticulitis
- Any concurrent anticancer treatment, except for hormonal therapy for non-cancer-related conditions (eg, hormone replacement therapy)
Trial locations and contacts
127 sites in 23 countries.
127 sites in 23 countries
United States17 sites
Research Site
Ann Arbor, Michigan, 48109
Research Site
Boston, Massachusetts, 02215
Research Site
Charlotte, North Carolina, 28204
Research Site
Chicago, Illinois, 60612
Research Site
Columbus, Ohio, 43210
Research Site
Dallas, Texas, 75246
Research Site
Houston, Texas, 77090
Research Site
Las Vegas, Nevada, 89169
Research Site
New York, New York, 10029
Research Site
Philadelphia, Pennsylvania, 19104
Research Site
Philadelphia, Pennsylvania, 19111
Research Site
Pittsburgh, Pennsylvania, 15232
Research Site
Rochester, Minnesota, 55905
Research Site
St Louis, Missouri, 63110
Research Site
Tucson, Arizona, 85719
Research Site
Westwood, Kansas, 66205
Research Site
Winston-Salem, North Carolina, 27103
Japan12 sites
Research Site
Chūōku, 104-0045
Research Site
Fukuoka, 811-1395
Research Site
Hiroshima, 734-8551
Research Site
Isehara-shi, 259-1193
Research Site
Kashiwa, 277-8577
Research Site
Kobe, 650-0017
Research Site
Kōtoku, 135-8550
Research Site
Okayama, 700-8558
Research Site
Sayama, 589-8511
Research Site
Sunto-gun, 411-8777
Research Site
Yokohama, 236-0004
Research Site
Yokohama, 241-8515
France8 sites
Research Site
Avignon, 84918
Research Site
Bordeaux, 33000
Research Site
Clermont-Ferrand, 63011
Research Site
Dijon, 21079
Research Site
Lyon, 69373
Research Site
Marseille, 13005
Research Site
Montpellier, 34298
Research Site
Strasbourg, 67033
Italy8 sites
Research Site
Brescia, 25123
Research Site
Candiolo, 10060
Research Site
Florence, 50134
Research Site
Milan, 20132
Research Site
Milan, 20133
Research Site
Modena, 41124
Research Site
Naples, 80131
Research Site
Padova, 35128
Brazil7 sites
Research Site
Belo Horizonte, 30110-022
Research Site
Porto Alegre, 90560-030
Research Site
Rio de Janeiro, 22271-110
Research Site
São Paulo, 01321-001
Research Site
São Paulo, 01327-001
Research Site
São Paulo, 01509-900
Research Site
São Paulo, 04543-000
Germany7 sites
Research Site
Berlin, 12203
Research Site
Essen, 45122
Research Site
Freiburg im Breisgau, 79106
Research Site
Hanover, 30625
Research Site
Leipzig, 04103
Research Site
Ulm, 89081
Research Site
Würzburg, 97070
Russia7 sites
Research Site
Moscow, 115478
Research Site
Moscow Region, 143081
Research Site
Obninsk, 249036
Research Site
Saint Petersburg, 191014
Research Site
Saint Petersburg, 195271
Research Site
Saint Petersburg, 197022
Research Site
Saint Petersburg, 197758
South Korea7 sites
Research Site
Busan, 49267
Research Site
Cheongju-si, 28644
Research Site
Goyang-si, 10408
Research Site
Seongnam-si, 13620
Research Site
Seoul, 06351
Research Site
Seoul, 110-744
Research Site
Seoul, 138-736
Taiwan6 sites
Research Site
Changhua, 500
Research Site
Taichung, 40447
Research Site
Taichung, 40705
Research Site
Tainan, 704
Research Site
Taipei, 112
Research Site
Taipei, 235
Canada5 sites
Research Site
Hamilton, Ontario, L8V 5C2
Research Site
Montreal, Quebec, H3T 1E2
Research Site
Toronto, Ontario, M4N 3M5
Research Site
Toronto, Ontario, M5G 2M9
Research Site
Victoria, British Columbia, V8R 6V5
Spain5 sites
Research Site
Barcelona, 08035
