FORTIFI-HN01: A Study of Ficerafusp Alfa (BCA101) or Placebo in Combination With Pembrolizumab in First-Line PD-L1-pos, R or M HNSCC

Last updated: March 20, 2026
Sponsor: Bicara Therapeutics
Overall Status: Active - Recruiting

Phase

2/3

Condition

Lung Cancer

Head And Neck Cancer

Carcinoma

Treatment

Placebo

Pembrolizumab (KEYTRUDA®)

Ficerafusp alfa

Clinical Study ID

NCT06788990
BCA101X301
2024-519654-37-00
  • Ages > 18
  • All Genders

Study Summary

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

This study intends to evaluate the safety and efficacy of ficerafusp alfa in combination with pembrolizumab versus placebo with pembrolizumab in 1L PD-L1-positive, recurrent or metastatic Head and Neck Squamous Cell Carcinoma (HNSCC).

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age ≥18 years on the day the Informed Consent Form is signed.

  • Histologically or cytologically confirmed R or M HNSCC. Eligible primary tumorlocations are oral cavity, hypopharynx, larynx or oropharynx (with documentedHPV-negative disease if presenting with OPSCC). Note: primary tumor location ofparanasal sinuses and nasopharynx, any histology are excluded.

  • No prior systemic therapy administered in the R or M setting; and completed systemictherapy >6 months prior if given as part of multimodal treatment for locoregionallyadvanced disease in the adjuvant or definitive setting.

  • Archival tumor tissue or willing to undergo pretreatment biopsy at Screening ifarchival tissue is insufficient or unavailable.

  • PD-L1 CPS ≥1.

  • Measurable disease based on RECIST 1.1.

  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

  • Adequate organ function, as defined in the protocol.

Exclusion

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 andmultimodal treatment for locoregionally advanced disease).

  • Prior history of Grade ≥2 intolerance or hypersensitivity reaction to anti-EGFRtherapy or other murine proteins.

  • Prior therapy with an immune checkpoint inhibitor completed within 6 months prior tostudy treatment initiation.

  • Progressive disease <6 months from completion of curative intent systemic therapyfor locoregionally advanced HNSCC.

  • Life expectancy less than 3 months.

  • Known active central nervous system metastases, history of spinal cord compressionfrom tumor involvement, a history of carcinomatous meningitis, or leptomeningealdisease are excluded.

  • Current active major bleeding, or a recent major bleeding episode within 4 weeksprior to enrollment.

  • Subject participated in another clinical study or received treatment with anotherinvestigational drug must wait at least 5 half-lives of the treatment received or 4weeks (whichever is shorter) following prior therapy.

  • Active autoimmune disease requiring systemic treatment in the past 2 years.

  • Subjects with chronic hepatitis B virus (HBV) infection with active disease who meetthe criteria for anti-HBV therapy and are not on a suppressive antiviral therapyprior to initiation of study treatment.

  • Subjects with a known history of hepatitis C virus (HCV) who have not completedcurative antiviral treatment or have an HCV viral load above the limit ofquantification at Screening.

  • Known history of human immunodeficiency virus (HIV).

  • Receipt of any organ transplantation, including autologous and allogeneic stem celltransplantation, with the exception of transplants that do not requireimmunosuppression.

  • Known to be diagnosed and/or treated for any other additional malignancy within 2years prior to randomization with the exception of the following: curatively treatedbasal cell carcinoma or squamous cell carcinoma of the skin, and curatively resectedin situ cervical cancer, and curatively resected in situ breast cancer, and low-riskearly stage prostate cancer.

  • Any condition requiring systemic treatment with either corticosteroids (>10 mg dailyof prednisone or equivalent) or other immunosuppressive medication within 7 daysprior to the first dose of study treatment, except for topical, intranasal,intrabronchial, or ocular steroids.

  • Use of a live or live attenuated vaccine within 4 weeks prior to Screening.

Other Inclusion/Exclusion criteria may apply as defined in the protocol.

Study Design

Total Participants: 650
Treatment Group(s): 3
Primary Treatment: Placebo
Phase: 2/3
Study Start date:
January 28, 2025
Estimated Completion Date:
July 31, 2029

Study 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.

Phase 2 of the study will identify an optimal biologic dose (OBD) supported by the safety, tolerability, PK, PD, and efficacy data of ficerafusp alfa. In this part, eligible subjects will be randomized to one of three treatment arms at a 1:1:1 ratio:

  • Arm A: ficerafusp alfa 1500 mg once weekly (QW) + pembrolizumab 200 mg every three weeks (Q3W).

