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NCT02319044

Phase II Study of MEDI4736, Tremelimumab, and MEDI4736 in Combination w/ Tremelimumab Squamous Cell Carcinoma of the Head and Neck

Completed Phase 2 Results posted Last updated 29 September 2020
What this trial tests

Phase 2 trial testing MEDI4736 in Recurrent/Metastatic Squamous Cell Carcinoma of Head & Neck in 267 participants. Completed in 6 July 2020.

Timeline
15 April 2015
Primary endpoint
26 September 2016
6 July 2020

Quick facts

Lead sponsorAstraZeneca
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment267
Start date15 April 2015
Primary completion26 September 2016
Estimated completion6 July 2020
Sites125 locations across Georgia, France, Malaysia, Belgium, Taiwan, United Kingdom, Germany, Hungary

Drugs / interventions tested

Conditions studied

Sponsor

AstraZeneca — full company profile →

Who can join

Adults 18 to 96, any sex, with Recurrent/Metastatic Squamous Cell Carcinoma of Head & Neck. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Objective Response Rate at 6 Months Primary · After 6 months

Objective response rate, primary analysis, based on BICR assessments according to RECIST v1.1. The number (%) of patients with a response excludes unconfirmed responses

GroupValue95% CI
MEDI4736 + Tremelimumab7.73.75 – 13.69
MEDI47369.23.46 – 19.02
Tremelimumab1.60.04 – 8.53
Objective Response Rate at 12 Months Primary · After 12 months

Objective response rate (per RECIST 1.1 as assessed by blinded independent central review \[BICR\]) is defined as the number (%) of patients with a confirmed complete response or confirmed partial response and will be based on all treated patients who are PD-L1-positive with measurable disease at baseline per BICR. Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1. criteria are: Complete response \[CR\] = disappearance of all target lesions since baseline; and partial response \[PR\] = at least a 30% decrease in the sum of the diameters of target lesions.

Overall
GroupValue95% CI
MEDI4736 + Tremelimumab7.83.78 – 13.79
MEDI47369.23.46 – 19.02
Tremelimumab1.60.04 – 8.53
Current smoking/nicotine status - Total
GroupValue95% CI
MEDI4736 + Tremelimumab13.62.91 – 34.91
MEDI473614.30.36 – 57.87
Tremelimumab14.30.36 – 57.87
Current smoking/nicotine status - >10 pack years
GroupValue95% CI
MEDI4736 + Tremelimumab15.03.21 – 37.89
MEDI473614.30.36 – 57.87
Tremelimumab16.70.42 – 64.12
Current smoking/nicotine status - ≤10 pack years
GroupValue95% CI
MEDI4736 + Tremelimumab00.00 – 84.19
Tremelimumab00.00 – 97.50
Former smoking/nicotine status -Total
GroupValue95% CI
MEDI4736 + Tremelimumab6.82.54 – 14.25
MEDI47368.22.27 – 19.60
Tremelimumab00.00 – 8.04
Former smoking/nicotine status - >10 pack years
GroupValue95% CI
MEDI4736 + Tremelimumab5.21.08 – 14.38
MEDI47369.11.92 – 24.33
Tremelimumab00.00 – 10.89
Former smoking/nicotine status - ≤10 pack years
GroupValue95% CI
MEDI4736 + Tremelimumab10.02.11 – 26.53
MEDI47366.30.16 – 30.23
Tremelimumab00.00 – 26.46
Smoking/nicotine status - Never
GroupValue95% CI
MEDI4736 + Tremelimumab5.30.13 – 26.03
MEDI473611.10.28 – 48.25
Tremelimumab00.00 – 26.46
Best Objective Response Secondary · After 12 months

The best response a patient has had during their time in the study

Response - Total
GroupValue95% CI
MEDI4736 + Tremelimumab7.8
MEDI47369.2
Tremelimumab1.6
Total6.6
Response - Complete response (CR)
GroupValue95% CI
MEDI4736 + Tremelimumab0
MEDI47360
Tremelimumab0
Total0
Response - Partial response (PR)
GroupValue95% CI
MEDI4736 + Tremelimumab7.8
MEDI47369.2
Tremelimumab1.6
Total6.6
Non-response (NR) - Total
GroupValue95% CI
MEDI4736 + Tremelimumab92.2
MEDI473690.8
Tremelimumab98.4
Total93.4
NR - Stable disease (SD) >=6 months (24 weeks)
GroupValue95% CI
MEDI4736 + Tremelimumab5.4
MEDI47366.2
Tremelimumab0
Total4.3
NR - Unconfirmed complete or partial response (PR)
GroupValue95% CI
MEDI4736 + Tremelimumab1.6
MEDI47360
Tremelimumab0
Total0.8
NR - Stable disease
GroupValue95% CI
MEDI4736 + Tremelimumab3.9
MEDI47366.2
Tremelimumab0
Total3.5
NR - Progression
GroupValue95% CI
MEDI4736 + Tremelimumab64.3
MEDI473664.6
Tremelimumab69.8
Total65.8
Duration of Response - Participants Remaining in Response Secondary · After 12 months

Participants remaining in response - based on BICR assessments according to RECIST v1.1. An ongoing response was defined as a patient who had documented objective response and was still alive and progression-free at the time of the data cut-off.

Percentage remaining in response-3 months
GroupValue95% CI
MEDI4736 + Tremelimumab90.0
MEDI4736100
Tremelimumab100
Total94.1
Percentage remaining in response-6 months
GroupValue95% CI
MEDI4736 + Tremelimumab70.0
MEDI473666.7
Tremelimumab100
Total70.6
Percentage remaining in response-9 months
GroupValue95% CI
MEDI4736 + Tremelimumab58.3
MEDI473666.7
TremelimumabNA
Total64.2
Percentage remaining in response-12 months
GroupValue95% CI
MEDI4736 + Tremelimumab46.7
MEDI4736NA
TremelimumabNA
Total53.5
Percentage of ongoing response
GroupValue95% CI
MEDI4736 + Tremelimumab50.0
MEDI473666.7
Tremelimumab100
Total58.8
Time to Response Secondary · After 12 months

Time to response in patients with objective response based on BICR assessments according to RECIST 1.1

Number of responders
GroupValue95% CI
MEDI4736 + Tremelimumab100
MEDI4736100
Tremelimumab100
Total100
Week 8, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab10.0
MEDI47360
Tremelimumab0
Total5.9
Week 9, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab50.0
MEDI473616.7
Tremelimumab100
Total41.2
Week 16, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab10.0
MEDI473616.7
Tremelimumab0
Total11.8
Week 17, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab10.0
MEDI473616.7
Tremelimumab0
Total11.8
Week 20, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab0
MEDI473616.7
Tremelimumab0
Total5.9
Week 24, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab10.0
MEDI473616.7
Tremelimumab0
Total11.8
Week 25, where response is first observed
GroupValue95% CI
MEDI4736 + Tremelimumab10.0
MEDI473616.7
Tremelimumab0
Total11.8
Time to Onset of Response From First Dose Secondary · After 12 months

Time to onset of response in patients with objective response based on BICR assessments according to RECIST 1.1

GroupValue95% CI
MEDI4736 + Tremelimumab2.02 – 6
MEDI47364.12 – 6
Tremelimumab1.81.8 – 2
Total3.52 – 6
Disease Control Rate (DCR) Secondary · After 6 months

Disease control rate (DCR) at 6 months based on BICR assessments according to RECIST v1.1. DCR at 6 months was evaluated using 2 different approaches to the length of stable disease (SD). -Method 1: Patients who had a best objective response of complete response (CR) or partial response (PR) within 24 weeks or had demonstrated SD for a minimum interval of 24 weeks following randomization. -Method 2: Patients who had a best objective response of CR or PR in the first 24 weeks or who had demonstrated SD for a minimum interval of 16 weeks following randomization.