Research Site
Madrid, 28007
Research Site
Madrid, 28040
Research Site
Madrid, 28041
Research Site
Valencia, 46014
Australia4 sites
Research Site
Camperdown, 2050
Research Site
Elizabeth Vale, 5112
Research Site
Heidelberg, 3084
Research Site
Melbourne, 3000
Belgium4 sites
Research Site
Brussels, 1200
Research Site
Leuven, 3000
Research Site
Namur, 5000
Research Site
Roeselare, 8800
Portugal4 sites
Research Site
Coimbra, 3000-075
Research Site
Porto, 4099-001
Research Site
Porto, 4200-319
Research Site
Vila Nova de Gaia, 4434-502
United Kingdom4 sites
Research Site
London, SW3 6JJ
Research Site
Manchester, M20 4BX
Research Site
Newcastle upon Tyne, NE7 7DN
Research Site
Sutton, SM2 5PT
Argentina3 sites
Research Site
CABA, 1426
Research Site
CABA, C1012AAR
Research Site
CABA, C1426ANZ
Bulgaria3 sites
Research Site
Panagyurishte, 4500
Research Site
Plovdiv, 4004
Research Site
Sofia, 1527
Greece3 sites
Research Site
Athens, 11528
Research Site
Chaïdári, 124 62
Research Site
Thessaloniki, 54645
Netherlands3 sites
Research Site
Amsterdam, 1066 CX
Research Site
Maastricht, 6229 HX
Research Site
Nijmegen, 6525 GA
Philippines3 sites
Research Site
Manila, 1000
Research Site
Pasig, 1605
Research Site
Quezon City, 1112
Poland3 sites
Research Site
Bialystok, 15-027
Research Site
Bydgoszcz, 85-796
Research Site
Poznan, 61-866
Switzerland3 sites
Research Site
Basel, 4031
Research Site
Bern, 3010
Research Site
Lausanne, CH-1011
About this study
Official title: A Phase 3 Randomized, Double-blind, Multicenter, Global Study of Monalizumab or Placebo in Combination With Cetuximab in Participants With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck Previously Treated With an Immune Checkpoint Inhibitor
This is a randomized, double-blind, multicenter, global Phase 3 study to assess the efficacy and safety of monalizumab and cetuximab, compared to placebo and cetuximab, in Participants with recurrent or metastatic head and neck cancer
Read the detailed description
Participants with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) who had prior immune checkpoint inhibitor and platinum-based chemotherapy treatment will be randomized in a 2:1 ratio to monalizumab and cetuximab or placebo and cetuximab. Efficacy and safety assessments will be performed periodically from the time of enrollment and throughout the study. Participants in all arms will continue therapy until progression, unacceptable toxicity, withdrawal of consent, or another discontinuation criterion is met. All Participants will be followed for survival after progression is confirmed.
- Being tested
- Monalizumab, Cetuximab, Placebo
- Keywords
- head and neck cancer, Squamous Cell Carcinoma of the Head and Neck, monalizumab, cetuximab, Erbitux, oral cavity, larynx, pharynx, natural killer, oropharynx, hypopharynx
- Medical subject headings
- Squamous Cell Carcinoma of Head and Neck, Head and Neck Neoplasms, Laryngeal Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MonalizumabDrug
Also called IPH2201
Participants will receive IV infusion of monalizumab as stated in arm description.
CetuximabDrug
Also called Erbitux
Participants will receive IV infusion of cetuximab as stated in arm description.
PlaceboOther
Participants will receive IV infusion of placebo as stated in arm description.
