ClinicalTrials.gg
RecruitingNCT07807163FORTIFI-FLEXUpdated Oct 13, 2026

A Study Evaluating Ficerafusp Alfa (BCA101) QW in Combination With Pembrolizumab vs Alternative Ficerafusp Alfa Dosing in 1L R or M HNSCC

A Phase 2 interventional study of Ficerafusp alfa and Pembrolizumab (KEYTRUDA®) in Metastatic Head and Neck Squamous Cell Carcinoma and Recurrent Head and Neck Squamous Cell Carcinoma, sponsored by Bicara Therapeutics. Recruiting at 7 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-13.

Sponsored by Bicara Therapeutics · Phase 2, Interventional, and Treatment

Updated Oct 13, 20266 sites addedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Ficerafusp alfa is directed against two targets, Epidermal Growth Factor Receptor (EGFR) and Transforming Growth Factor beta (TGF-β).

The study aims to demonstrate that the antitumor activity of an alternative dosing regimen of ficerafusp alfa in combination with pembrolizumab is comparable to the weekly ficerafusp alfa regimen in 1L PD-L1-positive, recurrent or metastatic Head and Neck Squamous Cell Carcinoma (HNSCC).

Read the 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.

All participants will receive ficerafusp alfa 1500 mg once weekly (QW in combination with pembrolizumab 200 mg every three weeks (Q3W) for 12 weeks (loading phase). Participants who remain on study without progression at the end of the loading phase will enter the maintenance phase and will be randomized 2:1 to one of the following arms:

Arm A: Ficerafusp alfa 2250 mg Q3W [alternative dose] + pembrolizumab 200 mg Q3W Arm B: Ficerafusp alfa 1500 mg QW [standard dose] + pembrolizumab 200 mg Q3W.

02

Conditions studied

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

Keywords

  • head and neck cancer
  • HNSCC
  • recurrent HNSCC
  • metastatic HNSCC
  • first line treatment
  • Phase 2
  • Recurrent Head and Neck Squamous Cell Carcinoma
  • Metastatic Head and Neck Squamous Cell Carcinoma
  • Pembrolizumab
  • PD-L1+
  • TGF-beta
  • oral cavity
  • oropharynx
  • larynx
  • hypopharynx
  • Ficerafusp alfa
  • SCCHN
  • HPVneg
  • HPV negative
  • HPV-
  • BCA101
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 160 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

Bicara Therapeutics is the lead sponsor of 3 studies on the registry; 3 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

  • Age ≥18 years on the day the Form is signed.
  • 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 or definitive setting.
  • or willing to undergo pretreatment biopsy at Screening if archival tissue is insufficient or unavailable.
  • CPS ≥1.
  • based on 1.1.
  • (ECOG) performance status of 0 or 1.
  • Adequate organ function, as defined in the protocol.

Exclusion criteria

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 reaction to anti-EGFR therapy or other murine proteins.
  • Prior therapy with an completed within 6 months prior to study treatment initiation.
  • Progressive disease \<6 months from completion of curative intent systemic therapy for locoregionally advanced HNSCC.
  • less than 3 months.
  • Known active central nervous system , history of spinal cord compression from tumor involvement, a history of carcinomatous meningitis, or 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 drug must wait at least 5 half-lives of the treatment received or 4 weeks (whichever is shorter) following prior therapy.
  • Active disease requiring systemic treatment in the past 2 years.
  • Subjects with chronic 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 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 (HIV).
  • Receipt of any organ transplantation, including and allogeneic stem cell transplantation, with the exception of transplants that do not require .
  • Known to be diagnosed and/or treated for any other additional 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 (>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 within 4 weeks prior to Screening.
Terms in these criteria, in plain language(22)

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.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

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.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

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.

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.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Metastases

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

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

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.

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.

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.

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.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

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.

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.

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.

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 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
160 participants (estimated)

Study arms

  • Experimental
    Arm A

    Loading phase (12 weeks): Ficerafusp alfa 1500 mg QW (standard dose) + pembrolizumab 200 mg Q3W. Maintenance phase: Ficerafusp alfa 2250 mg Q3W (alternative dose) + pembrolizumab 200 mg Q3W.

    Drug: Ficerafusp alfa · Drug: Pembrolizumab (KEYTRUDA®)

  • Experimental
    Arm B

    Continuous ficerafusp alfa 1500 mg QW (standard dose) + pembrolizumab 200 mg Q3W.

    Drug: Ficerafusp alfa · Drug: Pembrolizumab (KEYTRUDA®)

Interventions

06

What researchers measure

Primary outcomes

  1. Proportion of participants in maintenance phase who are progression-free as assessed by blinded independent central review (BICR) per RECIST 1.1 and alive.

    Time frame: Approximately 9 months.

Secondary outcomes

  1. Serum exposure of ficerafusp alfa.

    Pre- and post-infusion serum concentrations and area under the curve (AUC) for ficerafusp alfa.

    Time frame: Approximately 9 months.

