- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03330249
Comparison of Two Concomitant Administration of RT With Cisplatin in Standard Infusion or Fractional Infusion (CisFRad)
Phase II Randomized Trial Comparating Two Concomitant Administration of Radiotherapy With Cisplatin in Patients With Not Operated or Inoperable HNSCC or With Recurrence High Risk in Adjuvant Postoperative Treatment
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The standard treatment for squamous cell carcinoma of the head and neck locally advanced non-operated or non-operable is a combination of radiotherapy and concomitant chemotherapy. Indeed, the meta-analysis MACH showed for RT / CT associations an absolute survival benefit of 8% compared with radiotherapy alone. Cisplatin delivered optimally, ie at a dose of 100 mg / m2 on day 1, D22 and D43 of radiotherapy is as effective as combinations of cisplatin and 5-fluorouracil.
In post operative, treatment of high risk recurrence forms by Cisplatin, concomitantly with radiotherapy, also increases local control and overall survival.
However, it is an association whose toxicity is significant. The usual limiting toxicities were mucositis, dysphagia, nausea and vomiting with malnutrition and biologically kidney failure and myelotoxicity. Only 2/3 of the patients receive 3 cycles of cisplatin initially programmed.
As shown in the RTOG 0129 trial, the number of cycles of cisplatin and thus the cumulative dose of cisplatin administered concurrently with radiation therapy, significantly influences the locoregional control, progression free survival and overall survival.
One method of reducing the toxicity and thereby, increase the cumulative dose, would be to split the administration of cisplatin.
Moreover, the efficacy of Cisplatin, which only the free fraction is active, seems correlated with AUC that peak plasma which would in turn responsible for toxicity. The completion of a pharmacokinetic study comparing the AUC and Cmax obtained with cisplatin 100 mg / m2 and cisplatin fractionated is essential.
Finally, the limiting renal toxicity induced by cisplatin is currently diagnosed using the creatinine clearance. The Neutrophil gelatinase-associated lipocalin (NGAL) urinary is a new diagnosis and prognosis marker of renal impairment following treatment with cisplatin. However, further studies are needed to validate its clinical utility.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Strasbourg, France, 67065
- Centre Paul Strauss
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Squamous cell carcinoma of head and neck cancer stage III or IV: oral cavity, oropharynx, larynx or hypopharynx.
- Patient non-operated and / or inoperable for reasons of non extirpabilité, local and regional expansion, general state or medical condition Or
- Patient operated within 8 weeks before radiation therapy with a high risk of recurrence: unsatisfactory surgical margins (R1) and / or lymph node involvement with capsular rupture.
- Activity Index according to WHO ≤ 2
- Age ≤ 70 years
- Ventricular ejection fraction left retained> 50%
- Renal allowing the administration of cisplatin: creatinine clearance> 60 ml / min (Cockroft formula)
- Hematologic function allowing administration of CT: PNN> 1500, Pl> 100000, Hb> 9g
- Satisfactory Liver function: SGOT and SGPT <3N; total bilirubin <20 mg / dL; INR <1.5; albumin> 30 g / l
- Stomatological care adapted
- Signature of informed consent
- Bilateral neck irradiation Indication
- Women and men of reproductive age should have accepted a medically effective contraception during the treatment period and at least 6 months after discontinuation of study treatment. If pregnancy is declared by a patient or partner of a patient, it must be followed for know the evolution of pregnancy.
