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NCT Number: NCT04974398

A Study of Penpulimab (AK105) in the First-line Treatment of Recurrent or Metastatic Nasopharyngeal Carcinoma

This study is a randomized, double-blind, multi-center phase III clinical study to compare the efficacy and safety of penpulimab combined with chemotherapy and placebo combined with chemotherapy in the first-line treatment of recurrent or metastatic nasopharyngeal carcinoma.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

12 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Voluntarily signed written Informed Consent Form(ICF).
  • Main study: Age of ≥ 18 years and ≤ 75 years at the time of enrollment.
  • Substudy: Age of ≥ 12 years and < 18 years. Weight≥ 35KG.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Expected survival of ≥ 3 months.
  • Histologically or cytologically confirmed nasopharyngeal carcinoma.
  • Subjects with primary metastatic (nasopharyngeal carcinoma, stage IVB defined by the Union for International Cancer Control and the American Joint Committee on Cancer Staging System edition 8) nasopharyngeal carcinoma who are not suitable for local treatment or radical treatment; subjects who have a local-regional recurrence and/or distant metastasis more than 6 months after the completion of prior radical treatment (radiotherapy with induction, concurrent, adjuvant chemotherapy); No systemic treatment has been received for recurrent or metastatic diseases, not amendable to local treatment or have received local treatment for the local-regional recurrent disease
  • At least one measurable lesion according to RECIST v1.1;
  • Has adequate organ function.
  • All female and male subjects of reproductive potential must agree to use an effective method of contraception, as determined by the Investigator, during and for 150 days after the last dose of study treatment.

Exclusion criteria

  • Subjects with pathologically diagnosed nasopharyngeal adenocarcinoma or sarcoma.
  • Subjects have had another malignancy within 3 years before the first dose, except nasopharyngeal carcinoma. Subjects with other malignancies that have been cured by local therapy such as basal or cutaneous squamous cell carcinoma, superficial bladder cancer, cervix or breast carcinoma in situ are not excluded.
  • Participation in treatment with an investigational drug or use of an investigational device within 4 weeks before first study dosing.
  • Have previously received immunotherapy, including immune checkpoint inhibitors, immune checkpoint agonists , immune cell therapy, and other treatments against tumor immune mechanism.
  • Active autoimmune disease requiring systemic treatment within 2 years prior to initial administration, or as an autoimmune disease that can recur or for which treatment is planned determined by the investigator.
  • Active or past history of definite inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis).
  • History of immunodeficiency; those who test positive for HIV antibody; current chronic use of systemic corticosteroids or immunosuppressive agents.
  • Known active tuberculosis (TB) (suspected of having active TB need to undergo clinical examination for exclusion of such possibility); known active syphilis infection.
  • Known history of allotransplantation and allogeneic hematopoietic stem cell transplantation.
  • Has known active Hepatitis B or Hepatitis C.
  • Active or untreated CNS metastases.
  • Subjects with peripheral neuropathy.
  • Unresolved toxicity from prior anti-tumor therapy, defined as toxicity that has not recovered .
  • Received a live vaccine within 30 days before the first dose or planned to receive a live vaccine during the study.
  • Known allergy to any study drug component; known history of serious hypersensitivity to other monoclonal antibodies.
  • Pregnant or nursing (lactating) women.

Treatment and study plan

Penpulimab

Drug

Arm A: Penpulimab (200 mg, administered on Day 1 of each cycle, Q3W) +cisplatin (80 mg/m2) or carboplatin (AUC 5) (administered on Day 1 of each cycle, Q3W, up to 6 cycles) + gemcitabine (1000 mg/ m2, administered on Days 1 and 8 of each cycle, Q3W, up to 6 cycles), 3 weeks (21 days) per cycle; followed by penpulimab (200 mg, administered on Day 1 of each cycle, Q3W) as maintenance treatment.

Other names: cisplatin/carboplatin, gemcitabine

Placebo

Drug

Arm B: Placebo (200 mg, administered on Day 1 of each cycle, Q3W) + cisplatin (80 mg/m2) or carboplatin (AUC 5) (administered on Day 1 of each cycle, Q3W, up to 6 cycles) + gemcitabine (1000 mg/m2, administered on Days 1 and 8 of each cycle, Q3W, up to 6 cycles), every 3 weeks (21 days) per cycle; followed by placebo(200 mg, administered on Day 1 of each cycle, Q3W) as maintenance treatment. Subjects in Arm B will have the opportunity to crossover to openlabel treatment with penpulimab monotherapy after radiographic disease progression.

Other names: cisplatin/carboplatin, gemcitabine

Primary outcomes

  1. Progression-free survival (PFS)

    Time frame: Up to 2 years

    PFS assessed by BIRC based on RECIST v1.1 .

Secondary outcomes

  1. Overall survival(OS)

    Time frame: Up to 4 years

    OS is defined as the time from the date of randomization to death from any cause.

  2. Objective response rate (ORR)

    Time frame: Up to 2 years

    ORR is the proportion of subjects with CR or PR based on RECIST v1.1.

  3. Duration of response (DoR)

    Time frame: Up to 2 years

    DoR is defined as the duration from the first documentation of objective response to the first documented disease progression or death due to any cause, whichever occurs first.

  4. Disease control rate (DCR)

    Time frame: Up to 2 years

    DCR is defined as the proportion of subjects with CR, PR, or SD, based on RECIST v1.1;

  5. Adverse event (AE)

    Time frame: From the time of informed consent signed through 90 days after the last dose of penpulimab

    An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment

  6. Maximum observed concentration (Cmax)

    Time frame: From first dose of penpulimab through 30 days after last dose of penpulimab

    Serum concentrations of penpulimab in individual subjects at different time points after penpulimab administration.

  7. Anti-drug antibodies (ADA)

    Time frame: From first dose of penpulimab through 30 days after last dose of penpulimab

    Number and percentage of subjects with detectable anti-drug antibody (ADA).

  8. PD-L1 expression

    Time frame: Baseline (Tumor tissue samples must be provided to the research center or central laboratory prior to initial administration).

    Detect PD-L1 expression in tumor samples and evaluate the correlation between PD-L1 and efficacy.

  9. Blood EBV level

    Time frame: Up to 2 years

    Detect the blood EBV level at baseline and changes after administration and evaluate the correlation between EBV and efficacy

Sponsors and collaborators

Lead sponsor

Akeso

Industry

Registry information

Official study title

A Randomized, Double-blind, Multi-center Phase III Study of Penpulimab (AK105) Combined With Chemotherapy Versus Placebo Combined With Chemotherapy in the First-line Treatment of Recurrent or Metastatic Nasopharyngeal Carcinoma

Important dates

Study start
2021
Primary completion
2026
Study completion
2026
First posted
Jul 23, 2021
Registry last updated
Apr 13, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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