- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03838263
Feasibility and Tolerance of Nivolumab Neoadjuvant Immunotherapy in High Risk HPV Driven Oropharynx Cancer (IMMUNEBOOST)
A Multicenter, Randomized, Open Label, Phase II Study Evaluating the Feasibility and Tolerance of Nivolumab Neoadjuvant Immunotherapy in High Risk HPV Driven Oropharynx Cancer
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Methodology:
Patient screened wil be randomized 2:1 between 2 arms:
- Experimental arm: Nivolumab 2 infusions (2 weeks part) before standard of care chemoradiation for 7 weeks with cisplatin at week 1, 4, and 7
- Control arm: Standard of care chemoradiation for 7 weeks with cisplatin at week 1, 4, and 7
Primary Objective:
To assess the feasibility and tolerance of neoadjuvant nivolumab treatment before chemoradiation in "high-risk" HPV-driven Oropharynx Cancer
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Avignon, France, 84918
- Institut Sainte Catherine
-
Clichy, France, 92100
- Hopital Beaujon
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Lyon, France, 69373
- Centre Léon Bérard
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Nice, France, 06189
- Centre Antoine Lacassagne
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Paris, France, 75015
- Hopital Europeen Georges Pompidou
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Paris, France, 75970
- Hôpital Tenon
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Paris, France, 75005
- Institut Curie
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Rouen, France, 76038
- Centre Henri Becquerel
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Suresnes, France, 92150
- Hopital FOCH
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Vandoeuvre-Les-Nancy, France, 54519
- Institut de Cancérologie de Lorraine Alexis Vautrin
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Villejuif, France, 94805
- Institut Gustave Roussy
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18 years old
- Histologically confirmed HPV-positive Oropharyngeal squamous cell carcinoma (OPSCC) amenable to curative treatment with RT-CT (HPV status is defined on the basis of the combination of 2 assays: p16 protein overexpression assessed by immunohistochemistry (IHC) and high-risk HPV DNA identification by in-situ Hybridization (ISH) or PCR. An HPV-driven OPSCC is defined as a tumor that is positive for both p16 IHC and HPV-DNA ISH or PCR)
According to the 8th TNM edition, eligible stages are as follow:
- Irrespective of tobacco consumption: Stage T4 (any N), N2 or N3 (any T)
- Only if tobacco consumption ≥10 pack- years: T1-3N1 and T3N0 (T1N0 and T2N0 irrespective of tobacco consumption are not eligible for the study)
- Planned date of chemoradiation allowing 2 treatment infusions, 2 weeks apart
- Eastern Cooperative Oncology Group (ECOG) performance status ≤1
Screening laboratory values must meet the following criteria (using CTCAE v5.0) and should be obtained within 7 days prior to the randomisation:
- Polynuclear neutrophils ≥1.5 x 10⁹/L
- Platelets ≥100 x 10⁹/L
- Hemoglobin ≥9.0 g/dL
- Alanine aminotransferase (ALAT)/aspartate transaminase (ASAT) ≤2.5 x upper limit of normal (ULN)
- Total Bilirubin ≤1.5 x ULN (except Gilbert Syndrome : <3.0 mg/dL)
- Creatinine clearance ≥60 mL/min (measured or calculated by Cockcroft and Gault formula)
- Potentially reproductive patients must agree to use a highly effective contraceptive method while on treatment and up to 6 months after the end of chemoradiation
- Women of childbearing potential must have a negative serum or urine pregnancy test done within 72 hours before randomisation
- Patients must be willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedures (including mandatory study-specific biopsies)
- Subjects must have at least one lesion amenable to biopsy
- Subjects must have at least one measurable lesion (different from the lesion amenable to biopsy) as per RECIST v1.1 to assess efficacy
- Consent to provide archived tumour tissue sample, if available
- Patients must be affiliated to a Social Security System
- Patient information and written informed consent form signed
Exclusion Criteria:
- Prior treatment for OPSCC
- Prior treatment with anti PD-1/PD-L1 and CTLA-4
- Distant metastases
- Tumour embolization within 28 days prior to the first dose of study drug.