Exclusion Criteria:
- Cancers of the nasopharynx, sinus or nasal cavities
- Histology other than squamous
- Presence of distant metastases
- Prior systemic chemotherapy (neoadjuvant)
- Other concomitant cancer therapies
- Presence of infection requiring the use of IV antibiotics including tuberculosis and HIV infection
- Coronary insufficiency, cardiac arrhythmias, uncontrolled or symptomatic heart failure
- Uncontrolled hypertension
- Peripheral neuropathy grade> 1
- Vaccination against yellow fever and phenytoin recent or planned
- History of cancer within 5 years prior to trial entry other than cutaneous basal cell carcinoma in situ or cervical
- Pregnant woman capable of being or during lactation
- Persons deprived of liberty, under guardianship
- Inability to submit to medical monitoring testing for geographical, social or psychic
- Unilateral cervical radiotherapy Indication
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Split Cisplatin and radiotherapy
25 mg/m2/day IV infusion at D1 to D4, at D22 to D25, at D43 to D46 during the radiotherapy
|
25 mg/m2/day IV infusion at D1 to D4, at D22 to D25, at D43 to D46 during the radiotherapy.
Other Names:
70 Gy in 35 fractions of 2 Gy in non-operated patients and 66 Gy in 33 fractions in post-operative.
Other Names:
|
Active Comparator: Cisplatin and radiotherapy
100 mg/m2/day IV infusion at D1, D22 and D43 during the radiotherapy
|
70 Gy in 35 fractions of 2 Gy in non-operated patients and 66 Gy in 33 fractions in post-operative.
Other Names:
100 mg/m2/day IV infusion at D1, D22 and D43 during the radiotherapy.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
cumulative dose of administered cisplatin in each arm
Time Frame: 36 months after the end of treatment
|
cisplatin dose amount received at each cycle
|
36 months after the end of treatment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Frequency of toxicities
Time Frame: Every week during treatment and every 3 months after treatment up to 3 years
|
Assessment of toxicity in accordance with NCI-CTC-AE 4.03
|
Every week during treatment and every 3 months after treatment up to 3 years
|
Maximum Platine Concentration [Cmax],
Time Frame: Cycle 1 before infusion, 90 min, 180 min,210 min, 270 min, 360 min and 420 min after the beginning of infusion in comparator arm and before infusion, 30 min, 45 min,75 min, 135 min, 225 min in experimental arm at Day 1 and Day 4
|
Blood sample
|
Cycle 1 before infusion, 90 min, 180 min,210 min, 270 min, 360 min and 420 min after the beginning of infusion in comparator arm and before infusion, 30 min, 45 min,75 min, 135 min, 225 min in experimental arm at Day 1 and Day 4
|
Area Under the Curve [AUC] of platine
Time Frame: Cycle 1 before infusion, 90 min, 180 min, 210 min, 270 min, 360 min and 420 min after the beginning of infusion in comparator arm and before infusion, 30 min, 45 min, 75 min, 135 min, 225 min in experimental arm at Day 1 and Day 4
|
Blood sample
|
Cycle 1 before infusion, 90 min, 180 min, 210 min, 270 min, 360 min and 420 min after the beginning of infusion in comparator arm and before infusion, 30 min, 45 min, 75 min, 135 min, 225 min in experimental arm at Day 1 and Day 4
|
Values of Neutrophil Gélatinase-associated Lipocalin (NGAL)
Time Frame: Baseline and 24hour after infusion of cisplatin in comparator arm and 24hour after the last infusion of cisplatin in experimental arm
|
Urinary sample
|
Baseline and 24hour after infusion of cisplatin in comparator arm and 24hour after the last infusion of cisplatin in experimental arm
|
Doses of radiation
Time Frame: 7 weeks after the beginning of radiotherapy
|
total dose received
|
7 weeks after the beginning of radiotherapy
|
Duration of radiation
Time Frame: 7 weeks after the beginning of radiotherapy
|
Interruption of radiotherapy due to toxicity
|
7 weeks after the beginning of radiotherapy
|
Loco-regional failure rate
Time Frame: 36 months after the end of randomization
|
Delay between the date of randomisation and the occurrence of a recurrence
