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HNSCCPhase 2NCT07090707

PD-1 Inhibitor Therapy Versus Radiotherapy in MPR Patients With Locally Advanced HNSCC After Neoadjuvant Immunochemotherapy (HNC-SYSU-006)

A Phase 2 study testing PD-1inhibitor and radiotherapy in people with HNSCC and PD-1, run by Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Head and neck malignant tumors rank as the sixth most common type of malignancy worldwide, with approximately 90% being squamous cell carcinoma (Head and Neck Squamous Cell Carcinoma, HNSCC). Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
HNSCC, PD-1, Radiotherapy
What is being tested?
PD-1inhibitor and radiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteChina
Study dates
1 Aug 2025to 31 Dec 2031
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • In this study, patients with locally advanced head and neck squamous cell carcinoma (AJCC 8th) who underwent standard surgical treatment after neoadjuvant immunochemotherapy and showed MPR in both primary lesions and lymph node pathology were selected. Locally advanced squamous cell carcinoma of head and neck includes: i) T3, N0, M0; 2) T1-T3, N1-N2, M0; 3) T4a, N0-2, M0.
  • No history of other malignant tumors
  • Ages 18-75
  • Normal baseline inspection:
  • The absolute value of neutrophil granulocyte (ANC) ≥1.5x109/L in the last 14 days without the use of granulocyte colony stimulating factor;
  • Platelets ≥100×109/L without blood transfusion in the past 14 days;
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  • Hemoglobin \&gt without blood transfusion or use of erythropoietin within the last 14 days; 9g/dL;
  • Total bilirubin ≤1.5× upper limit of normal value (ULN);
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5×ULN (ALT or AST ≤5×ULN in patients with liver metastasis);
  • Serum creatinine ≤1.5×ULN and creatinine clearance (calculated by Cockcroft-Gault formula) ≥60 ml/min;
  • Good coagulation function, defined as International Standardized ratio (INR) or prothrombin time (PT) ≤1.5 times ULN;
  • Normal thyroid function, defined as thyroid stimulating hormone (TSH) within the normal range. Subjects whose baseline TSH is outside the normal range can be enrolled if total T3 (or FT3) and FT4 are within the normal range;
  • The myocardial enzyme profile was within the normal range (if the researchers comprehensively judged that the simple laboratory abnormality was not clinically significant, it was also allowed to be included);
  • For female subjects of childbearing age, a urine or serum pregnancy test should be tested negative within 3 days prior to receiving the first study drug administration (day 1 of Cycle 1). If the urine pregnancy test results cannot be confirmed negative, a blood pregnancy test is requested. Women of non-reproductive age were defined as at least one year after menopause or having undergone surgical sterilization or hysterectomy;
  • If there is a risk of conception, all subjects (male or female) shall use contraception with an annual failure rate of less than 1% for the entire duration of treatment up to 120 days after the last study drug administration (or 180 days after the last chemotherapeutic drug administration).
  • 5 Sign informed consent

Who cannot join

  • 1 HNSCC is not the initial diagnosis of other malignant tumors or neoadjuvant therapy.
  • Prior to treatment An active autoimmune immune disease requiring systemic therapy (e.g. the use of disease-modifying drugs, glucocorticoids, or immunosuppressants) has occurred in the last 2 years. Alternative therapies (such as thyroxine, insulin, or physiologic glucocorticoids for adrenal or pituitary insufficiency) are not considered systemic therapy;
  • Known allogeneic organ transplantation (except corneal transplantation) or allogeneic hematopoietic stem cell transplantation;
  • Known history of human immunodeficiency virus (HIV) infection (i.e. HIV 1/2 antibody positive);
  • Untreated active hepatitis B (defined as HBsAg positive and HBV-DNA copy number detected greater than the upper limit of normal value in the laboratory of the study center);
  • Note: Hepatitis B subjects who meet the following criteria can also be enrolled:
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  • 1) HBV viral load \&lt before initial administration; At 1000 copies /ml (200 IU/ml), subjects should receive anti-HBV therapy to avoid viral reactivation throughout the study treatment period 2) For subjects with anti-HBC (+), HBsAg (-), anti-HBS (-), and HBV viral load (-), prophylactic anti-HBV therapy is not required, but close monitoring of viral reactivation is required
  • Active HCV infected subjects (HCV antibody positive and HCV-RNA level above the lower limit);
  • Pregnant or lactating women;
  • The presence of any serious or uncontrolled systemic disease, such as:
  • The resting electrocardiogram (ECG) presents significant and severely uncontrollable abnormalities in rhythm, conduction or morphology, such as complete left bundle branch block, Ⅱ degree or above heart block, ventricular arrhythmia or atrial fibrillation;
  • Unstable angina pectoris, congestive heart failure, and NYHA grade ≥ 2 chronic heart failure;
  • Any arterial thrombosis, embolism or ischemia, such as myocardial infarction, unstable angina pectoris, cerebrovascular accident or transient ischemic attack, occurred within 6 months before treatment;
  • Poor blood pressure control (systolic > 140 mmHg, diastolic > 90 mmHg);
  • A history of non-infectious pneumonia requiring glucocorticoid therapy or clinically active interstitial lung disease within 1 year prior to initial administration;
  • Active pulmonary tuberculosis;
  • There is an active or uncontrolled infection that requires systemic treatment;
  • Clinically active diverticulitis, abdominal abscess, gastrointestinal obstruction;
  • Liver diseases such as cirrhosis, decompensated liver disease, acute or chronic active hepatitis;
  • Poor diabetes control (fasting blood glucose (FBG) > 10mmol/L);
  • Urine routine indicated urine protein ≥++, and confirmed 24 hours urine protein quantity > 1.0 g;
  • Patients with mental disorders and unable to cooperate with treatment;
  • Medical history or evidence of disease that may interfere with test results, prevent subjects from fully participating in the study, abnormal values of treatment or laboratory tests, or other conditions that the investigator considers unsuitable for enrollment. The investigator considers other potential risks unsuitable for participation in the study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site
  • Sun yat-sen memorial hospital

