Op bloed gebaseerde biomarkers om beslissingen over behandeling en bestralingstherapie te informeren voor HPV-geassocieerde orofaryngeale plaveiselcel-hoofd-halskankers - DART 2.0
DART 2.0: ctHPV-DNA geïnformeerde gedeëscaleerde adjuvante en definitieve radiotherapie
This phase II trial examines the use of blood-based biomarkers is to help inform decision making for treatment and radiation therapy for patients with human papillomavirus (HPV) positive oropharyngeal squamous cell cancers. The standard treatments for head and neck cancers are radiation therapy with chemotherapy or surgery potentially followed by radiation therapy with or without chemotherapy. Radiation therapy uses high energy rays to kill tumor cells and shrink tumors. Giving chemotherapy along with radiation may kill more tumor cells. However, the cancer can recur or can spread to other parts of the body and all treatments can be associated with side effects. The purpose of this study is to evaluate a blood-based biomarker, using the NavDx testing device, for head and neck cancers in order to see if it can help improve selection of the intensity of treatment in order to best balance the side effects of treatment with the goal of decreasing cancer recurrence. This test could aid in early detection of recurrence and salvage therapy.
Studie Overzicht
Toestand
Conditie
- Klinisch stadium III HPV-gemedieerd (p16-positief) orofarynxcarcinoom AJCC v8
- Stadium III Orofaryngeaal (p16-negatief) carcinoom AJCC v8
- Klinisch stadium I HPV-gemedieerd (p16-positief) orofarynxcarcinoom AJCC v8
- Klinisch stadium II HPV-gemedieerd (p16-positief) orofarynxcarcinoom AJCC v8
- Stadium II orofaryngeaal (p16-negatief) carcinoom AJCC v8
- Stadium I Orofaryngeaal (p16-negatief) carcinoom AJCC v8
- Humaan Papillomavirus-gerelateerd Orofaryngeaal Plaveiselcelcarcinoom
Interventie / Behandeling
- Ander: Quality-of-Life Assessment
- Geneesmiddel: Cisplatin
- Geneesmiddel: Docetaxel
- Procedure: Magnetic Resonance Imaging
- Procedure: Computed Tomography
- Procedure: Positron Emission Tomography
- Ander: Observation Activity
- Straling: Intensity-Modulated Radiation Therapy
- Procedure: Biospecimen Collection
- Procedure: Modified Barium Swallow Study
- Ander: Questionnaire
- Straling: Diffusing Alpha-emitter Radiation Therapy
- Procedure: Intensity-Modulated Proton Therapy
Gedetailleerde beschrijving
PRIMARY OBJECTIVES:
I. To prospectively incorporate circulating tumor human papillomavirus deoxyribonucleic acid (ctHPVDNA) in combination with clinical and pathologic factors to appropriately select patients for treatment intensity.
II. To demonstrate patients traditionally offered adjuvant radiation therapy (RT) but at low risk of treatment failure based on clinical pathologic and post op ctHPVDNA risk factors have an acceptable 1-year progression free survival (PFS) warranting further study. (Favorable Intermediate Risk [GROUP 1]) III. To demonstrate based on clinical, pathologic, and ctHPVDNA risk factors a select population receiving diffusing alpha-emitter radiation therapy (DART) (+ multiple segment radiation therapy [MSRT] where applicable) is associated with acceptable 2 year PFS. (Unfavorable Intermediate Risk [GROUP 2]) IV. To quantify the rate of recurrence as defined by the 2 year PFS in an identified high risk population using the incorporation of ctHPVDNA. (High Risk [GROUP 3]) V. To prospectively use week 4 ctHPVDNA to guide treatment intensity of 56 versus (vs) 70 Gy with concurrent cisplatin to demonstrate 56 Gy with sufficient ctHPVDNA clearance results in an acceptable 2 year PFS. (Chemoradiation Cohort [GROUP 4])
SECONDARY OBJECTIVES:
I. To compare PFS by treatment arm including at landmark timepoints II. To assess the disease-free survival (DFS) in patients that are disease-free post-treatment.
III. To compare overall survival (OS) by treatment arm including at landmark timepoints.
IV. To compare patient reported outcomes (PROS) by treatment arm and modality. V. To evaluate treatment toxicity by Common Terminology Criteria for Adverse Events (CTCAE) criteria as rated by providers across treatment arms.
VI. To define patterns of recurrence by treatment arm. VII. To describe salvage therapy by treatment arm, including the rate, type, and success of salvage treatment.
VIII. To compare functional outcomes by treatment arm based on modified barium swallow study (MBSS) and Functional Oral Intake Scale (FOIS) by treatment arm.
IX. To return to work parameters by treatment arm as assessed by the Work Productivity and Activity Impairment Questionnaire (WPAI).
X. To quantify the costs of return visits for surveillance. XI. To assess end of treatment ctHPVDNA detectability and its association with PFS by comparing patients with detectable versus undetectable end of treatment ctHPVDNA within treatment arms.
XII. To compare outcomes by institution. XIII. To evaluate rates of post operative bleeding, tracheostomy, and readmission with 6 weeks of resection.
XIV. To compare methods of surveillance in diagnosis of recurrence including clinical evaluation, ctHPVDNA testing, and imaging.
XV. To investigate the impact of tobacco and smoking history on recurrence, PFS, and OS.
XVI. To perform a matched analysis of patients by clinical and pathologic risk factors to MC1273, MC1675, and MC Mucosal Sparing (NCT02736786).
CORRELATIVE RESEARCH OBJECTIVES:
I. Will investigate post-op Day 1 or 2 ctHPVDNA detectability as a surrogate for detectability for later post-op timepoints including risk of recurrence rates.
II. Will analyze salivary samples pre-treatment, post-op, and at the time of recurrence to determine whether salivary ctHPVDNA may further inform recurrence risk and surveillance in HPV(+) oropharyngeal squamous cell carcinoma (OPSCC).
III. Will characterize post-operative drain fluid and compare rates of detectability to blood and saliva in order with the aim to determine whether the regional drain represents a separate regional compartment for analysis.
IV. Will prospectively quantify pretreatment imaging for number of involved nodes, radiographic extranodal extension (rENE) as it relates to pathologic findings and risk of recurrence.
V. Will analyze within category of low intermediate, high intermediate, and high-risk patients the percentage of tumor infiltrating lymphocytes (TILs) and association with recurrence as well as differences across treatment groups.
VI. Will assess whether HPV is integrated vs episomal for each patient and the relationship of ctHPVDNA detectability and outcomes.
VII. Will investigate molecular markers on formalin-fixed paraffin-embedded (FFPE) from primary surgical specimens.
OUTLINE: Patients are assigned to 1 of 4 groups.
GROUP I: Patients undergo observation following standard of care surgery. Patients undergo MBSS at pre-operative (pre-op), 2 weeks post-operative (post-op), and 3 months follow-up. Patients also undergo computed tomography (CT), positron emission tomography (PET)/CT, or magnetic resonance imaging (MRI) at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing at pre-op, 1-2 days post-op, 2 weeks post-op, and 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence.
GROUP II: Patients undergo DART with/without mucosal sparing twice daily (BID) on days 1-12 Monday-Friday for a total of 20 fractions within 8 weeks of standard of care surgery. Patients receive concurrent docetaxel intravenously (IV) over 1 hour on days 1 and 8 (Mondays preferred). Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo MBSS at pre-op, 2 weeks post-op, and 3 and 12 months post-treatment. Patients also undergo CT, PET/CT, or MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing at pre-op, 1-2 days post-op, 2 weeks post-op, end of RT, and 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence.
GROUP III: Patients undergo intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT) once daily (QD) on days 1-40 Monday-Friday for a total of 30 fractions within 6 weeks of standard of care surgery. Depending on risk status, patients may also receive concurrent cisplatin IV over 1-2 hours once a week (QW) on Monday, Tuesday, or Wednesday or once every 3 weeks for 6 doses (or accepted alternate regimen when drug shortage applies per physician discretion). Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo MBSS at pre-op, post-op, and 3 and 12 months post-treatment. Patients also undergo CT, PET/CT, or MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing at pre-op, 1-2 days post-op, 2 weeks post-op, end of RT, and 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence.
