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Finotonlimab with chemotherapy in recurrent or metastatic head and neck cancer: a randomized phase 3 trial

  • Yuankai Shi,
  • Wei Guo,
  • Wei Wang,
  • Yunteng Wu,
  • Meiyu Fang,
  • Xiaoming Huang,
  • Ping Han,
  • Qingyuan Zhang,
  • Pin Dong,
  • Xiaohong Zhou,
  • Hanwei Peng,
  • Chunhong Hu,
  • Xiaopin Chen,
  • Shurong Zhang,
  • Zhiwei Chang,
  • Xiaojiang Li,
  • Yuhai Ding,
  • Song Qu,
  • Shanghua Jing,
  • Songnan Zhang,
  • Lin Gui,
  • Yan Sun,
  • Lin Wang,
  • Yanyan Liu,
  • Hui Wu,
  • Guoqing Li,
  • Zhichao Fu,
  • Jianhua Shi,
  • Hao Jiang,
  • Yuansong Bai,
  • Jiuwei Cui,
  • Yulong Zheng,
  • Wei Cui,
  • Xiaojing Jia,
  • Limin Zhai,
  • Qingqing Cai,
  • Deming Xiong,
  • Yunong Wu,
  • Junning Cao,
  • Rong Wu,
  • Guangyuan Hu,
  • Liang Peng,
  • Liangzhi Xie,
  • Wenlin Gai,
  • Yan Wang,
  • Yuehua Su

摘要

Immunotherapy combined with chemotherapy regimen has been shown to be effective in recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). However, due to the small number of patients, its efficacy remains controversial in Asian populations, particularly in mainland China. Here a randomized, double-blind phase 3 trial evaluated the efficacy and safety of finotonlimab (SCT-I10A), a programmed cell death 1 (PD-1) monoclonal antibody, combined with cisplatin plus 5-fluorouracil (C5F) for the first-line treatment of R/M HNSCC. Eligible patients (n = 370) were randomly 2:1 assigned to receive finotonlimab plus C5F (n = 247) or placebo plus C5F (n = 123). The primary endpoint was overall survival (OS). In the finotonlimab plus C5F group, OS was 14.1 months (95% confidence interval (CI) 11.1–16.4), compared with 10.5 months (95% CI 8.1–11.8) in the placebo plus C5F group. The hazard ratio was 0.73 (95% CI 0.57–0.95, P = 0.0165), meeting the predefined superiority criteria for the primary endpoint. Finotonlimab plus C5F showed significant OS superiority compared with C5F alone and acceptable safety profile with R/M HNSCC, supporting its use as a first-line treatment option for R/M HNSCC. These results validate the efficacy and safety of the combination of finotonlimab and C5F in Asian patients with R/M HNSCC. ClinicalTrials.gov identifier: NCT04146402.