Could setanaxib boost keytruda against head and neck cancer?
NCT ID NCT05323656
First seen Jun 25, 2026 · Last updated Jun 26, 2026 · Updated 1 time
Summary
This Phase 2 trial tested whether adding setanaxib (an experimental oral drug) to the standard immunotherapy pembrolizumab (Keytruda) works better than pembrolizumab alone for people with recurrent or metastatic squamous cell carcinoma of the head and neck. 55 adults whose cancer had returned or spread and who could not have surgery took part. The main goal was to see if the combination shrinks tumors more effectively.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- setanaxib (oral tablet) and pembrolizumab (Keytruda, IV infusion)
- What this could lead to
- If it works, this combination could slow tumor growth or shrink tumors in people with head and neck cancer that has returned or spread.
- What could go wrong
- This is a small, early Phase 2 trial with only 55 people. The drug may not improve outcomes over standard pembrolizumab alone, and side effects are possible.
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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55 people
The number who actually took part.
- Started
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Apr 2022
- Finished
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Aug 2025
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
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: * Male or female patients aged ≥18 years, inclusive, at the time of informed consent. * Willing and able to give informed consent and to comply with the requirements of the study. * Histologically- or cytologically-confirmed diagnosis of SCCHN that is recurrent or metastatic with or without nodal involvement, and with or without metastatic spread, and is not eligible for surgical resection. * Candidates for first-line treatment for pembrolizumab for recurrent or metastatic SCCHN, at the discretion of the investigator. * A positive CAFs level (defined as CAFs level in tumours ≥5%), performed at a central laboratory, with fresh tumour biopsy taken during or within 30 days prior to the Screening Period. If available, suitable archival tissue (taken within 6 months prior to the Screening Visit and where the patient has received no further anti-cancer therapy during this 6-month period) can be used to assess tumour CAFs level and determine patient eligibility. * Measurable disease, in accordance with RECIST v1.1, and with tumour accessible and of sufficient volume for pre-treatment and on-treatment biopsy. * Combined positive score (CPS) ≥1, as determined on the archival or fresh tumour biopsy taken during or within 30 days prior to the Screening Period. * HPV status known at randomisation. * Life expectancy of at least 6 months in the judgment of the investigator. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. * Adequate organ and bone marrow function within 35 days of starting study treatment. Criteria "a" to "c" cannot be met in patients with ongoing or recent (within 14 days of screening test) transfusions or who require ongoing growth factor support: 1. Absolute neutrophil count ≥1,000/mm3 (≥ 1.0×109/L). 2. Platelet count ≥100,000/mm3 (≥ 100×109/L). 3. Haemoglobin ≥9 g/dL, in the absence of transfusions for at least 2 weeks. Patients requiring ongoing transfusions or growth factor support to maintain haemoglobin ≥ 9g/dL are not eligible. 4. Total bilirubin ≤1.5×upper limit of normal (ULN) (if associated with liver metastases or Gilbert's disease, ≤3×ULN). 5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3×ULN. 6. Serum creatinine ≤2.0 mg/dL or creatinine clearance ≥40 mL/min (measured or calculated according to the method of Cockcroft and Gault). * Female patients of childbearing potential must use a highly effective method of contraception to prevent pregnancy for ≥4 weeks before randomisation and must agree to continue strict contraception up to 120 days after the last dose of IMP or pembrolizumab, whichever is the later. 1. For the purposes of this study, women of childbearing potential are defined as "fertile, following menarche and until becoming postmenopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy." 2. Postmenopausal state is defined as no menses for 12 months without an alternative medical cause. In female patients who are not using hormonal contraception or hormonal replacement therapy but with suspected menopause and less than 12 months of amenorrhea, a high follicle stimulating hormone (FSH) level in the postmenopausal range will be required at Screening to confirm a postmenopausal state. Confirmation with more than one FSH measurement is required. 3. Highly effective contraception is defined as methods that can achieve a failure rate of less than 1% per year when used consistently and correctly. * Female patients of childbearing potential must have a negative serum pregnancy test at Screening and a negative urine pregnancy test at Baseline/Randomisation before dosing. * Male patients with female partners of childbearing potential must be willing to use a condom and require their partner to use an a highly effective contraceptive method. * Male patients must refrain from donating sperm, and female patients must refrain from donating eggs, from Baseline until 120 days after the last dose of IMP or pembrolizumab, whichever is the later. Exclusion Criteria: * Diagnosis of immunosuppression or receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment, with the exception of intranasal and inhaled corticosteroids or systemic corticosteroids at doses not to exceed 10 mg/day of prednisone or equivalent. Steroids as premedication for hypersensitivity reactions due to radiographic contrast agents are allowed. * Anti-cancer mAb treatment within 4 weeks prior to study Day 1. * Chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 (radiation therapy can be allowed for palliative therapy of bone metastasis only). * Not recovered from AEs Grade 2 or greater (except for alopecia) due to previously administered agents. * Treatment with any investigational agent within 12 weeks of Screening Visit or 5 half-lives of the IMP (if known), whichever is longer, or current enrolment in an interventional clinical study. * Prior treatment with setanaxib or participation in a previous setanaxib clinical study. * Prior treatment with pembrolizumab. * Known additional malignancy that is progressing or requires active treatment excepting basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ cervical cancer that has undergone potentially curative therapy, or malignancy treated with curative intent and with no known active disease ≥2 years before the first dose of IMP and of low potential risk for recurrence. * Known active central nervous system metastases and/or carcinomatous meningitis. * Active autoimmune disease requiring systemic treatment within the past 3 months or documented history of clinically severe autoimmune disease, or syndrome that requires systemic steroids or immunosuppressive agents. The following are exceptions to this criterion: 1. Patients with vitiligo or alopecia. 