  • Arm B: ficerafusp alfa 750 mg QW + pembrolizumab 200 mg Q3W.

  • Arm C (control): placebo QW + pembrolizumab 200 mg Q3W.

The primary objective for the phase 3 portion is to compare the efficacy in subjects treated with ficerafusp alfa at the selected OBD in combination with pembrolizumab versus placebo with pembrolizumab. Eligible subjects will be randomized 2:1 in the treatment versus control arm during the phase 3 portion.

Connect with a study center

  • Site#0302

    Camperdown, New South Wales 2050
    Australia

    Active - Recruiting

  • Site #0306

    Kingswood, New South Wales 2747
    Australia

    Active - Recruiting

  • Site#0304

    Waratah, New South Wales 2298
    Australia

    Active - Recruiting

  • Site#0302

    Camperdown 2172563, New South Wales 2155400 2050
    Australia

    Site Not Available

  • Site #0306

    Kingswood 2161303, New South Wales 2155400 2747
    Australia

    Site Not Available

  • Site#0304

    Waratah 10103871, New South Wales 2155400 2298
    Australia

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  • Site #0305

    Southport, Queensland 4215
    Australia

    Active - Recruiting

  • Site#0307

    Tugun, Queensland 4224
    Australia

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  • Site #0305

    Southport 2148928, Queensland 2152274 4215
    Australia

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  • Site#0307

    Tugun 2145929, Queensland 2152274 4224
    Australia

    Site Not Available

  • Site #0303

    Heidelberg, Victoria 3084
    Australia

    Active - Recruiting

  • Site#0301

    North Melbourne, Victoria 3051
    Australia

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  • Site #0303

    Heidelberg 2163654, Victoria 2145234 3084
    Australia

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  • Site#0301

    North Melbourne 2154912, Victoria 2145234 3051
    Australia

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  • Site#0308

    Murdoch, Western Australia 6150
    Australia

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  • Site#0308

    Murdoch 8349091, Western Australia 2058645 6150
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    Salzburg, 5020
    Austria

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  • Site #1602

    Salzburg 2766824, 5020
    Austria

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    Vienna, 1090
    Austria

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    Vienna 2761369, 1090
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    Bruges, 8000
    Belgium

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    Bruges 2800931, 8000
    Belgium

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    Mons, 7000
    Belgium

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    Mons 2790869, 7000
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    Namur, 5000
    Belgium

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    Namur, 5530
    Belgium

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    Namur 2790471, 5000
    Belgium

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    Namur 2790471, 5530
    Belgium

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    Sint-Niklaas, 9100
    Belgium

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    Sint-Niklaas 2786578, 9100
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    Wilrijk, 2610
    Belgium

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    Vancouver, British Columbia V5Z 4E6
    Canada

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    Vancouver 6173331, British Columbia 5909050 V5Z 4E6
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    Montreal, Quebec H2X 0C1
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    Montréal, Quebec H2X 0C1
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    Montreal 6077243, Quebec 6115047 H2X 0C1
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    Prague, 15006
    Czechia

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    Amiens, 80480
    France

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    Amiens 3037854, 80480
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    Lyon, 69004
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    Rennes, 35042
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    Saint-Grégoire, 35760
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    Saint-Grégoire 2979619, 35760
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    Strasbourg, 67200
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    Strasbourg 2973783, 67200
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    Vandœuvre-lès-Nancy, 54519
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    Vandœuvre-lès-Nancy 2970797, 54519
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    Villejuif, 94805
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    Villejuif 2968705, 94805
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    Aachen, 52074
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    Aachen 3247449, 52074
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    Dresden, 01067
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    Düsseldorf, 40225
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    Düsseldorf 2934246, 40225
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    Karlsruhe, 76137
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    Bologna, 40138
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    Florence, 50134
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    Florence 3176959, 50134
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    Milan, 20142
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    Milan 3173435, 20132
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    Naples, 80131
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    Napoli 9031661, 80131
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    Palermo 2523920, 90127
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    Rome, 00161
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    Rome 3169070, 00186
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    Christchurch 2192362, 8011
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    Rotorua, 3010
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    Rotorua 6241325, 3010
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    Katowice, 40-519
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    Katowice 3096472, 40-519
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    Konin, 62-500
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    Konin 3095321, 62-500
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    Krakow, 31-826
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    Krakow 3094802, 31-826
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    Siedlce, 08-110
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    Warsaw, 02-781
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    Warsaw 756135, 02-781
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    Braga, 4710-243
    Portugal

