- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05727410
Neoadjuvant Nivolumab, Docetaxel, Cisplatin Therapy Followed by Surgery and Radiation Therapy for Resectable High Grade Salivary Gland Carcinoma
A Phase II Trial of Neoadjuvant Nivolumab, Docetaxel, Cisplatin Therapy Followed by Surgery and Radiation Therapy for Resectable High Grade Salivary Gland Carcinoma
Primary Objective:
- Major pathologic response rate defined by ≤ 10% of tumor composed of viable tumor
Secondary Objectives:
- Complete resection rate
- Response rate to neoadjuvant therapy according to RECIST 1.1
- Downstaging at pathologic staging compared to clinical staging performed at study entry
- Distant metastasis free survival (DMFS) rate at 2 years
- Disease free survival at 2 years
- Overall survival rate at 2 years
- Safety and feasibility
Exploratory Objectives:
- PD L1 expression by 28-8 immunohistochemistry
- IHC (HER2, AR, etc)
- Whole exome sequencing (WES)
- Whole transcriptome sequencing (WTS)
- Peripheral blood biomarkers (CD4+ T cells, CD8+ T cell, myeloid derived suppressor cells (MDSC), Treg etc)
- Interferon gamma related gene expression profile
- Multiplex florescence measure of tumor cells and tumor microenvironment cells
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Myung-Ju Ahn, Ph.D.
- Phone Number: +82-2-3410-1359
- Email: silk.ahn@samsung.com
Study Contact Backup
- Name: HyeJung Chae
- Phone Number: +82-2-3410-1359
- Email: hj33.chae@sbri.co.kr
Study Locations
-
-
-
Seoul, Korea, Republic of, 135-710
- Recruiting
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subjects with histologically- or cytologically-confirmed resectable, clinically node-positive high grade salivary gland carcinoma Adenoid cystic carcinoma: Tubular/cribriform pattern predominant, Solid pattern > 30% Poorly differentiated carcinoma Mucoepidermoid carcinoma, High grade Polymorphous adenocarcinoma, High grade Lymphoepithelial carcinoma Salivary duct carcinoma Adenocarcinoma, NOS, High grade Carcinosarcoma Squamous cell carcinoma Carcinoma ex pleomorphic adenoma - risk is determined by type of carcinoma and extent of invasion
- No previous chemotherapy treatment history
- Patients who have at least 1 measurable or non-measurable lesion per the RECIST Guideline Ver. 1.1 as confirmed by imaging within 28 days before the first does of investigational product.
- Strongly encourage (but not must) to provide newly obtained core or excisional biopsy of a tumor lesion not previously treated.
- ECOG Performance Status Score 0 or 1
- Patients with a life expectancy of at least 3 months
Patients whose latest laboratory data meet the below criteria within 28 days before the first dose of the investigational product. If the date of the laboratory tests at the time of enrollment is not within 28 days before the first dose of the investigational product, testing must be repeated within 28 days before the first dose of the investigational product, and these latest laboratory tests must meet the following criteria.
- White blood cells ≥2,000/mm3 and neutrophils ≥1,500/mm3
- Platelets ≥50,000/mm3
- Hemoglobin ≥8.0 g/dL
- AST (GOT) and ALT (GPT) ≤3.0-fold the upper limit of normal (ULN) of the study site
- Total bilirubin ≤1.5-fold the ULN of the study site
- Creatinine ≤1.5-fold the ULN of the study site or creatinine clearance (either the measured or estimated value using the Cockcroft-Gault equation) >45 mL/min
- Women of childbearing potential (including women with chemical menopause or no menstruation for other medical reasons) #1 must agree to use contraception#2 from the time of informed consent until 5 months or more after the last dose of the investigational product. Women must agree to use contraception#2 from the time of informed consent until 6 months or more after the last dose of docetaxel and 14 months or more after the last dose of cisplatin. Also, women must agree not to breastfeed from the time of informed consent until 5 months or more after the last dose of the investigational product. Women must agree not to breastfeed from the time of informed consent until 1 week or more after the last dose of docetaxel. Cisplatin has been reported to be found in human milk; women must agree not to breastfeed while receiving cisplatin.