    Guangzhou, Guangdong, 510000

    Haotian Cao, 18583879908, caobleat@gmail.com

Other trials in China

About this study

Official title: Prospective Exploratory Phase II Study of PD-1 Inhibitor Therapy Versus Radiotherapy in MPR Patients After Neoadjuvant Immunochemotherapy for Advanced Head and Neck Squamous Cell Carcinoma

Head and neck malignant tumors rank as the sixth most common type of malignancy worldwide, with approximately 90% being squamous cell carcinoma (Head and Neck Squamous Cell Carcinoma, HNSCC). Globally, there are about 650,000 new cases of HNSCC annually, with China contributing approximately 350,000 new cases each year. At initial diagnosis, 60% of patients already present with locally advanced HNSCC, necessitating comprehensive treatment strategies.

In the first half of the 20th century, radiotherapy was the primary treatment for HNSCC. However, due to its relatively low local control rate (70%), high rate of distant metastasis (20%), and low 5-year overall survival (OS) rate (40%), coupled with significant early and late adverse effects, radiotherapy often brought severe challenges to patients. For instance, 95% of patients developed radiation-induced oral mucositis, nearly all experienced xerostomia, taste disorders, radiation-induced dental caries, restricted mouth opening, swallowing difficulties, aspiration, and other functional impairments. Some patients even suffered severe complications, with 6% developing radiation-induced osteonecrosis of the jaw, and 0.1% experiencing secondary cancers such as radiation-induced sarcoma or squamous cell carcinoma in the head and neck region. Other complications, such as radiation-induced encephalopathy, also posed significant threats to patients' safety and quality of life. As surgical techniques improved towards the end of the 20th century, surgery gradually replaced radiotherapy as the dominant treatment for HNSCC.

Read more

Over the past four decades, despite the use of comprehensive treatments based on surgery supplemented by radiotherapy, chemotherapy, and targeted therapy, the 5-year survival rate for locally advanced HNSCC has not significantly improved, remaining around 50%. Recently, with the advent of immunotherapy centered on PD-1 inhibitors, treatment outcomes for HNSCC patients have improved markedly, and the therapeutic landscape is undergoing significant transformation. Concurrently, many studies have focused on neoadjuvant immunotherapy prior to surgery. In locally advanced lung cancer, neoadjuvant chemoimmunotherapy has been proven safe and effective through phase III clinical trials. Similarly, studies on head and neck tumors have shown that neoadjuvant immunotherapy-whether PD-1 monotherapy or in combination with chemotherapy-demonstrates favorable safety and efficacy. However, for patients who respond well to immunochemotherapy and achieve pathological downstaging, how to evaluate the relationship between therapeutic efficacy, staging, and prognosis, as well as how to plan subsequent treatments, remains unclear in existing guidelines. For some patients with locally advanced HNSCC who achieve major pathological response (MPR) or pathological complete response (pCR) after neoadjuvant immunochemotherapy and undergo extensive primary tumor resection and thorough neck lymph node dissection, there is no research to clarify whether postoperative adjuvant radiotherapy based on pretreatment TNM staging is still necessary.

