ClinicalTrials.gg
Not yet recruitingNCT07915258Updated Nov 4, 2026

Becotatug Vedotin Plus Pucotenlimab in Locally Advanced Head and Neck Squamous Cell Carcinoma With Suboptimal Response to Induction Immunochemotherapy

A Phase 2 interventional study of Becotatug Vedotin (MRG003) and Pucotenlimab in Squamous Cell Carcinoma of Head and Neck (SCCHN), sponsored by Sun Yat-sen University. Not yet recruiting at 4 sites in China. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by Sun Yat-sen University · Phase 2, Interventional, and Treatment

Updated Nov 4, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
22
Allocation
Not applicable
Ages
18 Years to 70 Years
Sex
All
01

Study summary

Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) may receive chemotherapy combined with immunotherapy before surgery to reduce tumor size. However, some patients do not respond adequately to this initial treatment, and additional treatment options are needed.

This study aims to evaluate the effectiveness and safety of combining becotatug vedotin (MRG003), an antibody-drug conjugate that targets the epidermal growth factor receptor (EGFR), with pucotenlimab (HX008), a PD-1 immune checkpoint inhibitor, in patients whose disease remains stable or progresses after induction immunotherapy combined with platinum-based chemotherapy.

This is a prospective, multicenter, single-arm, phase II clinical trial. Eligible patients with locally advanced, resectable HNSCC will receive two cycles of becotatug vedotin plus pucotenlimab, administered every three weeks before surgery. After treatment, patients will undergo tumor response assessment followed by curative-intent surgery and appropriate postoperative treatment.

The primary objective is to evaluate the objective response rate (ORR), defined as the proportion of patients achieving complete or partial tumor response. The study will also assess pathological response, surgical outcomes, treatment safety, and long-term survival.

The study seeks to determine whether this additional preoperative treatment strategy may improve tumor response and provide further opportunities for organ preservation in patients who have not benefited adequately from initial induction immunochemotherapy.

Read the detailed description

**Background and Rationale**

Locally advanced head and neck squamous cell carcinoma (HNSCC) often requires extensive surgical resection, which may significantly impair speech, swallowing, appearance, and quality of life. Although induction immunochemotherapy combining platinum-based chemotherapy with programmed cell death protein 1 (PD-1) inhibitors has demonstrated promising antitumor activity, a proportion of patients experience stable disease (SD) or progressive disease (PD). These patients may have limited opportunities for tumor downstaging and organ preservation before definitive surgery.

Becotatug vedotin (MRG003) is an epidermal growth factor receptor (EGFR)-targeting antibody-drug conjugate (ADC) that delivers a cytotoxic payload to tumor cells. Pucotenlimab (HX008) is a PD-1 inhibitor that enhances antitumor immune responses. The combination may provide complementary antitumor mechanisms and represents a potential treatment strategy for patients with inadequate responses to previous induction immunochemotherapy.

**Study Design and Treatment**

This is a prospective, multicenter, open-label, single-arm, phase II clinical study designed to evaluate the efficacy and safety of becotatug vedotin combined with pucotenlimab as an adaptive neoadjuvant treatment strategy.

Eligible participants will have histologically confirmed, locally advanced (stage III-IVA), resectable HNSCC with SD or PD following at least two cycles of induction immunochemotherapy containing platinum-based chemotherapy and a PD-1 inhibitor, as assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). Resectability will be confirmed by a multidisciplinary team.

Participants will receive becotatug vedotin at 2.0 mg/kg intravenously and pucotenlimab at 200 mg intravenously, administered every three weeks for two cycles.

Following completion of study treatment, radiological tumor response will be assessed before curative-intent surgery. Postoperative adjuvant treatment, including radiotherapy with or without chemotherapy, will be administered according to standard clinical practice.

**Study Objectives and Assessments**

The primary objective is to evaluate the objective response rate (ORR) according to RECIST v1.1 after adaptive neoadjuvant therapy.

Secondary assessments include pathological complete response, major pathological response, R0 resection, organ preservation, safety, perioperative complications, and survival outcomes, including event-free survival, disease-free survival, and overall survival.

Exploratory analyses of tumor tissue and peripheral blood samples will investigate potential biomarkers associated with treatment response and mechanisms underlying resistance to induction immunochemotherapy.

**Statistical Design**

A Simon's two-stage minimax design will be employed, with a null ORR of 10%, a target ORR of 35%, a one-sided significance level of 0.05, and 80% statistical power.

In the first stage, 11 evaluable participants will be enrolled. If no more than one participant achieves a complete or partial response, the study will be stopped early for insufficient efficacy. If at least two participants achieve an objective response, an additional seven evaluable participants will be enrolled, resulting in a total of 18 evaluable participants.

If at least five of the 18 evaluable participants achieve an objective response, the regimen will be considered to have sufficient antitumor activity to warrant further investigation.

Allowing for approximately 15% attrition or non-evaluable participants, up to 22 participants are planned to be enrolled.

