- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT07578467
Combining Neo-adjuvant ATR-inhibition With Nodal SBRT for Early-stage Resectable HPV+ OPSCCs
A Phase Ib/II Study Combining Neo-adjuvant ATR-inhibition With Nodal SBRT for Early-stage Resectable HPV+ OPSCCs
This research study is testing whether a new study drug (called ATRN-119) is safe and effective when combined with a single, highly targeted dose of radiation therapy (called stereotactic body radiation therapy or SBRT) to treat early-stage throat cancer that is caused by HPV.
The goal of this study is to treat cancer effectively while reducing side effects and helping patients maintain a better quality of life over the long term. Researchers hope that this approach will be just as successful-or possibly more successful-than current treatments, which already have high cure rates.
Participants will:
- Take 800mg of ATRN-119 every day for 10 days
- Receive 1 treatment (called a "fraction") of SBRT to the neck on day 3 of ATRN-119 dosing.
- Keep a short diary to track ATRN-119 dosing. The diary will be provided by study team
- Receive standard of care treatment after treatment with ATRN-119 + SBRT including TransOral Robotic Surgery (TORS) to remove the primary tumor with Neck Dissection and adjuvant therapy (if indicated)
- Receive additional safety checkups and tests by researchers during routine visits with their cancer doctor for 2 years after study treatment
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Estimado)
Fase
- Fase 2
- Fase 1
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Nick Lukens, MD
- Número de teléfono: 215-662-6567
- Correo electrónico: RadOncCRU@PennMedicine.upenn.edu
Copia de seguridad de contactos de estudio
- Nombre: Casey Hanna
- Número de teléfono: 215 - 615 - 1611
- Correo electrónico: casey.hanna@pennmedicine.upenn.edu
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:
- Age ≥ 18
- Patients that have been diagnosed with HPV-positive throat cancer (OPSCC) at an early stage (stage I or II), confirmed by a biopsy.
- Patients' blood calcium level is within a safe range
- Patients' blood, kidney, and liver health are strong enough, shown through specific medical test results
- If a participant is female, she must not be pregnant or breastfeeding.
- If a participant is male, he must agree to use highly effective birth control from the start of the study until a short period after the last dose of the study drug.
Exclusion Criteria:
- Patients with late-stage tumors (Stage III or IV)
- If the cancer has already spread to distant parts of the body (M1) when first diagnosed
- Prior advanced head and neck cancer requiring radiation or major surgery
- Patients whose original tumor site cannot be identified
- Patients that have a known additional malignancy that is progressing or requires active treatment
- Patients that had a surgical procedure performed within 7 days prior to first scheduled dose of ATRN-119. This does not include procedures that are used to diagnose or determine extent of study disease (such as biopsies).
- Patients taking medications that strongly affect how the body processes certain drugs (CYP enzymes) at the same time as the study treatment.
- Patients with active infections and/or receiving systemic antibiotics or anti-viral medications.
- Patients with uncontrolled HIV or active hepatitis B or C are usually not eligible. However, those whose infections are well-controlled on treatment for at least a month and meet certain viral load limits can participate
- Current or past diagnosis of leukemia within the past 5 years.
- Patients with a history of non-malignant gastrointestinal (GI) bleeding, gastric stress ulcerations, or peptic ulcer disease within the past 3-months.
- Patient has uncontrolled hypertension at time of enrollment.
- Patients who recently had serious kidney problems or kidney disease.
- Patients cannot have taken another experimental drug within 30 days-or within a period equal to five times that drug's half-life-before starting this study
- Medical illness that, in the opinion of the Investigator, may impact the safety of the patient
- Patients who use recreational drugs or have mental health conditions that might make it hard to follow study visits, based on the doctor's judgment.
- Known hypersensitivity to ATRN-119 or its ingredients
- Patients with serious liver disease or liver problems that could affect how the body processes the study drug
- Patients who are fairly limited in daily activities (ECOG score of 2 or higher)
- Patients with serious other health problems that the doctor thinks could prevent them from completing the study
- Pregnancy or lactation
- Inability to provide informed consent
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: N / A
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: Treatment Arm
Patients will take 800mg of ATRN-119 every day for 10 days.