2. Any chronic skin condition that does not require systemic therapy. 3. Patients with coeliac disease controlled by diet alone. * Any evidence of current interstitial lung disease or pneumonitis, or a prior history of interstitial lung disease or non-infectious pneumonitis requiring high-dose glucocorticoids. * Active infection requiring systemic therapy. * Known human immunodeficiency virus (HIV) infection or acute or chronic hepatitis B or C infection. Patients with a past or resolved hepatitis B virus infection (defined as the presence of hepatitis B core antibody \[HBcAb\] and absence of hepatitis B surface antigen \[HBsAg\]) are eligible provided the hepatitis virus DNA test is negative. Patients positive for hepatitis C antibody are eligible only if polymerase chain reaction (PCR) is negative for hepatitis C virus RNA. Patients with ongoing anti-viral therapy with potent inhibitors of cytochrome P450 (CYP) 3A4 are not eligible. Testing for HIV is only required if clinically indicated and is not mandatory for this study. * Serious chronic gastrointestinal conditions associated with diarrhoea. * History of significant haematological problems, such as blood dyscrasias requiring treatment, aplastic anaemia, myelodysplastic syndrome, or leukaemia. * Surgery (eg, stomach bypass) or medical condition that might significantly affect absorption of medicines (as judged by the investigator). * A positive pregnancy test or breastfeeding for female patients. * Evidence of any of the following cardiac conduction abnormalities: a QTc Fredericia interval \>450 milliseconds for male patients or \>470 milliseconds for female patients. Patients with a second- or third-degree atrioventricular block are to be excluded. * TSH \>ULN at Screening. * Unstable cardiovascular disease as defined by any of the following: 1. Unstable angina within 6 months prior to Screening 2. Myocardial infarction, coronary artery bypass graft surgery, or coronary angioplasty within 6 months prior to Screening 3. Cerebrovascular accident within 6 months prior to Screening 4. New York Heart Association Class III or IV heart failure * Presence of any laboratory abnormality or condition that, in the opinion of the investigator, could interfere with or compromise a patient's treatment, assessment, or compliance with the protocol and/or study procedures. * Any other condition that, in the opinion of the investigator, constitutes a risk or contraindication for the participation of the patient in the study, or that could interfere with the study objectives, conduct, or evaluation. * Use of medications known to be potent CYP3A4 inhibitors or inducers, or potent uridine diphosphate (UDP)-glucuronosyltransferase 1A9 (UGT1A9) inhibitors or inducers, within 21 days prior to IMP administration. * Legal incapacity or limited legal capacity. * Psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent. * Patients who are unable to provide informed consent, are incarcerated or unable to follow protocol requirements. * Previous randomisation in this study.
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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.
Contacts and locations
Locations
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Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo - Ospedale San Paolo Polo Universitario
Milan, Milan, 20142, Italy
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Centre Hospitalier Universitaire Amiens-Picardie - Site Sud
Amiens, Picardie, 80054, France
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Centre Léon Bérard
Lyon, 69008, France
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Centre de Lutte contre le Cancer - Centre Oscar Lambret
Lille, Hauts-de-France, 59000, France
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Centrum Onkologii Im. Prof. F. Łukaszczyka w Bydgoszczy
Bydgoszcz, Kuyavian-Pomeranian Voivodeship, 85-792, Poland
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Complejo Hospitalario de Navarra
Pamplona, 31008, Spain
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Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Roma, 00168, Italy
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Hospital Clínic de Barcelona
Barcelona, 08036, Spain
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Hospital Universitario La Paz
Madrid, 28046, Spain
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Hospital Universitario Virgen del Rocío
Seville, 41013, Spain
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Hôpital Saint-André
Bordeaux, 33000, France
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Hôpital de la Timone
Marseille, 13005, France
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Institut Régional du Cancer de Montpellier
Montpellier, 34298, France
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Institut de Cancérologie de Lorraine
Vandœuvre-lès-Nancy, Grand Est, 54519, France
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Medizinische Hochschule Hannover
Hanover, Lower Saxony, 30625, Germany
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Mount Sinai Comprehensive Cancer Center
Miami Beach, Florida, 33140, United States
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Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie-Państwowy Instytut Badawczy O. w Gliwicach
Gliwice, Silesian Voivodeship, 44-102, Poland
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Ramsay Health Clinic Belharra
Bayonne, 64100, France
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Siteman Cancer Center - North County
Florissant, Missouri, 63031, United States
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Siteman Cancer Center - St. Peters
City of Saint Peters, Missouri, 63376, United States
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Siteman Cancer Center - West County
Creve Coeur, Missouri, 63141, United States
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The Royal Marsden Hospital - London
London, England, SW3 6JJ, United Kingdom
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The Royal Marsden Hospital Head and Neck Unit
Sutton, England, SM5 5PT, United Kingdom
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Washington University School of Medicine Center for Advanced Medicine
St Louis, Missouri, 63110, United States
More trials for these conditions
Other studies related to the condition(s) this trial covers.
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- Smartphone app aims to combat malnutrition in head and neck cancer patients
- Can adding radiation boost immunotherapy against spread head and neck cancer?
- Can a Two-Pronged attack shrink Hard-to-Treat cancers?
- New hope for hard-to-treat cancers? experimental combo enters phase 2 trial