**Safety and Follow-up**

Adverse events, serious adverse events, immune-related adverse events, and perioperative complications will be monitored throughout the study. Participants will undergo postoperative follow-up, including imaging assessments for disease recurrence and long-term survival evaluation, according to the study protocol.

02

Conditions studied

  • Squamous Cell Carcinoma of Head and Neck (SCCHN)

Keywords

  • Locally advanced head and neck squamous cell carcinoma
  • Adaptive neoadjuvant therapy
  • Induction immunochemotherapy
  • Antibody-drug conjugate
  • Becotatug vedotin (MRG003)
  • Pucotenlimab (HX008)
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 22 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

Sun Yat-sen University is the lead sponsor of 1,690 studies on the registry; 619 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

**Inclusion Criteria:**

  1. Voluntarily provides written before undergoing any study-specific procedures.
  2. Aged 18 to 70 years, regardless of sex.
  3. confirmed locally advanced (stage III-IVA, AJCC 8th edition) head and neck squamous cell carcinoma (HNSCC).
  4. Has received at least two cycles of induction immunochemotherapy comprising platinum-based chemotherapy and a inhibitor.
  5. Has achieved stable disease (SD) or progressive disease (PD) as the best response to induction immunochemotherapy according to v1.1. A multidisciplinary team (MDT) considers that additional adaptive therapy may reduce tumor burden, decrease the extent of surgical resection, or improve the opportunity for organ preservation.
  6. The interval between completion of induction immunochemotherapy and the first dose of study treatment does not exceed 28 days.
  7. Disease remains amenable to curative-intent surgery with an anticipated R0 resection, as confirmed by an MDT including an experienced head and neck surgeon.
  8. (ECOG) performance status of 0 or 1.
  9. At least one according to RECIST v1.1 before initiation of study treatment.
  10. Adequate organ function, as assessed within 7 days before the first study dose:

    • ≥1.5 × 10⁹/L.
    • count ≥100 × 10⁹/L.
    • ≥90 g/L.
    • Total ≤1.5 × (ULN).
    • (ALT) and aspartate aminotransferase (AST) ≤2.5 × ULN (≤5 × ULN in the presence of liver ).
    • Serum creatinine ≤1.5 × ULN or ≥60 mL/min (Cockcroft-Gault formula).
  11. Women of and men whose partners are women of childbearing potential agree to use effective throughout the study and for at least 6 months after the last dose.
  12. Willing and able to comply with study treatment, follow-up visits, laboratory examinations, and other protocol-required procedures.

**Exclusion Criteria:**

  1. Primary nasopharyngeal carcinoma.
  2. History of severe to becotatug vedotin, pucotenlimab, or any of their .
  3. Previous anticancer treatment for HNSCC other than the protocol-specified induction immunochemotherapy, including surgery, radiotherapy, other chemotherapy, targeted therapy, or biological therapy.
  4. Unresectable disease due to invasion of critical anatomical structures (e.g., carotid sheath involvement) or other factors, or medical to curative-intent surgery, as determined by the MDT.
  5. Distant metastatic disease (M1).
  6. Active disease or a history of autoimmune disease requiring systemic treatment within the previous 2 years, except for permitted conditions such as vitiligo or stable hypothyroidism.
  7. Active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  8. Requirement for long-term immunosuppressive therapy or use of systemic at immunosuppressive doses (>10 mg/day prednisone or equivalent) within 7 days before the first study dose.
  9. (HIV) infection; untreated active infection (HBsAg-positive with HBV DNA >1,000 IU/mL); or infection (HCV antibody-positive with detectable HCV RNA).
  10. Pregnancy or breastfeeding.
  11. Severe or uncontrolled systemic disease, including cardiovascular, pulmonary, infectious, or endocrine disorders.
  12. Major surgery or severe trauma within 4 weeks before the first study dose.
  13. Severe bleeding tendency or coagulation disorder, or clinically significant active bleeding within 1 month before the first study dose.
  14. Any other condition that, in the investigator's opinion, may compromise participant safety, study compliance, or interpretation of study results.
Terms in these criteria, in plain language(27)

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.

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.

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.

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.

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.

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.

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.

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.

Metastases

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

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.

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.

Excipients

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

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

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.

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.

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.

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.

05

Study design

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

Study arms

  • Experimental
    Adaptive Neoadjuvant Therapy

    Patients with locally advanced, resectable head and neck squamous cell carcinoma who have achieved stable disease or progressive disease following induction immunochemotherapy will receive becotatug vedotin (MRG003) at 2.0 mg/kg and pucotenlimab (HX008) at 200 mg intravenously every three weeks for two cycles, followed by curative-intent surgery and standard postoperative treatment as clinically indicated.