On day 3 of dosing, they will return to clinic for 1 fraction of SBRT.
|
ATRN-119 at 800 mg QD (every day) for 10 days
10 Gy administered to nodal disease (neck) only on day 3 of ATRN-119 dosing
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Phase Ib: Feasibility of a neo-adjuvant approach combining ATRN with SBRT before TORS
Periodo de tiempo: Within 6 weeks after study treatment
|
This will be judged by whether patients are able to have their planned surgery within 6 weeks after the study treatment, and whether there are no problems during surgery that the study doctor believes were caused by the study treatment.
|
Within 6 weeks after study treatment
|
|
Phase II: Major pathologic response (MPR) rate of radiated nodal disease
Periodo de tiempo: Immediately after standard of care primary tumor removal surgery
|
Researchers will measure how many patients have a strong treatment response in the affected lymph nodes that were treated with radiation, based on what is seen when the tissue is examined.
|
Immediately after standard of care primary tumor removal surgery
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Phase II: To assess safety of ATR inhibitor ATRN-119 with nodal SBRT prior to surgery
Periodo de tiempo: From start of study treatment through standard of care 2-year Follow-Up visit
|
This will be judged based on whether there are any surgery problems that the study doctor thinks were caused by the earlier treatment, as well as any side effects from the treatment.
|
From start of study treatment through standard of care 2-year Follow-Up visit
|
|
Phase II: Radiographic response rates
Periodo de tiempo: Pre-treatment MRI will be taken prior to enrollment as part of standard of care. Post-treatment Research MRI will be completed 1 week before standard of care tumor removal surgery.
|
This looks at how many patients' tumors shrink or improve based on imaging tests like scans.
This is assessed by comparing pre- and post- study treatment MRI (or CT) Neck scans using typical descriptive changes noted by a head and neck specialized radiologist.
|
Pre-treatment MRI will be taken prior to enrollment as part of standard of care. Post-treatment Research MRI will be completed 1 week before standard of care tumor removal surgery.
|
|
Phase II: Type of adjuvant treatment required
Periodo de tiempo: Within 4 months of primary tumor removal surgery
|
Percentage of patients requiring additional radiation therapy +/- chemotherapy after their main treatment as compared to historic controls (e.g.
75% requiring RT, 25% requiring chemotherapy).
Additional therapy is determined by the participant's care team as part of their standard of care treatment, so not all patients will receive additional radiation or chemotherapy.
|
Within 4 months of primary tumor removal surgery
|
|
Phase II: Pathologic response of primary tumor and nodal disease
Periodo de tiempo: Immediately after primary tumor removal surgery
|
This looks at how strongly the main tumor and the affected lymph nodes respond to treatment.
Pathologic response rates will be determined by comparing pre- and post- surgery tumor tissue samples for patients who have enough pre-op tissue to analyze from pathology.
|
Immediately after primary tumor removal surgery
|
|
Phase II: Assessment of Patient Reported quality of life
Periodo de tiempo: From enrollment to 24 Month Follow-Up Visit
|
Patients will be asked to take the M.D. Anderson Head & Neck Symptom Inventory Questionnaire (MDASI-HN) at multiple timepoints throughout the study.
The MDASI Head and Neck (MDASI-HN) questionnaire is scored by averaging patient-rated items on a 0-10 scale covering 13 core symptoms, 9 head/neck-specific symptoms, and 6 interference items.
Higher scores indicate greater symptom severity and worse interference with daily life.
|
From enrollment to 24 Month Follow-Up Visit
|
Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Phase II: Relapse-free survival (RFS) at two years
Periodo de tiempo: From the completion of treatment, either surgery in those not receiving adjuvant therapy, or completion of all adjuvant therapy and will last for 2 years
|
Participants will be checked over a 2-year period to see if their disease comes back.
A "relapse" means the disease returns either in the same place, nearby areas, or elsewhere in the body.
Any return of the disease must be confirmed with medical testing (like examining tissue under a microscope).
|
From the completion of treatment, either surgery in those not receiving adjuvant therapy, or completion of all adjuvant therapy and will last for 2 years
|
|
Phase II: Measures of activation of anti-tumor immunity in primary tumor and blood
Periodo de tiempo: From enrollment to date of primary tumor removal surgery
|
Researchers will study samples taken from each patient's main tumor and blood both before and after treatment given prior to the main therapy.
This helps them see how the treatment affects the cancer and the body.
|
From enrollment to date of primary tumor removal surgery
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
- Enfermedades urogenitales
- Enfermedades Genitales
- Procesos Patológicos
- Neoplasias
- Atributos de la enfermedad
- Infecciones
- Enfermedades virales
- Neoplasias por tipo histológico
- Neoplasias Glandulares y Epiteliales
- Enfermedades contagiosas
- Enfermedades De Transmisión Sexual Virales
- Enfermedades de transmisión sexual
- Infecciones por virus de ADN
- Carcinoma
- Neoplasias De Células Escamosas
- Infecciones por virus tumorales
- Condiciones Patológicas, Signos y Síntomas
- Carcinoma De Células Escamosas
- Infecciones por virus del papiloma
- Técnicas de investigación
- Terapéutica
- Procedimientos quirúrgicos, operativo
- Radioterapia
- Técnicas estereotáxicas
- Procedimientos neurociruúrgicos
- Radiocirugía
Otros números de identificación del estudio
- 15325
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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