Official Title
A Multicenter, Randomized, Double-blind, Phase 2/3 Study of Ficerafusp Alfa (BCA101) or Placebo in Combination With Pembrolizumab for First-Line Treatment of PD-L1-positive, Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
Brief Summary

Ficerafusp alfa is directed against two targets, Epidermal Growth Factor Receptor (EGFR)and Transforming Growth Factor beta (TGF-β).This study intends to evaluate the safety and efficacy of ficerafusp alfa in combinationwith pembrolizumab versus placebo with pembrolizumab in 1L PD-L1-positive, recurrent ormetastatic Head and Neck Squamous Cell Carcinoma (HNSCC).

Detailed Description

The mechanism of action of ficerafusp alfa involves dual targeting of two cancer targets,
EGFR and TGF-β, which are known to drive solid tumor growth and metastasis.

Phase 2 of the study will identify an optimal biologic dose (OBD) supported by the
safety, tolerability, PK, PD, and efficacy data of ficerafusp alfa. In this part,
eligible subjects will be randomized to one of three treatment arms at a 1:1:1 ratio:

- Arm A: ficerafusp alfa 1500 mg once weekly (QW) + pembrolizumab 200 mg every three
weeks (Q3W).

- Arm B: ficerafusp alfa 750 mg QW + pembrolizumab 200 mg Q3W.

- Arm C (control): placebo QW + pembrolizumab 200 mg Q3W.

The primary objective for the phase 3 portion is to compare the efficacy in subjects
treated with ficerafusp alfa at the selected OBD in combination with pembrolizumab versus
placebo with pembrolizumab. Eligible subjects will be randomized 2:1 in the treatment
versus control arm during the phase 3 portion.

Recruiting
Metastatic Head and Neck Squamous Cell Carcinoma
Recurrent Head and Neck Squamous Cell Carcinoma

Drug: Ficerafusp alfa

Investigational

Drug: Pembrolizumab (KEYTRUDA®)

Immunotherapy agent used in combination with investigational agent

Drug: Placebo

Placebo Control

Eligibility Criteria

Inclusion Criteria:

- Age ≥18 years on the day the Informed Consent Form is signed.

- Histologically or cytologically confirmed R or M HNSCC. Eligible primary tumor
locations are oral cavity, hypopharynx, larynx or oropharynx (with documented
HPV-negative disease if presenting with OPSCC). Note: primary tumor location of
paranasal sinuses and nasopharynx, any histology are excluded.

- No prior systemic therapy administered in the R or M setting; and completed systemic
therapy >6 months prior if given as part of multimodal treatment for locoregionally
advanced disease in the adjuvant or definitive setting.

- Archival tumor tissue or willing to undergo pretreatment biopsy at Screening if
archival tissue is insufficient or unavailable.

- PD-L1 CPS ≥1.

- Measurable disease based on RECIST 1.1.

- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

- Adequate organ function, as defined in the protocol.

Exclusion Criteria:

- Disease suitable for local therapy administered with curative intent.

- Prior treatment with anti-TGFβ therapy.

- Prior therapy with an anti-EGFR antibody (exception: radio sensitizing agents and
multimodal treatment for locoregionally advanced disease).

- Prior history of Grade ≥2 intolerance or hypersensitivity reaction to anti-EGFR
therapy or other murine proteins.

- Prior therapy with an immune checkpoint inhibitor completed within 6 months prior to
study treatment initiation.

- Progressive disease <6 months from completion of curative intent systemic therapy
for locoregionally advanced HNSCC.

- Life expectancy less than 3 months.

- Known active central nervous system metastases, history of spinal cord compression
from tumor involvement, a history of carcinomatous meningitis, or leptomeningeal
disease are excluded.

- Current active major bleeding, or a recent major bleeding episode within 4 weeks
prior to enrollment.

- Subject participated in another clinical study or received treatment with another
investigational drug must wait at least 5 half-lives of the treatment received or 4
weeks (whichever is shorter) following prior therapy.

- Active autoimmune disease requiring systemic treatment in the past 2 years.