Men must agree to use contraception#2 from the start of study treatment until 7 months or more after the last dose of the investigational product, until 3 months or more after the last dose of docetaxel, and until 11 months or more after the last dose of cisplatin.
- Women of childbearing potential are defined as all women after the onset of menstruation who are not postmenopausal and have not been surgically sterilized (e.g., hysterectomy, bilateral tubal ligation, bilateral oophorectomy). Postmenopause is defined as amenorrhea for ≥12 consecutive months without specific reasons. Women using oral contraceptives, intrauterine devices, or mechanical contraception such as contraceptive barriers are regarded as having childbearing potential.
- The subject must consent to use any two of the following methods of contraception: vasectomy or condom for patients who are male or female subject's partner and tubal ligation, contraceptive diaphragm, intrauterine device, spermicide, or oral contraceptive for patients who are female or male subject's partner.
Exclusion Criteria:
- Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX 40, CD137).
- Has received prior systemic anti-cancer therapy including investigational agents except patient had no active treatment for past 5 years
- Patients who have received antineoplastic drugs (e.g., chemotherapy agents, molecular-targeted therapy agents, or immunotherapy agents) for high-grade SGC before the first dose of the investigational product
- Has received prior radiotherapy.
- Patients with residual adverse effects of prior therapy or effects of surgery that would affect the safety evaluation of the investigational product in the opinion of the investigator or sub-investigator.
- Patients with concurrent autoimmune disease or history of chronic or recurrent autoimmune disease
- Patients with any metastasis in the brain or meninx that is symptomatic or requires treatment.
- Patients with pericardial fluid, pleural effusion, or ascites requiring treatment
- Patients who have experienced a transient ischemic attack, cerebrovascular accident, or thrombosis within 180 days before enrollment
Patients with a history of uncontrollable or significant cardiovascular disease meeting any of the following criteria:
- Myocardial infarction within 180 days before enrollment
- Uncontrollable angina pectoris within 180 days before enrollment
- New York Heart Association (NYHA) Class III or IV congestive heart failure
- Uncontrollable hypertension despite appropriate treatment (e.g., systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥ 90 mmHg lasting 24 hours or more)
- Arrhythmia requiring treatment
- Patients with uncontrollable diabetes mellitus
- Patients with systemic infections requiring treatment
- Patients who have received systemic corticosteroids (except for temporary use, e.g., for examination or prophylaxis of allergic reactions) or immunosuppressants within 28 days before enrollment
- Patients who have undergone surgical adhesion of the pleura or pericardium within 28 days before enrollment
- Patients who have undergone surgery under general anesthesia within 28 days before enrollment
- Patients who have undergone surgery involving local or topical anesthesia within 14 days before enrollment
- Patients who have received any radiopharmaceuticals (except for examination or diagnostic use of radiopharmaceuticals) within 56 days before the first dose of the investigational product
- Women who are pregnant or breastfeeding, or possibly pregnant
- Patients who have received any other unapproved drug (e.g., investigational use of drugs, unapproved combined formulations, or unapproved dosage forms) within 28 days before enrollment
- Patients judged to be incapable of providing consent for reasons such as concurrent dementia
- Other patients judged by the investigator or sub-investigator to be inappropriate as subjects of this study
- Patient with current or past history of hypersensitivity to Nivolumab.
- Patients with current or past history of severe hypersensitivity to any other antibody products
- Patients with a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: nivolumab, docetaxel, cisplatin Group
nivolumab, docetaxel, cisplatin (IV infusion every 3 weeks)
|
Patients will be treated with nivolumab 360mg and plus docetaxel 60mg/m2 and cisplatin 60mg/m2 every 3 weeks for 3 cycles and will be evaluated for the operability.
