- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05905315
Primary Chemoradiation VS. Neoadjuvant Chemotherapy Followed By Surgery As Treatment Strategy For LAVC (VULCANIZE-II)
Primary Chemoradiation VS. Neoadjuvant Chemotherapy Followed By Surgery As Treatment Strategy For Locally Advanced Vulvar Carcinoma
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Frederic Amant, Prof.
- Phone Number: 0031205129111
- Email: f.amant@nki.nl
Study Locations
-
-
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AMsterdam, Netherlands
- Recruiting
- NKI-AvL
-
Contact:
- F. Amant
-
Leiden, Netherlands
- Recruiting
- LUMC
-
Contact:
- L. Nooij
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Woman ≥ 18 years
- Signed and written informed consent.
- Histologically-confirmed primary or recurrent squamous cell carcinoma vulvar cancer FIGO stage Ib - IVa, T1b or higher, any N, M0.
Local tumour through which the size or localization implies requirement of treatment through primary chemoradiation or surgery consisting of extensive surgery (meaning surgery damaging pelvic organs or exenterative surgery). This can imply;
- T1b or larger tumour with (irresectable) groin metastases
- T1b or larger tumour with a close relationship to and/or involvement of the urethra or anal sphincter
- World Health Organization performance status of 0-2
- Adequate haematological function defined by platelet count >100x10E9/L, absolute leukocyte >3X10E9/L or neutrophil count (ANC) >1.5x10E9/L, and hemoglobin >6.0 mmol/L
- Adequate hepatic function defined by a total bilirubin level ≤1.5x the upper limit of normal (ULN) range and ASAT and ALAT levels ≤2.5x ULN for all subjects
- Adequate renal function defined by an estimated creatinine clearance ≥50mL/min according to the Cockroft-Gault formula (or local institutional standard method)
- Beta HCG level of 14 mIU/mL or below for women of childbearing potential
- Highly effective contraception for patients if the risk of conception exists
Exclusion Criteria:
Patients with highly suspicious or positive metastases to the pelvic lymph nodes
* Patients eligible for radical local excision without involvement of other organs
- Any psychiatric condition that would prohibit the understanding or rendering of informed consent
- Prior radiotherapy to the pelvis or groin area limiting full dose chemoradiation according to protocol
- Existing neuropathy which will hinder the intake of chemotherapy
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 |
---|---|
Active Comparator: Primary chemoradiation
Patients included in the standard treatment arm will receive a combination of weekly cisplatin combined with 30 fractions of external beam radiotherapy on the primary tumour with a total dose of 64.5 Gy.
Cisplatin will be given for six weeks intravenously with a dose of 40 mg/m2, if possible on the first day of the week.
On day 1 until day 5 the patient will receive external beam radiotherapy.
This will be repeated for a six-week period.
|
According to standard treatment.
|
Experimental: NACT (3-weekly carboplatin and paclitaxel) followed by surgery
Patients included in the experimental arm will be treated with intravenous infusion of paclitaxel 175 mg/m2, followed by carboplatin 5 area under the curve (AUC).
This will be administered in a 3-weekly scheme with preferably 3 and a maximum of 4 courses, with evaluation after two courses of chemotherapy by physical examination.
NACT will be subsequently followed by radical surgery in responding patients.
A four to six weeks interval after the last course of chemotherapy needs to be respected before surgery, to allow sufficient physical recovery.
|
Paclitaxel 175 mg/m2, followed by carboplatin 5 area under the curve (AUC).
This will be administered in a 3-weekly scheme.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Loco-regional control after 24 months per completed treatment including salvage treatment
Time Frame: 24 months after completed treatment
|
Proportion of patients free from local-regional progression
|
24 months after completed treatment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Disease-related treatment failure
Time Frame: 24 months after completed treatment
|
Patients without an event will be censored at their last date of contact.
The Kaplan-Meier method will be used to estimate freedom from disease-related failure.
Difference between the two main treatment arms, NACT vs. chemotherapy, will be tested using a log-rank test.
Incidences of disease-related failure will be reported based on the Kaplan-Meier estimates, together with confidence intervals for the hazard ratio using both 90 and 95% confidence levels.
|
24 months after completed treatment
|
Disease free survival
Time Frame: 24 months after completed treatment
|
24 months after completed treatment
|
|
Patterns of recurrence of disease
Time Frame: 24 months after completed treatment
|
Type of recurrence after treatment: local, regional or distant recurrence
|
24 months after completed treatment
|
Overall survival
Time Frame: 24 months after completed treatment
|
24 months after completed treatment
|
|
Treatment related death
Time Frame: 24 months after completed treatment
|
24 months after completed treatment
|
|
Prevention of trimodal treatment
Time Frame: 24 months after completed treatment
|
Proportion of patients that don't need adjuvant surgery (arm 1) and number of patients that don't need adjuvant radiotherapy (arm 2)
|
24 months after completed treatment
|
Functional organ preservation
Time Frame: 24 months after completed treatment
|
Proportion of patients for who an organ-sparing surgery is possible
|
24 months after completed treatment
|
Short term and long term complications
Time Frame: 24 months after completed treatment
|
According to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
|
24 months after completed treatment
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Frederic Amant, Prof., NKI-AvL
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
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
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Genital Neoplasms, Female
- Vulvar Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Genital Diseases
- Genital Diseases, Female
- Carcinoma
- Vulvar Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Carboplatin
- Paclitaxel
Other Study ID Numbers
- M22VL2
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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