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RecruitingLast updated: 20 April 2026

LiGeR - HN1: A study for people with metastatic or recurrent head and neck cancer to see whether adding targeted therapy to immunotherapy is more effective than immunotherapy aloneA Phase 3 Randomized, Open-label Study to Evaluate the Efficacy and Safety of Petosemtamab Plus Pembrolizumab vs Pembrolizumab in First-line Treatment of Recurrent or Metastatic PD-L1+ Head and Neck Squamous Cell Carcinoma

Trial purpose

Medical clipboardCancer treatment

Tumor type

Head and Neck Cancers Head and Neck

Age

People18+

Trial acronym

LiGeR - HN1

Clinical summary

Summary

The Phase 3 study will evaluate the efficacy and safety of a targeted drug called petosemtamab plus pembrolizumab immunotherapy, compared to pembrolizumab alone as first-line treatment for recurrent or metastatic PD-L1+ head and neck squamous cell carcinoma (HNSCC).

Eligible HNSCC primary tumour locations are back of the mouth (oropharynx), oral cavity, lower part of the throat (hypopharynx), and voice box (larynx). 

Participants will be randomly allocated (by chance) to receive either the combination petosemtamab + pembrolizumab or pembrolizumab monotherapy.

Prior treatment criteria

HNSCC patients should not have had previous systemic therapy administered in the incurable recurrent or metastatic setting, although prior systemic therapy as part of multimodal treatment for locally advanced disease is allowed if PD was at least 6 months after the last platinum-containing therapy dose. Previous treatments with anti PD(L)1 or anti-EGFR therapies are not allowed. In the case of cetuximab, people who have received cetuximab with radiation therapy as local treatment and PD was more than 1 year after the last dose of cetuximab are eligible.

Conditions

This trial is treating people with metastatic or locally recurrent disease

Eligibility

Inclusion

  1. Signed ICF before initiation of any study procedures
  2. Age ≥ 18 years at signing of ICF
  3. Histologically confirmed HNSCC with evidence of metastatic or locally recurrent disease not amenable to local therapy with curative intent.
  4. The eligible HNSCC primary tumor locations are oropharynx, oral cavity, hypopharynx, and larynx.
  5. HNSCC patients eligible to receive pembrolizumab as 1L monotherapy with tumors expressing PD-L1, CPS ≥1.
  6. HNSCC patients should not have had previous systemic therapy administered in the incurable recurrent or metastatic setting
  7. A new tumor biopsy, unless the patient has an available archival tumor sample with sufficient material
  8. Measurable disease per Investigator assessment as defined by RECIST v1.1 by radiologic methods
  9. ECOG Performance Status (PS) of 0-1
  10. Life expectancy ≥ 12 weeks, as per investigator assessment.
  11. Left ventricular ejection fraction (LVEF) ≥50% or ≥ institutional normal limit, whichever is higher, by echocardiogram (ECHO) or multigated acquisition (MUGA) scan
  12. Adequate organ function as defined per protocol.
  13. HIV-positive patients are eligible only if the cluster of differentiation 4 (CD4+) count is ≥ 300/µl, viral load is undetectable, and the patient is currently receiving highly active antiretroviral therapy

Exclusion

  1. Central nervous system metastases that are untreated or already treated but symptomatic, or require radiation, surgery, or continued steroid therapy to control symptoms within 21 days prior to randomization
  2. Known leptomeningeal involvement
  3. Any systemic anticancer therapy or investigational drug within 4 weeks or 5 half-lives, whichever is shorter, before randomization
  4. Requirement for immunosuppressive medication
  5. Major surgery or radiotherapy within 3 weeks of randomization
  6. Clinically significant toxicities related to prior anticancer therapies that have not returned to ≤ Grade 1 or baseline except for Grade ≤2- myalgia, neuropathy, alopecia, and any prior therapy related endocrinopathies
  7. History of hypersensitivity reaction to any of the excipients of petosemtamab or pembrolizumab.
  8. Unstable angina; history of congestive heart failure of Class II-IV New York Heart Association (NYHA) criteria, or serious cardiac arrhythmia requiring treatment; or history of myocardial infarction within 6 months prior to randomization
  9. History of prior malignancies within the last 5 years, with the exception of excised local cancer
  10. Current dyspnea at rest of any origin, or other diseases requiring continuous oxygen therapy
  11. Current serious illness or medical conditions including, but not limited to, uncontrolled active infection, clinically significant pulmonary, metabolic or psychiatric disorders
  12. Patients with known infectious diseases as per protocol.
  13. Pregnant or breastfeeding patients.
  14. The patient has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy of prednisone >10 mg/day or equivalent, or any other form of immunosuppressive therapy
  15. The patient has an active autoimmune disease that has required systemic immune suppressive treatment in the past 2 years; replacement therapy is not considered immune suppressive treatment
  16. The patient has had an allogeneic tissue/solid organ transplant.
  17. Patient has a primary tumor site of nasopharynx, or sinonasal carcinoma (any histology)

Other protocol defined inclusion/exclusion criteria may apply.

Inclusion

  • You have had treatment, but your cancer has come back (relapsed or recurrent).
  • Your cancer has spread to other parts of the body (metastatic) or has grown into nearby parts of the body (locally advanced).

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

Participating hospitals

Recruiting hospitals

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More information

Trial Identifiers

Information on this page is partially produced from ClinicalTrials.gov, EU Clinical Trials Register *. View further details about this trial on the registry via the links below:

Trial sponsor

Merus N.V.

Scientific Title

A Phase 3 Randomized, Open-label Study to Evaluate the Efficacy and Safety of Petosemtamab Plus Pembrolizumab vs Pembrolizumab in First-line Treatment of Recurrent or Metastatic PD-L1+ Head and Neck Squamous Cell Carcinoma

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