Overview
Sponsor-declared trial summary
Resected squamous cell carcinoma of the head and neck
1. The purpose of this study is to demonstrate improvement in DiseaseFree Survival (DFS) with xevinapant compared to placebo when added to RT irrespective of subsequent anticancer therapy.
Key facts
- Sponsor
- Merck Healthcare KGaA
- Participant type
- Patients
- Age range
- 18-64 years, 65+ years
- Gender
- Male and Female
- Therapeutic area
- Diseases [C] - Neoplasms [C04]
- Trial duration
- 16 Dec 2022 → 28 Aug 2024
- Decision date (initial)
- 2024-02-26
- Transition trial
- Yes
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- Yes
- Funding sources
- Merck Healthcare KGaA
External identifiers
- EU CT number
- 2023-508528-36-00
- EudraCT number
- 2022-001144-18
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Efficacy
1. The purpose of this study is to demonstrate improvement in DiseaseFree Survival (DFS) with xevinapant compared to placebo when added to RT irrespective of subsequent anticancer therapy.
Conditions and MedDRA coding
Resected squamous cell carcinoma of the head and neck
Study design 1 period
| # | Title | Allocation | Blinding | Roles blinded | Arms |
|---|---|---|---|---|---|
| 1 | Phase III xevinapant and radiotherapy in resected LA SCCHN Phase III xevinapant and radiotherapy in resected LA SCCHN
|
Randomised Controlled | Double | [{"id":74114,"code":2,"name":"Investigator"},{"id":74113,"code":1,"name":"Subject"},{"id":74111,"code":3,"name":"Monitor"},{"id":74112,"code":5,"name":"Carer"}] | Arm A: Xevinapant (Debio 1143) + IMRT: Drug: Xevinapant (Debio 1143) Participants will receive 3 cycles of oral solution of Xevinapant (Debio 1143) at a dose of 200 milligrams per day (mg/day) once daily from Day 1 to 14, per 3- week cycle in combination with radiotherapy followed by 3 cycles of monotherapy of Xevinapant (Debio 1143) at a dose of 200 mg/day from Day 1 to 14, per 3-week cycle (Each cycle is of 3 weeks). Radiation: IMRT Participants will receive 66 Gy of intensity modulated radiation therapy (IMRT) in 33 fractions, 2 y/fraction, 5 days/week. Arm B: Placebo + IMRT: Radiation: IMRT Participants will receive 66 Gy of intensity modulated radiation therapy (IMRT) in 33 fractions, 2 Gy/fraction, 5 days/week. Drug: Placebo Participants will receive 3 cycles of oral solution of placebo matched to Xevinapant (Debio 1143) once daily from Day 1 to 14 per 3-week cycle in combination with radiotherapy followed by 3 cycles of monotherapy of placebo matched to Xevinapant (Debio 1143) from Day 1 to 14, per 3-week cycle (Each cycle is of 3 weeks). |
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 8
- Participants with Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-2 and able to tolerate standard of care IMRT treatment according to Investigator assessment
- Participants with histologically confirmed squamous cell carcinoma with one of the following primary sites: oral cavity, oropharynx, hypopharynx or larynx. Participants have received surgery with curative intent on these sites in the past 4 to 10 weeks before start of treatment (Cycle 1 Day 1)
- Oropharynx (OPC) participants must have known human papillomavirus (HPV) status as determined by p16 expression using immunohistochemistry ICH)
- Participants with no residual disease by computed tomography (CT) or magnetic resonance imaging (MRI) and have a high risk of relapse with 1 or 2 of the following criteria, confirmed by local histopathology:
- nodal extra-capsular extension (ECE) and positive resection margins (R1 or close margin less than or equal to (<=) 1 millimeter (mm)
- Are unfit to receive high-dose cisplatin by meeting one or more of the following criteria: estimated glomerular filtration rate (eGFR) < 60 milliliter per minute per 1.73 meter square (mL/min /1.73 m^2);History of hearing impairment, defined as Grade >= 2 audiometric hearing loss or tinnitus Grade >=2. An audiogram is not required if one of the other criteria meets unfitness to receive high-dose cisplatin; Peripheral neuropathy > = Grade 2 and if >= 70 years, unfit according to G8 questionnaire (Score <= 14) or ineligible for cisplatin treatment due to age limit according to national guidelines.