Patients with R0 resection will receive radiation 59.4 Gy in 27 fractions.
Boost RT of 6.6 Gy in 3 fractions to tumor bed and/or gross tumor will be optional in patients who had R1-R2 resection.
If tumors are regarded inoperable after neoadjuvant therapy (due to high risk of post-operative complication, or metastatic disease), they will be off from this study and receive the appropriate treatment, though they will be also included in the efficacy and safety analyses.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Major pathologic response rate defined by ≤ 10% of tumor composed of viable tumor
Time Frame: 6 months
|
Primary tumors were assessed for the percentage of residual viable tumor that was identified on routine hematoxylin and eosin staining, and tumors with no more than 10% viable tumor cells were considered to have had a major pathological response.
Patients who have progressive disease after neoadjuvant therapy and drop out from the study population will be counted as patients without major pathologic response.
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Complete resection rate
Time Frame: Up to 24 months
|
Complete resection indicates a microscopically margin-negative resection, in which no gross or microscopic tumor remains in the primary tumor bed.
Complete resection rate is defined as the percentage of the patients that underwent a resection and had a microscopically complete (or R0) resection.
|
Up to 24 months
|
Response rate to neoadjuvant therapy according to RECIST 1.1
Time Frame: Up to 24 months
|
RECIST 1.1 will be used as the primary measure for assessment of tumor response, date of disease progression, and as a basis for all protocol guidelines related to disease status (eg, discontinuation of study treatment).
|
Up to 24 months
|
Downstaging at pathologic staging compared to clinical staging performed at study entry
Time Frame: Up to 24 months
|
Downstaging defined as pathologic TNM less than clinical TNM.
Cancer staging calculator(AJCC 8th Edition)
|
Up to 24 months
|
Distant metastasis free survival (DMFS) rate at 2 years
Time Frame: Up to 24 months
|
Distant metastases free survival (DMFS) is defined as the time between date of enrollment and the date of first diagnosis of distant metastasis or death, whichever comes first.
Patients in whom distant metastases are discovered during neoadjuvant chemo/immunotherapy or the evaluation thereafter or at the immediate surgery, are considered to have an event at that time point.
|
Up to 24 months
|
Disease free survival at 2 years
Time Frame: Up to 24 months
|
Patients that have undergone a resection and are alive without distant metastases (regardless of locoregional failure) are censored at the last date available.
|
Up to 24 months
|
Overall survival rate at 2 years
Time Frame: Up to 24 months
|
Overall survival (OS) and is defined as the time between date of enrollment and date of death from any cause.
Patients alive at last follow-up are censored at the last date available.
|
Up to 24 months
|
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0.
Time Frame: Up to 24 months
|
Who dose discontinued due to adverse event.
