Can a One-Two punch of immunotherapy and radiation wipe out head and neck tumors before surgery?
NCT ID NCT07773987
First seen Aug 19, 2026 · Last updated Aug 20, 2026 · Updated 1 time
Summary
This phase 2 trial is testing whether combining the immunotherapy drug pembrolizumab with a short course of high-dose radiation, with or without additional radiation to nearby lymph nodes, can shrink or eliminate head and neck tumors before surgery. Adults with resectable squamous cell carcinoma of the oral cavity or oropharynx will receive two doses of pembrolizumab before and after radiation, followed by surgery about ten weeks later. The main goal is to see how often the tumor completely disappears by the time of surgery, comparing the two radiation approaches.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- Pembrolizumab (Keytruda) combined with radiotherapy and surgery
- What this could lead to
- If successful, this approach could increase the chance of eliminating all visible tumor before surgery, potentially improving long-term outcomes for head and neck cancer patients.
- What could go wrong
- This is a small, early-phase trial, so results may not apply broadly. Immunotherapy and radiation can cause side effects, and the added nodal irradiation may not improve outcomes.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 2
Tests whether the treatment actually works, and watches for side effects, in a larger group.
- Participants
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About 20 people
The number the study aims to enrol. It can still change while the study runs.
- Expected to start
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Oct 2026
An estimate. Start dates often move.
- Expected to finish
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Oct 2029
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Patients 18 years or older. * Patients with surgically resectable squamous cell carcinoma of the oral cavity or HPV-negative squamous cell carcinoma of the oropharynx. Resectability will be determined by the treating surgeon. Patients must have locoregionally advanced disease defined by clinical T3-4 staging and/or clinical node positive staging. * A CPS score of at least 1 on initial biopsy. * Zubrod, or Eastern Cooperative Oncology Group (ECOG) performance status 0-2. * Pregnancy. It is not known what effects this treatment has on human pregnancy or development of the embryo or fetus. Therefore, female patients participating in this study should avoid becoming pregnant, and male patients should avoid impregnating a female partner. Non-sterilized female patients of reproductive age and male patients should use effective methods of contraception through defined periods during and after study treatment as specified below. Female patients must meet one of the following: * Postmenopausal for at least one year before the screening visit, OR * Surgically sterile (i.e., undergone a hysterectomy or bilateral oophorectomy), OR * If subject is of childbearing potential (defined as not satisfying either of the above two criteria): * Agree to practice two effective methods of contraception (combination methods requires use of two of the following: diaphragm with spermicide, cervical cap with spermicide, contraceptive sponge, male or female condom, hormonal contraceptive, intrauterine device, etonogestrel implant, etc.) from the time of signing of the informed consent form through 90 days after the last dose of study agent, AND * Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR * Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence \[e.g., calendar, ovulation, symptom-thermal, post ovulation methods\] and withdrawal are not acceptable contraception methods). Male patients, even if surgically sterilized (i.e., status post vasectomy), must agree to one of the following: * Practice effective barrier contraception during the entire study treatment period and through 90 days after the last study drug dose, OR * Must also adhere to the guidelines of any study-specific pregnancy prevention program, if applicable, OR * Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence \[e.g., calendar, ovulation, symptom-thermal, post ovulation methods\] and withdrawal are not acceptable methods of contraception.) - Ability to understand a written informed consent document, and the willingness to sign it. Exclusion Criteria: * HPV-positive squamous cell carcinoma of the oropharynx. * Tumor inaccessible for clinic-based biopsy as determined by the treating surgeon. * Solid organ transplant requiring chronic immunosuppression. * Autoimmune disease requiring use of steroids or chronic immunosuppression. * Prior invasive malignancy within the past 3 years (except for T1a surgically treated melanoma with negative margins, any early-stage non-melanomatous skin cancer, early-stage prostate cancer, or differentiated thyroid cancer). Patients with benign non-metastasizing tumors are eligible. * Life expectancy less than 12 months. * Performance status Zubrod ≥ 3. * Patients with prior external beam radiation therapy (RT) to the head and neck that overlaps the expected treatment fields. a. Note: Patients receiving prior Iodine-131 therapy will be eligible. * Prior systemic therapy, including cytotoxic chemotherapy, biologic/targeted therapy, or immune therapy for the study cancer. * Body weight ≤ 30 kg. * Any of the following severe laboratory abnormalities within 30 days of registration, unless corrected prior to it: 1. Sodium \< 125 mmol/L or \> 155 mmol/L 2. Potassium \< 3.5 mmol/L or \> 6 mmol/L 3. Glucose \> 400 mg/dl 4. Serum calcium (ionized or adjusted for albumin) \< 7 mg/dl or \> 12.5 mg/dl 5. Magnesium \< 0.9 mg/dl or \> 3 mg/dl * Unstable angina and/or congestive heart failure requiring hospitalization within three months of registration. * Transmural myocardial infarction within three months of registration. * Medical or psychiatric illness that would compromise the patient's ability to tolerate treatment or limit compliance with study requirements. * Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception during treatment and for 6 months after radiation. This exclusion is necessary because the treatment involved in this study may be significantly teratogenic. Women who are breastfeeding are also excluded.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
1 site. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Froedtert & the Medical College of Wisconsin
Milwaukee, Wisconsin, 53226, United States
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