- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT02476669
Serial Plasma EBV DNA for Nasopharyngeal Carcinoma
Serial Plasma EBV DNA for Patients With Nasopharyngeal Carcinoma
Nasopharyngeal carcinoma (NPC) is an endemic malignancy in Southern China, Hong Kong, Taiwan, Singapore and Malaysia. It is highly associated with Epstein-Barr virus (EBV). Radiation therapy alone is indicated for early stage I to II diseases while concurrent chemoradiation is required for more advanced stage III to IVB diseases. Intensity-modulated radiation therapy (IMRT) is the standard radiation technique for NPC, in virtue of its superior target coverage and dose sparing to adjacent critical organs-at-risks.
Plasma EBV DNA and other novel plasma biomarkers have been extensively investigated in NPC. Previous studies have proven their predictive and prognostic values in NPC diagnosis, surveillance and survival outcomes.
We would like to investigate the roles of plasma biomarkers including plasma EBV DNA on treatment response evaluation, survival and prognosis on NPC, in the modern era of precision radiation therapy. This will provide important information on refining on the current edition of AJCC/UICC staging classification.
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Patients with histologically confirmed previously untreated NPC are be recruited to join tis study. The study has obtained approval from local institutional review board.
After written informed consent, baseline investigations including blood tests for routine hematology, biochemistry and plasma EBV DNA will be taken. Only 3ml of EDTA blood will be taken for plasma EBV DNA and other potential biomarkers. They will also undergo baseline imaging investigations including positron-emission tomography with integrated computed tomography (PET-CT) and magnetic resonance imaging (MRI) of the head and neck regions. An routine nasoendoscopy and nasopharyngeal biopsies will be obtained to confirm and delineate the mucosal extent of the disease.
If confirmed non-metastatic, patients will be treated with IMRT using 7-9 radiation beams. A total dose of 70Gy in 33-35 fractions over 6.5 to 7 weeks will be given. For advanced stage III to IVB diseases, concurrent chemoradiation using cisplatin 100mg/m2 on Day 1, 22 and 43 of IMRT followed by 3 cycles of adjuvant chemotherapy with cisplatin 80mg/m2 on Day 1 and 5-FU 1000mg/m2 from Day 1 to Day 4 every 4 weeks for 3 more cycles starting 4 weeks after completion of IMRT will also be given. Some patients will also receive induction chemotherapy with either (1) cisplatin 100mg/m2 on Day 1 and 5-FU 1000mg/m2 on Day 1 to 5, or cisplatin 100mg/m2 on Day 1 and gemcitabine 1000mg/m2 on Day 1 and Day 8, administered every 3 weeks for 3 cycles before commencement of chemoradiation, at the discretion of treating oncologists if their primary tumours are close to critical organs e.g. brainstem, optic chiasm or optic nerves.
After treatment patients will undergo nasopharyngeal biopsies, patients will undergo nasopharyngeal biopsies again at 8 weeks after completion of IMRT to confirm histological complete local remission. Blood will be taken again on the same day for plasma EBV DNA and other potential biomarkers. Additional biopsies and salvage local treatment e.g. brachytherapy, stereotactic or IMRT boost will be offered to patients who have persistent local disease at 12 weeks after completion of IMRT. If complete local remission is confirmed, patient will have regular follow up every 3 to 4 months for surveillance and survival outcomes. Regular imaging with MRI and CT scans every 3 to 4 months will also be arranged as well. Plasma EBV DNA will be measured again at 6 months and 1 year after completion of IMRT and then as clinically indicated afterwards.
For those with metastatic diseases at diagnosis, systemic chemotherapy (platinum-based chemotherapy with cisplatin and gemcitabine) will be offered. Blood taking for plasma EBV DNA and other potential biomarkers at baseline before chemotherapy commencement and then after every 3 cycles will be arranged. Plasma EBV DNA measurement and imaging examinations with CT and MRI scans will be arranged at baseline and then after 3-4 cycles of chemotherapy for tumour response evaluation. If the disease does not show progression according to RECIST 1.1, patients will receive up to 6 cycles of chemotherapy followed by consolidation IMRT to the nasopharynx and the neck with 60-70Gy in 33-35 fractions over 6-7 weeks. Additional stereotactic body radiation therapy (SBRT) will be offered to patients who have oligo-progression/oligo-metastasis (up to 3 lesions). Patients will have regular follow up every 3-4 months afterwards. Further salvage palliative chemotherapy or radiation therapy or best supportive care depending on the patients' wish and performance status will be offered to those who develop further relapse after first-line chemotherapy and/or consolidation IMRT.
The trend of baseline and serial plasma EBV DNA and other potential biomarkers will be monitored prospectively.
Type d'étude
Inscription (Anticipé)
Contacts et emplacements
Lieux d'étude
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Hong Kong, Hong Kong
- Recrutement
- Department of Clinical Oncology, Queen Mary Hospital
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Contact:
- Victor Lee, FRCR
- Numéro de téléphone: 852-2255-4352
- E-mail: vhflee@hku.hk
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Sous-enquêteur:
- Dora Kwong, MD
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Sous-enquêteur:
- Chi-Chung Tong, FRCR
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Sous-enquêteur:
- Chun-Kin Sze, FRCR
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- Patients with histologically confirmed previously untreated nasopharyngeal carcinoma
Exclusion Criteria:
- Patients who are pregnant or lactating
- Patients who are not mentally capable of giving written informed consent
- Patients with performance status ECOG=3 or above or patients who are expected not able to tolerate radiation therapy and/or chemotherapy
- Patients who refuse active treatment for their nasopharyngeal carcinoma
- Patients who cannot comply with radiation therapy and/or chemotherapy for their nasopharyngeal carcinoma
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Overall survival
Délai: 3 years
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Overall survival is calculated from the date of diagnosis of NPC to the date of death from any cause
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3 years
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Survie sans progression
Délai: 3 années
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La survie sans progression est calculée à partir de la date du diagnostic de NPC jusqu'à la date de progression de NPC ou la date de décès quelle qu'en soit la cause, selon la première éventualité.
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3 années
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Survie sans métastase à distance
Délai: 3 années
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La survie sans métastase à distance est calculée à partir de la date du diagnostic de NPC jusqu'à la date de la métastase à distance ou la date du décès quelle qu'en soit la cause, selon la première éventualité.
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3 années
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Cancer-specific survival
Délai: 3 years
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Cancer-specific survival is calculated from the date of diagnosis of NPC to the date of death due to cancer
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3 years
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Regional failure-free survival
Délai: 3 years
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Regional failure-free survival is calculated from the date of diagnosis of NPC to the date of regional nodal failure or date of death from any cause, whichever comes earlier.
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3 years
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Local failure-free survival
Délai: 3 years
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Local failure-free survival is calculated from the date of diagnosis of NPC to the date of local failure or date of death from any cause.
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3 years
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Victor Lee, FRCR, The University of Hong Kong
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Tumeurs par type histologique
- Tumeurs
- Tumeurs par site
- Tumeurs, glandulaires et épithéliales
- Tumeurs pharyngées
- Tumeurs oto-rhino-laryngologiques
- Tumeurs de la tête et du cou
- Maladies nasopharyngées
- Maladies pharyngées
- Maladies stomatognathiques
- Maladies oto-rhino-laryngologiques
- Tumeurs du nasopharynx
- Carcinome
- Carcinome du nasopharynx
Autres numéros d'identification d'étude
- NPC-biomarkers1
- HKCTR-1271 (Identificateur de registre: Hong Kong Clinical Trials Register)
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .