Inductive Camrelizumab and Apatinib for Patients With Locally Advanced and Resectable Oral Squamous Cell Carcinoma

  • STATUS
    Recruiting
  • participants needed
    20
  • sponsor
    Shanghai Jiao Tong University School of Medicine
Updated on 19 February 2024
cancer
white blood cell count
renal function
metastasis
squamous cell carcinoma
immune checkpoint inhibitor
growth factor
targeted therapy
immunosuppression
chemoradiotherapy
vegf
carcinoma
vascular endothelial growth factor
hypoxia
tumor growth
leukocyte count
apatinib
angiogenesis
neovascularization
tumor angiogenesis
squamous cell carcinoma of the head and neck
tumor burden
lymph node metastases
camrelizumab
head and neck squamous cell carcinoma
vascular endothelial growth factor receptor 2

Summary

In patients with locally advanced oral squamous cell carcinoma (OSCC), due to the large tumor burden and neck lymph node metastasis, comprehensive treatment is recommended, including surgery, radiotherapy, chemotherapy and others. Pre-operative inductive therapy can reduce tumor volume, increase organ retention rate, and reduce distant metastasis rate. Vascular endothelial growth factor (VEGF) receptor in head and neck squamous cell carcinoma is over-expressed and associated with disease invasion and poor prognosis. The use of targeted therapy against VEGF can not only inhibit tumor neovascularization, but also make the effectiveness of chemotherapeutic agents. VEGF and VEGFR are closely related to immune escape. Tumor growth requires new blood vessels to supply nutrients and oxygen, and VEGF can stimulate neovascularization. However, tumor neovascularization is often abnormal and distorted, which prevents immune active substances from reaching the tumor site. After tumor hypoxia, high expression of VEGF will induce tumor cells to express programmed cell death protein-1 (PD-1), which further leads to immune escape. Targeted drugs against angiogenesis can relieve immunosuppression to a certain extent, and theoretically have a synergistic effect with anti-PD-1 immunotherapy. The innovation of this study is the combination of immune checkpoint inhibitor, Camrelizumab, and targeted drug against VEGFR, Apatinib, as an inductive therapy to treat the patients with locally advanced OSCC, followed with radical surgery and post-operative radiotherapy/chemoradiotherapy, the major pathologic response and safety will be evaluated as the primary surrogate endpoints, the 2-year survival rate and local recurrence rate will be the second endpoints.

Details
Condition Oral Neoplasm, oral cavity cancer, head and neck cancer, head and neck cancer, oral cavity cancer, VEGFR2 Inhibitor, Programmed Cell Death 1 Inhibitor, Inductive Therapy
Age 18-75 years
Treatment Apatinib, Camrelizumab, Radical surgery, Post-operative radiotherapy/chemoradiotherapy
Clinical Study IdentifierNCT04393506
SponsorShanghai Jiao Tong University School of Medicine
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Eastern cooperative oncology group performance status (ECOG PS) score: 0-2 points
Pathological diagnosis of oral squamous cell carcinoma (including tongue, gums, cheeks, mouth floor, hard palate, posterior molar region)
Clinical stage of III/IVA (AJCC 2018)
Blood routine: white blood cells> 3,000/mm3, hemoglobin> 8g/L, platelets> 80,000/mm3
Liver function: Alanine Transaminase/Aspartate Transaminase <2.5 times the upper limit of normal, bilirubin <1.5 times the upper limit of normal
Renal function: serum creatinine <1.5 times the upper limit of normal
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Exclusion Criteria

There are still unresolved toxic reactions above CTCAE level 2 caused by previous anti-cancer treatment
Obvious cardiovascular abnormalities [such as myocardial infarction, superior vena cava syndrome, heart disease of grade 2 or higher diagnosed according to the classification criteria of the New York Heart Association (NYHA) 3 months before enrollment]
Active severe clinical infection (> CTCAE 5.0 version 2 infection)
Difficult to control hypertension (systolic blood pressure> 150 mmHg and / or diastolic blood pressure> 90 mmHg) or cardiovascular disease with clinical significance (such as activity)-such as cerebrovascular accident ( 6 months before randomization), myocardial infarction (6 months before randomization), unstable angina, New York Cardiology Society (NYHA Appendix 5) congestive heart failure grade II or above, or severe arrhythmia that cannot be controlled with drugs or has potential impact on experimental treatment
Women during pregnancy or lactation
Participated in other clinical studies within 30 days before enrollment
Other circumstances that the investigator thinks are not suitable for participating in the study
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