METHOD 1: Disease control (DC) at 6 months
GroupValue95% CI
MEDI4736 + Tremelimumab13.2
MEDI473621.5
Tremelimumab1.6
Total12.5
METHOD 1: No DC at 6 months
GroupValue95% CI
MEDI4736 + Tremelimumab86.8
MEDI473678.5
Tremelimumab98.4
Total87.5
METHOD 1: No DC at 6 months-Not evaluable/missing
GroupValue95% CI
MEDI4736 + Tremelimumab20.2
MEDI473620.0
Tremelimumab22.2
Total20.6
METHOD 2: DC at 6 months
GroupValue95% CI
MEDI4736 + Tremelimumab20.2
MEDI473626.2
Tremelimumab9.5
Total19.1
METHOD 2: No DC at 6 months
GroupValue95% CI
MEDI4736 + Tremelimumab79.8
MEDI473673.8
Tremelimumab90.5
Total80.9
METHOD 2: No DC at 6 months-Not evaluable/missing
GroupValue95% CI
MEDI4736 + Tremelimumab20.2
MEDI473620.0
Tremelimumab22.2
Total20.6
Disease Control Rate (DCR) Secondary · After 12 months

Disease control rate (DCR) at 12 months based on BICR assessments according to RECIST v1.1. DCR at 6 months was evaluated using 2 different approaches to the length of stable disease (SD). -Method 1: Patients who had a best objective response of complete response (CR) or partial response (PR) within 24 weeks or had demonstrated SD for a minimum interval of 24 weeks following randomization. -Method 2: Patients who had a best objective response of CR or PR in the first 24 weeks or who had demonstrated SD for a minimum interval of 16 weeks following randomization.

DC at 12 months
GroupValue95% CI
MEDI4736 + Tremelimumab10.1
MEDI473612.3
Tremelimumab1.6
Total8.6
No DC at 12 months
GroupValue95% CI
MEDI4736 + Tremelimumab89.9
MEDI473687.7
Tremelimumab98.4
Total91.4
No DC at 12 months-Not evaluable/missing
GroupValue95% CI
MEDI4736 + Tremelimumab20.2
MEDI473620.0
Tremelimumab22.2
Total20.6
Progression-free Survival (PFS) Secondary · After 6 months

Progression status at 6 months based on BICR assessments according to RECIST v1.1 at time of Progression Free Survival (PFS) analysis. Progression was defined as the time from the data of randomization until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient withdrew from therapy or received another anti-cancer therapy prior to progression. -Target Lesions, Non Target Lesions and New Lesions are not necessarily mutually exclusive categories. -Progression death refers to death in the absence of RECIST 1.1 progression

Progression-Total
GroupValue95% CI
MEDI4736 + Tremelimumab82.0
MEDI473682.1
Tremelimumab88.1
Total83.5
Total-RECIST 1.1 Progression
GroupValue95% CI
MEDI4736 + Tremelimumab57.9
MEDI473659.7
Tremelimumab67.2
Total60.7
RECIST 1.1 progression-Target Lesions
GroupValue95% CI
MEDI4736 + Tremelimumab43.6
MEDI473643.3
Tremelimumab55.2
Total46.4
RECIST 1.1 progression-Non-target lesions
GroupValue95% CI
MEDI4736 + Tremelimumab21.1
MEDI473626.9
Tremelimumab32.8
Total25.5
RECIST 1.1 progression-New lesions
GroupValue95% CI
MEDI4736 + Tremelimumab26.3
MEDI473620.9
Tremelimumab26.9
Total25.1
Progression-Death
GroupValue95% CI
MEDI4736 + Tremelimumab24.1
MEDI473622.4
Tremelimumab20.9
Total22.8
No progression-Total
GroupValue95% CI
MEDI4736 + Tremelimumab18.0
MEDI473617.9
Tremelimumab11.9
Total16.5
No progression-PD free and still being followed
GroupValue95% CI
MEDI4736 + Tremelimumab14.3
MEDI473613.4
Tremelimumab4.5
Total11.6
Progression-free Survival (PFS) Secondary · After 12 months

