ClinicalTrials.gg
Not yet recruitingNCT07901803APACUpdated Oct 28, 2026

Aspirin and PAClitaxel in Head & Neck Squamous Cell Carcinoma

A Phase 2 interventional study of Aspirin and Paclitaxel in Head and Neck (HNSCC), Head and Neck Squamous Cell Carcinoma (HNSCC) - Recurrent/Metastatic (R/M) and Head and Neck Squamous Cell Carcinoma, sponsored by Washington University School of Medicine. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-28.

Sponsored by Washington University School of Medicine · Phase 2, Interventional, and Treatment

Updated Oct 28, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This is a phase II trial of aspirin and paclitaxel in patients with recurrent/metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC) who have received prior platinum and PD-1 inhibitor treatment and have an alteration in the PI3K pathway.

02

Conditions studied

  • Head and Neck (HNSCC)
  • Head and Neck Squamous Cell Carcinoma (HNSCC) - Recurrent/Metastatic (R/M)
  • Head and Neck Squamous Cell Carcinoma
  • Recurrent / Metastatic Head and Neck Squamous Cell Carcinoma

Keywords

  • Recurrent / Metastatic Head and Neck Squamous Cell Carcinoma
  • HNSCC
  • aspirin
  • paclitaxel
  • PI3K altered
  • PIK3CA
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 40 is below 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

Washington University School of Medicine is the lead sponsor of 1,803 studies on the registry; 271 are open to participants now.

Of its 329 completed or terminated interventional studies of FDA-regulated products, 216 (66%) have results posted.

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

  • Recurrent or head and neck squamous cell carcinoma (R/M HNSCC). Eligible primary tumor sub-sites include oral cavity, oropharynx, larynx, hypopharynx, nasal cavity and paranasal sinus. Also allowed:
  • P16+ (HPV-related) level 2-3 neck node and unknown primary
  • Second primary HNSCC in a previously radiated field not amenable to curative-intent surgery and/or re-radiation
  • PI3K alteration (defined in protocol) or PIK3CA amplification
  • per 1.1.
  • Previously treated with platinum-based chemotherapy in one of the following ways:
  • R/M disease within 6 months of definitive cisplatin + radiation therapy (DCisRT) OR
  • R/M disease within 6 months of post-operative adjuvant cisplatin + radiation therapy (POACisRT) OR
  • Progressive disease on or after or intolerance to platinum agent given for R/M disease.
  • Previously treated with inhibitor in one of the following ways:

    • R/M disease within 6 months of PD-1 inhibitor given as part of curative-intent therapy OR
    • Progressive disease on or after PD-1 inhibitor given for R/M disease OR
    • Intolerance to prior PD-1 inhibitor in the curative or metastatic setting OR
    • Not an appropriate candidate for PD-1 inhibitor therapy due to co-morbidity (i.e., disease or organ/stem cell transplant)
  • At least 18 years of age.
  • performance status ≤ 2
  • Adequate bone marrow and organ function as defined below:

    • ≥ 1.5 K/cumm
    • ≥ 100 K/cumm
    • ≥ 8.0 g/dL
    • Total ≤ 1.5 x IULN (≤ 3 x IULN for subjects with Gilbert's disease)
    • (SGOT)/ALT(SGPT)/alkaline phosphatase (ALP) ≤ 3.0 x IULN (ALP ≤ 5.0 x IULN for subjects with documented bone metastasis)
    • > 30 mL/min by Cockcroft-Gault
  • The effects of paclitaxel on the developing human fetus are unknown. For this reason, women of and men must agree to use adequate prior to study entry, for the duration of study participation, and for 30 days after completion of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study or should a man suspect he has fathered a child, she must inform her treating physician immediately.
  • Ability to understand and willingness to sign an IRB approved written document. Legally authorized representatives may sign and give informed consent on behalf of study participants.

Exclusion criteria

Exclusion Criteria:

  • Prior paclitaxel or docetaxel given to treat R/M HNSCC. Prior taxane in the curative-intent setting and/or for the treatment of another cancer is permitted if the last dose was administered at least 1 year prior to enrollment.
  • Palliative radiation therapy within 2 weeks of C1D1.
  • Prior or concurrent whose natural history has the potential to interfere with the safety or efficacy assessment of the regimen. Patients with prior or concurrent malignancy that does NOT meet that definition are eligible for this trial
  • Currently receiving any other investigational agents.
  • Recurrence, , or incurable second primary SCC of cutaneous, or nasopharynx origin.
  • Patients with untreated . Patients with treated brain metastases are allowed if post-treatment brain-imaging after CNS-directed therapy shows no evidence of progression.
  • Concurrent oral anticoagulation for a prior history of deep venous thrombosis/pulmonary embolism or atrial fibrillation.
  • major bleeding within the past 3 months (from screening).
  • Concurrent aspirin or antiplatelet therapy (e.g. clopidogrel, ticagrelor) as secondary prevention for a prior history of atherosclerotic cardiovascular disease (ASCVD) requiring intervention. ASCVD events are defined as acute coronary syndrome, myocardial infarction, stable or unstable angina, coronary or arterial revascularization, stroke, , and/or peripheral artery disease.
  • A history of allergic reactions attributed to compounds of similar chemical or biologic composition to paclitaxel, aspirin, or other agents used in the study.
  • Pregnant and/or breastfeeding. Women of must have a negative urine pregnancy test within 14 days of study registration.
Terms in these criteria, in plain language(20)

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.

