ClinicalTrials.gg
RecruitingNCT07026474RePaIr-HNUpdated Sep 10, 2026

Re-Radiochemotherapy and Pembrolizumab vs. Immuno(Chemo)Therapy for Locoregionally Recurrent PD-L1 Positive (CPS≥1) HNSCC

A Phase 3 interventional study of radiotherapy and Cisplatin in Recurrent Head and Neck Squamous Cell Carcinoma, sponsored by Universität des Saarlandes. Recruiting at 24 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-10.

Sponsored by Universität des Saarlandes · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Oct 2025; still recruiting 1 year later.
Phase
Phase 3
Study type
Interventional
Enrollment
214
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Prospective, open-label, randomized controlled phase III trail that aims to investigate whether Re-Radiochemotherapy (Re-RCT) and sequential immunotherapy with pembrolizumab improves overall survival compared to the standard treatment with pembrolizumab alone (± chemotherapy) in locoregionally recurrent PD-L1 positive (CPS≥1) HNSCC.

02

Conditions studied

  • Recurrent Head and Neck Squamous Cell Carcinoma
03

In context

Squamous Cell Carcinoma of Head and Neck

2,018 studies on the registry are indexed under Squamous Cell Carcinoma of Head and Neck; 573 are open to participants now.

This study's planned enrollment of 214 is above the median of 48 across 1,653 interventional studies indexed under Squamous Cell Carcinoma of Head and Neck.

Browse Squamous Cell Carcinoma of Head and Neck studies →

Lead sponsor

Universität des Saarlandes is the lead sponsor of 68 studies on the registry; 17 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Written obtained from the subject prior to performing any protocol-related procedures.
  • Age ≥ 18 years at time of study entry.
  • (ECOG) performance status of 0, 1 or 2.
  • Locoregionally recurrent or second primary HNSCC.
  • Histological confirmation of HNSCC.
  • Tumor is surgically not resectable or surgical resection bears great potential for relevant functional morbidity or patient refuses surgery.
  • No distant (cM0).
  • combined positive score (CPS) ≥1 according to local pathological PD-L1 assessment. A validated test must be used in an accredited laboratory.
  • Prior radio(chemo)therapy of the neck (time interval ≥ 6 months).
  • Adequate normal organ and marrow function as defined: ≥ 9.0 g/dL; Leukocytes (WBC) ≥ 3,000 per mm\^3 or Neutrophils ≥ 1,500 per mm\^3; count > 100,000 per mm\^3.
  • Serum ≤ 1.5 x institutional (ULN). This will not apply to subjects with confirmed Gilbert's syndrome (persistent or recurrent hyperbilirubinemia that is predominantly unconjugated in the absence of haemolysis or hepatic pathology).
  • (SGOT) / ALT (SGPT) ≤ 2.5 x institutional ULN.
  • ≥ 40ml/min (calculated from serum creatinine using the Cockcroft-Gault formula).
  • Female subject of should have a negative serum pregnancy within 72 hours prior to receiving the first dose of RT and/or the first dose of pembrolizumab. A highly sensitive pregnancy test must be used.
  • Female subjects of childbearing potential must be willing to use a highly effective measure (see also Section 7.1.9 Contraception and pregnancy testing during the trial). Highly effective contraception is required for the course of the trial through 120 days after the last dose of trial therapy.
  • Generative male subjects must agree to use a highly effective method of contraception (see also Section 7.1.9 Contraception and pregnancy testing during the trial), starting with the first dose of trial therapy through 120 days after the last dose of trial therapy.
  • Subject is willing and able to comply with the protocol for the duration of the trial including undergoing treatment and scheduled visits and examinations including.

