safety and efficacy study of pdr001 in patients with recurrent or metastatic nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: the purpose of this randomized controlled phase ii study is to assess the efficacy of pdr001 versus investigator's choice of chemotherapy in patients with advanced nasopharyngeal carcinoma (npc). by blocking the interaction between pd-1 and its ligands pd-l1 and pd-l2, pdr001 leads to the activation of a t-cell mediated antitumor immune response.

this was an open-label, multi-center, randomized, and controlled phase ii study to evaluate the efficacy and safety of spartalizumab versus investigator's choice of treatment in subjects with moderately differentiated/undifferentiated locally advanced recurrent or metastatic npc who progressed on or after first-line treatment. participants who met the inclusion/exclusion criteria were randomized in a 2:1 ratio to either investigational arm (spartalizumab) or control arm (commonly used chemotherapy as per investigator's choice). participants treated with spartalizumab could continue treatment until confirmed progressive disease as per immune-related response criteria (irrc). participants in the chemotherapy arm were allowed to crossover to spartalizumab if they had radiological progression as per response evaluation criteria in solid tumors version 1.1 (recist v1.1) documented by an independent central review and the investigator believed this was the best treatment option for the patient.

Eligibility criteria:
inclusion criteria: * histologically documented non-keratinizing locally advanced recurrent or metastatic npc. * must be resistant to platinum-based chemotherapy (defined as progression on or after platinum-based chemotherapy given in the recurrent/metastatic setting). * may have received at least 1 prior therapy for recurrent or metastatic disease, up to 2 prior systemic therapies. * an archival tumor specimen or newly obtained tumor sample may be submitted at screening/baseline (a fresh tumor sample is preferred), unless agreed differently between novartis and the investigator. * at least 1 measurable lesion (as per recist v1.1) progressing or new since last anti-tumor therapy. * prior treated brain or meningeal metastases must be without mri evidence of progression for at least 8 weeks and off systemic steroids for at least 2 weeks prior to screening/baseline. * patient must be willing to undergo testing for human immunodeficiency virus (hiv) if not tested within the past 6 months. if hiv+ positive, patient will be eligible if: his/ her cd4+ count ≥ 300/μl; his/her viral load is undetectable; he/she is currently receiving highly active antiretroviral therapy (haart). exclusion criteria: * history of severe hypersensitivity reactions to other mabs * active autoimmune disease or a documented history of autoimmune disease, except vitiligo or resolved asthma/atopy that is treated with broncho-dilators. * active hbv or hcv infections requiring therapy. * prior pd-1- or pd-l1-directed therapy or any therapeutic cancer vaccine. * patients receiving systemic treatment with any immunosuppressive medication. * use of any vaccines against infectious diseases (e.g. varicella, pneumococcus) within 4 weeks of initiation of study treatment.

Keywords: pdr001 nasopharyngeal cancer moderately differentiated/undifferentiated locally advanced recurrent or metastatic npc after first- line platinum-based therapy