GROUP IV: Patients undergo IMRT or IMPT therapy QD on days 1-40 Monday-Friday for 28 or 35 fractions based on biomarker response along with concurrent cisplatin IV over 1-2 hours QW on Monday, Tuesday, or Wednesday or once every 3 weeks for 6 doses (or accepted alternate regimen when drug shortage applies per physician discretion). Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo MBSS prior to RT and at 3 and 12 months post RT. Patients undergo CT, PET/CT, or MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing pre-RT, 4 weeks into RT, anticipated fraction 20, end of RT, 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at prior to RT, at the end of RT, at any clinical recurrence.
After completion of study treatment, patients are followed up at 4-6 weeks post treatment, every 3 months post-treatment for 2 years, every 6 months for year 3, and annually for years 4 and 5.
Studietype
Inschrijving (Geschat)
Fase
- Fase 2
Contacten en locaties
Studiecontact
- Naam: Clinical Trials Referral Office
- Telefoonnummer: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
Studie Locaties
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Arizona
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Scottsdale, Arizona, Verenigde Staten, 85259
- Werving
- Mayo Clinic in Arizona
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Hoofdonderzoeker:
- Samir H. Patel, M.D.
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Contact:
- Clinical Trials Referral Office
- Telefoonnummer: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
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Contact:
- Shelby Watkin
- Telefoonnummer: 480-342-2000
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Florida
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Jacksonville, Florida, Verenigde Staten, 32224-9980
- Werving
- Mayo Clinic in Florida
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Contact:
- Clinical Trials Referral Office
- Telefoonnummer: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
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Hoofdonderzoeker:
- Adam L. Holtzman, M.D.
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Contact:
- Caroline Pamboukas
- Telefoonnummer: 904-953-2791
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Minnesota
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Rochester, Minnesota, Verenigde Staten, 55905
- Werving
- Mayo Clinic in Rochester
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Hoofdonderzoeker:
- David M. Routman, M.D.
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Contact:
- Clinical Trials Referral Office
- Telefoonnummer: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- PRE-REGISTRATION (optional): Provide written informed consent
- Age >= 18 years
- Histological confirmation of squamous cell carcinoma originating from or suspected to be originating from the oropharynx
- Plan for gross total surgical resection via trans oral surgery with curative intent and at least unilateral neck dissection OR chemoradiotherapy with cisplatin. Note: The patient must be cisplatin eligible even if an alternate is used due to drug shortage
- Absence of distant metastases on standard diagnostic work-up =< 16 weeks prior to registration. (Chest CT or PET/CT)
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) =< 1
- Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
- Ability to complete questionnaire(s) by themselves or with assistance
- Provide written informed consent
- Willing to return to enrolling institution for follow-up (during the active monitoring phase of the study)
- Willing to provide blood samples for correlative research purposes, including anonymous shipment of samples to for NavDx testing
Exclusion Criteria:
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Any of the following:
- Pregnant women
- Nursing women
- Men or women of childbearing potential who are unwilling to employ adequate contraception
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Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
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Immunocompromised patients and patients known to be human immunodeficiency virus (HIV)+
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Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
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Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
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Other active malignancy =< 5 years prior to registration. EXCEPTIONS: Nonmelanotic skin cancer or carcinoma-in-situ of the cervix, or prostate or localized endometrioid endometrial cancer. NOTE: If there is a history or prior malignancy, they must not be receiving other specific treatment for their cancer
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Prior history of radiation therapy to the affected site
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Prior systemic chemotherapy in the last 5 years
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Contraindication to radiation therapy as determined by the treating team
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History of allergic reaction to docetaxel
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Receiving any medications or substances which in the opinion of the investigators would interfere with treatment. Examples could include strong inhibitors of cytochrome P450 3A4 (CYP3A4) at oncologist discretion
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Severe pre-existing ototoxicity or neuropathy that would, in the opinion of the investigator, preclude the use of cisplatin chemotherapy
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cT4 primary tumor
- NOTE: Patients with no intermediate risk factors after surgery, low risk patients, as defined by T1, T2, tumors with lymph node less than 3cm, no intermediate or high-risk factors such as lymphatic invasion (LVSI), extranodal extension (ENE), perineural invasion (PNI), positive margin, will be withdrawn from study and be observed per current clinical standard of care. Patients found to be both HPV negative and p16 negative will be withdrawn from study.
- Patients found to have HPV non 16 type, or HPV detectability in blood less than <20tumor tissue modified viral (TTMV) will not be candidates for de-escalation in Groups 1 and 2 and will be treated in Group 3 unless otherwise meeting criteria for low risk. They will receive 60 Gy +/- cisplatin or acceptable alternate regimen when drug shortages of cisplatin exist. If treated primarily with chemoradiation (chemoRT) (Group 4), these patients will not be candidates for de-escalation if TTMV is < 50 TTMV but can remain on study receiving 70 Gy with all corresponding correlative studies applying
- Patients with unknown (radiologic/clinically occult) primaries but neck adenopathy suspected to be HPV associated oropharyngeal carcinoma can be registered to go on study for Groups 1-3. Should after primary resection, no primary tumor be identified, the patient will be withdrawn from study and be treated per institutional standard of care. Group 4 patients must have an identifiable (clinically or radiologically apparent) primary tumor
- All treatment primarily, including surgery and chemotherapy will be performed at the enrolling institution
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Actieve vergelijker: Group 1 (observation)
Patients undergo observation following standard of care surgery. Patients undergo modified barium swallow study (MBSS) at pre-op, 2 weeks post-op, and 3 months follow-up. Patients also undergo CT, PET/CT, or magnetic MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing at pre-op, 1-2 days post-op, 2 weeks post-op, and 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence. |
Ancillary studies
Andere namen:
Undergo MRI
Andere namen:
Undergo CT scan
Andere namen:
Undergo PET scan
Andere namen:
Undergo observation
Andere namen:
Undergo blood and saliva specimen collection for NavDx testing
Andere namen:
Undergo MBSS
Andere namen:
Ancillary studies
Andere namen:
|
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Experimenteel: Group 2 (DART, docetaxel)
Patients undergo DART with/without mucosal sparing BID on days 1-12 Monday-Friday for a total of 20 fractions within 8 weeks of standard of care surgery. Patients receive concurrent docetaxel IV over 1 hour on days 1 and 8 (Mondays preferred). Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo MBSS at pre-op, 2 weeks post-op, and 3 and 12 months post-treatment. Patients also undergo CT, PET/CT, or MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing at pre-op, 1-2 days post-op, 2 weeks post-op, end of RT, and 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence. |
Ancillary studies
Andere namen:
Given IV
Andere namen:
Undergo MRI
Andere namen:
Undergo CT scan
Andere namen:
Undergo PET scan
Andere namen:
Undergo blood and saliva specimen collection for NavDx testing
Andere namen:
Undergo MBSS
Andere namen:
Ancillary studies
Andere namen:
Undergo DART
Andere namen:
|
|
Experimenteel: Group 3 (IMRT/IMPT, with/without cisplatin)
Patients undergo IMRT or IMPT QD on days 1-40 Monday-Friday for a total of 30 fractions within 6 weeks of standard of care surgery. Depending on risk status, patients may also receive concurrent cisplatin IV over 1-2 hours once a week QW on Monday, Tuesday, or Wednesday or once every 3 weeks for 6 doses (or accepted alternate regimen when drug shortage applies per physician discretion). Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo MBSS at pre-op, 2 weeks post-op, and 3 and 12 months post-treatment. Patients also undergo CT, PET/CT, or MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing at pre-op, 1-2 days post-op, 2 weeks post-op, end of RT, and 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence. |
Ancillary studies
Andere namen:
Given IV
Andere namen:
Undergo MRI
Andere namen:
Undergo CT scan
Andere namen:
Undergo PET scan
Andere namen:
Undergo IMRT
Andere namen:
Undergo blood and saliva specimen collection for NavDx testing
Andere namen:
Undergo MBSS
Andere namen:
Ancillary studies
Andere namen:
Undergo IMPT
Andere namen:
|
|
Experimenteel: Group 4 (IMRT/IMPT, cisplatin)
Patients undergo IMRT or IMPT therapy QD on days 1-40 Monday-Friday for 28 or 35 fractions based on biomarker response along with concurrent cisplatin IV over 1-2 hours QW on Monday, Tuesday, or Wednesday or once every 3 weeks for 6 doses (or accepted alternate regimen when drug shortage applies per physician discretion). Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo MBSS prior to RT and at 3 and 12 months post RT. Patients undergo CT, PET/CT, or MRI at baseline and 3 months and 1, 2 and 5 years post treatment. Patients undergo blood specimen collection for NavDx testing pre-RT, 4 weeks into RT, anticipated fraction 20, end of RT, 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 48, and 60 months as well as saliva sample collection at pre-op, end of RT, and any clinical recurrence. |