| Study group | Role | What they receive |
|---|---|---|
| Monalizumab 750 mg Q2W + Cetuximab 400 mg/m^2 | Experimental | Participants will receive intravenous (IV) monalizumab 750 mg every two weeks (Q2W) and IV cetuximab 400 mg/m^2 initial dose followed by 250 mg/m^2 every one week (Q1W) until disease progression, unacceptable toxicity, withdrawal of consent, or another discontinuation criterion was met. Receives: Drug: Monalizumab; Drug: Cetuximab |
| Placebo Q2W + Cetuximab 400 mg/m^2 | Active comparator | Participants will receieve IV placebo matched to monalizumab Q2W and IV cetuximab 400 mg/m^2 initial dose followed by 250 mg/m^2 Q1W until disease progression, unacceptable toxicity, withdrawal of consent, or another discontinuation criterion was met. Receives: Drug: Cetuximab; Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS) in Human Papillomavirus (HPV)-Unrelated Analysis Set
The OS is defined as time from the date of randomization until death due to any cause regardless of whether the participant withdraws from randomized therapy or receives another anti-cancer therapy (i.e. date of death or censoring - date of randomization + 1). The OS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from a stratified log-rank test and hazard ratio (HR) and confidence intervals (CIs) from a stratified Cox proportional hazards model. Analyses were stratified on World Health Organization/ Eastern Cooperative Oncology Group performance status (WHO/ECOG PS) (0 or 1) and number of prior lines of therapy in recurrent or metastatic (R/M) setting (1 or 2).
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Secondary outcomes (11)
Overall Survival in Full Analysis Set (FAS)
The OS is defined as time from the date of randomization until death due to any cause regardless of whether the participant withdraws from randomized therapy or receives another anti-cancer therapy (i.e. date of death or censoring - date of randomization + 1). The OS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from a stratified log-rank test and HR and CIs from a stratified Cox proportional hazards model. Analyses were stratified on HPV status (OPC HPV positive or HPV-unrelated), WHO/ECOG PS (0 or 1) and number of prior lines of therapy in R/M setting (1 or 2).
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Progression-Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by Investigator Assessment in HPV-unrelated Analysis Set
PFS per RECIST 1.1 as assessed by the investigator is defined as time from randomization until date of RECIST 1.1-defined radiological progressive disease (PD) or death regardless of whether participant withdraws from therapy or received subsequent anticancer therapy prior to progression. PD: at least 20% increase in sum of diameters of target lesions (TLs), taking as reference the smallest sum on study (nadir) and sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing non-TLs (NTLs) or appearance of new lesions. PFS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from stratified log-rank test and HR and CIs from a stratified Cox proportional hazards model. Analyses were stratified on WHO/ECOG PS (0/1) and no. of prior lines of therapy in R/M setting.
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Progression-Free Survival Per RECIST 1.1 by Investigator Assessment in FAS
PFS per RECIST 1.1 as assessed by the investigator is defined as time from randomization until date of RECIST 1.1-defined radiological progressive disease (PD) or death regardless of whether participant withdraws from therapy or received subsequent anticancer therapy prior to progression. PD: at least 20% increase in sum of diameters of target lesions (TLs), taking as reference the smallest sum on study (nadir) and sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing NTLs or appearance of new lesions. PFS was analyzed using Kaplan-Meier technique. Statistical analysis was performed using P-value from a stratified log-rank test and HR and CIs from a stratified Cox proportional hazards model. Analyses were stratified on HPV status, WHO/ECOG PS (0/1) and no. of prior lines of therapy in R/M setting.
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Percentage of Participants With Objective Response (OR) Per RECIST 1.1 in HPV-unrelated Analysis Set
The OR is defined as the percentage of participants with at least one confirmed investigator-assessed response of complete response (CR) or partial response (PR) as assessed by RECIST 1.1 guidelines. The CR is defined as disappearance of all TLs and NTLs, any pathological lymph nodes (target and non-target) must have reduction in short axis < 10 mm, and no new lesions. The PR is defined as at least a 30% decrease in the sum of the diameters (SoD) of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. Percentage of participants with OR is reported. Participants who had measurable disease at baseline per the site investigator were analyzed for this outcome.
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Percentage of Participants With OR Per RECIST 1.1 in FAS
The OR is defined as the percentage of participants with at least one confirmed investigator-assessed response of CR or PR as assessed by RECIST 1.1 guidelines. The CR is defined as disappearance of all TLs and NTLs, any pathological lymph nodes (target and non-target) must have reduction in short axis < 10 mm, and no new lesions. The PR is defined as at least a 30% decrease in the SoD of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. Percentage of participants with OR is reported. Participants who had measurable disease at baseline per the site investigator were analyzed for this outcome.
