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Nasopharyngeal Carcinoma (NPC)Phase 3NCT07706985

Efficacy and Safety of TPC Induction Chemotherapy Combined With Nimotuzumab and Toripalimab "Immune Sandwich" Regimen Versus Full-Course Immunotherapy for Locally Advanced Nasopharyngeal Carcinoma

A Phase 3 study testing Toripalimab combined with Nimotuzumab and Nimotuzumab in people with Nasopharyngeal Carcinoma (NPC), run by Sun Yat-sen University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Immunotherapy combined with chemoradiotherapy has become standard care for locally advanced nasopharyngeal carcinoma, yet radiotherapy-induced lymphopenia may impair the efficacy of concurrent PD-1 blockade. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Nasopharyngeal Carcinoma (NPC)
What is being tested?
Toripalimab combined with Nimotuzumab and Nimotuzumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
566 participants
Where
1 siteChina
Study dates
20 Jul 2026to 20 Jul 2033
Phase
Phase 3
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

Who may be able to join

  • Aged between 18 and 70 years, regardless of gender
  • Histologically or cytologically confirmed diagnosis of nasopharyngeal carcinoma
  • Locoregionally advanced nasopharyngeal carcinoma classified as Stage III-IVA per the 8th AJCC staging system, excluding T3-4N0 and T3N1 disease
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Adequate organ and bone marrow function as demonstrated by laboratory test results obtained within 7 days prior to enrollment. No blood products, hematopoietic growth factors, albumin, or other intravenous/subcutaneous corrective medications are permitted within 14 days before laboratory testing. Specific criteria are listed below.Hematology: Absolute Neutrophil Count (ANC) ≥ 1.5 × 10⁹/L; Platelet (PLT) count ≥ 75 × 10⁹/L; Hemoglobin (HGB) ≥ 9.0 g/dL;Liver function: Total Bilirubin (TBIL) ≤ 2 × Upper Limit of Normal (ULN); Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) ≤ 5 × ULN; serum albumin ≥ 28 g/L; Alkaline Phosphatase (ALP) ≤ 5 × ULN. Renal function: Serum Creatinine (Cr) ≤ 1.5 × ULN, or Creatinine Clearance (CCr) ≥ 50 mL/min (calculated via the Cockcroft-Gault formula). For patients with urine protein ≥ 2+ on routine urinalysis, a 24-hour urine collection is required, with total 24-hour urinary protein quantification < 1 g. Coagulation function: International Normalized Ratio (INR) ≤ 2.3, or prothrombin time (PT) prolongation ≤ 6 seconds
  • Able to provide written informed consent and comply with all protocol-specified study visits and related procedures.

Who cannot join

  • Diagnosis of another malignant tumor within 5 years prior to the first study drug administration, excluding radically treated basal cell carcinoma, squamous cell carcinoma of the skin, and/or radically resected carcinoma in situ
  • Symptomatic congestive heart failure (New York Heart Association [NYHA] Class II-IV) or left ventricular ejection fraction (LVEF) <50% on echocardiography
  • Patients with acute or chronically active hepatitis B or hepatitis C infection: HBV DNA >2000 IU/mL or 10⁴ copies/mL; HCV RNA >10³ copies/mL; concurrent positive hepatitis B surface antigen (HBsAg) and anti-HCV antibody. Subjects with viral loads below the above thresholds after nucleotide antiviral therapy are eligible for enrollment
  • Past or current history of pulmonary diseases including pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, drug-induced pneumonitis, or severely impaired pulmonary function
  • Active tuberculosis (TB) receiving anti-tuberculosis treatment, or having received anti-tuberculosis therapy within 1 year before the first study drug dose.
  • Human immunodeficiency virus (HIV) infection (positive HIV 1/2 antibody), or known syphilis infection requiring treatment
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  • Severe active or poorly controlled infections. Severe infection requiring hospitalization within 4 weeks before the first dose, including but not limited to complications from infection, bacteremia, or severe pneumonia
  • History of active autoimmune diseases requiring systemic therapy (e.g., disease-modifying agents, corticosteroids, immunosuppressants) within 2 years prior to the first dose. Replacement therapies (e.g., thyroxine, insulin, physiological corticosteroids for adrenal or pituitary insufficiency) are permitted. Known history of primary immunodeficiency. Subjects with only positive autoantibodies will be assessed by the investigator to confirm the presence of autoimmune disease
  • Female patients who are pregnant or breastfeeding
  • Prior radiotherapy, chemotherapy, or surgery for nasopharyngeal and cervical lesions (excluding biopsy)
  • History of hypersensitivity to any study drug or its components