Progression status at 12 months based on BICR assessments according to RECIST v1.1 at time of Progression Free Survival (PFS) analysis. Progression was defined as the time from the data of randomization until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient withdrew from therapy or received another anti-cancer therapy prior to progression. -Target Lesions, Non Target Lesions and New Lesions are not necessarily mutually exclusive categories. -Progression death refers to death in the absence of RECIST 1.1 progressio

Progression-Total
GroupValue95% CI
MEDI4736 + Tremelimumab88.7
MEDI473683.6
Tremelimumab89.6
Total87.6
Total-RECIST 1.1 Progression
GroupValue95% CI
MEDI4736 + Tremelimumab64.7
MEDI473659.7
Tremelimumab68.7
Total64.4
RECIST 1.1 progression-Target Lesions
GroupValue95% CI
MEDI4736 + Tremelimumab50.4
MEDI473647.8
Tremelimumab56.7
Total51.3
RECIST 1.1 progression-Non-target lesions
GroupValue95% CI
MEDI4736 + Tremelimumab23.3
MEDI473628.4
Tremelimumab32.8
Total27.0
RECIST 1.1 progression-New lesions
GroupValue95% CI
MEDI4736 + Tremelimumab27.1
MEDI473623.9
Tremelimumab23.9
Total25.5
Progression-Death
GroupValue95% CI
MEDI4736 + Tremelimumab24.1
MEDI473623.9
Tremelimumab20.9
Total23.2
No progression-Total
GroupValue95% CI
MEDI4736 + Tremelimumab11.3
MEDI473616.4
Tremelimumab10.4
Total12.4
No progression-PD free and still being followed
GroupValue95% CI
MEDI4736 + Tremelimumab6.8
MEDI473611.9
Tremelimumab3.0
Total7.1
Overall Survival Secondary · After 12 months

Survival status at time of overall survival analysis. 'Still in survival follow-up' includes patients known to be alive at data cut-off. 'Terminated prior to death' includes patients with unknown survival status or patients who were lost to follow-up.

Death
GroupValue95% CI
MEDI4736 + Tremelimumab64.7
MEDI473665.7
Tremelimumab76.1
Total67.8
Still in survival follow-up
GroupValue95% CI
MEDI4736 + Tremelimumab30.1
MEDI473628.4
Tremelimumab16.4
Total26.2
Terminated prior to death
GroupValue95% CI
MEDI4736 + Tremelimumab5.3
MEDI47366.0
Tremelimumab7.5
Total6.0
Terminated prior to death-Voluntary discon.
GroupValue95% CI
MEDI4736 + Tremelimumab5.3
MEDI47366.0
Tremelimumab4.5
Total5.2
Terminated prior to death-Other
GroupValue95% CI
MEDI4736 + Tremelimumab0
MEDI47360
Tremelimumab3.0
Total0.7
Quality of Life Secondary · After 12 months

Improvement in quality of life was assessed using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires: -The impact of treatment on Health-Related Quality of Life, functioning, and symptoms was evaluated using the EORTC QLQ-C30 v3. -Head and neck cancer-specific symptoms were evaluated using the EORTC QLQ-H\&N35. The symptom and QoL/function improvement rate was defined as the number (%) of patients with 2 consecutive assessments at least 14 days apart that showed a clinically meaningful improvement (a decrease from baseline score ≥10 or EORTC QLQ-C30 scales) in th