Some studies suggest that for patients with pN1 stage, adjuvant radiotherapy after thorough neck lymph node dissection does not significantly impact local control or long-term survival. Literature indicates that the recurrence rate of cervical lymph nodes in N1-stage head and neck squamous cell carcinoma is approximately 8%, meaning that about 92% of N1-stage patients who receive postoperative radiotherapy to the cervical lymphatic drainage area might be overtreated. For patients who achieve pCR after neoadjuvant immunochemotherapy, continuing radiotherapy in the original region after high-quality surgery further increases the likelihood of overtreatment. For locally advanced HNSCC patients who achieve pCR or MPR in the primary tumor and lymph nodes, whether routine radiotherapy should be administered following high-quality surgical resection and lymph node dissection remains controversial in the academic community.

This leads to our clinical question: In patients with locally advanced HNSCC who achieve MPR in both the primary tumor and lymph nodes after neoadjuvant immunochemotherapy and undergo standard surgical treatment, can maintenance therapy with PD-1 inhibitors replace adjuvant radiotherapy?

This study aims to enroll patients who have undergone neoadjuvant immunochemotherapy followed by standard surgical treatment and achieved MPR in both the primary tumor and lymph nodes. Patients will be divided into an experimental group and a control group. The experimental group will receive maintenance therapy with PD-1 inhibitors, while the control group will follow guideline-recommended adjuvant treatments (radiotherapy or concurrent chemoradiotherapy based on platinum compounds) according to tumor classification and staging before neoadjuvant immunochemotherapy. Outcomes such as 2-year

Conditions
HNSCC, PD-1, Radiotherapy
Being tested
PD-1inhibitor, radiotherapy
Keywords
HNSCC, PD-1, radiotherapy
Medical subject headings
Squamous Cell Carcinoma of Head and Neck

What participants receive

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

  • PD-1inhibitorDrug

    The PD-1 monoclonal antibody was the same as the neoadjuvant therapy before surgery, and the postoperative level was maintained at Q3*6.

  • radiotherapyRadiation

    According to the guidelines, concurrent chemoradiotherapy is required, and carboplatin (50mg/m2) plus concurrent radiotherapy or cisplatin (30mg/m2) plus concurrent radiotherapy is optional.

Study groups in NCT07090707
Study groupRoleWhat they receive
Arm 1(PD-1)ExperimentalRadiotherapy free treatment: the experimental group took PD-1 inhibitor maintenance regimen.
Receives: Drug: PD-1inhibitor
Arm 2(radiotherapy)Active comparatorconventional radiotherapy (chemoradiotherapy) regimen, and received comprehensive treatment according to the guidelines (radiotherapy or platinum-based concurrent chemoradiotherapy as stipulated in the guidelines).
Receives: Radiation: radiotherapy

What is being measured

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

  1. Disease-free survival (DFS)

    DFS(by months) is defined as the time from treatment until the date of the first relapse (local/regional recurrence or distant metastasis) or death (from any cause) whichever comes firsts and regardless of whether the patient withdraws from treatment or receives another anti-cancer therapy prior to disease DFS is defined as the time from treatment until the date of the first relapse (local/regional recurrence or distant metastasis) or death (from any cause) whichever comes firsts and regardless of whether the patient withdraws from treatment or receives another anti-cancer therapy prior to disease relapse.

    Measured: 2 years

  2. Percentage of adverse events graded by CTCAE v5.0 and RTOG

    Percentage of adverse events that are possibly, probably or definitely related to study treatment per Criteria for Adverse Events version 5 (CTCAE v5.0) and RTOG. Change From Baseline 90 days after surgery.

    Measured: 90 days after surgery

Secondary outcomes (4)
  1. Overall survival(OS)

    The time(measured by months) from day 1 of study treatment until death from any cause.

    Measured: 5 years

  2. regional recurrence-free survival (RRFS)

    The time( by months) from randomization to clinically confirmed recurrence in the lymph node drainage area. Deaths were counted in RRFS.

    Measured: 2 years

  3. distant metastasis free survival (DMFS)

    The time( by months) from randomization to clinically confirmed distant metastasis.

    Measured: 2 years

  4. Number and percentage of Participants With Treatment-Related Adverse Events as Assessed by CTCAE v5.0 and RTOG

    The detail number and percentage of adverse events by every systems Assessed by CTCAE v5.0 and RTOG.

    Measured: 2 years

Timeline

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

  1. First posted29 Jul 2025
  2. Study start1 Aug 2025 (estimated)
  3. Primary completion1 Dec 2027 (estimated)
  4. Study completion31 Dec 2031 (estimated)

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
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07090707
Sponsor's protocol ID
SYSKY-2024-1094-02
Status last verified
Jul 2025
First submitted
21 Jul 2025
Last updated
29 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing PD-1inhibitor and radiotherapy in people with HNSCC and PD-1, run by Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University at 1 site in China.

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 16 inclusion and 23 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: opening soon, as of the sponsor's last update on 29 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Jinsong Li, MD (008618583879908, caobleat@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Disease-free survival (DFS) (time frame: 2 years). 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 29 Jul 2025.

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