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A Study to Assess Radiation Induced Mucositis in Patients of Head and Neck Cancer Administered Chemo-Radiation With or Without P276-00

Primary Purpose

Radiation Induced Mucositis in Head and Neck Cancer

Status
Completed
Phase
Phase 2
Locations
India
Study Type
Interventional
Intervention
P276-00
Radiation Therapy
Cisplatin
Sponsored by
Piramal Enterprises Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Radiation Induced Mucositis in Head and Neck Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Able to understand and willing to give an informed consent for the study.
  2. Pathologically (histologically or cytologically) confirmed (from primary tumor and/or lymph nodes), non-metastatic diagnosis of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx eligible for treatment with concomitant chemoradiation as first-line treatment; subjects with a history of surgical management are not eligible
  3. Have a plan to receive a continuous course of radiation (3DRT or IMRT) as single daily fractions of 2.0 Gy, with a cumulative radiation dose between 66 and 70 Gy. Planned radiation treatment fields must include at least 2 oral sites (maxillary or mandibular labial mucosa, right or left buccal mucosa, right or left floor of the mouth, ventral tongue, right or left lateral tongue, or soft palate), with each site receiving more than equal to 50 Gy
  4. Have a plan to receive a standard cisplatin regimen administered weekly (30 to 40 mg/m2)
  5. Have an Eastern Co-operative Oncology Group (ECOG) performance status less than equal to 2
  6. Males or females aged 18 years or older
  7. Pre-treatment dental procedures must be completed with recovery and the prophylactic insertion of gastric feeding tubes (if planned) prior to entry into the study
  8. Adequate bone marrow function measured within two weeks prior to enrollment based upon CBC/differential, defined as follows:

    1. Absolute neutrophil count (ANC) more than equal to 1,500 cells/mm3
    2. Platelets more than equal to 100,000 cells/mm3
    3. Hemoglobin (Hb) more than equal to 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hb more than equal to 8.0 g/dl prior to the start of RT is acceptable)
  9. Adequate hepatic function measured within two weeks prior to enrollment defined as follows

    1. Bilirubin less than equal to 1.5 mg/dl
    2. AST less than equal to 2 times ULN
    3. ALT less than equal to 2 times ULN
  10. Adequate renal function measured within two weeks prior to enrollment and defined as follows

    1. Serum creatinine less than equal to 1.5 mg/dl
    2. Creatinine clearance (CC) more than equal to 60 ml/min determined by 24-hour urine collection or estimated by the Cockcroft-Gault formula:
  11. Have a negative serum pregnancy test for women of childbearing potential at time of screening and negative urine pregnancy test within 72 hrs prior to first dose of study drug

Exclusion Criteria:

  1. Tumor of the lips, sinuses, salivary glands, nasopharynx, or unknown primary tumor
  2. Metastatic disease (M1) Stage IVC as per the AJCC, 7th edition
  3. Prior radiation to the head and neck
  4. Have undergone induction CT
  5. History of malignant tumors other than HNC (except non-melanoma skin cancer) unless disease free for a minimum of 3 years
  6. Severe co-morbidity, defined as:

    1. Symptomatic and/or uncontrolled cardiac disease, New York Heart Association Classification III or IV
    2. Acute myocardial infarction within the last 6 months
    3. Acute bacterial or fungal infection requiring systemic antibiotics at the time of enrollment
    4. Subjects known to be seropositive for human immunodeficiency virus (HIV) or subjects with Acquired Immune Deficiency Syndrome (AIDS), known current acute or chronic Hepatitis B, known Hepatitis C (antigen positive), or hepatic cirrhosis
    5. Subjects with active tuberculosis
    6. Collagen vascular disease, such as scleroderma, as this is thought to predispose subjects to increased risk for radiation-associated toxicities
  7. Have used any other investigational drug therapy within 1 month prior to Day 1 of study drug administration or non-recovery (to Grade less than equal to 1) from adverse effects of the investigational agent received prior to this period
  8. Prior allergic reaction to any of the agents administered during the course of treatment
  9. Have QTcF more than equal to 450 msec at screening
  10. Pregnant or breastfeeding women

Sites / Locations

  • Bharat Cancer Hospital & Research Institute
  • Sri Venkateshwara Hospitals
  • Mazumdar Shaw Cancer Center
  • Tata Memorial Hospital
  • Curie Manavta Cancer Centre
  • Ruby Hall Clinic
  • Meenakshi Mission Hosp. & Res. Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

P276-00

Arm Description

Outcomes

Primary Outcome Measures

Number of severe Radiation Induced Mucositis (WHO grade >=3)
For Phase2, to assess the incidence of severe (WHO Grade >=3) Radiation Induced Mucositis (RIM)occurring up to a cumulative radiation dose of 66 Gray (Gy) based on the WHO mucositis scale in subjects with locally advanced squamous cell carcinoma of the head and neck (SCCHN) treated with cisplatin and radiotherapy plus P276-00 For Phase 3 To assess and compare the incidence of severe (WHO Grade>=3) Radiation Induced Mucositis (RIM) occurring up to a cumulative radiation dose of 54 Gy based on the WHO mucositis scale To assess and compare the incidence of severe (WHO Grade>=3) RIM occurring up to a cumulative radiation dose of 66 Gy based on the WHO mucositis scale in subjects with locally advanced SCCHN treated with cisplatin and radiotherapy plus P276-00 or cisplatin and radiotherapy (the two treatment arms).

