Neoadjuvant PD-L1 antibody plus chemotherapy for locally advanced head and neck squamous cell carcinoma

Single-Arm Exploratory Study of PD-L1 Antibody Plus Neoadjuvant Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma

This trial will try giving the PD-L1 antibody adebrelimab with docetaxel and cisplatin before surgery for people with stage III–IVB head and neck squamous cell carcinoma to see if it shrinks tumors and improves surgical outcomes.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 69 (estimated)
• Ages: 18 Years to 85 Years
• Sex: All
• Sponsor: Shandong Tumor Hospital (Academic / other)
• Drugs / interventions: adebelimab, Adabelimab, chemotherapy, immunotherapy, radiation, prednisone, Adebrelimab
• Locations: 1 site (Jinan, Shandong)
• Trial ID: NCT07055841 on ClinicalTrials.gov

What this trial studies

This single-arm Phase 2 study will enroll about 69 patients with locally advanced (stage III–IVB) head and neck squamous cell carcinoma. Participants will receive adebrelimab (a PD-L1 antibody) combined with a TP chemotherapy regimen (docetaxel and cisplatin) as neoadjuvant treatment for 1–4 weeks. After neoadjuvant therapy, patients will proceed to planned surgery and then enter a follow-up period to monitor response, safety, and longer-term outcomes. Safety labs and standard oncologic assessments will be used to track adverse events and tumor response.

Who should consider this trial

Good fit: People with histologically confirmed head and neck squamous cell carcinoma at AJCC stage III–IVB, who have not had prior systemic therapy, have ECOG 0–1, adequate blood, liver and kidney function, and are able to undergo surgery are the intended participants.

Not a fit: Patients with poor performance status, inadequate organ function, prior systemic treatment for their head and neck cancer, or distant metastatic (stage IVC) disease are unlikely to benefit from this neoadjuvant approach.

Why it matters

Potential benefit: If successful, this approach could shrink tumors before surgery, making operations easier and potentially improving longer-term control of the cancer.

How similar studies have performed: Early-phase studies of neoadjuvant PD-1/PD-L1 therapies in head and neck cancer have shown promising tumor responses, though combining PD-L1 blockade with TP chemotherapy before surgery is less well established and remains exploratory.

Eligibility criteria

Inclusion Criteria:

* 1\. Patients with head and neck squamous cell carcinoma diagnosed by histology or cytology;
* 2\. Have not received systematic treatment for head and neck squamous cell carcinoma in the past;
* 3\. According to the AJCC TNM staging system, it is divided into stages III-IVB;
* 4\. ECOG score: 0-1 point;
* 5\. Expected survival period ≥ 12 weeks;
* 6\. The main organ functions well and the laboratory test data meets the following standards: (1) Blood routine: absolute neutrophil count ≥ 1.5 × 109/L (or greater than the lower limit of normal laboratory values in the research center), platelet count ≥ 100 × 109/L, hemoglobin ≥ 90g/L; (2) Liver function: serum total bilirubin ≤ 1.5 times the upper limit of the standard value (ULN), AST and ALT ≤ 2.5 times ULN. If the patient has liver metastasis, this standard is ≤ 5 times ULN; (3) Renal function: CrCl ≥ 60 ml/min/1.73 m2 (calculated according to the Cockcroft Gault formula);
* 7\. Female subjects with fertility, as well as male subjects with partners who are fertility women, are required to use a medically approved contraceptive measure (such as intrauterine device, contraceptive pill, or condom) during the study treatment period, at least 6 months after the last use of adebelimab, and at least 6 months after the last use of chemotherapy;
* 8\. Voluntarily join this study, sign the informed consent form, have good compliance, and cooperate with follow-up.