Exclusion criteria

Exclusion Criteria:

  • Prior radio(chemo)therapy of the neck less than 6 months ago.
  • Distant (cM1).
  • Is currently participating and receiving trial therapy or has participated in a trial of an agent and received trial therapy or used an investigational device within 4 weeks of the first dose of treatment.
  • Current or prior use of medication within 14 days before the first dose of trial treatment. The following are exceptions to this criterion:

    1. Intranasal, inhaled, topical , or local steroid injections (e.g., intra articular injection)
    2. Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent
    3. Steroids as premedication for reactions (e.g., CT scan premedication).
  • Prior chemotherapy or targeted small molecule therapy within 2 weeks or anti-cancer monoclonal antibody (mAb) within 4 weeks prior to trial day 1 or who has not recovered from AEs due to a previously administered agent. (Subjects with ≤ grade 2 neuropathy are an exception to this criterion and may qualify for the trial.)
  • History or concurrent other . Exceptions include patients, who have been disease free for at least 3 years. Further exceptions are completely resected basal cell carcinoma or squamous cell carcinoma of the skin or successfully treated in situ carcinoma.
  • Active disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • History of (non-infectious) pneumonitis that required steroids, evidence of interstitial lung disease or active, non-infectious pneumonitis.
  • Has an active or chronic infection requiring systemic antibacterial, antifungal or antiviral therapy within 14 days prior to randomization or first dose of study drugs.
  • Known hypersensitivity to the active substances or to any of the .
  • History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  • Known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
  • Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment.
  • Infection with (HIV) (HIV 1/2 antibodies).
  • Active (e.g., HBsAg reactive) or (e.g., HCV RNA [qualitative] is detected).
  • within 30 days of planned start of trial therapy.
  • Performance status of >2 on the Performance Scale.
  • Prior treatment with a /PD-L1 antibody in primary treatment of locally advanced HNSCC less than 6 months ago.
Terms in these criteria, in plain language(23)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
214 participants (estimated)

Study arms

  • Experimental
    Investigational arm

    Patients receive Re-RCT followed by pembrolizumab immunotherapy for up to 2 years. Concomitant chemotheraphy is cisplatin. In case of renal dysfunction carboplatin can be used instead of cisplatin.

    Other: radiotherapy · Drug: Cisplatin · Drug: Alternative medications: carboplatin · Drug: Pembrolizumab

  • Active comparator
    Control arm

    Patients receive pembrolizumab monotherapy for up to 2 years. At the discretion of the treating physician, up to 6 additional cycles of cisplatin or carboplatin in combination with 5-fluorouracil may be given.

    Drug: Pembrolizumab · Drug: cisplatin + 5-fluorouracil (5FU) · Drug: Alternative medications: carboplatin + 5-fluorouracil (5FU)

Interventions

  • Otherradiotherapy

    single doses of 1.8Gy up to a total dose of 55.8Gy to 63.0Gy

  • 40mg/m² BSA weekly concomitant to re-irradiation

  • i.v., 200mg absolute, q3w

  • Drugcisplatin + 5-fluorouracil (5FU)

    Drug pages: Cisplatin · Fluorouracil

    Cisplatin: 100mg/m² BSA d1, q3w / 5-FU: 1000mg/m² BSA d1-4, q3w

  • DrugAlternative medications: carboplatin + 5-fluorouracil (5FU)

    Drug pages: Carboplatin · Fluorouracil

    Carboplatin: AUC5 d1, q3w / 5-FU: 1000mg/m² BSA d1-4, q3w

  • AUC2 weekly

  • i.v., 200mg absolute, q3w, starting within 8-14 days after completion of RCT

06

What researchers measure

Primary outcomes

  1. Overall survival (OS)

    To evaluate the efficacy of a sequential treatment of Re-RCT followed by pembrolizumab compared to standard therapy with pembrolizumab ± chemotherapy, the primary endpoint of the trial is overall survival rate at 2 years.