Secondary Outcome Measures

Time to onset of severe RIM (WHO Grade ≥ 3)
To evaluate the time to onset of severe RIM (WHO Grade>=3) as defined by the number of days between start of study treatment and the first time that WHO Grade 3 or 4 mucositis was observed (regardless of whether it had been Grade 0,1 or 2 previously)
Duration of severe RIM (WHO Grade>=3)
To assess the duration of severe RIM (WHO Grade>=3) as defined by the number of days from the onset of severe RIM as defined above, to the day when severe RIM resolved (first time when WHO Grade 0, 1, or 2 was observed)
Progression-Free Survival (PFS)
To assess Progression-Free Survival (PFS)
Overall Survival (OS)
To assess Overall Survival (OS)

Full Information

First Posted
July 11, 2013
Last Updated
September 3, 2014
Sponsor
Piramal Enterprises Limited
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1. Study Identification

Unique Protocol Identification Number
NCT01903018
Brief Title
A Study to Assess Radiation Induced Mucositis in Patients of Head and Neck Cancer Administered Chemo-Radiation With or Without P276-00
Official Title
A Multicenter, Phase II/III Study to Assess Radiation Induced Mucositis in Subjects With Locally Advanced Squamous Cell Carcinoma of the Head and Neck Administered Cisplatin and Radiation With or Without P276-00
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
July 2012 (undefined)
Primary Completion Date
March 2014 (Actual)
Study Completion Date
September 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Piramal Enterprises Limited

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A Clinical Study to Assess Radiation Induced Mucositis in Subjects with Locally Advanced Squamous Cell Carcinoma of the Head and Neck
Detailed Description
A Multicenter, Phase II/III Study to Assess Radiation Induced Mucositis in Subjects with Locally Advanced Squamous Cell Carcinoma of the Head and Neck Administered Cisplatin and Radiation with or without P276-00 The Phase II component will be a single arm, open label, multicenter study to assess RIM in subjects with locally advanced SCCHN treated with P276-00 in combination with radiation therapy and cisplatin. ' The Phase III component will be a randomized, assessor blinded, multicenter, two-arm study to compare the time to onset of WHO Grade ≥ 3 RIM in subjects with locally advanced SCCHN (OC, OP, HP, and L) who are receiving definitive CRT for treatment of their malignancy. Subjects receiving definitive CRT will receive weekly intravenous cisplatin administered during radiation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Radiation Induced Mucositis in Head and Neck Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Enrollment
73 (Actual)