Exclusion Criteria:

* 1\. There is uncontrollable pleural effusion, pericardial effusion, or peritoneal effusion that requires repeated drainage;
* 2\. Have a history of allergies to any components of Adabelimab in the past;
* 3\. Have received any of the following treatments:

  1. Received any other investigational drug within 4 weeks prior to the first use of the investigational drug or had a half-life of no more than 5 from the last investigational drug;
  2. Simultaneously enrolled in another clinical study, unless it is an observational (non interventional) clinical study or an interventional clinical study follow-up;
  3. Received anti-tumor therapy (including radiotherapy, chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, or tumor embolization) within 2 weeks prior to the first use of the investigational drug;
  4. Subjects who need to receive corticosteroids (equivalent to\>10mg prednisone per day) within 2 weeks prior to the first use of the study drug. Allow the use of hormones for routine chemotherapy pretreatment without the need for dose adjustment. Other special circumstances require communication with the researcher. In the absence of active autoimmune diseases, inhalation or local use of steroids and corticosteroids with a dosage greater than 10mg/day of prednisone efficacy dose are allowed as substitutes for adrenal cortex hormones;
  5. Individuals who have received anti-tumor vaccines or have received live vaccines within 4 weeks prior to the first administration of the study drug;
  6. Having undergone major surgery or suffered severe trauma within 4 weeks prior to the first use of the investigational drug;
  7. Patients who have received previous treatment with paclitaxel drugs;
* 4\. The toxicity of previous anti-tumor treatments has not recovered to ≤ CTCAE 5.0 Grade 1 (excluding hair loss) or the level specified in the inclusion/exclusion criteria;
* 5\. Active autoimmune diseases, history of autoimmune diseases (such as interstitial pneumonia, colitis, hepatitis, pituitary inflammation, vasculitis, nephritis, hyperthyroidism, hypothyroidism, including but not limited to the above diseases or syndromes); Excluding childhood asthma/allergies with vitiligo or those who have already recovered, patients who do not require any intervention in adulthood; Autoimmune mediated hypothyroidism treated with stable doses of thyroid replacement hormone; Type I diabetes with a stable dose of insulin;
* 6\. Have a history of immune deficiency, including HIV test positive, or have other acquired or congenital immune deficiency diseases, or have a history of organ transplantation and allogeneic bone marrow transplantation, or active hepatitis (hepatitis B reference: HBV DNA test value exceeds 500 IU/ml or 2500 copies/mL);
* 7\. The subject has uncontrolled cardiovascular clinical symptoms or diseases, including but not limited to: (1) NYHA class II or above heart failure; (2) Unstable angina pectoris; (3) Have experienced myocardial infarction within one year; (4) Clinically significant supraventricular or ventricular arrhythmias that have not been clinically intervened or are still poorly controlled after clinical intervention;
* 8.Within 4 weeks prior to the first use of the investigational drug, there has been a severe infection (CTCAE 5.0\>grade 2), such as severe pneumonia requiring hospitalization, bacteremia, infection complications, etc; Baseline chest imaging examination suggests the presence of active pulmonary inflammation, symptoms and signs of infection within 2 weeks prior to the first use of the study drug, or the need for oral or intravenous administration Or intravenous use of antibiotics for treatment, except for prophylactic use of antibiotics;
* 9\. History of interstitial lung disease (excluding history of radiation pneumonia and non infectious pneumonia that have not been treated with steroids);
* 10\. Patients with active pulmonary tuberculosis infection found through medical history or CT examination, or patients with a history of active pulmonary tuberculosis infection within the past year before enrollment, or patients with a history of active pulmonary tuberculosis infection more than one year ago but without formal treatment;
* 11\. Diagnosed with any other malignant tumor within 5 years prior to the first use of the investigational drug, except for malignant tumors with low-risk metastasis and mortality risk (5-year survival rate\>90%), such as basal cell or squamous cell carcinoma or cervical carcinoma in situ that have been adequately treated;
* 12\. Pregnant or lactating women;
* 13\. According to the researcher's assessment, there may be other factors that could force the subject to terminate the study midway, such as suffering from other serious illnesses (including mental illnesses) that require concurrent treatment, severe abnormal laboratory test values, family or social factors that may affect the subject's safety or the collection of trial data.

Where this trial is running

Jinan, Shandong

• Cancer Hospital of Shandong First Medical University — Jinan, Shandong, China (Recruiting)

Study contacts

• Principal investigator: wanjun chen, physician — Shandong Cancer Hospital and Institute
• Study coordinator: Xiuping Ding, Dr.

Conditions Squamous Cell Carcinoma of Head and Neck; PD-L1; Local late stage