- "Participants with adequate hematologic, renal and hepatic function as defined in the protocol"
- Other protocol-defined inclusion criteria could apply
Exclusion criteria 9
- Any condition, including any uncontrolled disease state other than SCCHN that in the Investigator's opinion constitutes an inappropriate risk or a contraindication for participation in the study or that could interfere with the study objectives, conduct, or evaluation
- Participant with incomplete surgery
- Primary tumor of nasopharyngeal, paranasal sinuses, nasal cavity, salivary, thyroid or parathyroid gland, skin or unknown primary site
- Prior definitive, neoadjuvant, concurrent or adjuvant (C)RT to the head and neck region which may jeopardize the primary tumor irradiation plan,or any other prior SCCHN systemic treatment, including investigational agents
- Participation in any interventional clinical study within 28 days prior to screening or during participation in this study
- Known contraindication to undergoing positron emission tomography with 18F-FDG-PET-CT scans, or both contrast-enhanced MRI and contrast enhanced CT scans
- Known allergy to Xevinapant (Debio 1143) or any excipient known to be present in Xevinapant (Debio 1143) or in the placebo formulation
- Participants with recurrent or metastatic disease
- Other protocol-defined exclusion criteria could apply
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 1
- Disease-Free Survival (DFS)
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 1
PRD10233281 · Product
- Active substance
- Xevinapant
- Substance synonyms
- C08012907-N, DEBIO 1143, (5S,8S,10AR)-N-(DIPHENYLMETHYL)-5-((2S)-2-(METHYLAMINO)PROPANAMIDO)-3-(3-METHYLBUTANOYL)-6-OXODECAHYDROPYRROLO(1,2-A)(1,5)DIAZOCINE-8-CARBOXAMIDE, (5S,8S,10AR)-N-(DIPHENYLMETHYL)DECAHYDRO-5-(((2S)-2-(METHYLAMINO)-1-OXOPROPYL)AMINO)-3-(3-METHYL-1-OXOBUTYL)-6-OXOPYRROLO(1,2-A)(1,5)DIAZOCINE-8-CARBOXAMIDE, (5S,8S,10AR)-N-BENZHYDRYL-5-((S)-2-(METHYLAMINO)PROPANAMIDO)-3-(3-METHYLBUTANOYL)-6-OXODECAHYDROPYRROLO[1,2-A][1,5]DIAZOCINE-8-CARBOXAMIDE, DEBIO-1143, AT-406
- Other product name
- Debio 1143
- Pharmaceutical form
- ORAL SOLUTION
- Route of administration
- ORAL USE
- Max daily dose
- 200 mg milligram(s)
- Max total dose
- 3600 mg milligram(s)
- Max treatment duration
- 18 Week(s)
- Authorisation status
- Not Authorised
- MA holder
- MERCK HEALTHCARE KGAA
- Paediatric formulation
- No
- Orphan designation
- No
Placebo 1
N/A · Product
- Other product name
- N/A
- Pharmaceutical form
- N/A
- ATC code
- N/A — N/A
- Marketing authorisation
- N/A
- MA holder
- N/A
- MA country
- Iceland
- Paediatric formulation
- No
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Merck Healthcare KGaA
- Sponsor organisation
- Merck Healthcare KGaA
- Address
- Frankfurter Strasse 250
- City
- Darmstadt
- Postcode
- 64293
- Country
- Germany
Scientific contact point
- Organisation
- Merck Healthcare KGaA
- Contact name
- Communication Center Merck KGaA
Public contact point
- Organisation
- Merck Healthcare KGaA
- Contact name
- Communication Center Merck KGaA
Third parties 6
| Organisation | City, country | Duties |
|---|---|---|
| IQVIA Limited ORG-100008655
|
Reading, United Kingdom | On site monitoring, Code 10, Code 12, Code 2, Interactive response technologies (IRT), Data management, E-data capture, Code 8, Code 9 |
| IQVIA RDS Hellas Single Member S.A. ORG-100048380
|
Chalandri, Greece | On site monitoring, Code 12, Code 5, Code 8 |
| Radialogica LLC ORG-100048281
|
Saint Louis, United States | Other |
| Inivata Limited ORG-100046830
|
Cambridge, United Kingdom | Other |
| Q Squared Solutions Limited ORG-100042527
|
Livingston, United Kingdom | Other, Laboratory analysis |
| Q Squared Solutions LLC ORG-100043195
|
Durham, United States | Other |
Locations
12 EU/EEA countries · 88 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| Austria | Ended | 10 | 5 |
| Belgium | Ended | 11 | 4 |
| Czechia | Ended | 9 | 3 |
| France | Ended | 86 | 25 |
| Germany | Ended | 18 | 7 |
