Study of MEDI4736 Monotherapy and in Combination With Tremelimumab Versus Standard of Care Therapy in Patients With Head and Neck Cancer

This is a randomized, open-label, multi-center, global, Phase III study to determine the
efficacy and safety of MEDI4736 + tremelimumab combination therapy and MEDI4736 monotherapy
versus SoC therapy in the target patient population.

The main objectives of the study are to:

- assess the efficacy of MEDI4736 + tremelimumab combination therapy versus SoC in
patients with squamous cell carcinoma of the head and neck (SCCHN), in terms of overall
survival (OS), regardless of PDL-1 status

- assess the efficacy of MEDI4736 monotherapy versus SOC in patients with SCCHN, in terms
of OS, regardless of PDL-1 status

Patients will undergo a screening assessment on their tumor tissue sample to determine PD-L1
expression per a pre-specified cut-off level. Patients with ≥25% of tumor cells with membrane
staining will be considered PD-L1 positive while those with 0% to 24% of tumor cells with
membrane staining will be considered PD-L1 negative. Based on the underlying PD-L1 status,
patients will be randomized in a 1:1:1 ratio to receive treatment with MEDI4736 monotherapy,
MEDI4736 + tremelimumab combination therapy, or SoC therapy. Patients who discontinue
treatment in 1 treatment group may not switch to treatment in a different group.

Stratification factors include PD-L1 status, human papillomavirus status, (in patients with
oropharyngeal cancer only), and smoking status.

Tumor assessments will be performed every 8 weeks until objective tumor response by Response
Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1).

Inclusion Criteria: - Age ≥18 years; - Written informed consent obtained from the
patient/legal representative; - Histologically or cytologically confirmed recurrent or
metastatic SCCHN; - Tumor progression or recurrence during or after only one palliative
systemic treatment regimen for recurrent or metastatic disease that must have contained a
platinum agent OR progression within 6 months of the last dose of platinum given as part of
multimodality therapy with curative intent; - Confirmed PD-L1-positive or -negative SCCHN
by the Ventana PD-L1 SP263 IHC assay; - WHO/Eastern Cooperative Oncology Group (ECOG)
performance status of 0 or 1; At least 1 measurable lesion, - Not previously irradiated; -
No prior exposure to immune-mediated therapy; - Adequate organ and marrow function;
Evidence of post-menopausal status or negative urinary or serum pregnancy test for female
pre-menopausal patients. Exclusion Criteria: - Histologically or cytologically confirmed
squamous cell carcinoma of any other primary anatomic location in the head and neck; -
Received more than 1 palliative systemic regimen for recurrent or metastatic disease; -Any
concurrent chemotherapy, Investigational Product, biologic, or hormonal therapy for cancer
treatment; - Receipt of any investigational anticancer therapy within 28 days or 5
half-lives; - Receipt of last dose of an approved (marketed) anticancer therapy
(chemotherapy, targeted therapy, biologic therapy, mAbs, etc) within 21 days prior to the
first dose of study treatment; - Major surgical procedure within 28 days prior to the first
dose of Investigational Product; - Any unresolved toxicity NCI CTCAE Grade ≥2 from previous
anticancer therapy with the exception of alopecia, vitiligo, and the laboratory values
defined in the inclusion criterion; - Current or prior use of immunosuppressive medication
within 14 days before the first dose of their assigned Investigational Product; - History
of allogeneic organ transplantation; - Active or prior documented autoimmune or
inflammatory disorders; - Uncontrolled intercurrent illness; - Patients with a history of
brain metastases, spinal cord compression, or leptomeningeal carcinomatosis; - Mean QT
interval corrected for heart rate (QTc) ≥470 ms calculated from 3 electrocardiograms (ECGs)
using Fridericia's Correction; - History of active primary immunodeficiency; - Active
tuberculosis; - Active infection including hepatitis B, hepatitis C or human
immunodeficiency virus (HIV); - Receipt of live, attenuated vaccine within 30 days prior to
the first dose of Investigational Product; - Pregnant or breast-feeding female patients; -
Known allergy or hypersensitivity to Investigational Product