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IMRT Combined With Toripalimab in Unresectable Locally Recurrent Nasopharyngeal Carcinoma.

Primary Purpose

Nasopharyngeal Carcinoma, Nasopharyngeal Neoplasms, Nasopharyngeal Diseases

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Tolipalimab
Reirradiation
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasopharyngeal Carcinoma focused on measuring toripalimab, IMRT, Intensity-Modulated Radiation Therapy, PD-1

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Histologically confirmed Recurrent Nasopharyngeal Carcinoma ( the recurrence time was more than 12 months from the end of the first course of radiotherapy)
  2. Patients with histologically confirmed nasopharyngeal carcinoma(WHO type II-III)
  3. Subjects must have measurable disease by CT or MRI per RECIST 1.1 criteria;
  4. Can provide either a newly obtained or archival tumor tissue sample.
  5. Tumor staged as rT0-4N1-3M0 or T2-4N0M0,II-IVa (according to the 8th AJCC edition).
  6. 18 Years to 65 Years
  7. Eastern Cooperative Oncology Group performance status ≤1
  8. Adequate marrow function: neutrocyte count≥1.5×10e9/L, hemoglobin ≥90g/L and platelet count ≥100×10e9/L.Alanine Aminotransferase (ALT)/Aspartate Aminotransferase (AST) ≤2.5×upper limit of normal (ULN), and bilirubin ≤ 1.5×ULN. Adequate renal function: creatinine clearance rate ≥ 60 ml/min (Cockcroft-Gault formula).
  9. Life expectancy ≥ 3months
  10. Subjects must be willing to participate in the research and sign an informed consent form (ICF)
  11. Female of child bearing potential, a negative urine or serum pregnancy test result within 72 h before study treatment. Participants of reproductive potential must be willing to use adequate contraception for the course of the study through 60 days after the last dose of Toripalimab.
  12. Male subjects with WOCBP partner must be willing to use adequate contraception for the course of the study through 120 days after the last dose of Toripalimab.

Exclusion Criteria:

  1. operable recurrence of nasopharyngeal cancer: rT1N0M0 rT2N0M0 (the tumour was confined in the superficial parapharyngeal spacer) rT3N0M0 (the tumour was confined in the base wall of the sphenoid sinus) rT0N1-3M0 (the tumour was not invasion into the cervical vertebrae, brachial plexus, deep muscles of the neck, or carotid artery)
  2. Has known allergy to large molecule protein products or any compound of study therapy
  3. Has known Subjects with other malignant tumors
  4. Has any active autoimmune disease or history of autoimmune disease
  5. Has a history of psychiatric substance abuse, alcoholism, or drug addiction;
  6. the laboratory examination value does not meet the relevant standards within 7 days before enrollment
  7. Received a systematic Glucocorticoid therapy within 4 weeks of the first dose of study medication.
  8. Has a known history of active TB (bacillus tuberculosis) within 1 year; patients with adequately treated active TB with 1 year.
  9. Prior therapy with a PD-1, anti-PD-Ligand 1 (PD-L1) or CTLA-4 agent;
  10. Has active autoimmune disease (e.g., uveitis, enteritis, hepatitis, hypophysitis, nephritis, vasculitis, hyperthyroidism, and asthma requiring bronchodilator therapy) Patients with skin disease that doesn't require systemic treatment (e.g., vitiligo, psoriasis, or alopecia) will be allowed to enroll.
  11. Has a known history of human immunodeficiency virus (HIV).
  12. Has hepatitis B surface antigen (HBsAg) positive or hepatitis C virus (HCV) antibody positive
  13. Has received a live vaccine within 4 weeks of planned start of study therapy
  14. Pregnancy or breast feeding

Sites / Locations

  • Sun Yat-sen University Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Toripalimab +Radiotherapy

Arm Description

Radiotherapy, intensity-modulated radiation therapy (IMRT), 60 Gy 2.2Gy per fraction ,5 fractions per week, for 6 weeks. Radiation begun the day after the first dose of Toripalimab. Toripalimab (240mg dose every 3 weeks for 7 cycles, one cycle is three weeks ) will be administered as an intravenous infusion over 60 minutes.

Outcomes

Primary Outcome Measures

ORR
Objective Response Rate

Secondary Outcome Measures

PFS
Progression-Free Survival is defined as time interval from recruitment to tumor progression or censoring.
OS
Overall Survival is defined as time interval from recruitment to all-caused death or censoring.
Incidence of Treatment-Emergent Adverse Events
Adverse events (AE), Serious Adverse Event(SAE)