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Duration of Response (DoR) Per RECIST 1.1 in HPV-unrelated Analysis Set
The DoR is defined as the time from the date of first documented confirmed response until date of documented progression or death in the absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1). The CR is defined as disappearance of all target and non-target lesions, no new lesions, and normalization of tumor marker level. The PR is defined as at least a 30% decrease in the SoDs of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. The PD is defined as at least a 20% increase in the SoDs of TLs, taking as reference the smallest previous SoDs (nadir) and the sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing NTLs or appearance of new lesions. The DoR was analyzed using Kaplan-Meier technique.
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Duration of Response Per RECIST 1.1 in FAS
The DoR is defined as the time from the date of first documented confirmed response until date of documented progression or death in the absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1). The CR is defined as disappearance of all target and non-target lesions, no new lesions, and normalization of tumor marker level. The PR is defined as at least a 30% decrease in the SoDs of TLs (compared to baseline) and no new lesions. Confirmation of CR and PR is required by a repeat, consecutive assessment no less than 4 weeks from the date of first documentation. The PD is defined as at least a 20% increase in the SoDs of TLs, taking as reference the smallest previous SoDs (nadir) and the sum must demonstrate an absolute increase of at least 5 mm from nadir or unequivocal progression of existing NTLs or appearance of new lesions. The DoR was analyzed using Kaplan-Meier technique.
Measured: Baseline (-28 to -1) through 17.5 months (maximum observed duration)
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
An adverse event (AE) is any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first.
Measured: Day 1 through 21.4 months (maximum observed duration)
Number of Participants With Abnormal Clinical Laboratory Parameters Reported as TEAEs
Participants with abnormal laboratory parameters reported as TEAEs are reported. Laboratory analysis included hematology and clinical chemistry. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first.
Measured: Day 1 through 21.4 months (maximum observed duration)
Number of Participants With Abnormal Vital Signs Reported as TEAEs
Participants with abnormal vital signs (heart rate, blood pressure, temperature, and respiratory rate) reported as TEAEs are reported. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first.
Measured: Day 1 through 21.4 months (maximum observed duration)
Number of Participants With Electrocardiograms (ECGs) Reported as TEAEs
Participants with Abnormal ECGs reported as TEAEs are reported. TEAEs included events from the first dose of study drug, up to 90 days after the last dose of study drug received or up to the start date of any subsequent anticancer therapy following discontinuation of study drug, or the final safety DCO date of 01Sep2022, whichever occurred first.
Measured: Day 1 through 21.4 months (maximum observed duration)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Oct 2020
- Study start2 Oct 2020
- Primary completion11 May 2022
- Study completion24 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Squamous Cell Carcinoma of the Head and NeckStudies of the same condition, open and under way.
- More trials run by AstraZenecaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Parallel study. Participants will be randomized in a 2:1 ratio to monalizumab and cetuximab or placebo and cetuximab.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 370 participants (actual)
Sponsor and investigators
- Lead sponsor
- AstraZeneca
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Innate Pharma
- Responsible party
- Sponsor
- Investigators
- Roger B Cohen, MD, Principal investigator, Abramson Cancer Center, Perelman Center for Advanced MedicineJérôme Fayette, MD, Principal investigator, Centre Leon BerardDario Ruscica, MD, Study director, AstraZeneca, Cambridge, UK
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04590963
- Sponsor's protocol ID
- D7310C00001
- Other IDs
- 2024-511813-39-00, 2019-004770-25, 2019
- Acronym
- INTERLINK-1
- Status last verified
- Sep 2026
- First submitted
- 23 Sep 2020
- Last updated
- 9 Sep 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Publications
Nowojewski A, Wheal A, Dott W, Ruscica D, Ghiorghiu S, Valastro B. Implementation of the Study Participant Feedback Questionnaire to understand participant experience in a phase 3 oncology clinical trial. BMJ Open. 2025 Oct 28;15(10):e094596. doi: 10.1136/bmjopen-2024-094596.
PubMed 41151963