- Subjects with chronic hepatitis B virus (HBV) infection with active disease who meet
the criteria for anti-HBV therapy and are not on a suppressive antiviral therapy
prior to initiation of study treatment.

- Subjects with a known history of hepatitis C virus (HCV) who have not completed
curative antiviral treatment or have an HCV viral load above the limit of
quantification at Screening.

- Known history of human immunodeficiency virus (HIV).

- Receipt of any organ transplantation, including autologous and allogeneic stem cell
transplantation, with the exception of transplants that do not require
immunosuppression.

- Known to be diagnosed and/or treated for any other additional malignancy within 2
years prior to randomization with the exception of the following: curatively treated
basal cell carcinoma or squamous cell carcinoma of the skin, and curatively resected
in situ cervical cancer, and curatively resected in situ breast cancer, and low-risk
early stage prostate cancer.

- Any condition requiring systemic treatment with either corticosteroids (>10 mg daily
of prednisone or equivalent) or other immunosuppressive medication within 7 days
prior to the first dose of study treatment, except for topical, intranasal,
intrabronchial, or ocular steroids.

- Use of a live or live attenuated vaccine within 4 weeks prior to Screening.

Other Inclusion/Exclusion criteria may apply as defined in the protocol.

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
Australia
Austria
Belgium
Canada
Czechia
France
Germany
Ireland
Italy
New Zealand
Poland
Portugal
Spain
United Kingdom
United States
Locations