| Greece | Ended | 8 | 3 |
| Italy | Ended | 37 | 15 |
| Netherlands | Ended | 9 | 3 |
| Poland | Ended | 7 | 1 |
| Portugal | Ended | 11 | 4 |
| Romania | Ended | 17 | 5 |
| Spain | Ended | 39 | 13 |
| Rest of world
Japan, Korea, Republic of, Switzerland, Brazil, United States, China, Turkey, United Kingdom, Canada, Georgia, India, Israel, Mexico, Argentina, Taiwan
|
— | 386 | — |
Investigational sites
Country notifications
Trial-start, recruitment-start, end and early-termination notifications submitted per Member State
| Country | Trial start | Trial end | Recruitment start | Recruitment end | Early termination |
|---|---|---|---|---|---|
| Austria | 2023-09-26 | 2024-06-24 | |||
| Belgium | 2023-03-31 | 2024-06-24 | |||
| Czechia | 2023-05-25 | 2024-06-24 | |||
| France | 2023-02-09 | 2024-08-27 | 2023-02-23 | 2024-06-24 | |
| Germany | 2023-04-05 | 2024-07-23 | 2023-05-31 | 2024-06-24 | |
| Greece | 2023-03-30 | 2024-08-08 | 2024-03-27 | 2024-06-24 | |
| Italy | 2022-12-16 | 2024-07-22 | 2023-02-24 | 2024-06-24 | |
| Netherlands | 2023-04-25 | 2024-06-24 | 2024-03-07 | 2024-06-24 | |
| Poland | 2023-05-15 | 2024-07-29 | 2023-07-31 | 2024-06-24 | |
| Portugal | 2023-07-28 | 2024-07-26 | 2023-11-08 | 2024-06-24 | |
| Romania | 2022-12-22 | 2024-07-26 | 2023-04-25 | 2024-06-24 | |
| Spain | 2023-01-27 | 2024-07-26 | 2023-05-04 | 2024-06-24 |
Oversight and notifications
Regulatory notifications under CTR Articles 38, 52, 53, 54 and 77
Urgent safety measures 1 · Art. 54 CTR
Urgent safety measure US-31945
- Event date
- 2024-06-25
- Submission date
- 2024-06-28
- In response to
- OTHER
- Member states affected
- Belgium, Netherlands, Austria, Czechia, France, Germany, Greece, Italy, Portugal, Spain, Poland, Romania
- Event description
- After the IDMC meeting on 20 June 2024 for the xevinapant Trilynx study, the IDMC notified the sponsor that the study crossed the pre-defined futility boundary at the first Interim Analysis (IA). An imbalance was seen for the reported Adverse Events in the xevinapant arm compared to placebo. The sponsor subsequently made the decision to discontinue the study.
Due to the similarity in the patient population and treatment combination between the xevinapant studies, the sponsor also decided to discontinue study MS202359_0002 on 24th June 2024. - Measures taken
- • Screening and enrollment activities via the IRT system (Cenduit) were stopped. As from today, screening, enrollment and Investigational Medicine Product (IMP) assignment (Xevinpant/placebo) via the IRT system are closed.
• The investigators and sites were informed of the sponsors decision
• For patients currently in screening:
o Patients currently in screening (signed ICF) would be documented as screen failures. The investigators have been instructed to inform patients about the study discontinuation in a timely manner.
• For patients on treatment:
o Treatment with xevinapant/placebo was stopped immediately. No IMP would be dispensed to the patients with immediate effect
o The investigators has been told to contact their patient(s) by phone within the next 24 hours and instruct their patient(s) to stop the intake of xevinapant/placebo immediately.
o Per Investigator discretion patients may continue and complete IMRT treatment according to the Protocol.
• For patients in DFS or OS follow-up:
o all assessments will be discontinued, and the patients will be informed about study discontinuationby the investigators in a timely manner. "
Results and documents
Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial
Summary of results Art. 37(4) CTR
| Title | Submission date | Status | Type |
|---|---|---|---|
| Summary of Results - CSR synopsis SUM-90809
|
2025-07-18T08:24:38 | Submitted | Summary of Results |
Layperson summary Annex V
| Title | Submission date | Status | Type |
|---|---|---|---|
| Lay Person Summary | 2025-07-18T08:24:54 | Submitted | Laypersons Summary of Results |
Documents 57 files
Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.
