Combining PET/CT and EBV DNA to Evaluate the Hazard of Progression in the Follow-up of Locally Advanced NPC

December 17, 2020 updated by: Hai-Qiang Mai,MD,PhD, Sun Yat-sen University

Combining Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography and Plasma EBV DNA to Evaluate the Hazard of Progression in the Follow-up of Locally Advanced Nasopharyngeal Carcinoma

PET/CT and EBV DNA are important in diagnosis of NPC. We consider that combining post-treament PET/CT and plasma EBV DNA may be effective in evaluating the hazard of progression in the follow-up of Locally Advanced Nasopharyngeal Carcinoma. Hence we establish this prospective cohort study.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Newly-diagnosed patients with stage III or IV non-metastatic Nasopharyngeal Carcinoma (AJCC 7th) will be recruited. All subjects receiving chemoradiotherapy will undergo a baseline integrated [18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) scan or traditional follow-up examination and plasma EBV DNA test before the start of chemoradiotherapy.

Patients receiving IMRT treatment will receive a dedicated FDG PET/CT protocol 12 weeks after the end of chemoradiotherapy (primary endpoint).Plasma EBV DNA test will be performed 4, 12, 24 weeks after the end of IMRT treatment. In patients with negative PET/CT results, 2 follow-up visits are required to complement nasopharyngoscope examination and plasma EBV DNA test in the frist year. All patients will undergo annual PET/CT or traditional follow-up examination and plasma EBV DNA test 1 year after completing chemoradiation unless recurrent/residual disease is histopathologically-confirmed.

Patients with a PET/CT result suspecting for residual/recurrent/metastatic tumor must have pathological and/or clinical evidence of tumor existence before salvage therapy is started.

Study Type

Observational

Enrollment (Actual)

387

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Guangdong
      • Guangzhou, Guangdong, China, 510060
        • Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

NPC patients after induction chemotherapy and concurrent chemoradiotherapy or concurrent chemoradiotherapy alone

Description

Inclusion Criteria:

  • Patients must be informed of the investigational nature of this study and given written informed consent.
  • Aged between 18-65, male/female.
  • Staged III or IV (AJCC 7th) NPC patients with histologically confirmed non-keratinizing nasopharyngeal carcinoma (including differentiated type and undifferentiated type, WHO II and III).
  • Received induction chemotherapy and/or concurrent chemoradiotherapy.
  • ECOG scale 0-1.
  • Fertile women should practice contraception during the study period.
  • HGB ≥90g/L ,WBC ≥4*109/L , PLT ≥100*109/L,
  • With normal liver function test (ALT and AST ≤2.5*ULN, TBil ≤2.0*ULN)
  • With normal renal function test (serum creatinine ≤1.5*ULN)

Exclusion Criteria:

  • Women in pregnancy or lactation
  • Prior malignancy except adequately treated basal cell, squamous cell skin cancer, or cervical cancer in situ.
  • Any severe intercurrent disease, which may bring unacceptable risk or affect the compliance of the trial, for example, unstable cardiac disease requiring treatment, renal disease, chronic hepatitis, diabetes with poor control (fasting plasma glucose >1.5×ULN), and emotional disturbance.
  • Already involved in other clinical trial.
  • Mental disorder, civil disability, limited capacity for civil conduct.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
PET/CT and EBV DNA
Patients receiving chemoradiotherapy will receive a dedicated FDG PET/CT protocol 12 weeks after the end of IMRT (primary endpoint).Plasma EBV DNA test will be performed 4, 12, 24 weeks after the end of IMRT. In patients with negative PET/CT results, 2 follow-up visits are required to complement nasopharyngoscope examination and plasma EBV DNA test in the frist year. All patients will undergo annual PET/CT or traditional follow-up examination and plasma EBV DNA test 1 year after completing chemoradiation unless recurrent/residual disease is histopathologically-confirmed.
Device: PET/CT and EBV DNA
PET/CT and EBV DNA will be proformed after the IMRT treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Negative predictive value (NPV) of FDG PET/CT
Time Frame: 12 weeks after IMRT treatment
The negative predictive value (NPV) of FDG PET/CT for detecting tumor existence
12 weeks after IMRT treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Negative predictive value (NPV) of EBV DNA
Time Frame: 2-year
Negative predictive value (NPV) of EBV DNA for detecting tumor existence
2-year
PFS
Time Frame: 2-year
progression free survival after radical treatment
2-year
Negative predictive value (NPV) of combined EBV DNA and FDG PET/CT
Time Frame: 2-year
Negative predictive value (NPV) of combined EBV DNA and FDG PET/CT for detecting tumor existence
2-year
OS
Time Frame: 2-year
overall survival after radical treatment
2-year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sun Yat-sen University

Investigators

  • Study Chair: Haiqiang Mai, Dr, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

October 1, 2018

Primary Completion (ACTUAL)

December 12, 2019

Study Completion (ACTUAL)

December 12, 2020

Study Registration Dates

First Submitted

July 18, 2018

First Submitted That Met QC Criteria

July 18, 2018

First Posted (ACTUAL)

July 26, 2018

Study Record Updates

Last Update Posted (ACTUAL)

December 19, 2020

Last Update Submitted That Met QC Criteria

December 17, 2020

Last Verified

December 1, 2020

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Post-treament PET/CT in NPC

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

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.

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