VS-101 combined with chemoradiotherapy for head and neck squamous cell carcinoma

A Multi-center, Randomized, Open-label, Parallel-group, Phase 2 Study to Evaluate the Efficacy and Safety of VS-101 in Combination With Chemoradiotherapy (CRT) in Patients With Head and Neck Cancer

We will test whether adding the experimental drug VS-101 to standard cisplatin-based chemoradiotherapy helps adults with locally advanced head and neck squamous cell carcinoma respond better to treatment.

Quick facts

• Phase: PHASE2
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: VSPharmTech Co.,Ltd. (industry)
• Drugs / interventions: chemotherapy, radiation
• Locations: 3 sites (New Haven, Connecticut and 2 other locations)
• Trial ID: NCT06959082 on ClinicalTrials.gov

What this trial studies

This is a phase 2, multi-center, randomized, open-label, parallel-group trial comparing standard cisplatin-based chemoradiotherapy with or without the investigational agent VS-101 in adults with locally advanced head and neck squamous cell carcinoma. Eligible patients must have pathologically confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx at specified AJCC 8th edition stages, measurable disease by RECIST 1.1, and be planned for definitive intensity-modulated radiation therapy with daily 2.0 Gy fractions and concurrent cisplatin. Participants are randomized to receive VS-101 in combination with standard chemoradiotherapy or standard chemoradiotherapy alone, with safety and tumor response monitored during and after treatment. The trial is open-label and conducted at multiple U.S. centers to gather preliminary efficacy and safety data to inform further development.

Who should consider this trial

Good fit: Ideal candidates are adults with pathologically confirmed, measurable squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx at specified AJCC 8th edition stages who are planned for definitive cisplatin-based chemoradiotherapy without prior surgical excision.

Not a fit: Patients with early-stage disease, metastatic disease, non-squamous histology, those who cannot receive cisplatin or radiation, or who require primary surgical resection are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, adding VS-101 could increase tumor response and disease control rates and potentially improve long-term outcomes for patients receiving definitive chemoradiotherapy.

How similar studies have performed: Other trials combining targeted or novel agents with chemoradiotherapy in head and neck cancer have produced mixed results with some subgroup benefits but also increased toxicity, so adding a new agent like VS-101 is promising but not yet proven.

Eligibility criteria

Inclusion Criteria:

1. Males or females aged more than 18 years at the time of ICF signing
2. Diagnosed based on position emission tomography (PET), computed tomography (CT), or magnetic resonance imaging (MRI) with pathologically confirmed (histologic or cytological) head and neck squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx
3. Defined by American Joint Committee on Cancer \[AJCC\] Guidelines 8th Edition:

   * Oral cavity, hypopharynx, or larynx (independent of p16): Stage III, IVa, IVb per TNM guidelines; or
   * Oropharyngeal p16 negative disease: Stage III, IVa, IVb per TNM guidelines; or
   * Oropharyngeal p16 positive disease: T4 (N0-N3), M0; or N3 (T1-T4), M0.
4. Have measurable disease based on RECIST 1.1
5. Subjects with head and neck cancer who have limited to those receiving definitive CRT without surgical excision
6. Subjects prescribed standard intensity-modulated radiation therapy (IMRT) with daily fractions of 2.0 Gy to a cumulative planned dose of 70 Gy
7. Subjects with Eastern Cooperative Oncology Group (ECOG) Performance Statue (PS) of 0 \~ 2
8. Subjects with the status of National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0 Grade 1 or lower for acute or chronic adverse reaction at the time of screening
9. Subjects with an expected survival period of at least 20 weeks
10. Subjects who can comply with the requirements of the clinical trial protocol
11. Ability to understand and willingness to sign a written informed consent document

Exclusion Criteria:

1. Medical History

   1. Patients with a history of prior radiation to the head and neck region or with a known susceptibility to radiation (e.g., genetic condition, connective tissue disease)
   2. Patients with suicidal behavior, major depression, or other psychiatric disorders (bipolar disorder, attention deficit hyperactivity disorder, etc.)
   3. Patients with neuroleptic malignant syndrome, tardive dyskinesia, elderly with dementia, uncontrolled hyperglycemia and diabetes, and patients with venous thromboembolism
   4. Patients with orthostatic hypotension caused by cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure or electrocardiogram abnormality), cerebrovascular disease, or conditions prone to hypotension (dehydration, decreased blood volume, and taking antihypertensive medication)
   5. Patients with a history of seizures
   6. Patients with possible cognitive and motor performance impairments (drowsiness and sedation) (However, if the investigator determines that cognitive and motor performance impairments are not likely to be impaired, enrollment is possible.)
   7. Patients with conditions that may increase core body temperature (such as strenuous exercise, exposure to excessive heat, taking anticholinergic drugs, or patients prone to dehydration)
   8. Patients with dysphagia \[those who are taking drugs that may be affected (However, if the investigator determines that dysphagia is unlikely to occur, enrollment is possible), those with aspiration pneumonia, those with esophageal dyskinesia\]
   9. Patients with a history of clinically significant allergic disease (with the exception of mild allergic rhinitis that does not require treatment) or hypersensitivity to other drugs(aspirin, antibiotics, etc.)
2. Subjects who show abnormalities in the following test results at the time of screening:

   1. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \>2.5 × upper limit of normal (ULN)
   2. Creatine clearance ≤60 mL/min (using Cockcroft-Gault (C-G) formula)
   3. Absolute neutrophil count (ANC) \<1,500/µL
   4. Platelets \<100,000/µL
   5. Hemoglobin \<9 g/dL
   6. Serum calcium \>1.5 × ULN
   7. Total bilirubin \> 2 × ULN
   8. Prothrombin time (PT) (International Normalized Ratio \[INR\]) \>1.5 × ULN or activated partial thromboplastin time (aPTT) (sec) greater than the normal range
   9. Positive result for serum tests (hepatitis B or C virus, human immunodeficiency virus \[HIV\], rapid plasma reagin \[RPR\] test)
   10. Patients who show significant abnormalities in electrocardiogram (ECG) test results (e.g.,QTcF \> 450 msec)
3. Subjects who received hypofractionated chemoradiation regimens (\> 2 Gy per day)
4. Subjects with known hypersensitivity to components or excipients of clinical investigational drugs
5. Subjects with a history of drug abuse (especially hypnotics, centrally acting analgesics, opiates, or central nervous system drugs such as antipsychotic drugs)
6. Contraindicated Drugs and Treatments:

   1. Subjects who have administered cytochrome P450 (CYP) 3A4 or CYP2D6 inducers or inhibitors (e.g., carbamazepine, rifampin, ketoconazole, quinidine, fluoxetine, paroxetine, itraconazole, clarithromycin, etc.) within 28 days of baseline
   2. Subjects who received chemotherapy within 28 days of baseline (drugs or treatment known to have anticancer effects such as cytotoxic chemotherapy, antihormonal therapy, and targeted therapy)
   3. Subjects who have administered intravenous antibiotics, antivirals, or antifungals within 14 days from baseline
   4. Subjects who have administered benzodiazepines (e.g., lorazepam) within 3 days from baseline
   5. Subjects who participated in another clinical trial within 4 weeks of the baseline and administered the clinical trial drug
7. Subjects and their spouses (or partners) with childbearing potential who are not using medically acceptable methods of contraception for the duration of the trial and for 14 months (in female subjects) and 11 months (in male subjects) after the last dose of cisplatin treatment
8. Subjects who, in the judgment of other investigators, are not suitable to participate in the study"

Where this trial is running

New Haven, Connecticut and 2 other locations

• Yale Cancer Center — New Haven, Connecticut, United States (RECRUITING)
• Cancer Center of Kansas — Wichita, Kansas, United States (RECRUITING)
• NYU Langone Health — Manhattan, New York, United States (RECRUITING)

Conditions: Head and Neck Cancer Squamous Cell Carcinoma