EORTC QLQ-C30 Function-Physical
GroupValue95% CI
MEDI4736 + Tremelimumab126.7 – 20.8
MEDI473613.66.4 – 26.7
Tremelimumab5.11.4 – 16.9
EORTC QLQ-C30 Function-Role
GroupValue95% CI
MEDI4736 + Tremelimumab16.310.0 – 25.5
MEDI473616.78.3 – 30.6
Tremelimumab11.84.7 – 26.6
EORTC QLQ-C30 Function-Cognitive
GroupValue95% CI
MEDI4736 + Tremelimumab2516.2 – 36.4
MEDI473629.416.8 – 46.2
Tremelimumab10.73.7 – 27.2
EORTC QLQ-C30 Function-Emotional
GroupValue95% CI
MEDI4736 + Tremelimumab13.57.9 – 22.1
MEDI473613.66.4 – 26.7
Tremelimumab2.60.5 – 13.2
EORTC QLQ-C30 Function-Social
GroupValue95% CI
MEDI4736 + Tremelimumab18.311.0 – 28.8
MEDI473615.26.7 – 30.9
Tremelimumab16.17.1 – 32.6
EORTC QLQ-C30 Symptom-Fatigue
GroupValue95% CI
MEDI4736 + Tremelimumab16.810.9 – 25.0
MEDI473617.39.4 – 29.7
Tremelimumab7.53.0 – 17.9
EORTC QLQ-C30 Symptom-Pain
GroupValue95% CI
MEDI4736 + Tremelimumab22.815.4 – 32.4
MEDI473620.811.7 – 34.3
Tremelimumab6.72.3 – 17.9
EORTC QLQ-C30 Symptom-Nausea/vomiting
GroupValue95% CI
MEDI4736 + Tremelimumab22.212.5 – 36.3
MEDI473616.74.7 – 44.8
Tremelimumab17.66.2 – 41.0

Adverse events — posted to ClinicalTrials.gov

Time frame: AEs and SAEs were collected from time the informed consent was signed through 90 days after the last dose of the last study treatment or until another therapy was initiated.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

MEDI4736 AND TREMELIMUMAB COMBINATION
Serious: 59/133 (44%)
Deaths: 86/133
MEDI4736
Serious: 18/65 (28%)
Deaths: 44/67
Tremelimumab
Serious: 25/65 (38%)
Deaths: 51/67

Serious adverse events (111 terms)

ReactionSystemMEDI4736 AND TREMELIMUMAB …MEDI4736Tremelimumab
PneumoniaInfections and infestations
DiarrhoeaGastrointestinal disorders
Lung infectionInfections and infestations
DehydrationMetabolism and nutrition disorders
HypercalcaemiaMetabolism and nutrition disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
NauseaGastrointestinal disorders
PyrexiaGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
Pneumonia aspirationRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
ColitisGastrointestinal disorders
DysphagiaGastrointestinal disorders
Small intestinal obstructionGastrointestinal disorders
VomitingGastrointestinal disorders
Pneumonia bacterialInfections and infestations
HypernatraemiaMetabolism and nutrition disorders
Tumour painNeoplasms benign, malignant and unspecified (incl cysts and polyps)
DizzinessNervous system disorders
HaemoptysisRespiratory, thoracic and mediastinal disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
Angina pectorisCardiac disorders
Atrial fibrillationCardiac disorders
BradycardiaCardiac disorders
Cardiac arrestCardiac disorders
Other adverse events (41 terms — click to expand)