|
Up to 24 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Myung-Ju Ahn, Ph.D., Samsung Medical Center
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
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 by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Head and Neck Neoplasms
- Stomatognathic Diseases
- Mouth Diseases
- Salivary Gland Diseases
- Mouth Neoplasms
- Carcinoma
- Salivary Gland Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Docetaxel
- Cisplatin
- Nivolumab
Other Study ID Numbers
- 2022-02-103
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
Clinical Trials on High-grade Salivary Gland Carcinoma
-
National Cancer Institute (NCI)CompletedRecurrent Salivary Gland Cancer | Recurrent Adenoid Cystic Carcinoma of the Oral Cavity | High-grade Salivary Gland Carcinoma | High-grade Salivary Gland Mucoepidermoid Carcinoma | Low-grade Salivary Gland Carcinoma | Low-grade Salivary Gland Mucoepidermoid Carcinoma | Salivary Gland Acinic Cell... and other conditionsCanada
-
National Cancer Institute (NCI)TerminatedRecurrent Salivary Gland Cancer | Stage IVA Salivary Gland Cancer | Stage IVB Salivary Gland Cancer | Stage IVC Salivary Gland Cancer | High-grade Salivary Gland Mucoepidermoid Carcinoma | Salivary Gland Acinic Cell Tumor | Salivary Gland Adenocarcinoma | Salivary Gland Poorly Differentiated CarcinomaUnited States
-
Northwestern UniversityBristol-Myers Squibb; National Cancer Institute (NCI)Active, not recruitingMajor Salivary Gland Carcinoma | Recurrent Salivary Gland Carcinoma | Stage IVA Major Salivary Gland Carcinoma | Stage IVB Major Salivary Gland Carcinoma | Stage IVC Major Salivary Gland Carcinoma | Minor Salivary Gland Carcinoma | Stage IV Major Salivary Gland CarcinomaUnited States
-
M.D. Anderson Cancer CenterRecruitingRecurrent Primary Peritoneal High Grade Serous Adenocarcinoma | High Grade Ovarian Serous Adenocarcinoma | Recurrent High Grade Fallopian Tube Serous Adenocarcinoma | Recurrent High Grade Ovarian Serous Adenocarcinoma | High Grade Fallopian Tube Serous Adenocarcinoma | Peritoneal High Grade...United States
-
National Cancer Institute (NCI)RecruitingRecurrent Salivary Gland Carcinoma | Metastatic Salivary Gland Carcinoma | Unresectable Salivary Gland Carcinoma | Locally Advanced Salivary Gland CarcinomaUnited States
-
Turku University HospitalUniversity of HelsinkiRecruitingHigh Grade Serous Carcinoma | High Grade Ovarian Serous AdenocarcinomaFinland
-
NRG OncologyNational Cancer Institute (NCI)RecruitingRecurrent Salivary Gland Carcinoma | Stage III Major Salivary Gland Cancer AJCC v8 | Stage IV Major Salivary Gland Cancer AJCC v8 | Metastatic Salivary Gland Carcinoma | Unresectable Salivary Gland CarcinomaUnited States
-
Radboud University Medical CenterDutch Cancer SocietyCompletedAdenoid Cystic Carcinoma | Salivary Gland Cancer | Salivary Duct CarcinomaNetherlands
-
National Cancer Institute (NCI)CompletedRecurrent Salivary Gland Carcinoma | Salivary Gland Adenoid Cystic Carcinoma | Stage IV Major Salivary Gland Cancer AJCC v7 | Malignant Salivary Gland NeoplasmUnited States, Canada
-
Radboud University Medical CenterDutch Cancer SocietyRecruitingSalivary Gland Cancer | Salivary Duct CarcinomaNetherlands
Clinical Trials on nivolumab, docetaxel, cisplatin Group
-
Zhejiang Cancer HospitalWenzhou Medical University; Second Affiliated Hospital, School of Medicine,... and other collaboratorsUnknownNasopharyngeal Carcinoma | ChemoradiationChina
-
SanofiCompletedLung NeoplasmsFrance, Netherlands, Spain, Turkey, Belgium, Finland, Italy, United Kingdom
-
Optimal Health ResearchCompletedBreast Cancer | Lung Cancer | Prostate CancerUnited States
-
Air Force Military Medical University, ChinaUnknown
-
University of ChicagoTerminatedNon-small Cell Lung CancerUnited States
-
National Cancer Center, KoreaSeoul National University Bundang Hospital; Gachon University Gil Medical Center and other collaboratorsUnknownGastric CancerKorea, Republic of
-
Spanish Lung Cancer GroupTerminatedNon Small Cell Lung Cancer | BRCA1 MutationSpain
-
Sun Yat-sen UniversityRecruitingNasopharyngeal CarcinomaChina
-
Asan Medical CenterCompletedResected Advanced Gastric CancerKorea, Republic of
-
Hospital of Stomatology, Wuhan UniversityJiangsu HengRui Medicine Co., Ltd.RecruitingOral Squamous Cell CarcinomaChina