- ICH GCP
- Registre américain des essais cliniques
- Essai clinique 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
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Estimé)
Phase
- Phase 2
- La phase 1
Contacts et emplacements
Coordonnées de l'étude
- Nom: Nick Lukens, MD
- Numéro de téléphone: 215-662-6567
- E-mail: RadOncCRU@PennMedicine.upenn.edu
Sauvegarde des contacts de l'étude
- Nom: Casey Hanna
- Numéro de téléphone: 215 - 615 - 1611
- E-mail: casey.hanna@pennmedicine.upenn.edu
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
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 d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: 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
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Phase Ib: Feasibility of a neo-adjuvant approach combining ATRN with SBRT before TORS
Délai: 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
Délai: 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
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Phase II: To assess safety of ATR inhibitor ATRN-119 with nodal SBRT prior to surgery
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Phase II: Relapse-free survival (RFS) at two years
Délai: 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
Délai: 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
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
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
- Maladies urogénitales
- Maladies génitales
- Processus pathologiques
- Tumeurs
- Attributs de la maladie
- Infections
- Maladies virales
- Tumeurs par type histologique
- Tumeurs, glandulaires et épithéliales
- Maladies transmissibles
- Maladies sexuellement transmissibles, virales
- Maladies sexuellement transmissibles
- Infections par le virus de l'ADN
- Carcinome
- Tumeurs à cellules squameuses
- Infections virales tumorales
- Conditions pathologiques, signes et symptômes
- Carcinome épidermoïde
- Infections à papillomavirus
- Techniques d'investigation
- Thérapeutique
- Procédures chirurgicales, opératoires
- Radiothérapie
- Techniques stéréotaxiques
- Procédures neurochirurgicales
- Radiochirurgie
Autres numéros d'identification d'étude
- 15325
Informations sur les médicaments et les dispositifs, documents d'étude
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