Site # 0137
Birmingham, Alabama, United States

Site #0147
Phoenix, Arizona, United States

Site #0107
La Jolla, California, United States

Site #0106
Los Angeles, California, United States

Site#0144
Sacramento, California, United States

Site #0130
San Francisco, California, United States

Site #0150
Stanford, California, United States

Site #0122
Aurora, Colorado, United States

Site #0124
Aurora, Colorado, United States

Site#0121
Aurora, Colorado, United States

Site#0127
Newark, Delaware, United States

Site #0148
Jacksonville, Florida, United States

Site #0136
Palm Bay, Florida, United States

Site #0105
Tampa, Florida, United States

Site #0133
Chicago, Illinois, United States

Site#0140
Iowa City, Iowa, United States

Site #0149
Westwood, Kansas, United States

Site#0109
Lexington, Kentucky, United States

Site#0111
Louisville, Kentucky, United States

Site#0115
Louisville, Kentucky, United States

Site #0112
Baltimore, Maryland, United States

Site #0131
Boston, Massachusetts, United States

Site#0101
Boston, Massachusetts, United States

Site #0156
Maplewood, Minnesota, United States

Site #0146
Rochester, Minnesota, United States

Site #0114
St Louis, Missouri, United States

Site #0119
Hackensack, New Jersey, United States

Site #0145
Newark, New Jersey, United States

Site #0155
New York, New York, United States

Site#0142
New York, New York, United States

Site#0118
Durham, North Carolina, United States

Site#0154
Canton, Ohio, United States

Site#0117
Cincinnati, Ohio, United States

Site #0151
Cleveland, Ohio, United States

Site #0108
Cleveland, Ohio, United States

Site #0113
Portland, Oregon, United States

Site #0103
Pittsburgh, Pennsylvania, United States

Site #0123
Pittsburgh, Pennsylvania, United States

Site #0132
Providence, Rhode Island, United States

Site#0104
Charleston, South Carolina, United States

Site#0126
Nashville, Tennessee, United States

Site #0116
Nashville, Tennessee, United States

Site#0102
Houston, Texas, United States

Site #0152
Waco, Texas, United States

Site#0134
Charlottesville, Virginia, United States

Site #0129
Richmond, Virginia, United States

Site #0138
Richmond, Virginia, United States

Site #0125
Seattle, Washington, United States

Site#0120
Vancouver, Washington, United States

Site #0141
Madison, Wisconsin, United States

Site #0157
Madison, Wisconsin, United States

Site#0302
Camperdown, New South Wales, Australia

Site #0306
Kingswood, New South Wales, Australia

Site#0304
Waratah, New South Wales, Australia

Site #0305
Southport, Queensland, Australia

Site#0307
Tugun, Queensland, Australia

Site #0303
Heidelberg, Victoria, Australia

Site#0301
North Melbourne, Victoria, Australia

Site#0308
Murdoch, Western Australia, Australia

Site #1602
Salzburg, Austria

Site #1601
Vienna, Austria

Site #1007
Bruges, Belgium

Site #1005
Mons, Belgium

Site #1002
Namur, Belgium

Site #1003
Namur, Belgium

Site #1001
Sint-Niklaas, Belgium

Site #1006
Wilrijk, Belgium

Site #0202
Vancouver, British Columbia, Canada

Site #0203
Montreal, Quebec, Canada

Site #2102
Prague, Czechia

Site #0809
Amiens, France

Site #0810
Lyon, France

Site #0805
Rennes, France

Site #0807
Saint-Grégoire, France

Site #0808
Strasbourg, France

Site #0806
Vandœuvre-lès-Nancy, France

Site #0801
Villejuif, France

Site #0710
Aachen, Germany

Site #0707
Dresden, Germany

Site #0706
Düsseldorf, Germany

Site #0717
Karlsruhe, Germany

Site #0602
Dublin, Ireland

Site #0601
Dublin, Ireland

Site #0904
Bologna, Italy

Site #0911
Florence, Italy

Site #0907
Milan, Italy

Site #0901
Milan, Italy

Site #0905
Milan, Italy

Site #0915
Naples, Italy

Site #0908
Palermo, Italy

Site #0917
Rome, Italy

Site #0918
Rome, Italy

Site #0906
Rome, Italy

Site #0401
Christchurch, New Zealand

Site#0402
Rotorua, New Zealand

Site #1401
Gdansk, Poland

Site #1403
Katowice, Poland

Site #1407
Konin, Poland

Site #1404
Krakow, Poland

Site #1402
Siedlce, Poland

Site #1406
Warsaw, Poland

Site #1506
Braga, Portugal

Site #1503
Coimbra, Portugal

Site #1508
Lisbon, Portugal

Site #1501
Portimão, Portugal

Site #1505
Porto, Portugal

Site #1507
Porto, Portugal

Site #1502
Senhora da Hora, Portugal

Site #1301
Barcelona, Spain

Site #1305
Barcelona, Spain

Site #1304
Barcelona, Spain

Site #1310
Madrid, Spain

Site #1303
Madrid, Spain

Site #1306
Pamplona, Spain

Site #1309
Santander, Spain

Site #1307
Valencia, Spain

Site #1308
Valencia, Spain

Site #0504
Aberdeen, United Kingdom

Site #0512
Birmingham, United Kingdom

Site #0513
Cambridge, United Kingdom

Site #0511
Leeds, United Kingdom

Site #0507
Liverpool, United Kingdom

Site #0505
London, United Kingdom

Site #0502
London, United Kingdom

Site #0508
Manchester, United Kingdom

Site #0506
Middlesex, United Kingdom

Site #0503
Nottingham, United Kingdom

Site #0515
Oxford, United Kingdom

Site # 0501
Sutton, United Kingdom

Contacts

Medical Affairs
1-617-468-4219
FORTIFI_inquiries@bicara.com

Not Provided

Bicara Therapeutics
NCT Number
Keywords
Phase 2/3
Ficerafusp alfa
BCA101
Recurrent Head and Neck Squamous Cell Carcinoma (R HNSCC)
Metastatic Head and Neck Squamous Cell Carcinoma (M HNSCC)
Pembrolizumab
EGFR
TGF-beta
HNSCC
PD-L1+
Head and Neck Cancer
Oral Cavity
Oropharynx
Larynx
Hypopharynx
MeSH Terms
Squamous Cell Carcinoma of Head and Neck
Camurati-Engelmann Syndrome
Head and Neck Neoplasms
Laryngeal Diseases
Pembrolizumab