Ancillary studies
Andere namen:
Given IV
Andere namen:
Undergo MRI
Andere namen:
Undergo CT scan
Andere namen:
Undergo PET scan
Andere namen:
Undergo IMRT
Andere namen:
Undergo blood and saliva specimen collection for NavDx testing
Andere namen:
Undergo MBSS
Andere namen:
Undergo IMPT
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Progression-free survival (PFS)
Tijdsspanne: From registration to the first of either disease progression/recurrence or death, assessed up to 5 years
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Progression-free survival (PFS), the time from treatment initiation until disease progression or worsening. PFS at specific timepoints will be estimated using Kaplan-Meier methodology. |
From registration to the first of either disease progression/recurrence or death, assessed up to 5 years
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Progression-free survival (PFS) follow-up
Tijdsspanne: At years 1, 2, 3, 4, and 5
|
Progression-free survival (PFS) is defined as the time from treatment initiation until disease progression or worsening. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response versus (vs.) no response), we'll use logistic regression models. |
At years 1, 2, 3, 4, and 5
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Disease-free survival (DFS)
Tijdsspanne: From time of surgery and also from end of all treatment across all the groups, assessed up to 5 years
|
Disease-free survival (DFS) is the measure of time after treatment during which no sign of cancer is found. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
From time of surgery and also from end of all treatment across all the groups, assessed up to 5 years
|
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Overall survival (OS)
Tijdsspanne: At years 1, 2, 3, 4, and 5
|
Overall survival (OS) is defined as the duration of patient survival from the time of treatment initiation. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
At years 1, 2, 3, 4, and 5
|
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Patient reported outcomes (PROs)
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
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Incidence of adverse events
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Patterns of recurrence and rate of salvage therapy for Low Intermediate Risk (GROUP 1) and multiple segment radiation therapy (MSRT) + de-escalated adjuvant radiation therapy (DART)
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Functional outcomes - modified barium swallow study (MBSS)
Tijdsspanne: Up to 5 years
|
Measured by modified barium swallow (MBSS). Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Functional outcomes - PROs
Tijdsspanne: Up to 5 years
|
Measure by patient reported outcomes (PROs). Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Proton vs photon treatment toxicity - PROs
Tijdsspanne: Up to 5 years
|
Assessed by PROs. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Proton vs photon treatment toxicity - MBSS
Tijdsspanne: Up to 5 years
|
Assessed by MBSS. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
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Proton vs photon treatment toxicity - dosimetric differences
Tijdsspanne: Up to 5 years
|
Assessed by dosimetric differences including to organs at risk and the primary tumor bed in the case of mucosal sparing. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
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Costs of return visits for surveillance
Tijdsspanne: Up to 5 years
|
Presented descriptively and ANOVA models with tukey's adjustment for pairwise comparison will be utilized to test difference in arms. |
Up to 5 years
|
|
Assessment of surveillance circulating human papillomavirus deoxyribonucleic acid (ctHPVDNA) preceding clinical or radiologic detection of recurrence
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Matched analysis of patients by clinical and pathologic risk factor to MC1273 and MC1675 de-escalation arms to overall GROUP 1 and GROUP 2 cohorts including 2-year PFS
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Evaluation of return to work
Tijdsspanne: Up to 5 years
|
Will be assessed by the Work Productivity and Activity Impairment Questionnaire (WPAI). Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Evaluation of end of treatment treatment circulating human papillomavirus deoxyribonucleic acid (ctHPVDNA) detectability as a marker of risk of progression
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Functional outcomes of DART alone vs. DART + MSRT
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
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Feasibility of DART regimen outside of Mayo Clinic
