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RecruitingNCT03815903INDUCTIONUpdated Jul 18, 2019

Induction Chemotherapy for Locally Advanced Head and Neck Squamous Cell Carcinoma

A Phase 3 interventional study of Induction chemotherapy and Chemoradiotherapy in Locally Advanced Malignant Neoplasm, sponsored by Barretos Cancer Hospital. Recruiting at 1 site in Brazil. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-07-18.

Sponsored by Barretos Cancer Hospital · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
434
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The benefit of induction chemotherapy followed by chemoradiotherapy for locally advanced head and neck squamous cell carcinoma is unknown. The present study is investigating if this therapeutic strategy improve overall survival.

02

Conditions studied

03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Confirmed histological diagnosis of squamous cell carcinoma or undifferentiated carcinoma of the oropharynx, hypopharynx or larynx;
  • Locally advanced stage (stage IVa / b - AJCC 8th edition), classified as resectable ** or unresectable and candidate for treatment based on radiotherapy and chemotherapy;
  • Locally advanced stage (stage III - AJCC 8th edition), classified as resectable or unresectable, positive p16 and candidate for treatment based on radiotherapy and chemotherapy;
  • It will be allowed to include a patient with cervical lymphadenectomy if the primary lesion is measurable;
  • Presence of measurable disease according to RECIST 1.1 criteria;
  • ECOG performance status of 0-1;
  • ≥ 18 years;
  • Adequate marrow reserve indicated by:

    • Absolute neutrophil count (ANC) ≥ 1500 / mm³ or Platelets> 100,000 / mm³
    • Hemoglobin ≥ 9 g / dL - red blood cell transfusion will be allowed in the screening period if necessary
  • Adequate renal and hepatic function:

    • Serum bilirubin ≤ 1.5 times the upper limit of normal the TGO and TGP ≤ 3 upper limit of normal. If hepatic metastasis ≤ 5 upper limit of normal
    • Serum creatinine ≤ 1.5 mg / dL and creatinine clearance ≥ 60 mL / min calculated by Cockcroft-Gault.

Exclusion criteria

Exclusion Criteria:

  • Patient submitted to curative resection of the primary site and / or metastatic site. NOTE: Patients submitted to cervical lymphadenectomy without surgery to the primary tumor are eligible;
  • Radiation therapy or previous chemotherapy for head / neck tumor;
  • Patients with occult primary tumor;
  • T4 from any site, resectable, with invasion of cartilage or jaw;
  • History of BMT or stem cell therapy;
  • Synchronous tumor or previous history of neoplasia, except for in situ carcinoma of the cervix, basal cell carcinoma or epidermoid carcinoma. Patients with previous history of cancer already treated and without evidence of disease for more than 3 years may participate in the study;
  • Prophylactic use of G-CSF or GM-CSF two weeks prior to the study;
  • Clinically significant heart disease: unstable angina or myocardial infarction 6 months prior to study entry Symptomatic ventricular arrhythmia the ICC classified as NYHA ≥ II • Uncontrolled hypercalcemia;
  • Uncontrolled infection;
  • Any other comorbidity that the investigator's judgment is inappropriate for the study;
  • Peripheral neuropathy> grade 2;
  • Hearing loss> grade 2;
  • Known positive serology for hepatitis B, hepatitis C or HIV
  • Use of antiretrovirals;
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
434 participants (estimated)

Study arms

  • Active comparator
    A - induction chemotherapy

    Drug: Induction chemotherapy · Combination Product: Chemoradiotherapy

  • Experimental
    B - chemoradiotherapy

    Combination Product: Chemoradiotherapy

Interventions

  • DrugInduction chemotherapy

    3 cycles, each 21 days, of Cisplatin 80mg/m2 plus Paclitaxel 175mg/m2

  • Combination productChemoradiotherapy

    Radiotherapy 70Gy convencional fractionation concomitant to 3 cycles, each 21 days, of Cisplatin 100mg/m2

05

What researchers measure

Primary outcomes

  1. 3-years overall survival

    Time frame: From date of randomization until 3 years

Secondary outcomes

  1. Progression free survival

    PFS

    Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months

  2. Systemic relapse free survival

    Time frame: From date of randomization until the date of first systemic relapse or date of death from any cause, whichever came first, assessed up to 100 months

  3. Overall survival

    Time frame: From date of randomization until the date of death from any cause, whichever came first, assessed up to 100 months

  4. Overall response rate

    Time frame: At the end of Cycle 3 of IC (each cycle is 21 days) and 8 weeks after the end of radiotherapy, through study completion, an average of 6 months

  5. Adverse Events Rates

    Time frame: At the end of cycle 1, cycle 2 and cycle 3 (each cycle is 21 days).

  6. 1-year functional organ preservation rate

    Time frame: From date of randomization until 1 year after

  7. Quality of Life (EORTC Quality of Life Questionnare - C30 version 3.0)

    The QLQ-C30 is composed of both multi-item scales and single-item measures. These include five functional scales, three symptom scales, a global health status / QoL scale, and six single items. Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems.

    Time frame: From date of randomization until 5 years

  8. Overall response rate to induction chemotherapy

    Time frame: At the end of Cycle 3 (each cycle is 21 days)

06

Study locations

1 of 1 sites recruiting
  • Barretos Cancer Hospital
    Barretos, São Paulo 14784-400, Brazil
    • Pedro De Marchi, MD, MSc · Contact · pedrodemarchi@yahoo.com.br · +55 17 33216600
    • Raiany Carvalho, RN · Contact · raiany.carvalho@hcancerbarretos.com.br · +55 17 33216600
    • Augusto E Mamere, MD, MSc · Sub investigator
    • Alexandre A Jacinto, MD · Sub investigator
    • Domingos Boldrini Junior, MD, MSc · Sub investigator
    • Renato C Capuzzo, MD · Sub investigator
    • Carlos R Santos, MD · Sub investigator
    • Andre L Carvalho, MD, PhD · Sub investigator
    • Luciano S Vianna, MD, PhD · Sub investigator
    • Josiane D Mourão, MD · Sub investigator
    • Ricardo R Gama, MD, PhD · Sub investigator
    • Gustavo J Dix, MD, MSc · Sub investigator
    • Diogo D Prado, MD · Sub investigator
    • Pedro De Marchi, MD, MSc · Principal investigator
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03815903
Lead sponsor
Barretos Cancer Hospital
Responsible party
Sponsor
First posted
Jan 24, 2019
Start date
Dec 19, 2018
Primary completion
Dec 2020 (estimated)
Completion
Dec 2025 (estimated)
Last update
Jul 18, 2019

Oversight

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

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