Study of Pembrolizumab Given Prior to Surgery and in Combination With Radiotherapy Given Post-surgery for Advanced Head and Neck Squamous Cell Carcinoma (MK-3475-689)
This research is investigating a new treatment approach for advanced head and neck squamous cell carcinoma (LA-HNSCC). The study compares pembrolizumab given before surgery and in combination with radiotherapy (with or without chemotherapy) after surgery, against the standard treatment of radiotherapy (with or without chemotherapy) after surgery alone. Pembrolizumab is a type of immunotherapy that helps your body’s immune system fight cancer. Researchers want to see if this new combination improves the time patients live without their cancer coming back. The study is for people recently diagnosed with certain stages of head and neck cancer who are able to have surgery.
At a glance
What is this study about?
This study, known as MK-3475-689, is looking into a new treatment for a specific type of head and neck cancer called squamous cell carcinoma, which has spread locally but not to distant parts of the body (this is called 'locoregionally advanced'). The cancer can affect areas like the voice box, throat, and mouth. The main goal is to find out if adding a medication called pembrolizumab to the usual treatment before and after surgery can help people live longer without their cancer coming back. Pembrolizumab is an immunotherapy, which means it works by helping your own immune system recognise and fight the cancer cells.
Currently, the standard treatment for this type of cancer often involves surgery to remove the tumour, followed by radiotherapy to kill any remaining cancer cells, sometimes with chemotherapy alongside it. In this study, some participants will receive pembrolizumab before their surgery and then continue with it after surgery, alongside radiotherapy (and possibly chemotherapy). Others will receive the standard treatment of just radiotherapy (and possibly chemotherapy) after surgery. By comparing these two approaches, the researchers hope to see if the new method is more effective.
The study is a 'Phase 3' trial, which means it's a large study, usually one of the final steps before a new treatment might become more widely available if it proves to be safe and effective. It's 'open-label,' meaning both the doctors and participants will know which treatment is being given. Researchers will pay close attention to how long participants live without the cancer returning, which is a key measure of success in cancer trials.
Key takeaways
- New study for specific advanced head and neck cancers.
- Compares immunotherapy (pembrolizumab) plus standard treatment versus standard treatment alone.
- Aims to improve time lived without cancer return.
- Involves treatment before and after surgery, combined with radiotherapy.
- Participants are closely monitored throughout the study.
- Participation is voluntary; you can withdraw at any time.
Who may be eligible?
To join this study, you would need to have been recently diagnosed with a specific type of head and neck cancer (squamous cell carcinoma) that is at certain stages (Stage III or IVA) and can be removed by surgery. This could be HPV-positive cancer in the oropharynx at a specific stage, or HPV-negative cancer in the oropharynx, or cancer in the voice box, lower throat, or mouth at Stages III or IVA.
You would also need to be fit enough for surgery, as decided by your doctor, and able to undergo scans (like CT or MRI) to measure your tumour. If you are able to have children, you and your partner would need to agree to use effective contraception during the study and for six months afterwards. Women who are pregnant or breastfeeding cannot take part. Your overall health should be good, often measured by an 'ECOG performance status' of 0 or 1, which means you're generally able to carry out your daily activities.
However, you wouldn't be able to join if your cancer has spread to distant parts of your body or is at a very advanced local stage (T4B and/or N3). The study also excludes certain types of head and neck cancer, such as those in the nasal cavity or unknown primary cancers. If you've previously had similar immunotherapy treatments (like anti-PD-1 drugs) or are pregnant, you won't be able to participate.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Are you diagnosed with certain advanced head and neck squamous cell cancer (Stages III/IVA) that can be removed by surgery?
- Are you generally fit and able to have surgery?
- Are you willing to use effective contraception if you or your partner can have children?
- Have you *not* had this type of immunotherapy (e.g., anti-PD-1) before?
- Is your cancer *not* spread to distant parts of your body?
- Are you *not* pregnant or breastfeeding?
What does participation involve?
If you take part in this study, you would first undergo a screening process to ensure you meet all the eligibility criteria. This would involve medical checks, scans like CT or MRI, and providing a small sample of your tumour (biopsy). If eligible, you would then be randomly assigned to one of two treatment groups. One group would receive pembrolizumab medication before surgery, followed by surgery, and then further pembrolizumab along with radiotherapy (and possibly chemotherapy). The other group would have surgery followed by radiotherapy (and possibly chemotherapy) without pembrolizumab. The exact details of visits and tests would depend on your specific treatment schedule, but would involve regular checks and scans to monitor your health and the cancer. The total duration of your participation would involve the treatment period and follow-up to track your health and any return of the cancer. You would also need to use contraception for several months after your last dose of study treatment.
Potential risks and benefits
Locations (192)
- Moores Cancer Center ( Site 1885)Verified postcodeLa Jolla, United States
- University of Southern California Norris Comprehensive Cancer Center ( Site 1850)Verified postcodeLos Angeles, United States
- Hoag Memoriall Hospital Presbyterian ( Site 2056)Verified postcodeNewport Beach, United States
- UC Davis Health System ( Site 1864)Verified postcodeSacramento, United States
- St. Joseph Heritage Healthcare ( Site 1806)Verified postcodeSanta Rosa, United States
- University of Colorado Cancer Center ( Site 1838)Verified postcodeAurora, United States
- MedStar Washington Hospital Center ( Site 2062)Verified postcodeWashington D.C., United States
- George Washington University Medical Faculty Associates ( Site 2035)Verified postcodeWashington D.C., United States
- University of Florida ( Site 1832)Verified postcodeGainesville, United States
- University of Miami, Sylvester Comprehensive Cancer Center ( Site 2008)Verified postcodeMiami, United States
- AdventHealth Orlando-AdventHealth Medical Group Hematology & Oncology at Orlandoc ( Site 2054)Verified postcodeOrlando, United States
- Orlando Health Cancer Institute ( Site 2061)Verified postcodeOrlando, United States
Common questions
What is Pembrolizumab?
Pembrolizumab is an immunotherapy drug that helps your body's own immune system find and fight cancer cells.
What does 'locoregionally advanced' mean?
This means the cancer has grown into nearby tissues or spread to nearby lymph nodes, but has not spread to distant parts of the body.
What is the 'standard of care' treatment?
This refers to the best known and most commonly used treatment for a specific condition, which in this case involves surgery and radiotherapy, sometimes with chemotherapy.
Will I know which treatment I am receiving?
Yes, this is an 'open-label' study, meaning both you and your medical team will know which treatment you are assigned to.
What is Event-Free Survival?
This is a measure of how long someone lives without their cancer coming back, growing, or without needing to start a new cancer treatment, or unfortunately, passing away from the cancer or treatment.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
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