Tijdsspanne: Up to 5 years
|
Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
ctHPVDNA detectability
Tijdsspanne: At post-operative day 1 or 2
|
Due to the limited sample size, these analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
At post-operative day 1 or 2
|
|
Salivary ctHPVDNA analysis for recurrence risk and surveillance
Tijdsspanne: Up to 5 years
|
Salivary samples will be analyzed pre-treatment, post-op, and at the time of recurrence to determine whether salivary ctHPVDNA may further inform recurrence risk and surveillance in HPV(+) oropharyngeal squamous cell carcinoma. Due to the limited sample size, these analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Characterization of post-operative drain fluid
Tijdsspanne: Up to 5 years
|
We will characterize post-operative drain fluid and compare rates of detectability to blood and saliva in order with the aim to determine whether the regional drain represents a separate regional compartment for analysis. Due to the limited sample size, these analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Quantification of pre-treatment imaging
Tijdsspanne: Up to 5 years
|
We will prospectively quantify pretreatment imaging for number of involved nodes, radiographic extranodal extension as it relates to pathologic findings and risk of recurrence. Due to the limited sample size, these analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Percentage of tumor infiltrating lymphocytes (TILs)
Tijdsspanne: Up to 5 years
|
We will analyze within category of low intermediate, high intermediate, and high-risk patients the percentage of TILs and association with recurrence as well as differences across treatment groups. Due to the limited sample size, these analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Assessment of integrated vs episomal HPV
Tijdsspanne: Up to 5 years
|
Comparison of methods of surveillance as defined by the date of diagnosis of recurrence by ctHPVDNA testing as compared to clinical examination and imaging. Sensitivity, specificity, negative predictive value, and positive predictive value of each will be reported. Measure whether HPV is integrated vs episomal for each patient and the relationship of ctHPVDNA detectability and outcomes. These analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
|
Assess Molecular Markers Using FFPE
Tijdsspanne: Up to 5 years
|
We will investigate molecular markers on formalin-fixed paraffin-embedded (FFPE) from primary surgical specimens. Due to the limited sample size, these analyses will be hypothesis generating and descriptive in nature. Descriptive statistics will be summarized and the exploratory data will be correlated with clinical endpoints (PFS, time-to-progression, etc.). For time-to-event data, the Kaplan-Meier method will be used. For categorical data, we'll use the Fisher's exact test. For biomarker data used to predict binary outcomes (i.e. response vs. no response), we'll use logistic regression models. |
Up to 5 years
|
Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: David M, Routman, M.D., Mayo Clinic in Rochester
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Stomatognatische ziekten
- Neoplasmata per site
- Neoplasmata
- Neoplasmata per histologisch type
- Hoofd- en nekneoplasmata
- Neoplasmata, glandulair en epitheel
- KNO-ziekten
- Faryngeale neoplasmata
- Otorinolaryngologische neoplasmata
- Faryngeale ziekten
- Carcinoom
- Orofaryngeale neoplasmata
- Kwaliteit, toegang en evaluatie van de gezondheidszorg
- Organische chemicaliën
- Onderzoekstechnieken
- Epidemiologische methoden
- Methoden
- Therapeutica
- Klinische laboratoriumtechnieken
- Diagnostische technieken en procedures
- Diagnose
- Koolwaterstoffen
- Cycloparaffins
- Koolwaterstoffen, alicyclisch
- Koolwaterstoffen, cyclisch
- Terpenen
- Gegevensverzameling
- Evaluatiemechanismen voor gezondheidszorg
- Kwaliteit van de gezondheidszorg
- Volksgezondheid
- Milieu en volksgezondheid
- Anorganische chemicaliën
- Chloorverbindingen
- Stikstofverbindingen
- Taxoids
- Cyclodecanes
- Diterpenen
- Elementen
- Metalen
- Chemie -technieken, analytisch
- Spectrumanalyse
- Metalen, zwaar
- Platinumverbindingen
- Radiotherapie
- Overgangselementen
- Radiotherapie, conform
- Radiotherapie, computerondersteund
- Docetaxel
- Cisplatine
- 1,2-diaminocyclohexaanplatina II-citraat
- Observatie
- Enquêtes en vragenlijsten
- Exemplaarbehandeling
- Magnetische resonantiespectroscopie
- Platina
- Radiotherapie, intensiteit gemoduleerd
Andere studie-ID-nummers
- GMROR2271
- 22-004443 (Andere identificatie: Mayo Clinic in Rochester)
- DART 2.0 (Andere identificatie: Mayo Clinic in Rochester)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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