- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05835804
Intratumoral Gemcitabine, Paclitaxel, Carboplatine and Intravenous Nivolumab for Locally Recurrence of Head and Neck Cancers (NIVOCHIMLOC)
Patients with locally recurrent squamous-cell carcinoma of the head and neck (SCCHN) after Chemotherapy and immunotherapy have a very poor prognosis and limited therapeutic options.
Intratumoral chemotherapy (ITC) with cisplatin and epinephrine in order to increase the local cisplatin retention lead to a 50 % response rate in several studies but was given up due to the poor local tolerance with frequent necrosis of the peritumoral tissues. Gemcitabine, carboplatin and paclitaxel (GCP) are used in advanced SCCHN. These chemotherapies seem to be interesting options for intratumoral infusion: their different effect could lead to avoid chemotherapy resistance with a good tolerance profile, without tissue necrosis profile. The other major option for recurrent SCCHN is immunotherapy by Nivolumab, an anti PD-1 with a 13% mediane response rate. Nevertheless, the failure of this treatment stay unclear, but immunosuppressive action of the tumour is suspected. The presence of tumoral antigen could lead to better response to immunotherapy; association of chemotherapy and immunotherapy seems a promosing association to avoid treatment resistance as cytotoxic release tumoral antigen; it could also be associated to an abscopal effect.
The aim of the study is to evaluate the efficacy of ITC using GCP in LOCAL recurrent SCCHN treated by nivolumab.
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Aline HOUESSINON, MD
- Phone Number: 03 22 45 54 99
- Email: houessinon.aline@chu-amiens.fr
Study Locations
-
-
Picardie
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Amiens, Picardie, France, 80054
- CHU Amiens Picardie
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Sub-Investigator:
- Stéphanie DAKPE, Pr
-
Sub-Investigator:
- Alexandre COUTTE, MD
-
Sub-Investigator:
- Jérémie BETTONI, MD
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Sub-Investigator:
- Michel LEFRANC, Pr
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Sub-Investigator:
- Bernard DEVAUCHELLE, Pr
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Sub-Investigator:
- Aurelie MOREIRA, MD
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Sub-Investigator:
- Sylvie TESTELIN, Pr
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Contact:
- Aline HOUESSINON, MD
- Phone Number: 03 22 45 54 99
- Email: houessinon.aline@chu-amiens.fr
-
Sub-Investigator:
- Bruno CHAUFFERT, Pr
-
Sub-Investigator:
- Aurelie BIET, MD
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Sub-Investigator:
- Cyril PAGE, Pr
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Sub-Investigator:
- Antoine GALMICHE, PR
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Sub-Investigator:
- Jean Marc CONSTANS, Pr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- WHO status : 0, 1 or 2.
- Age > 18ans
- Locally recurrence of a histologically-proven SCCHN after failure of conventional treatments (surgery, radiotherapy, chemotherapy with platinum compounds, cetuximab)
- Nivolumab treatment in second line encouring according to AMM but with insufficient efficacy
- Possible location of the tumour by clinical examination, CT-scan
- Metastases are admitted if there is no vital prognoses threaten and if a clinical benefit is expected by treating local recurrence.
- Neutrophils > 1000/mm3.
- Platelets > 100 000/mm3.
- Blood créatinine < 15 mg/L. Blood bilirubine < 30 mg/L
- Prothrombin rate > 70 %.
- Social insurance
- Informed consent
Exclusion Criteria:
- WHO status : 0, 1 or 2.
- Age > 18ans
- Locally recurrence of a histologically-proven SCCHN after failure of conventional treatments (surgery, radiotherapy, chemotherapy with platinum compounds, cetuximab)
- Nivolumab treatment in second line encouring according to AMM but with insufficient efficacy
- Possible location of the tumour by clinical examination, CT-scan
- Metastases are admitted if there is no vital prognoses threaten and if a clinical benefit is expected by treating local recurrence.
- Neutrophils > 1000/mm3.
- Platelets > 100 000/mm3.
- Blood créatinine < 15 mg/L. Blood bilirubine < 30 mg/L
- Prothrombin rate > 70 %.
- Social insurance
- Informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intratumoral chemotherapy
|
After local anaesthesia, intratumoral catheter will be place (one or several depending tumour criteria).The catheter placement could be guided by radiological imaging.
Gemcitabine (200mg/l), carboplatin (100mg/l) and paclitaxel (20mg/l) will be each diluted in each in 160ml of NaCl0.9%.
GCP will be administered successively for 8hours, at 20ml/h with a total duration of 24hours.
The ITC will be done every 28 days for 6 times maximum in case of good response and tolerance.
Nivolumab 240 mg IV will be started 1 to 7 days before the first intratumoral infusion and every 15 days, until progression or 2 until years in case of partial response, complete response or stabilization.
Evaluation of tumour size will be done by CT-scan, or MRI 2every 2 months and PET-FDG every 3 months.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
local response rate according to RECIST criteria
Time Frame: 3 years
|
RECIST is a standard way to measure the response of a tumor to treatment. The criteria to determine whether a tumor disappears, shrinks, are complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Evaluation of target lesions
|
3 years
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PI2020_843_0003
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.
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