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Head and Neck Squamous Cell CarcinomaPhase 2NCT07677475

MRG003 Plus Toripalimab Versus Toripalimab as Neoadjuvant Therapy for PD-L1-Positive, Resectable, Locally Advanced Head and Neck Squamous Cell Carcinoma

A Phase 2 study testing MRG003 (Becotatug vedotin) and Toripalimab and Toripalimab in people with Head and Neck Squamous Cell Carcinoma, run by Dongguan People's Hospital 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

This is a multicenter, prospective, randomized, controlled Phase II trial evaluating the safety and efficacy of MRG003 (Becotatug vedotin) combined with Toripalimab versus Toripalimab alone as neoadjuvant therapy for PD-L1-positive, resectable locally advanced head and neck squamous cell carcinoma. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Head and Neck Squamous Cell Carcinoma
What is being tested?
MRG003 (Becotatug vedotin) and Toripalimab and Toripalimab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
65 participants
Where
1 siteChina
Study dates
10 Aug 2026to 30 Jun 2029
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 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult
  1. Histologically or cytologically confirmed head and neck squamous cell carcinoma (HNSCC), PD-L1 positive (CPS ≥ 1)
  2. Treatment-naïve, pathologically confirmed stage III-IVA resectable non-oropharyngeal HNSCC (oral cavity, larynx, hypopharynx) OR HPV-negative oropharyngeal SCC, OR HPV-positive stage III T4N0-2 resectable oropharyngeal cancer (AJCC 8th edition)
  3. No prior antitumor treatment (radiotherapy, chemotherapy, targeted therapy, or immunotherapy)
  4. Age 18 to 70 years
  5. ECOG performance status 0 or 1
  6. Adequate organ function within 14 days before first dose (no blood products or growth factors within 14 days):
  • ANC ≥ 1.0 × 10⁹/L, Hb ≥ 90 g/L, PLT ≥ 75 × 10⁹/L
  • ALT/AST ≤ 1.5 × ULN, total bilirubin ≤ 1.5 × ULN, ALP < 2.5 × ULN
  • CrCl ≥ 50 mL/min (Cockcroft-Gault)
  • APTT and INR ≤ 1.5 × ULN
  1. At least one measurable lesion per RECIST 1.1
  2. Life expectancy ≥ 12 weeks
  3. Female subjects of childbearing potential and male subjects with reproductive potential must use medically accepted contraception during treatment and for 3 months after last dose
  4. Voluntary signed informed consent, good compliance, willing to undergo follow-up

Trial locations and contacts

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

Liji Jiang, Master contact

0769-28637916

keynotejiang@163.com

China1 site
  • The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital)

    Dongguan, Guangdong, 523059

    Liji Jiang, Master, 0769-28637916, keynotejiang@163.com

Other trials in China

About this study

Official title: MRG003 (Becotatug Vedotin) Plus Toripalimab Versus Toripalimab as Neoadjuvant Therapy for PD-L1-Positive, Resectable, Locally Advanced Head and Neck Squamous Cell Carcinoma: A Multicenter, Prospective, Randomized, Controlled Phase II Trial

This is a multicenter, prospective, randomized, controlled Phase II trial evaluating the safety and efficacy of MRG003 (Becotatug vedotin) combined with Toripalimab versus Toripalimab alone as neoadjuvant therapy for PD-L1-positive, resectable locally advanced head and neck squamous cell carcinoma. A total of 65 subjects are planned (43 experimental, 22 control). The experimental arm receives two cycles of MRG003 (Becotatug vedotin) 2.0 mg/kg intravenously on Day 1 followed by Toripalimab 240 mg intravenously on Day 1 every 3 weeks, while the control arm receives two cycles of Toripalimab 240 mg alone. After neoadjuvant therapy, both arms undergo radical surgery 3-4 weeks later, followed by risk-adapted adjuvant radiotherapy or chemoradiotherapy with concurrent Toripalimab (3 cycles) and then 12 cycles of adjuvant Toripalimab maintenance. The primary endpoint is the major pathological response rate.