8. Arms, Groups, and Interventions

Arm Title
P276-00
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
P276-00
Intervention Type
Radiation
Intervention Name(s)
Radiation Therapy
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Primary Outcome Measure Information:
Title
Number of severe Radiation Induced Mucositis (WHO grade >=3)
Description
For Phase2, to assess the incidence of severe (WHO Grade >=3) Radiation Induced Mucositis (RIM)occurring up to a cumulative radiation dose of 66 Gray (Gy) based on the WHO mucositis scale in subjects with locally advanced squamous cell carcinoma of the head and neck (SCCHN) treated with cisplatin and radiotherapy plus P276-00 For Phase 3 To assess and compare the incidence of severe (WHO Grade>=3) Radiation Induced Mucositis (RIM) occurring up to a cumulative radiation dose of 54 Gy based on the WHO mucositis scale To assess and compare the incidence of severe (WHO Grade>=3) RIM occurring up to a cumulative radiation dose of 66 Gy based on the WHO mucositis scale in subjects with locally advanced SCCHN treated with cisplatin and radiotherapy plus P276-00 or cisplatin and radiotherapy (the two treatment arms).
Time Frame
Week 15
Secondary Outcome Measure Information:
Title
Time to onset of severe RIM (WHO Grade ≥ 3)
Description
To evaluate the time to onset of severe RIM (WHO Grade>=3) as defined by the number of days between start of study treatment and the first time that WHO Grade 3 or 4 mucositis was observed (regardless of whether it had been Grade 0,1 or 2 previously)
Time Frame
Week 15
Title
Duration of severe RIM (WHO Grade>=3)
Description
To assess the duration of severe RIM (WHO Grade>=3) as defined by the number of days from the onset of severe RIM as defined above, to the day when severe RIM resolved (first time when WHO Grade 0, 1, or 2 was observed)
Time Frame
Week 15
Title
Progression-Free Survival (PFS)
Description
To assess Progression-Free Survival (PFS)
Time Frame
1year
Title
Overall Survival (OS)
Description
To assess Overall Survival (OS)
Time Frame
1year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able to understand and willing to give an informed consent for the study. Pathologically (histologically or cytologically) confirmed (from primary tumor and/or lymph nodes), non-metastatic diagnosis of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx eligible for treatment with concomitant chemoradiation as first-line treatment; subjects with a history of surgical management are not eligible Have a plan to receive a continuous course of radiation (3DRT or IMRT) as single daily fractions of 2.0 Gy, with a cumulative radiation dose between 66 and 70 Gy. Planned radiation treatment fields must include at least 2 oral sites (maxillary or mandibular labial mucosa, right or left buccal mucosa, right or left floor of the mouth, ventral tongue, right or left lateral tongue, or soft palate), with each site receiving more than equal to 50 Gy Have a plan to receive a standard cisplatin regimen administered weekly (30 to 40 mg/m2) Have an Eastern Co-operative Oncology Group (ECOG) performance status less than equal to 2 Males or females aged 18 years or older Pre-treatment dental procedures must be completed with recovery and the prophylactic insertion of gastric feeding tubes (if planned) prior to entry into the study Adequate bone marrow function measured within two weeks prior to enrollment based upon CBC/differential, defined as follows: Absolute neutrophil count (ANC) more than equal to 1,500 cells/mm3 Platelets more than equal to 100,000 cells/mm3 Hemoglobin (Hb) more than equal to 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hb more than equal to 8.0 g/dl prior to the start of RT is acceptable) Adequate hepatic function measured within two weeks prior to enrollment defined as follows Bilirubin less than equal to 1.5 mg/dl AST less than equal to 2 times ULN ALT less than equal to 2 times ULN Adequate renal function measured within two weeks prior to enrollment and defined as follows Serum creatinine less than equal to 1.5 mg/dl Creatinine clearance (CC) more than equal to 60 ml/min determined by 24-hour urine collection or estimated by the Cockcroft-Gault formula: Have a negative serum pregnancy test for women of childbearing potential at time of screening and negative urine pregnancy test within 72 hrs prior to first dose of study drug Exclusion Criteria: Tumor of the lips, sinuses, salivary glands, nasopharynx, or unknown primary tumor Metastatic disease (M1) Stage IVC as per the AJCC, 7th edition Prior radiation to the head and neck Have undergone induction CT History of malignant tumors other than HNC (except non-melanoma skin cancer) unless disease free for a minimum of 3 years Severe co-morbidity, defined as: Symptomatic and/or uncontrolled cardiac disease, New York Heart Association Classification III or IV Acute myocardial infarction within the last 6 months Acute bacterial or fungal infection requiring systemic antibiotics at the time of enrollment Subjects known to be seropositive for human immunodeficiency virus (HIV) or subjects with Acquired Immune Deficiency Syndrome (AIDS), known current acute or chronic Hepatitis B, known Hepatitis C (antigen positive), or hepatic cirrhosis Subjects with active tuberculosis Collagen vascular disease, such as scleroderma, as this is thought to predispose subjects to increased risk for radiation-associated toxicities Have used any other investigational drug therapy within 1 month prior to Day 1 of study drug administration or non-recovery (to Grade less than equal to 1) from adverse effects of the investigational agent received prior to this period Prior allergic reaction to any of the agents administered during the course of treatment Have QTcF more than equal to 450 msec at screening Pregnant or breastfeeding women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr.Sarbani Ghosh Laskar, MD
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bharat Cancer Hospital & Research Institute
City
Surat
State/Province
Gujarat
ZIP/Postal Code
395010
Country
India
Facility Name
Sri Venkateshwara Hospitals
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560068
Country
India
Facility Name
Mazumdar Shaw Cancer Center
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560099
Country
India
Facility Name
Tata Memorial Hospital
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400012
Country
India
Facility Name
Curie Manavta Cancer Centre
City
Nashik
State/Province
Maharashtra
ZIP/Postal Code
422004
Country
India
Facility Name
Ruby Hall Clinic
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411001
Country
India
Facility Name
Meenakshi Mission Hosp. & Res. Centre
City
Madurai
State/Province
Tamil Nadu
ZIP/Postal Code
625107
Country
India

12. IPD Sharing Statement

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A Study to Assess Radiation Induced Mucositis in Patients of Head and Neck Cancer Administered Chemo-Radiation With or Without P276-00

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