    Time frame: 2 years

07

Study locations

20 of 24 sites recruiting
  • Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Radioonkologie und Strahlentherapie
    Berlin, 13353, Germany
    Not yet recruiting
  • Klinikum Chemnitz gGmbH, Klinik für Radioonkologie
    Chemnitz, 09116, Germany
    Recruiting
  • Klinikum Darmstadt GmbH, Institut für Radioonkologie und Strahlentherapie
    Darmstadt, 64283, Germany
    Recruiting
  • Gemeinschaftspraxis Hämatologie-Onkologie Dresden
    Dresden, 01307, Germany
    Recruiting
  • Helios Klinikum Erfurt, Klinik für Strahlentherapie
    Erfurt, 99089, Germany
    Recruiting
  • Uniklinikum Erlangen, Strahlenklinik
    Erlangen, 91054, Germany
    Recruiting
  • Universitätsmedizin Frankfurt, Klinik für Strahlentherapie und Onkologie
    Frankfurt am Main, 60590, Germany
    Recruiting
  • UKGM Gießen, Klinik für Strahlentherapie
    Giessen, 35392, Germany
    Recruiting
  • Universitätsklinikum Hamburg-Eppendorf, Zentrum für Onkologie; II. Medizinische Klinik und Poliklinik
    Hamburg, 20246, Germany
    Recruiting
  • Medizinische Hochschule Hannover (MHH), Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation
    Hanover, 30625, Germany
    Recruiting
  • Marien Hospital Herne, Klinik für Strahlentherapie und Radio-Onkologie
    Herne, 44625, Germany
    Recruiting
  • Universitätsklinikum des Saarlandes, Klinik für Strahlentherapie und Radioonkologie
    Homburg, 66421, Germany
    Recruiting
  • Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Strahlentherapie
    Kiel, 24105, Germany
    Not yet recruiting
  • Universitätsklinikum Leipzig, Klinik und Poliklinik für Strahlentherapie
    Leipzig, 4103, Germany
    Not yet recruiting
  • Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Radioonkologie der Strahlentherapie
    Mainz, 55131, Germany
    Recruiting
  • TUM Klinikum Rechts der Isar, Klinik und Poliklinik für RadioOnkologie und Strahlentherapie
    München, 81675, Germany
    Recruiting
  • Universitätsklinikum Münster, Klinik für Strahlentherapie - Radioonkologie
    Münster, 48149, Germany
    Recruiting
  • Universitätsklinikum Regensburg, Klinik und Poliklinik für Strahlentherapie
    Regensburg, 93053, Germany
    Recruiting
  • Universitätsmedizin Rostock, Klinik und Poliklinik für Strahlentherapie / MVZ der Universitätsmedizin Rostock am Standort Südstadt gGmbH
    Rostock, 18059, Germany
    Recruiting
  • Klinikum St.-Elisabeth Straubing GmbH, Klinik für Hals-Nasen-Ohren-Heilkunde
    Straubing, 94315, Germany
    Recruiting
  • Klinikum Stuttgart, Klinik für Strahlentherapie und Radioonkologie
    Stuttgart, 70174, Germany
    Recruiting
  • Universitätsklinikum Tübingen, Klinik für Radioonkologie
    Tübingen, 72076, Germany
    Recruiting
  • Universitätsklinikum Ulm, Klinik für Hals- Nasen-Ohrenheilkunde, Kopf- und Halschirurgie
    Ulm, 89075, Germany
    Recruiting
  • Universitätsspital Zürich, Klinik für Radio-Onkologie
    Zurich, 8091, Switzerland
    Not yet recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Oct 2025 (actual). Primary completion is estimated for Dec 2032, 86 months after the start.

Of 51 non-industry phase 3 interventional studies under Squamous Cell Carcinoma of Head and Neck, half reached primary completion within 95 months of starting (the median), counting those still running; a quarter within 67 and three quarters within 121. This study's planned 86 months is close to that.

Counting every sponsor, half of 78 studies reached it within 76 months; a quarter within 38 and three quarters within 117.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 10, 2025
First posted
Jun 18, 2025
StartActual
Oct 30, 2025
Primary completionEst.
Dec 2032
CompletionEst.
Dec 31, 2032
Last update
Sep 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07026474
Lead sponsor
Universität des Saarlandes
Responsible party
Sponsor
First posted
Jun 18, 2025
Start date
Oct 30, 2025
Primary completion
Dec 2032 (estimated)
Completion
Dec 31, 2032 (estimated)
Last update
Sep 10, 2026

Study contacts

Studienzentrum der Klinik für Strahlentherapie und Radioonkologie
Contact
repair.radonk@uks.eu
+49 6841 - 16 24688
Markus Hecht, Prof. Dr. med.
Contact
markus.hecht.clinicaltrials@uks.eu
+49 6841 - 16 24606

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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