| Type | Title | Version |
|---|---|---|
| Laypersons summary of results (for publication) | Lay Person Summary - Dutch | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_CZ | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_DE | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_EL | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_EN | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_ES | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_FR | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_IT | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_PL | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_PT | 1 |
| Laypersons summary of results (for publication) | Lay Person Summary_RO | 1 |
| Recruitment arrangements (for publication) | K1_PFIS_EN_2023-508528-36-00 | 1 |
| Recruitment arrangements (for publication) | K1_PFIS_EN_2023-508528-36-00_for publication | V1.0 |
| Recruitment arrangements (for publication) | K1_PFIS_EN_2023-508528-36-00_FOR PUBLICATION | V1.0 |
| Recruitment arrangements (for publication) | K2_RecruitMat_Informed Consent Guide_FR_2023-508528-36-00_for pub | V01FRA01 |
| Recruitment arrangements (for publication) | K2_RecruitMat_Patient Advocacy Letter_FR_2023-508528-36-00_for pub | V01FRA02 |
| Recruitment arrangements (for publication) | K2_RecruitMat_Patient Brochure_FR_2023-508528-36-00_for pub | V01FRA01 |
| Recruitment arrangements (for publication) | K2_RecruitMat_Patient Poster_FR_2023-508528-36-00_for publication | V01FRA01 |
| Subject information and informed consent form (for publication) | L1_ ICF_HIV_IT_ 547_ 2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITAv1 |
| Subject information and informed consent form (for publication) | L1_ ICF_Main_FR_2023-508528-36-00_red for pub | V4.1FRA1.0 |
| Subject information and informed consent form (for publication) | L1_ ICF_Pregnancy_FR_2023-508528-36-00_Redacted for publication | V1.0FRA2.0 |
| Subject information and informed consent form (for publication) | L1_ SIS or ICF_HIV_IT_ 2023-508528-36-00_FOR PUBLICATION | V1.0ITAv1 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF Main_ES_2023-508528-36-00_FOR PUBLICATION | V4.1ESP1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF Optional FSR_ES_2023-508528-36-00_FOR PUBLICATION | V1.0ESP1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF PP_ES_2023-508528-36-00_FOR PUBLICATION | V1.0ESP2.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Main_IT_ 2023-508528-36-00_REDACTED FOR PUBLICATION | V4.1ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Future Research_IT_2023-508528-36-00_FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Future Research_IT_542_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Future Research_IT_547_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITAv1 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Future Research_IT_548_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Future Research_IT_551_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Future Research_IT_554_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Genetic Research_IT_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Genetic Research_IT_542_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Genetic Research_IT_547_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITAv1 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Genetic Research_IT_551_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_Optional Genetic Research_IT_554_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_PP_IT_2023-508528-36-00_FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_PP_IT_542_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITA1.0 |
| Subject information and informed consent form (for publication) | L1_SIS or ICF_PP_IT_547_2023-508528-36-00_REDACTED FOR PUBLICATION | V1.0ITAv1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_CITELINE_EU Information Release Consent_IT_2023-508528-36-00 | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_eCOA HH_App_Screenshots_EN_FR_2023-508528-36-00_red for pub | V1.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_GP letter_IT_2023-508528-36-00_FOR PUBLICATION | v4.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_HHTrainingModule_Screenshots_EN_FR_2023-508528-36-00_for pub | V1.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Informed Consent Guide_IT_2023-508528-36-00_FOR PUBLICATION | V01 ITA |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Advocacy Letter_IT_2023-508528-36-00_FOR PUBLICATION | V01 ITA |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Brochure_IT_2023-508528-36-00_FOR PUBLICATION | V01 ITA |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Emergency Card_FR_2023-508528-36-00_Red for pub | V01FRA01 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Emergency Card_IT_2023-508528-36-00 | V01 ITA |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Poster_IT_2023-508528-36-00_FOR PUBLICATION | V01 ITA |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Study Guide_FR_2023-508528-36-00_for pub | V01FRA01 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Patient Study Guide_IT_2023-508528-36-00_FOR PUBLICATION | V01 ITA |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Release Consent_IT_2023-508528-36-00_REDACTED FOR PUBLICATION | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Subject Diary_IT_2023-508528-36-00_REDACTED FOR PUBLICATION | V3.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Visit Reminder Card_FR_2023-508528-36-00_for pub | V01FRA01 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Visit Reminder Card_IT_2023-508528-36-00_FOR PUBLICATION | V01 ITA |
| Summary of results (for publication) | Summary of results_CSR synopsis_Redacted | 1 |
Application history
4 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2023-12-22 | Belgium | Acceptable 2024-02-20
|
2024-02-21 |
| 2 | SUBSTANTIAL MODIFICATION | SM-3 | 2024-08-02 | Acceptable | 2024-09-10 | |
| 3 | SUBSTANTIAL MODIFICATION | SM-4 | 2024-08-02 | Acceptable | 2024-09-13 | |
| 4 | SUBSTANTIAL MODIFICATION | SM-5 | 2024-08-02 | 2024-09-16 |