Read the detailed description

This study builds upon the limitations of neoadjuvant immunotherapy monotherapy (e.g., KEYNOTE-689), which showed a low MPR rate (9.8% overall, 13.7% in CPS>10) and a 25.6% progression rate, by exploring the synergistic combination of the EGFR-targeting antibody-drug conjugate MRG (Becotatug vedotin) with the PD-1 inhibitor Toripalimab. Eligible patients are treatment-naïve, PD-L1 positive (CPS ≥1), stage III-IVA resectable non-oropharyngeal, HPV-negative oropharyngeal, or specific HPV-positive oropharyngeal HNSCC, ECOG PS 0-1, aged 18-70. In the neoadjuvant phase, the experimental group receives MRG (Becotatug vedotin) 2.0 mg/kg (based on actual body weight) intravenously without prophylactic premedication, followed by Toripalimab 240 mg intravenously over 30-60 minutes on Day 1 of each 3-week cycle for 2 cycles; infusion reactions are monitored for at least 120 minutes after the first dose and 60 minutes thereafter. Dose reduction of MRG (Becotatug vedotin) to 1.5 mg/kg is permitted for toxicity, with permanent discontinuation if intolerance persists; Toripalimab dose modification is not allowed. The control group receives Toripalimab 240 mg alone on the same schedule. Three to four weeks after Cycle 2 Day 1, both arms undergo radical tumor resection; surgery is performed even if radiological progression occurs during neoadjuvant therapy, provided surgical criteria are met. Postoperatively, patients are stratified by pathology: those with extranodal extension or positive/inadequate margins receive adjuvant chemoradiotherapy (cisplatin 100 mg/m² every 3 weeks for 3 cycles plus radiotherapy at 60-70 Gy depending on risk), while those without receive adjuvant radiotherapy alone (same doses). During adjuvant radiotherapy, both arms concurrently receive 3 cycles of Toripalimab 240 mg every 3 weeks. After completing radiotherapy, all patients receive 12 cycles of adjuvant Toripalimab 240 mg every 3 weeks as maintenance. Secondary endpoints include event-free survival, pathologic complete response rate, objective response rate, R0 resection rate, surgical down-staging rate, safety (CTCAE v6.0), and quality of life; exploratory endpoints include overall survival and biomarker analysis. The MPR rate is compared using the exact test, assuming 45% in the experimental arm versus approximately 9.8% in the historical control, with a one-sided alpha of 0.025, 80% power, and 10% dropout, yielding the required sample size of 65. The full analysis set is the primary analysis population.

Being tested
MRG003 (Becotatug vedotin) and Toripalimab, Toripalimab
Keywords
MRG003, Vebecototagene Autoleucovorin, Toripalimab, Neoadjuvant Therapy
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.

  • MRG003 (Becotatug vedotin) and ToripalimabDrug

    Toripalimab 240 mg administered intravenously over 30-60 minutes on Day 1 of each 3-week cycle, followed immediately by MRG003 (Becotatug vedotin) 2.0 mg/kg (based on actual body weight) administered intravenously without prophylactic premedication. Neoadjuvant phase: 2 cycles of both drugs. Adjuvant toripalimab: 3 cycles concurrent with radiotherapy, then 12 cycles maintenance. For MRG003 (Becotatug vedotin), monitor infusion reactions for at least 120 minutes after first dose and at least 60 minutes after subsequent doses if tolerated. Dose reduction of MRG003 (Becotatug vedotin) to 1.5 mg/kg is permitted once for toxicity; permanent discontinuation if intolerance persists at reduced dose. Toripalimab dose remains fixed throughout; no dose modification is permitted.

  • ToripalimabDrug

    Toripalimab 240 mg administered intravenously over 30-60 minutes on Day 1 of each 3-week cycle. Neoadjuvant phase: 2 cycles. Adjuvant phase (concurrent with radiotherapy): 3 cycles. Adjuvant maintenance (after radiotherapy): 12 cycles. No prophylactic premedication required. No dose modification of toripalimab is permitted.