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    Braga 2742032, 4710-243
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    Coimbra,
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    Coimbra 2740637,
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    Lisbon, 1099-023
    Portugal

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    Lisbon 2267057, 1099-023
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    Portimão, 8500-338
    Portugal

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    Portimão 2264456, 8500-338
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  • Site #1505

    Porto, 4200-072
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  • Site #1507

    Porto, 4200-319
    Portugal

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    Porto 2735943, 4200-072
    Portugal

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    Porto 2735943, 4200-319
    Portugal

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  • Site #1502

    Senhora da Hora, 4464-509
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    Senhora da Hora 2734140, 4464-509
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    Barcelona, 08035
    Spain

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    Barcelona, 08041
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    Barcelona, 08036
    Spain

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    Barcelona 3128760, 08035
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    Barcelona 3128760, 08041
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    Barcelona 3128760, 08036
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    Madrid, 28041
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  • Site #1310

    Madrid, 28027
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    Madrid 3117735, 28041
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  • Site #1310

    Madrid 3117735, 28027
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  • Site #1306

    Pamplona, 31008
    Spain

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    Pamplona 3114472, 31008
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    Santander, 39008
    Spain

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  • Site #1309

    Santander 3109718, 39008
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    Valencia, 46010
    Spain

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  • Site #1308

    Valencia, 46014
    Spain

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    Valencia 2509954, 46010
    Spain

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  • Site #0504

    Aberdeen, AB25 2ZN
    United Kingdom

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  • Site #0504

    Aberdeen 2657832, AB25 2ZN
    United Kingdom

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  • Site #0512

    Birmingham, B15 2TH
    United Kingdom

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  • Site #0513

    Cambridge, CB2 0QQ
    United Kingdom

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  • Site #0513

    Cambridge 2653941, CB2 0QQ
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  • Site #0511

    Leeds, LS9 7TF
    United Kingdom

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  • Site #0507

    Liverpool, L7 8YA
    United Kingdom

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  • Site #0507

    Liverpool 2644210, L7 8YA
    United Kingdom

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  • Site #0502

    London, WC1E 6AG
    United Kingdom

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  • Site #0505

    London, SW3 6JJ
    United Kingdom

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  • Site #0502

    London 2643743, WC1E 6AG
    United Kingdom

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  • Site #0505

    London 2643743, SW3 6JJ
    United Kingdom

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  • Site #0508

    Manchester, M20 4BX
    United Kingdom

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  • Site #0508

    Manchester 2643123, M20 4BX
    United Kingdom

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  • Site #0506

    Middlesex, HA6 2RN
    United Kingdom

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  • Site #0503

    Nottingham, NG5 1PB
    United Kingdom

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  • Site #0503

    Nottingham 2641170, NG5 1PB
    United Kingdom

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  • Site #0515

    Oxford, OX3 7LE
    United Kingdom

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  • Site #0515

    Oxford 2640729, OX3 7LE
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    Sutton, SM2 5PT
    United Kingdom

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    Sutton 2636503, SM2 5PT
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    Birmingham, Alabama 35233
    United States

