RecruitingPhase 2NCT07371234

Low-Dose Radiotherapy and Anti-PD-1 Immunotherapy as Neoadjuvant Treatment for Resectable Locally Advanced Head and Neck Squamous Cell Carcinoma

A Single Arm, Phase II Clinical Study of Low-Dose Radiotherapy Combined With Anti-PD-1 Monoclonal Antibody Immunotherapy as Neoadjuvant Treatment for Surgically Resectable, Locally Advanced Head and Neck Squamous Cell Carcinoma (HNSCC)


Sponsor

Xiwei XU

Enrollment

22 participants

Start Date

Dec 15, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

Over 60% of head and neck squamous cell carcinoma (HNSCC) patients are diagnosed at a locally advanced stage. While standard treatments involve surgery and chemoradiotherapy, prognosis remains poor, with 50-60% experiencing local recurrence within two years. Neoadjuvant therapy can potentially reduce tumor burden, preserve organs, and lower distant metastasis risk. Despite the KEYNOTE-689 trial showing that adjuvant two-cycle pembrolizumab increased major pathological response to 9.8% in stage III-IVB HNSCC, this result remains insufficient. More effective immunotherapy-based combinations are urgently needed to improve long-term survival after neoadjuvant treatment. Preclinical and clinical evidence indicates that low-dose radiotherapy can activate the tumor immune microenvironment and synergize with immunotherapy. Based on this rationale, the present clinical trial will evaluate a neoadjuvant regimen combining LDRT with two cycles of an anti-PD-1 inhibitor in patients with surgically resectable, locally advanced HNSCC.


Eligibility

Min Age: 18 YearsMax Age: 75 Years

Plain Language Summary

Simplified for easier understanding

This study is testing whether combining low-dose radiation therapy with an immunotherapy drug (anti-PD-1) before surgery can shrink locally advanced head and neck squamous cell cancer more effectively, making surgery more successful. **You may be eligible if...** - You are between 18 and 75 years old - You have been newly diagnosed with stage III–IVB squamous cell carcinoma of the mouth, throat, or voice box - You have not yet received any treatment for this cancer - You are in good physical condition (ECOG 0 or 1) - Your cancer is considered operable based on your surgeon's assessment - Your blood counts, organ function, and thyroid levels meet required thresholds **You may NOT be eligible if...** - You have already received treatment for head and neck cancer - You have a history of serious autoimmune disease or organ/stem cell transplant - You are HIV-positive or have untreated active hepatitis B or C - You are pregnant or unwilling to use effective contraception - You have uncontrolled heart disease or other serious conditions Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGNeoadjuvant and Adjuvant Immunotherapy

Neoadjuvant therapy with Toripalimab (240mg, Day 1, Q3W, 2 cycles);Adjuvant immunotherapy with Toripalimab (240mg, Day 1, Q3W, for a total of 15 cycles).

RADIATIONLow-dose radiotherapy

Low-dose radiotherapy (1 Gy/fraction, on Days 1, 8, and 15 of each cycle, Q3W, for 2 cycles; total dose: 6 Gy in 6 fractions).

PROCEDURESurgery

Radical surgery performed 3-4 weeks after neoadjuvant therapy, following a re-evaluation of surgical indications by the surgeon.

RADIATIONAdjuvant Radiotherapy

Low-risk group: 60 Gy in 30 fractions, using intensity-modulated radiation therapy (IMRT); High-risk group: 66 Gy in 33 fractions, or 70 Gy in 35 fractions for residual lesions, using intensity-modulated radiation therapy (IMRT).

DRUGAdjuvant Cisplatin

High-risk group:Cisplatin 100 mg/m² is administered via intravenous infusion on Day 1 of every 21-day cycle during radiotherapy, for a total of 3 cycles.


Locations(1)

The Fifth Affiliated Hospital,Sun Yat-sen University

Guangdong, China

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NCT07371234


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