Pembrolizumab (MK-3475) plus platinum and gemcitabine as first-line treatment of recurrent/metastatic head and neck squamous cell carcinoma (PIPER): a phase 2, multicentre, single-arm protocol study in Malaysia

Cheong, Sok Ching and Selvam, Bawani and Ho, Gwo Fuang and Nor, Ibtisam Muhamad and Tan, Chih Kiang and Wong, Yoke Fui and Teo, Soo Hwang and Lim, Kue Peng and Chai, Annie Wai Yeeng and Yahya, Abqariyah and Wan Ishak, Wan Zamaniah (2024) Pembrolizumab (MK-3475) plus platinum and gemcitabine as first-line treatment of recurrent/metastatic head and neck squamous cell carcinoma (PIPER): a phase 2, multicentre, single-arm protocol study in Malaysia. BMJ Open, 14 (12). e076898. ISSN 2044-6055, DOI https://doi.org/10.1136/bmjopen-2023-076898.

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Official URL: https://doi.org/10.1136/bmjopen-2023-076898

Abstract

Introduction Treatment combination of pembrolizumab plus platinum and 5-fluorouracil (PF) has increased the survival of recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). The combination of platinum and gemcitabine (PG) has been shown to be superior to PF in the treatment of R/M nasopharyngeal carcinoma patients. Therefore, we hypothesise that the combination of pembrolizumab with PG would be comparable to pembrolizumab with PF as a first-line treatment in R/M HNSCC.Methods and analysis This is an open-label, multicentre, single-arm, phase 2 study of pembrolizumab plus PG for first-line treatment in subjects with R/M HNSCC in Malaysia. The study is conducted using the Optional Simon optimal 2-stage design. At the initial stage, 26 subjects will be enrolled and if seven or more patients achieve an objective response rate (ORR), then 63 patients will be enrolled. Subjects will be given pembrolizumab 200 mg3 every 3 weeks up to 35 cycles in combination with chemotherapy for up to six cycles of platinum (either cisplatin at 35 mg/m2 intravenous on day 1 and day 8 or carboplatin at area under the curve 5 intravenous on day 1 of each 3-week cycle) and gemcitabine at 1250 mg/m2 intravenous on days 1 and 8 of a 3-week cycle. The primary end point is the ORR as per Response Evaluation Criteria in Solid Tumors 1.1. Secondary end points include the overall survival, progression free survival, response duration and safety. The exploratory objectives include relationships of microbiome profiles, prognostic and predictive biomarkers with the clinical responses.Ethics and dissemination The study was approved by the ethics committee of the University Malaya Medical Centre (202213-10884). Findings will be disseminated through conference presentations and peer review publications.Trial registration number ClinicalTrials.gov (www.clinicaltrial.gov); NCT05286619.

Item Type: Article
Funders: My Starfish Foundation
Uncontrolled Keywords: Head & neck tumours; CHEMOTHERAPY; IMMUNOLOGY
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Dentistry > Dept of Oral & Maxillofacial Surgery
Faculty of Medicine
Faculty of Medicine > Social & Preventive Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 17 Mar 2025 03:59
Last Modified: 17 Mar 2025 03:59
URI: http://eprints.um.edu.my/id/eprint/47247

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