ReactionSystemMEDI4736 AND TREMELIMUMAB …MEDI4736Tremelimumab
DiarrhoeaGastrointestinal disorders
FatigueGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
AstheniaGeneral disorders
AnaemiaBlood and lymphatic system disorders
ConstipationGastrointestinal disorders
NauseaGastrointestinal disorders
Weight decreasedInvestigations
PyrexiaGeneral disorders
HypothyroidismEndocrine disorders
DysphagiaGastrointestinal disorders
CoughRespiratory, thoracic and mediastinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
PruritusSkin and subcutaneous tissue disorders
ArthralgiaMusculoskeletal and connective tissue disorders
HyponatraemiaMetabolism and nutrition disorders
RashSkin and subcutaneous tissue disorders
VomitingGastrointestinal disorders
Back painMusculoskeletal and connective tissue disorders
InsomniaPsychiatric disorders
PainGeneral disorders
HypertensionVascular disorders
Oedema peripheralGeneral disorders
HypercalcaemiaMetabolism and nutrition disorders
HypokalaemiaMetabolism and nutrition disorders
HeadacheNervous system disorders
HypotensionVascular disorders
DehydrationMetabolism and nutrition disorders
Neck painMusculoskeletal and connective tissue disorders
Productive coughRespiratory, thoracic and mediastinal disorders
TachycardiaCardiac disorders
HypomagnesaemiaMetabolism and nutrition disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
ParaesthesiaNervous system disorders
Dry skinSkin and subcutaneous tissue disorders
Ear painEar and labyrinth disorders
Mucosal inflammationGeneral disorders
HyperkalaemiaMetabolism and nutrition disorders
HypoalbuminaemiaMetabolism and nutrition disorders

Most-reported serious reactions: Pneumonia, Diarrhoea, Lung infection, Dehydration, Hypercalcaemia, Dyspnoea, Nausea, Pyrexia.

Data from ClinicalTrials.gov NCT02319044 adverse events section.

Sponsor's own description

The purpose of this study is to determine the efficacy and safety of investigational medical products (MEDI4736 monotherapy, tremelimumab monotherapy, and MEDI4736 + tremelimumab combination therapy) in the treatment of patients with recurrent or metastatic carcinoma of the head and neck who have progressed during or after treatment with a platinum containing regimen for recurrent/metastatic disease.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Combination strategies with PD-1/PD-L1 blockade: current advances and future directions.
    Yi M, Zheng X, Niu M, Zhu S, et al · · 2022 · cited 1018× · PMID 35062949 · DOI 10.1186/s12943-021-01489-2
  2. Immunology and Immunotherapy of Head and Neck Cancer.
    Ferris RL. · · 2015 · cited 515× · PMID 26351330 · DOI 10.1200/jco.2015.61.1509
  3. Cold and hot tumors: from molecular mechanisms to targeted therapy.
    Wu B, Zhang B, Li B, Wu H, et al · · 2024 · cited 280× · PMID 39420203 · DOI 10.1038/s41392-024-01979-x
  4. Safety and Efficacy of Durvalumab With or Without Tremelimumab in Patients With PD-L1-Low/Negative Recurrent or Metastatic HNSCC: The Phase 2 CONDOR Randomized Clinical Trial.
    Siu LL, Even C, Mesía R, Remenar E, et al · · 2019 · cited 234× · PMID 30383184 · DOI 10.1001/jamaoncol.2018.4628
  5. Durvalumab: First Global Approval.
    Syed YY. · · 2017 · cited 130× · PMID 28643244 · DOI 10.1007/s40265-017-0782-5
  6. Tumor microenvironment: an evil nexus promoting aggressive head and neck squamous cell carcinoma and avenue for targeted therapy.
    Bhat AA, Yousuf P, Wani NA, Rizwan A, et al · · 2021 · cited 119× · PMID 33436555 · DOI 10.1038/s41392-020-00419-w
  7. Cervical cancer - State of the science: From angiogenesis blockade to checkpoint inhibition.
    Minion LE, Tewari KS. · · 2018 · cited 87× · PMID 29666026 · DOI 10.1016/j.ygyno.2018.01.009
  8. Radio-Immunotherapy-Induced Immunogenic Cancer Cells as Basis for Induction of Systemic Anti-Tumor Immune Responses - Pre-Clinical Evidence and Ongoing Clinical Applications.
    Derer A, Deloch L, Rubner Y, Fietkau R, et al · · 2015 · cited 77× · PMID 26500646 · DOI 10.3389/fimmu.2015.00505

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