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  • Site # 0137

    Birmingham 4049979, Alabama 4829764 35233
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    Phoenix, Arizona 85054
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    Phoenix 5308655, Arizona 5551752 85054
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    La Jolla, California 92093
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    Los Angeles, California 90095
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    Sacramento, California 95817
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    San Francisco, California 94143
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    Stanford, California 94305
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    La Jolla 5363943, California 5332921 92093
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    Los Angeles 5368361, California 5332921 90095
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    Sacramento 5389489, California 5332921 95817
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    San Francisco 5391959, California 5332921 94143
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    Stanford 5398563, California 5332921 94305
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    Aurora, Colorado 80012
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    Aurora, Colorado 80045
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    Aurora, Colorado 80045
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    Aurora 5412347, Colorado 5417618 80012
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    Aurora 5412347, Colorado 5417618 80045
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    Aurora 5412347, Colorado 5417618 80045
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    Newark, Delaware 19713
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    Newark 4143861, Delaware 4142224 19713
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    Jacksonville, Florida 32224
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    Palm Bay, Florida 32901
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    Tampa, Florida 33612
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    Jacksonville 4160021, Florida 4155751 32224
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    Palm Bay 4167499, Florida 4155751 32901
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    Tampa 4174757, Florida 4155751 33612
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    Chicago, Illinois 60064
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    Chicago 4887398, Illinois 4896861 60064
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    Iowa City, Iowa 52242
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    Iowa City 4862034, Iowa 4862182 52242
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    Westwood, Kansas 66205
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    Westwood 4281639, Kansas 4273857 66205
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    Lexington, Kentucky 40536
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    Louisville, Kentucky 40202
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    Louisville, Kentucky 40202
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    Lexington 4297983, Kentucky 6254925 40536
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    Louisville 4299276, Kentucky 6254925 40202
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    Louisville 4299276, Kentucky 6254925 40202
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    Baltimore, Maryland 21201
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    Baltimore 4347778, Maryland 4361885 21201
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    Boston, Massachusetts 02114
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    Boston, Massachusetts 02136
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    Boston 4930956, Massachusetts 6254926 02114
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    Boston 4930956, Massachusetts 6254926 02136
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    Maplewood, Minnesota 55109
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    Rochester, Minnesota 55905
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    Maplewood 5036588, Minnesota 5037779 55109
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    Rochester 5043473, Minnesota 5037779 55905
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    St Louis, Missouri 63110
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    St Louis 4407066, Missouri 4398678 63110
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    Hackensack, New Jersey 07601
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    Newark, New Jersey 07103
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    New York, New York 10003
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    New York, New York 10021
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    New York 5128581, New York 5128638 10003
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    New York 5128581, New York 5128638 10021
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    Durham, North Carolina 27703
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    Durham 4464368, North Carolina 4482348 27703
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    Cleveland 5150529, Ohio 5165418 44106
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    Portland, Oregon 97213
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  • Site #0103

    Pittsburgh, Pennsylvania 15206
    United States

    Active - Recruiting

  • Site #0123

    Pittsburgh, Pennsylvania 15240
    United States

    Active - Recruiting

  • Site #0103

    Pittsburgh 5206379, Pennsylvania 6254927 15206
    United States

    Active - Recruiting

  • Site #0123

    Pittsburgh 5206379, Pennsylvania 6254927 15240
    United States

    Site Not Available

  • Site #0132

    Providence, Rhode Island 02903
    United States

    Active - Recruiting

  • Site #0132

    Providence 5224151, Rhode Island 5224323 02903
    United States

    Site Not Available

  • Site#0104

    Charleston, South Carolina 29425
    United States

    Active - Recruiting

  • Site#104

    Charleston, South Carolina 29425
    United States

    Active - Recruiting

  • Site#0104

    Charleston 4574324, South Carolina 4597040 29425
    United States

    Site Not Available

  • Site #0116

    Nashville, Tennessee 37232
    United States

    Active - Recruiting

  • Site#0126

    Nashville, Tennessee 37203
    United States

    Active - Recruiting

  • Site #0116

    Nashville 4644585, Tennessee 4662168 37232
    United States

    Site Not Available

  • Site#0126

    Nashville 4644585, Tennessee 4662168 37203
    United States

    Active - Recruiting

  • Site#0102

    Houston, Texas 77005
    United States

    Active - Recruiting

  • Site #0152

    Waco, Texas 676712
    United States

    Active - Recruiting

  • Site#0102

    Houston 4699066, Texas 4736286 77005
    United States

    Site Not Available

  • Site #0152

    Waco 4739526, Texas 4736286 676712
    United States

    Site Not Available

  • Site#0134

    Charlottesville, Virginia 22904
    United States

    Active - Recruiting

  • Site #0129

    Richmond, Virginia 23219
    United States

    Active - Recruiting

  • Site #0138

    Richmond, Virginia 23249
    United States

    Active - Recruiting

  • Site#0134

    Charlottesville 4752031, Virginia 6254928 22904
    United States

    Site Not Available

  • Site #0129

    Richmond 4781708, Virginia 6254928 23219
    United States

    Active - Recruiting

  • Site #0138

    Richmond 4781708, Virginia 6254928 23249
    United States

    Site Not Available

  • Site #0125

    Seattle, Washington 98109
    United States

    Active - Recruiting

  • Site#0120

    Vancouver, Washington 98684
    United States

    Active - Recruiting

  • Site #0125

    Seattle 5809844, Washington 5815135 98109
    United States

    Site Not Available

  • Site#0120

    Vancouver 5814616, Washington 5815135 98684
    United States

    Site Not Available

  • Site #0141

    Madison, Wisconsin 53705
    United States

    Active - Recruiting

  • Site #0157

    Madison, Wisconsin 53792
    United States

    Active - Recruiting

  • Site #0141

    Madison 5261457, Wisconsin 5279468 53705
    United States

    Site Not Available

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