Trial locations and contacts

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

Liu Guoying contact

18127919832

liugy0109@163.com

China1 site, 1 recruiting
  • Sun Yat-sen Memorial Hospital, Sun Yat-sen University

    Guangzhou, Guangdong, 510060

    Liu Guoying, 18127919832, liugy0109@163.com

    Recruiting

Other trials in China

About this study

Official title: Efficacy and Safety of TPC Induction Chemotherapy Combined With Nimotuzumab and Toripalimab "Immune Sandwich" Regimen Versus Full-Course Immunotherapy for Locally Advanced Nasopharyngeal Carcinoma: A Multicenter, Randomized, Open-Label, Non-Inferiority Phase III Clinical Study

Immunotherapy combined with chemoradiotherapy has become standard care for locally advanced nasopharyngeal carcinoma, yet radiotherapy-induced lymphopenia may impair the efficacy of concurrent PD-1 blockade. Existing evidence supports synergistic anti-tumor activity between the anti-EGFR antibody nimotuzumab and toripalimab. This multicenter, open-label, non-inferiority Phase III trial randomizes eligible stage III-IVA LA-NPC patients 1:1 to two arms. The experimental group receives an "immune sandwich" regimen: TPC induction plus nimotuzumab and toripalimab, concurrent radiotherapy with weekly nimotuzumab only, followed by toripalimab maintenance. The control arm adopts full-course toripalimab throughout induction, concurrent radiotherapy and adjuvant phases. The primary endpoint is 3-year event-free survival, with secondary endpoints covering overall survival, local/distant control rates, objective response rate and treatment-related toxicities. A total of 566 subjects will be enrolled to verify whether the simplified sandwich strategy delivers non-inferior survival with better safety profiles.

Read the detailed description

The survival outcomes of patients with locally advanced nasopharyngeal carcinoma (LA-NPC) have been greatly elevated with the combination of immunotherapy and targeted therapy. Numerous previous studies have confirmed that PD-1 immune checkpoint inhibitors exert prominent anti-tumor efficacy for locally advanced nasopharyngeal carcinoma. Large-scale Phase III trials including CONTINUUM, DIPPER and DIAMOND verified that adding anti-PD-1 agents to chemoradiotherapy remarkably extended event-free survival (EFS) of high-risk LA-NPC patients, with the 3-year EFS rate reaching up to 86%-88%. In addition, anti-EGFR targeted antibody nimotuzumab could boost radiotherapy sensitivity and further optimize long-term survival for LA-NPC patients when combined with comprehensive chemoradiotherapy. Mechanistic research revealed that EGFR pathway activation upregulates tumor PD-L1 expression, and the combination of nimotuzumab and toripalimab generates synergistic anti-tumor effects.

However, intensive full-course immunotherapy throughout induction, concurrent and adjuvant phases may lead to severe treatment-related lymphopenia during radiotherapy, which potentially weakens immunotherapeutic efficacy and increases adverse reaction risks. Our previous exploratory trial demonstrated an "immune sandwich" strategy (toripalimab only applied in induction and adjuvant stages without concurrent immunotherapy plus weekly nimotuzumab during radiation) achieved comparable survival benefits while reducing treatment toxicity.

This study aims to design a multicenter, randomized, open-label non-inferiority Phase III clinical trial to compare the efficacy and safety of the "immune sandwich" regimen (TPC induction chemotherapy plus nimotuzumab and toripalimab, concurrent nimotuzumab monotherapy radiotherapy followed by toripalimab maintenance) versus the full-course toripalimab combined regimen for patients with locally advanced nasopharyngeal carcinoma.

Being tested
Toripalimab combined with Nimotuzumab, Nimotuzumab
Medical subject headings
Nasopharyngeal Carcinoma

What participants receive

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

  • Toripalimab combined with NimotuzumabDrug

    Induction Chemotherapy Phase: TPC chemotherapy regimen: Nab-paclitaxel: 200 mg/m², intravenous infusion on Day 1;Cisplatin: 60 mg/m², intravenous infusion on Day 1;Capecitabine: 1000 mg/m² orally twice daily on Days 1-14;Each cycle lasts 21 days, for a total of 3 cycles.