  2. Objective response rate (ORR) per RECIST 1.1 by blinded independent central review (BICR).

    ORR is defined as the proportion of subjects who have a confirmed CR or PR per RECIST 1.1. by BICR.

    Time frame: Approximately 1 year.

  3. Disease control rate (DCR) per RECIST 1.1 by blinded independent central review (BICR)

    DCR is defined as the proportion of subjects who have a SD, CR or PR per RECIST 1.1. by BICR

    Time frame: Approximately 1 year.

  4. Clinical Benefit Rate (CBR) per RECIST 1.1 by blinded independent central review (BICR)

    CBR is defined as the proportion of subjects who demonstrated CR + PR + SD\>6 months per RECIST 1.1 by BICR.

    Time frame: Approximately 3 years.

  5. Duration of Response (DOR) per RECIST 1.1 by blinded independent central review (BICR).

    For subjects who demonstrated CR or PR, DOR is defined as the time from first documented evidence of CR or PR until disease progression or death, whichever occurs first per RECIST 1.1 by BICR.

    Time frame: Approximately 3 years.

  6. Progression-free survival (PFS) per RECIST 1.1 by blinded independent central review (BICR).

    Defined as the time from Cycle 1 Day 1\[TK16.1\] to the first documented PD per RECIST 1.1 as determined by BICR or death due to any cause, whichever occurs first.

    Time frame: Approximately 3 years.

  7. Overall Survival (OS)

    Defined as the time from the Cycle 1 Day 1 to death due to any cause.

    Time frame: Approximately 3 years.

  8. Time to Response (TTR) per RECIST 1.1 by blinded independent central review (BICR)

    For subjects who demonstrated CR or PR, TTR is defined as the time from Cycle 1 Day 1 to first documented evidence of CR or PR per RECIST 1.1 by BICR.

    Time frame: Approximately 3 years.

  9. Deep Response Rate by blinded independent central review (BICR)

    Defined as the proportion of responders who achieve a deep response.

    Time frame: Approximately 3 years.

  10. Time to maximum tumor shrinkage

    Time to maximum tumor shrinkage is defined as the time from Cycle 1 Day 1 to the maximum reduction in target lesion diameter by BICR.

    Time frame: Approximately 3 years.

  11. Incidence of ≥Grade 3 TEAEs

    Time frame: Up to 30 days post end of treatment.

  12. Incidence of Serious adverse events (SAEs)

    Time frame: Up to 90 days post end of treatment.

  13. Incidence of Adverse events (AEs) leading to dose modifications (dose reduction, interruption, dose held, or discontinuation)

    Time frame: Up to 90 days post end of treatment.

07

Study locations

7 of 7 sites recruiting
  • Site US077
    Fort Myers, Florida 33980, United States
    Recruiting
  • Site US078
    Orlando, Florida 32827, United States
    Recruiting
  • Site US075
    St. Petersburg, Florida 33701, United States
    Recruiting
  • Site US076
    West Palm Beach, Florida 33410, United States
    Recruiting
  • Site US069
    Baton Rouge, Louisiana 70809, United States
    Recruiting
  • Site US074
    Tyler, Texas 75702, United States
    Recruiting
  • Site US073
    Roanoke, Virginia 24014, United States
    Recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

1 registry update 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

Start is estimated for Sep 2026; primary completion for Mar 2028, 18 months later.

Of 68 industry-sponsored phase 2 interventional studies under Squamous Cell Carcinoma of Head and Neck, half reached primary completion within 43 months of starting (the median), counting those still running; a quarter within 30 and three quarters within 60. This study's planned 18 months is below that.

Counting every sponsor, half of 366 studies reached it within 53 months; a quarter within 35 and three quarters within 82.

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

Registered
Aug 18, 2026
First posted
Sep 8, 2026
StartEst.
Sep 2026
Primary completionEst.
Mar 2028
CompletionEst.
Mar 2029
Last update
Oct 13, 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.
Sites
6 sites added
Show 6 added (6 United States)
  • Site US077 · Fort Myers, United States
  • Site US078 · Orlando, United States
  • Site US075 · St. Petersburg, United States
  • Site US076 · West Palm Beach, United States
  • Site US069 · Baton Rouge, United States
  • Site US073 · Roanoke, United States
Oct 13, 2026
Show all 1 update
  1. Oct 13, 2026
    6 sites added
    Show 6 added (6 United States)
    • Site US077 · Fort Myers, United States
    • Site US078 · Orlando, United States
    • Site US075 · St. Petersburg, United States
    • Site US076 · West Palm Beach, United States
    • Site US069 · Baton Rouge, United States
    • Site US073 · Roanoke, United States
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07807163
Lead sponsor
Bicara Therapeutics
Responsible party
Sponsor
First posted
Sep 8, 2026
Start date
Sep 2026 (estimated)
Primary completion
Mar 2028 (estimated)
Completion
Mar 2029 (estimated)
Last update
Oct 13, 2026

Study contacts

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

Oversight

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

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