Study groups in NCT07677475
Study groupRoleWhat they receive
MRG003 + ToripalimabExperimentalParticipants receive 2 cycles of neoadjuvant combination therapy with toripalimab plus MRG003 (Becotatug vedotin). After the neoadjuvant phase, radical surgery is performed. Postoperative management follows the same risk-adapted criteria as the control arm: participants with ENE or positive/inadequate margins receive adjuvant chemoradiotherapy, while those without receive adjuvant radiotherapy alone. During adjuvant radiotherapy, participants receive 3 cycles of concurrent toripalimab. After radiotherapy, all participants receive 12 cycles of adjuvant toripalimab maintenance therapy.
Receives: Drug: MRG003 (Becotatug vedotin) and Toripalimab; Drug: Toripalimab
Toripalimab MonotherapyActive comparatorParticipants receive 2 cycles of neoadjuvant toripalimab monotherapy. After the neoadjuvant phase, radical surgery is performed. Postoperative management is determined by pathology: participants with extranodal extension (ENE) or positive/inadequate margins receive adjuvant chemoradiotherapy (cisplatin 100 mg/m² every 3 weeks for 3 cycles plus radiotherapy at 60-70 Gy depending on risk), while those without receive adjuvant radiotherapy alone. During adjuvant radiotherapy, participants receive 3 cycles of concurrent toripalimab. After radiotherapy, all participants receive 12 cycles of adjuvant toripalimab maintenance therapy.
Receives: Drug: Toripalimab

What is being measured

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

  1. Major Pathological Response (MPR) rate

    Proportion of patients with major pathological response, defined as ≤ 10% residual viable tumor in the primary tumor and all sampled lymph nodes after completion of neoadjuvant therapy.

    Measured: At the time of surgical specimen evaluation (approximately 6-8 weeks after initiation of neoadjuvant therapy)

Secondary outcomes (6)
  1. Event-Free Survival (EFS)

    Time from randomization to first documented radiographic progression, progression leading to inoperability, or death from any cause.

    Measured: From randomization up to approximately 36 months

  2. Pathologic Complete Response (pCR) Rate

    Proportion of subjects with no residual viable tumor cells in the primary tumor bed or resected lymph nodes after neoadjuvant therapy.

    Measured: At definitive surgery (approximately Week 6-8 after randomization)

  3. Objective Response Rate (ORR) per RECIST 1.1

    Proportion of subjects achieving complete response (CR) or partial response (PR) according to RECIST 1.1 after 2 cycles of neoadjuvant therapy.

    Measured: After completion of 2 cycles of neoadjuvant therapy (approximately Week 6)

  4. Safety: Incidence of Adverse Events and Serious Adverse Events

    Incidence, severity, and relationship of adverse events (AEs) and serious adverse events (SAEs) graded by CTCAE v5.0.

    Measured: From first dose of study drug through 90 days after last dose or 30 days after surgery, whichever occurs later

  5. On-Time Surgery Rate

    Proportion of subjects who undergo radical surgery within 49 days after Cycle 2 Day 1 of neoadjuvant therapy.

    Measured: Within 49 days after Cycle 2 Day 1( (each cycle is 21 days))

  6. R0 Resection Rate

    Proportion of subjects who achieve complete (microscopically margin-negative) resection at definitive surgery.

    Measured: At definitive surgery (approximately Week 6-8 after randomization)

Timeline

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

  1. First posted30 Jun 2026
  2. Study start10 Aug 2026 (estimated)
  3. Primary completion30 Jan 2029 (estimated)
  4. Study completion30 Jun 2029 (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
Model description
This is a randomized, parallel-arm, open-label, Phase 2 clinical trial. Eligible patients are randomized in a 2:1 ratio to receive either neoadjuvant MRG003 (Becotatug vedotin) plus toripalimab (Experimental Arm) or neoadjuvant toripalimab monotherapy (Control Arm).
Masking
None (open label)
Enrolment
65 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07677475
Sponsor's protocol ID
IIT-2026-008
Status last verified
Jul 2026
First submitted
23 Jun 2026
Last updated
5 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: This study does not currently have a plan to share individual participant data. The research team will not provide access to the raw data set.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing MRG003 (Becotatug vedotin) and Toripalimab and Toripalimab in people with Head and Neck Squamous Cell Carcinoma, run by Dongguan People's Hospital 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?

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 5 Aug 2026. 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 Liji Jiang, Master (0769-28637916, keynotejiang@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Major Pathological Response (MPR) rate (time frame: At the time of surgical specimen evaluation (approximately 6-8 weeks after initiation of neoadjuvant therapy)). 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 5 Aug 2026.

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