    Toripalimab: 240 mg toripalimab injection, intravenous infusion on Day 0; 21-day cycles for 3 cycles total.

    Nimotuzumab: 400 mg nimotuzumab, intravenous infusion on Days 0 and 8; 21-day cycles for 3 cycles total.

    Concurrent Radiotherapy Phase: Toripalimab: 240 mg toripalimab injection via intravenous infusion starting on the first day of radiotherapy, administered every 21 days for 3 cycles.

    Nimotuzumab: 200 mg nimotuzumab via intravenous infusion once weekly for 6 consecutive weeks, starting on the first day of radiotherapy.

    Adjuvant Phase: Toripalimab injection 240 mg is administered via intravenous infusion once every 21 days per cycle.

  • NimotuzumabDrug

    Induction Chemotherapy Phase: TPC chemotherapy regimen: Nab-paclitaxel: 200 mg/m², intravenous infusion on Day 1;Cisplatin: 60 mg/m², intravenous infusion on Day 1;Capecitabine: 1000 mg/m² orally twice daily on Days 1-14;Each cycle lasts 21 days, for a total of 3 cycles.

    Toripalimab: 240 mg toripalimab injection, intravenous infusion on Day 0; 21-day cycles for 3 cycles total.

    Nimotuzumab: 400 mg nimotuzumab, intravenous infusion on Days 0 and 8; 21-day cycles for 3 cycles total.

    Concurrent Radiotherapy Phase: Nimotuzumab: 200 mg nimotuzumab via intravenous infusion once weekly for 6 consecutive weeks, starting on the first day of radiotherapy.

    Adjuvant Phase: Toripalimab injection 240 mg is administered via intravenous infusion once every 21 days per cycle.

Study groups in NCT07706985
Study groupRoleWhat they receive
Full-Course Immunotherapy GroupActive comparatorInduction Chemotherapy Phase:TPC chemotherapy+ Toripalimab + Nimotuzumab; Concurrent Radiotherapy Phase:Nimotuzumab + Toripalimab; Adjuvant Treatment Phase:Toripalimab
Receives: Drug: Toripalimab combined with Nimotuzumab
Concurrent Immunotherapy-Omitted GroupExperimentalInduction Chemotherapy Phase:TPC chemotherapy+ Toripalimab + Nimotuzumab; Concurrent Radiotherapy Phase:Nimotuzumab; Adjuvant Treatment Phase:Toripalimab
Receives: Drug: Nimotuzumab

What is being measured

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

  1. Event-Free Survival

    Defined as the time from the date of randomization to the first documented tumor progression (assessed per RECIST Version 1.1, regardless of continued study treatment) or death from any cause, whichever occurs first.

    Measured: From randomization to 3 years

Secondary outcomes (5)
  1. Overall Survival

    Defined as the time from randomization to death from any cause.

    Measured: From randomization to 3 years and 5 years

  2. Locoregional Recurrence-Free Survival

    Defined as the time from randomization to the first documented locoregional tumor recurrence.

    Measured: From randomization to 3 years

  3. Distant Metastasis-Free Survival

    Defined as the time from randomization to the first documentation of distant tumor metastasis.

    Measured: From randomization to 3 years

  4. Objective Response Rate

    The proportion of subjects achieving complete response (CR) or partial response (PR) assessed per RECIST Version 1.1 at the completion of radiotherapy in the analysis population.

    Measured: 9 weeks and 3 months

  5. Incidence of Treatment-Emergent Adverse Events

    Acute toxicities will be evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI-CTCAE v5.0). Late radiation toxicities will be assessed via the Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Late Radiation Morbidity Scoring Schema.

    Measured: Through treatment completion, an average of 1 year

Timeline

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

  1. First posted16 Jul 2026
  2. Study start20 Jul 2026 (estimated)
  3. Primary completion20 Jul 2030 (estimated)
  4. Study completion20 Jul 2033 (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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
566 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07706985
Sponsor's protocol ID
SYSKY-2026-425-02
Status last verified
Jul 2026
First submitted
6 Jul 2026
Last updated
16 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Toripalimab combined with Nimotuzumab and Nimotuzumab in people with Nasopharyngeal Carcinoma (NPC), run by 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 6 inclusion and 11 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: looking for participants now, as of the sponsor's last update on 16 Jul 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 Liu Guoying (18127919832, liugy0109@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Event-Free Survival (time frame: From randomization to 3 years). 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 16 Jul 2026.

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