- Contra-indication(s) to receive high-dose cisplatin as listed in the most updated Summary of Product Characteristics (including creatinine clearance <60 mL/min, pre-existing hearing loss or neurological disorder)
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or gastritis, or psychiatric illness and social situations that would limit compliance with study requirement or compromise the ability of the subject to give written informed consent
- Current or prior use of immunosuppressive medication within 14 days before the first dose, including intranasal and inhaled corticosteroids or systemic corticosteroids
- Active or prior documented autoimmune or inflammatory disease within the 2 years prior to start of treatment (including inflammatory bowel disease [e.g., ulcerative colitis, Crohn's disease], celiac disease, irritable bowel disease, or other serious chronic gastrointestinal conditions associated with diarrhea; systemic lupus erythematosus; Wegener syndrome [granulomatosis with polyangiitis]; myasthenia gravis; Graves' disease; rheumatoid arthritis; hypophysitis, uveitis, etc.) The following are exceptions to these criteria:a) Subjects with vitiligo or alopecia, b) Subjects with hypothyroidism (e.g.,Hashimoto syndrome) stable on hormone replacement and c) Subjects with psoriasis not requiring systemic treatment (within the past 2 years)
- History of primary immunodeficiency or organ transplant requiring immunosuppressive drugs
- Patients with a known HIV, active hepatitis B or C infection
- Other invasive malignancy within 3 years except for noninvasive malignancies such as cervical carcinoma in situ, non-melanomatous carcinoma of the skin or ductal carcinoma in situ of the breast that has/have been surgically cured
- Pregnant women or women who are breast-feeding
- Patients with any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the study
- Individuals deprived of liberty or placed under the authority of a tutor
- Severe infection requiring parenteral antibiotics treatment
- Known history or active symptomatic interstitial lung disease
- Patients with major surgery within 28 days, or open biopsy within 7 days, prior to randomisation. Patients must have recovered from major side effects of the surgery before randomisation
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: Experimental arm
Experimental arm with nivolumab 2 infusions (2 weeks apart) before Standard of care chemoradiation for 7 weeks with high-dose cisplatin (100 mg/m²) at week 1, 4 and 7
|
2 nivolumab infusion (240 mg IV) 2 weeks apart (on day 1 and day 15) followed by standard chemoradiation.
Other Names:
Standard of Care chemoradiation for 7 weeks (70 Gray delivered to the tumor by IMRT) with high-dose cisplatin (100mg/m2) at week 1, 4 and 7
Other Names:
|
Active Comparator: Control arm
Control arm: Standard of care chemoradiation for 7 weeks with high-dose cisplatin (100 mg/m²) at week 1, 4 and 7
|
Standard of Care chemoradiation for 7 weeks (70 Gray delivered to the tumor by IMRT) with high-dose cisplatin (100mg/m2) at week 1, 4 and 7
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The rate of patients that fulfill the 3 or 5 conditions as described below (Feasibility assessment of nivolumab neoadjuvant treatment before chemoradiation)
Time Frame: Between baseline and until 3 months (at the end of chemoradiation)
|
the rate of patients : (1) who can receive the 2 nivolumab infusions planned at D1 and between D14 to D16 among patients in the experimental arm And (2) who can receive chemoradiation at D30 (-2 /+7) after the second nivolumab infusion, without delay of more than 7 days with respect to the planned start of chemoradiation (RT-CT) among patients in the experimental arm And (3) with no radiotherapy break of one week or more, among patients in the experimental arm and patients in the control arm separately And (4) with minimal dose of radiotherapy (dose received >95% of theoretical dose) among patients in the experimental arm and patients in the control arm separately And (5) with minimal dose of chemotherapy of ≥200 mg/m² of cisplatin (CDDP) among patients in the experimental arm and patients in the control arm separately |
Between baseline and until 3 months (at the end of chemoradiation)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The incidence of Adverse Events related or not related to chemoradiation and Nivolumab
Time Frame: During treatment phase and until 90 days after the last fraction of radiotherapy
|
Acute and delayed toxicities assessed according to national cancer institute (NCI) common terminology criteria for adverse events (CTCAE) version 5.0
|
During treatment phase and until 90 days after the last fraction of radiotherapy
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Objective Response Rate in the experimental arm
Time Frame: Between baseline and up to 17 days after the second infusion of nivolumab
|
Radiological response will be assessed according to RECIST 1.1.
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Between baseline and up to 17 days after the second infusion of nivolumab
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Tumor Response in both arms
Time Frame: Between baseline and 3 months after the end of chemoradiation
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Radiological response will be assessed according to RECIST 1.1.
|
Between baseline and 3 months after the end of chemoradiation
|
Overall Survival (OS)
Time Frame: Between baseline and 2 years after the end of chemoradiation
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the time from randomization to death from any cause
|
Between baseline and 2 years after the end of chemoradiation
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Locoregional control (LRC)
Time Frame: Between baseline and 2 years after the end of chemoradiation
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the absence of disease progression (radiological progression according to RECIST 1.1 or clinical progression) or recurrence at the site of the primary tumor and loco-regional lymph nodes.
|
Between baseline and 2 years after the end of chemoradiation
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Progression-Free Survival (PFS)
Time Frame: Between baseline and 2 years after the end of chemoradiation
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The time from randomization to progression or death from any cause
|
Between baseline and 2 years after the end of chemoradiation
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Objective Response Rate in the experimental arm
Time Frame: Between baseline and up to 17 days after the second infusion of nivolumab
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Standardized uptake value (SUV) evolution will be assessed by positron emission tomography (PET)-scan.
|
Between baseline and up to 17 days after the second infusion of nivolumab
|
Tumor Response in both arms
Time Frame: Between baseline and 3 months after the end of chemoradiation
|
SUV evolution will be assessed by PET-scan.
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Between baseline and 3 months after the end of chemoradiation
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Haïtham MIRGHANI, MD, PhD, Hopital Europeen Georges Pompidou
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Site
- Pharyngeal Neoplasms
- Otorhinolaryngologic Neoplasms
- Head and Neck Neoplasms
- Pharyngeal Diseases
- Stomatognathic Diseases
- Otorhinolaryngologic Diseases
- Oropharyngeal Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Cisplatin
- Nivolumab
Other Study ID Numbers
- UC-0130/1804
- 2018-000626-60 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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