    Drug: Becotatug Vedotin (MRG003) · Drug: Pucotenlimab

Interventions

  • Becotatug vedotin (MRG003) is an epidermal growth factor receptor (EGFR)-targeting antibody-drug conjugate (ADC). It will be administered intravenously at a dose of 2.0 mg/kg on Day 1 of each 21-day cycle for two cycles, in combination with pucotenlimab.

  • Pucotenlimab (HX008) is a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1). It will be administered intravenously at a fixed dose of 200 mg on Day 1 of each 21-day cycle for two cycles, in combination with becotatug vedotin.

06

What researchers measure

Primary outcomes

  1. Objective Response Rate (ORR)

    The proportion of participants achieving a complete response (CR) or partial response (PR), as assessed by investigators using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1), based on radiological assessments before and after adaptive neoadjuvant treatment. The ORR will be reported with an exact 95% confidence interval using the Clopper-Pearson method.

    Time frame: From baseline to preoperative tumor assessment after two treatment cycles (approximately 6-10 weeks after the first dose)

Secondary outcomes

  1. Pathological Complete Response Rate (pCR)

    The proportion of participants with no residual viable invasive tumor cells in the primary tumor bed and all regional lymph nodes, as determined by histopathological examination of surgical specimens.

    Time frame: At curative-intent surgery, approximately 6-12 weeks after the first study dose

  2. Major Pathological Response Rate (MPR)

    The proportion of participants with 10% or less residual viable tumor cells in the resected tumor tissue, as assessed by histopathological examination.

    Time frame: At curative-intent surgery, approximately 6-12 weeks after the first study dose

  3. R0 Resection Rate

    The proportion of participants undergoing curative-intent surgery who achieve microscopically negative surgical margins (R0 resection), as confirmed by histopathological examination.

    Time frame: At curative-intent surgery, approximately 6-12 weeks after the first study dose

  4. Organ Preservation Rate

    Among participants assessed by a multidisciplinary team before study enrollment as requiring function-ablative surgery, the proportion who undergo organ-function-preserving surgery while achieving R0 resection after adaptive neoadjuvant treatment.

    Time frame: From baseline surgical assessment to definitive surgery, approximately 6-12 weeks after the first study dose

  5. Incidence of Adverse Events (AEs)

    The incidence and severity of adverse events, serious adverse events, and immune-related adverse events, graded according to NCI CTCAE version 6.0. Treatment-related events, events leading to dose modification or discontinuation, and perioperative complications will also be assessed.

    Time frame: From first study drug administration through the protocol-defined safety follow-up period (up to 48 months)

  6. Event-Free Survival (EFS) Rate at 1 and 2 Years

    The estimated proportion of participants remaining event-free at 1 year and 2 years after initiation of adaptive neoadjuvant therapy, calculated using the Kaplan-Meier method according to the protocol-defined event criteria.

    Time frame: At 1 year and 2 years after the first study dose

  7. Disease-Free Survival (DFS) Rate at 1 and 2 Years

    The estimated proportion of participants remaining disease-free at 1 year and 2 years following curative-intent surgery, calculated using the Kaplan-Meier method.

    Time frame: At 1 year and 2 years after curative-intent surgery

  8. Overall Survival (OS) Rate at 1 and 2 Years

    The estimated proportion of participants alive at 1 year and 2 years after initiation of adaptive neoadjuvant therapy, calculated using the Kaplan-Meier method.

    Time frame: At 1 year and 2 years after the first study dose

  9. Clinicopathological Downstaging Rate

    The proportion of participants whose postoperative pathological TNM stage (pTNM) is lower than the clinical TNM stage (cTNM) assessed after induction immunochemotherapy and before adaptive neoadjuvant treatment.

    Time frame: From baseline staging to postoperative pathological assessment, approximately 6-12 weeks after the first study dose

07

Study locations

4 sites
08

References and documents

Individual participant data

Plan to share: No — There is currently no plan to share de-identified individual participant data (IPD) with researchers outside the study team. Study data will be managed in accordance with the approved protocol, informed consent, institutional ethics requirements, and applicable Chinese regulations. Aggregate study findings may be disseminated through scientific publications.

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Nov 4, 2026
Show all 1 update
  1. Nov 4, 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
NCT07915258
Collaborators
Lepu Biopharma Co., Ltd.
Responsible party
Yujie Liang (Chief Physician, Hospital of Stomatology, Sun Yat-Sen University) — Principal investigator
First posted
Nov 4, 2026
Start date
Jan 2027 (estimated)
Primary completion
Sep 2028 (estimated)
Completion
Dec 2030 (estimated)
Last update
Nov 4, 2026

Study contacts

Yujie Liang, PhD
Contact
liangyj35@mail.sysu.edu.cn
+86 13242879610
Bin Zeng, PhD
Contact
zengb29@mail.sysu.edu.cn
+86 18819472975
Yujie Liang, PhD
principal investigator · Hospital of Stomatology, Sun Yat-Sen University

Oversight

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

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Studies of the drugs tested here: Becotatug vedotin · Pucotenlimab

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