Dose Finding Study of Zanzalintinib With Pembrolizumab and Cetuximab in Head and Neck SCC
A Phase I Study of Zanzalintinib With Pembrolizumab and Cetuximab in Patients With Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck
University of Chicago
36 participants
Sep 29, 2025
INTERVENTIONAL
Conditions
Summary
This Phase I clinical trial evaluates the safety, tolerability, and optimal dosing of Zanzalintinib in combination with Pembrolizumab and Cetuximab in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M HNSCC). The study aims to establish the maximally tolerated dose (MTD) and recommended Phase II dose (RP2D) while also exploring efficacy outcomes, including progression-free survival (PFS) and overall survival (OS).
Eligibility
Inclusion Criteria15
- Histologically or cytologically confirmed recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M HNSCC), which is considered incurable by local therapies.
- Primary tumor locations: oropharynx, oral cavity, hypopharynx, larynx, nasopharynx, and sinonasal. Unknown primary is also eligible.
- Age: Participants must be at least 18 years old.
- ECOG Performance Status: Must be 0-1.
- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.
- For oropharyngeal cancer: HPV (p16) testing is required. p16 Immunohistochemistry (IHC) is sufficient for Human Papillomavirus (HPV) testing.
- Programmed cell death ligand 1 (PD-L1) combined positive score (CPS) : For patients with previously untreated R/M disease, a combined positive score (CPS) of 1 or greater is required. There is no PD-L1 restriction for patients who have previously received anti-PD(L)1 therapy.
- Recovery to baseline or ≤ Grade 1 severity (CTCAE v5) from any adverse events (AEs), including immune-related AEs from prior treatments.
- Adequate organ and marrow function, including:
- Absolute neutrophil count (ANC) ≥ 1500/mm3.
- Platelets ≥ 100,000/mm3.
- Hemoglobin ≥ 9 g/dL.
- Normal liver and kidney function.
- Capable of understanding and complying with the protocol requirements and must have signed the informed consent document.
- Contraception: Sexually active fertile subjects must agree to use a highly effective method of contraception during the study and for 2 months after the last dose of cetuximab and 4 months after the last dose of pembrolizumab.
Exclusion Criteria10
- Prior treatment with Zanzalintinib or other vascular endothelial growth factor receptor (VEGFR)-targeted therapies, -Cetuximab, or other epidermal growth factor receptor (EGFR) inhibitors.
- More than two prior lines of systemic therapy in the recurrent/metastatic setting.
- Relapsed disease within 3 months of definitive therapy.
- Prior treatment with small molecule kinase inhibitors, chemotherapy, biologic, or other anticancer therapies within certain time frames (2-4 weeks before the first dose of study treatment).
- Brain metastases or cranial epidural disease unless stable after treatment for at least 4 weeks.
- Concomitant anticoagulation with oral anticoagulants or platelet inhibitors, unless on stable doses of acceptable anticoagulants.
- Active infection requiring systemic treatment or significant cardiovascular, gastrointestinal, or other serious health issues that may affect study participation.
- Known or suspected autoimmune disease, except for specific conditions like type I diabetes or controlled skin disorders.
- Pregnancy or breastfeeding: Women must not be pregnant or breastfeeding at screening.
- Other malignancies within the past 2 years (except for certain low-grade cancers like localized skin cancers).
Interventions
Experimental receptor tyrosine kinases (RTKs)
Food and Drug Administration (FDA) approved monoclonal antibody directed against the epidermal growth factor (EGFR).
FDA approved monoclonal immunoglobulin (Ig) G4 antibody directed against human cell surface receptor PD-1 (programmed death-1 or programmed cell death-1)
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT06912087