Metastases

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

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.

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.

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.

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.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

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.

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).

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.

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.

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.

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.

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.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Paclitaxel + Aspirin

    Paclitaxel will be given intravenously over the course of 60 minutes on an outpatient basis on Days 1, 8, 15, and 22 of each 28-day cycle. Aspirin will be administered on an outpatient basis and taken each day of a 28-day cycle.

    Drug: Aspirin · Drug: Paclitaxel

Interventions

  • Aspirin is administered orally at a 162 mg dose. Aspirin will be administered each day and taken at approximately the same time every day, with or without food.

  • Paclitaxel will be administered intravenously at a dose of 80 mg/m\^2.

    Also known as: Onxal, Abraxane

06

What researchers measure

Primary outcomes

  1. Objective response rate (ORR)

    ORR is defined as the proportion of participants achieving a confirmed complete response (CR) or partial response (PR) as their best overall response according to RECIST v1.1. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.

    Time frame: Start of treatment through completion of treatment or time of disease progression (total estimated time: 12 months)

Secondary outcomes

  1. Incidence of protocol-specified subset of adverse events (AEs) as assessed by CTCAE v6.0

    Protocol-specified subset of AEs include AEs outside of those listed as follows: nausea, vomiting, fatigue, anemia, white blood cell decreased, neutrophil count decreased, thrombocytopenia, peripheral sensory neuropathy, peripheral motor neuropathy, infusion related reaction, bleeding/hemorrhage, weight loss, anorexia, edema, diarrhea, mucositis oral, arthralgia, and myalgia. For participants experiencing the same AE more than once, the maximum observed grade will be used in participant-level summaries.

    Time frame: Start of treatment through 28 days after completion of treatment (total estimated time: 13 months)

  2. Duration of Response (DOR)

    DOR is defined as the time from the first documented complete response (CR) or partial response (PR) to disease progression according to RECIST version 1.1 or death from any cause, whichever occurs first. Participants who are alive without documented progression will be censored at the date of their last follow-up. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.

    Time frame: Time of CR or PR to time of disease progression or death from any cause, whichever occurs first (total estimated time: 4 years)

  3. Progression-free survival (PFS)

    PFS is defined as the time from the first dose of paclitaxel to disease progression according to RECIST version 1.1 or death from any cause, whichever occurs first. Participants who are alive without documented progression will be censored at the date of their last follow-up.

    Time frame: Date of first paclitaxel dose until disease progression or death from any cause (total estimated time: 4 years)

  4. Overall Survival (OS)

    OS is defined as the time from the first dose of paclitaxel to death from any cause. Participants who are alive at the time of analysis will be censored at the date of their last follow-up.

    Time frame: Date of first paclitaxel dose to death from any cause (total estimated time: 4 years)

07

Study locations

1 site
  • Washington University School of Medicine
    St Louis, Missouri 63110, United States
    • Brendan Knapp, MD · Contactbjknapp@wustl.edu · 314-747-8092
    • Brendan Knapp, MD · Principal investigator
    • Douglas Adkins, MD · Sub investigator
    • Christine Auberle, MD · Sub investigator
    • Peter Oppelt, MD · Sub investigator
    • Jesse Zaretsky, MD, PhD · Sub investigator
    • Esther Lu, PhD · Sub investigator
08

References and documents

Individual participant data

Plan to share: Yes — Anonymized dataset may be available from the corresponding author on reasonable request.

Supporting information: Study protocol, Statistical analysis plan

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 Dec 2026; primary completion for Jun 2029, 29 months later.

Of 298 non-industry phase 2 interventional studies under Squamous Cell Carcinoma of Head and Neck, half reached primary completion within 56 months of starting (the median), counting those still running; a quarter within 37 and three quarters within 85. This study's planned 29 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
Oct 22, 2026
First posted
Oct 28, 2026
StartEst.
Dec 31, 2026
Primary completionEst.
Jun 30, 2029
CompletionEst.
Jun 30, 2032
Last update
Oct 28, 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.
Registered
First appeared on the registry. No changes since
Oct 28, 2026
Show all 1 update
  1. Oct 28, 2026
    First appeared on the registry

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
NCT07901803
Responsible party
Sponsor
First posted
Oct 28, 2026
Start date
Dec 31, 2026 (estimated)
Primary completion
Jun 30, 2029 (estimated)
Completion
Jun 30, 2032 (estimated)
Last update
Oct 28, 2026

Study contacts

Brendan Knapp, MD
Contact
bjknapp@wustl.edu
314-747-8092
Brendan Knapp, MD
principal investigator · Washington University School of Medicine

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drugs tested here: Aspirin · Paclitaxel

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