Randomized non-comparative phase II trial of nivolumab plus paclitaxel in subjects with recurrent/metastatic head and neck squamous cell carcinoma unable for cisplatin-based chemotherapy. NIVOTAX TTCC study.

Patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) who are ineligible for cisplatin have limited treatment options, and the role of chemoimmunotherapy in this population remains unexplored. NIVOTAX was a randomized, non-comparative, multicenter, phase II trial ev...

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Published in:European Journal of Cancer Vol. 241
Main Authors: Docampo, Lara Iglesias, Basté, Neus, Oliva, Marc, Carral, Alberto, Pérez Segura, Pedro, Medina-Colmenero, Ana, Cirauqui, Beatriz, Arrazubi, Virginia, Martínez Trufero, Javier, Gutiérrez Calderón, Vanesa, García Castaño, Almudena, Rubió-Casadevall, Jordi, del Barco, Edel, Basterretxea, Laura, Bruixola, Gema, Cabellos, Ruth Álvarez, Flor, María José, Braña, Irene, Caballero, Javier, Martínez, Joaquina
Format: research randomized controlled trial Journal Article
Published: Pergamon Press - An Imprint of Elsevier Science Jun2026
Online Access:View this record in EBSCOhost
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        09598049
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      jtl: European Journal of Cancer
      issn: 09598049
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      dt: Jun2026
      vid: 241
      pid: 2410
      pub: Pergamon Press - An Imprint of Elsevier Science
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        194226031
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        10.1016/j.ejca.2026.116775
        194226031
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        atl: Randomized non-comparative phase II trial of nivolumab plus paclitaxel in subjects with recurrent/metastatic head and neck squamous cell carcinoma unable for cisplatin-based chemotherapy. NIVOTAX TTCC study.
      aug:
        au:
          Docampo, Lara Iglesias
          Basté, Neus
          Oliva, Marc
          Carral, Alberto
          Pérez Segura, Pedro
          Medina-Colmenero, Ana
          Cirauqui, Beatriz
          Arrazubi, Virginia
          Martínez Trufero, Javier
          Gutiérrez Calderón, Vanesa
          García Castaño, Almudena
          Rubió-Casadevall, Jordi
          del Barco, Edel
          Basterretxea, Laura
          Bruixola, Gema
          Cabellos, Ruth Álvarez
          Flor, María José
          Braña, Irene
          Caballero, Javier
          Martínez, Joaquina
        affil: Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
      sug:
        subj:
          Head and Neck Neoplasms Drug Therapy
          Carcinoma, Squamous Cell Drug Therapy
          Neoplasm Recurrence, Local
          Neoplasm Metastasis
          Immune Checkpoint Inhibitors Therapeutic Use
          Antineoplastic Agents Therapeutic Use
          Paclitaxel Therapeutic Use
          Drug Therapy, Combination
          Drug Resistance, Neoplasm
          Treatment Failure
          Cisplatin
          Chemotherapy, Cancer
          Treatment Outcomes Evaluation
          Human
          Randomized Controlled Trials
          Random Assignment
          Antineoplastic Agents Administration and Dosage
          Progression-Free Survival
          Overall Survival
          Patient Safety
          Prospective Studies
          Confidence Intervals
          Descriptive Statistics
          Adverse Drug Event
          Mortality
      ab: Patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) who are ineligible for cisplatin have limited treatment options, and the role of chemoimmunotherapy in this population remains unexplored. NIVOTAX was a randomized, non-comparative, multicenter, phase II trial evaluating paclitaxel plus nivolumab (nivotax) in previously untreated, platinum-ineligible R/M HNSCC (platinum-refractory, unfit, or cumulative dose ≥225 mg/m²). Patients were randomized 2:1 to weekly paclitaxel (80 mg/m²) plus biweekly nivolumab (240 mg) or weekly cetuximab (250 mg/m²) for 12 weeks, followed by maintenance nivolumab q4 weeks or weekly cetuximab for up to 24 months. The primary endpoint was 2-year overall survival (2yOS). Key secondary endpoints were median OS; progression-free survival (PFS), overall response rate (ORR) and safety. 141 patients were randomized (nivotax, n = 93; Erbitax, n = 48). Baseline characteristics were balanced. After a median follow-up of 12.1 months (33.1 months for alive patients), 2yOS was 24.7% (95% CI 15.9–33.5) with nivotax and 13.4% (95% CI 3.6–23.2) with Erbitax. Median OS, PFS and ORR were similar in both arms. No differences were observed by age, PD-L1 CPS and Karnofsky Performance Scale. Grade > 3 treatment-related adverse events (AEs) occurred in 38% and 43% of patients, respectively. Higher mortality was observed in the nivotax arm (18% vs 8.3%) due to higher occurrence of respiratory AEs deemed treatment unrelated by investigators. The primary endpoint of 2yOS was met. However, respiratory AEs and associated mortality emerged as a safety concern in the nivotax arm, limiting further evaluation of this regimen. • The NIVOTAX trial met its primary endpoint of improved 2-year OS rate. • PFS, ORR and DCR were similar in nivotax and erbitax regimens. • Age, KPI and PDL1 CPS status did not impact on efficacy parameters. • Safety profile was similar in both treatment regimens. • Increased treatment unrelated respiratory events led to higher mortality in the nivotax arm.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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