Iparomlimab/Tuvorlimab (QL1706) and Modified TPF Regimen for Induction Therapy in LANPC

The Efficacy and Safety of Iparomlimab/Tuvorlimab (QL1706) Combined With Modified TPF Regimen for Induction Therapy in Locally Advanced Nasopharyngeal Carcinoma

This is a prospective, open-label, multicenter, single-arm clinical study. A total of 30 patients with locally advanced nasopharyngeal carcinoma who have not received prior systemic treatment are planned to be enrolled at three centers. After enrollment, the patients will receive induction therapy with Iparomlimab/Tuvorlimab(QL-1706) in combination with a modified TPF regimen, followed by concurrent chemoradiotherapy with cisplatin according to the standards of clinical practice.

Inclusion Criteria:

• Age: ≥ 18 years old;

• Patients with nasopharyngeal carcinoma diagnosed by pathology (including histology or cytology), with a clinical stage of III - IV (excluding T3N0 - 1) (according to the UICC/AJCC TNM staging system (8th edition));

• No prior systematic treatment (surgery, radiotherapy, chemotherapy, etc.); At least one measurable lesion on imaging examination (according to RECIST criteria version 1.1);

• ECOG PS: 0 - 1 points;

• Expected survival time ≥ 3 months;

• Normal function of major organs, meeting the following criteria:

  1. Blood routine tests should meet the following (without blood transfusion within 14 days):

     1. HB ≥ 100 g/L,
     2. WBC ≥ 3 × 10⁹/L,
     3. ANC ≥ 1.5 × 10⁹/L,
     4. PLT ≥ 100 × 10⁹/L;

  2. Biochemical tests should meet the following criteria:

     1. BIL < 1.5 times the upper limit of normal (ULN),
     2. ALT and AST < 2.5 ULN, GPT ≤ 1.5 × ULN;
     3. Serum Cr ≤ 1 ULN, endogenous creatinine clearance rate > 60 ml/min (Cockcroft - Gault formula);

• Male subjects and women of childbearing potential must use contraception from the start of the first dose of the study drug until 24 weeks after the last dose of the study drug;

• Normal function of major organs, with basically normal blood routine, blood biochemistry and coagulation function tests;

• The investigator believes that the patient will benefit from the treatment in terms of survival;

• The patient voluntarily participates in this study and provides a written informed consent form.

Exclusion Criteria:

• Active, known, or suspected autoimmune diseases;
• Patients with hypertension whose blood pressure cannot be controlled within the normal range with antihypertensive medications (systolic blood pressure > 160 mmHg, diastolic blood pressure > 90 mmHg);
• Inherited bleeding tendency or coagulation disorders. Clinically significant bleeding symptoms occurred within 12 weeks before screening or there is a definite bleeding tendency (cumulative blood loss exceeding 50 ml within 24 hours);
• Uncontrolled cardiac clinical symptoms or diseases, such as: (1) Heart failure of NYHA class II or above; (2) Unstable angina; (3) Myocardial infarction within 24 weeks; (4) Clinically significant supraventricular or ventricular arrhythmias requiring treatment or intervention;
• Interstitial lung disease, drug-induced pneumonia, radiation pneumonia requiring steroid treatment, active pneumonia with clinical symptoms, or severe pulmonary function impairment;
• Subjects with active hepatitis B (HBV DNA ≥ 2000 IU/mL or 10⁴ copies/mL) or hepatitis C (positive for hepatitis C antibody and HCV-RNA above the lower limit of detection of the analytical method);
• Subjects with allergic reactions to the drugs used in this study;
• Pregnant or lactating women;
• Other conditions considered by the investigator as unsuitable for participation in this study.