|
36 months after the end of randomization
|
overall survival
Time Frame: 36 months after the end of randomization
|
Delay between the date of randomization and death
|
36 months after the end of randomization
|
Collaborators and Investigators
Investigators
- Principal Investigator: Christian BOREL, MD, Centre Paul Strauss
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- GORTEC 2015-02
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Squamous Cell Carcinoma of the Head and Neck
-
National Cancer Institute (NCI)Not yet recruitingStage II Squamous Cell Carcinoma of the Head and Neck | Stage III Squamous Cell Carcinoma of the Head and Neck | Stage IV Squamous Cell Carcinoma of the Head and NeckUnited States
-
Washington University School of MedicineCelgene CorporationActive, not recruitingHead and Neck Cancer | Squamous Cell Carcinoma of the Head and Neck | Cancer of Head and Neck | Neoplasms, Head and Neck | Cancer of the Head and Neck | Carcinoma, Squamous Cell of the Head and NeckUnited States
-
Bristol-Myers SquibbActive, not recruitingSquamous Cell Carcinoma of the Head and Neck; Head and Neck Cancer; Head and Neck Carcinoma; Cancer of the Head and NeckFrance
-
Arnaud Bewley, MDNational Cancer Institute (NCI); Genentech, Inc.TerminatedStage III Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8 | Resectable Cutaneous Squamous Cell Carcinoma of the Head and Neck | Locally Advanced Cutaneous Squamous Cell Carcinoma of the Head and NeckUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RecruitingStage III Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8 | Stage IV Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8 | Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck | Resectable Cutaneous Squamous Cell Carcinoma of the Head and Neck | Stage...United States
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)RecruitingRecurrent Head and Neck Squamous Cell Carcinoma | Advanced Head and Neck Squamous Cell Carcinoma | Metastatic Head-and-neck Squamous-cell Carcinoma | Locally Advanced Head and Neck Squamous Cell Carcinoma | Stage III Cutaneous Squamous Cell Carcinoma of the Head and Neck | Stage IV Cutaneous...United States
-
Eben RosenthalNational Cancer Institute (NCI)CompletedHead and Neck Cancer | Head and Neck Squamous Cell Carcinoma | Squamous Cell Carcinoma of the Head and Neck (SCCHN)United States
-
Glenn J. HannaSecura Bio, Inc.Active, not recruitingMetastatic Head and Neck Cancer | Advanced Head and Neck Squamous Cell Carcinoma | Recurrent Squamous Cell Carcinoma of the Head and Neck | Squamous Cell Carcinoma of the Head and Neck (SCCHN) | Advanced Head and Neck CancerUnited States
-
Hi-Q Marine Biotech International, Ltd.RecruitingSquamous Cell Carcinomas of the Head and NeckTaiwan
-
Queensland HealthMerck Sharp & Dohme LLCRecruitingHead and Neck Cancer | Cutaneous Squamous Cell Carcinoma of the Head and NeckAustralia
Clinical Trials on Split Cisplatin
-
Cairo UniversityUnknown
-
Markman Biologics CorporationUnknown
-
Chang Gung Memorial HospitalCompletedNeurosensory Function of Inferior Alveolar Nerve
-
Hugo W. Moser Research Institute at Kennedy Krieger...University of Maryland; National Institutes of Health (NIH); National Institute... and other collaboratorsCompleted
-
University of PittsburghNational Institute of Neurological Disorders and Stroke (NINDS); National Institute... and other collaboratorsRecruitingCommunity Mobility of Older Adults | Locomotor Adaptability | Gait AutomaticityUnited States
-
Hugo W. Moser Research Institute at Kennedy Krieger...Eunice Kennedy Shriver National Institute of Child Health and Human Development...Completed
-
NorgineCompletedColorectal Cancer | Colorectal Carcinoma | Colon CleansingUnited Kingdom, Spain, Belgium, France, Germany, Italy, Poland
-
University of PaviaCompleted
-
Tufts UniversityRecruiting
-
University Hospital, GhentDutch Burnwound Foundation, NetherlandCompletedFull Thickness Skin DefectsBelgium