Full Information

First Posted
February 24, 2019
Last Updated
April 24, 2022
Sponsor
Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT03854838
Brief Title
IMRT Combined With Toripalimab in Unresectable Locally Recurrent Nasopharyngeal Carcinoma.
Official Title
A Single Center 、Single Arm Phase I/II Clinical Trial of Intensity-modulated Radiotherapy Combined With Toripalimab in the Treating of Unresectable Locally Recurrent Nasopharyngeal Carcinoma.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 1, 2019 (Actual)
Primary Completion Date
February 1, 2021 (Actual)
Study Completion Date
February 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy and safety of intensity-modulated radiation therapy combined with toripalimab in patients with the unresectable locally recurrent nasopharyngeal carcinoma.
Detailed Description
This is an open-label ,single center ,non-randomized, single arm exploratory study. All eligible patients presented with non-keratinizing NPC and stage rT0-4N1-3M0 /rT2-4N0M0 are assigned to receive IMRT combined with toripalimab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Carcinoma, Nasopharyngeal Neoplasms, Nasopharyngeal Diseases, Head and Neck Neoplasm
Keywords
toripalimab, IMRT, Intensity-Modulated Radiation Therapy, PD-1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Toripalimab +Radiotherapy
Arm Type
Experimental
Arm Description
Radiotherapy, intensity-modulated radiation therapy (IMRT), 60 Gy 2.2Gy per fraction ,5 fractions per week, for 6 weeks. Radiation begun the day after the first dose of Toripalimab. Toripalimab (240mg dose every 3 weeks for 7 cycles, one cycle is three weeks ) will be administered as an intravenous infusion over 60 minutes.
Intervention Type
Drug
Intervention Name(s)
Tolipalimab
Other Intervention Name(s)
JS001
Intervention Description
Radiation begun the day after the first dose of Toripalimab. Toripalimab (240mg dose every 3 weeks for 7 cycles, one cycle is three weeks) will be administered as an intravenous infusion over 60 minutes.
Intervention Type
Radiation
Intervention Name(s)
Reirradiation
Intervention Description
intensity-modulated radiation therapy (IMRT), 60 Gy 2.2Gy per fraction ,5 fractions per week, for 6 weeks
Primary Outcome Measure Information:
Title
ORR
Description
Objective Response Rate
Time Frame
Through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
PFS
Description
Progression-Free Survival is defined as time interval from recruitment to tumor progression or censoring.
Time Frame
up to 3 years
Title
OS
Description
Overall Survival is defined as time interval from recruitment to all-caused death or censoring.
Time Frame
up to 3 years
Title
Incidence of Treatment-Emergent Adverse Events
Description
Adverse events (AE), Serious Adverse Event(SAE)
Time Frame
Through study completion, an average of half a year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed Recurrent Nasopharyngeal Carcinoma ( the recurrence time was more than 12 months from the end of the first course of radiotherapy) Patients with histologically confirmed nasopharyngeal carcinoma(WHO type II-III) Subjects must have measurable disease by CT or MRI per RECIST 1.1 criteria; Can provide either a newly obtained or archival tumor tissue sample. Tumor staged as rT0-4N1-3M0 or T2-4N0M0,II-IVa (according to the 8th AJCC edition). 18 Years to 65 Years Eastern Cooperative Oncology Group performance status ≤1 Adequate marrow function: neutrocyte count≥1.5×10e9/L, hemoglobin ≥90g/L and platelet count ≥100×10e9/L.Alanine Aminotransferase (ALT)/Aspartate Aminotransferase (AST) ≤2.5×upper limit of normal (ULN), and bilirubin ≤ 1.5×ULN. Adequate renal function: creatinine clearance rate ≥ 60 ml/min (Cockcroft-Gault formula). Life expectancy ≥ 3months Subjects must be willing to participate in the research and sign an informed consent form (ICF) Female of child bearing potential, a negative urine or serum pregnancy test result within 72 h before study treatment. Participants of reproductive potential must be willing to use adequate contraception for the course of the study through 60 days after the last dose of Toripalimab. Male subjects with WOCBP partner must be willing to use adequate contraception for the course of the study through 120 days after the last dose of Toripalimab. Exclusion Criteria: operable recurrence of nasopharyngeal cancer: rT1N0M0 rT2N0M0 (the tumour was confined in the superficial parapharyngeal spacer) rT3N0M0 (the tumour was confined in the base wall of the sphenoid sinus) rT0N1-3M0 (the tumour was not invasion into the cervical vertebrae, brachial plexus, deep muscles of the neck, or carotid artery) Has known allergy to large molecule protein products or any compound of study therapy Has known Subjects with other malignant tumors Has any active autoimmune disease or history of autoimmune disease Has a history of psychiatric substance abuse, alcoholism, or drug addiction; the laboratory examination value does not meet the relevant standards within 7 days before enrollment Received a systematic Glucocorticoid therapy within 4 weeks of the first dose of study medication. Has a known history of active TB (bacillus tuberculosis) within 1 year; patients with adequately treated active TB with 1 year. Prior therapy with a PD-1, anti-PD-Ligand 1 (PD-L1) or CTLA-4 agent; Has active autoimmune disease (e.g., uveitis, enteritis, hepatitis, hypophysitis, nephritis, vasculitis, hyperthyroidism, and asthma requiring bronchodilator therapy) Patients with skin disease that doesn't require systemic treatment (e.g., vitiligo, psoriasis, or alopecia) will be allowed to enroll. Has a known history of human immunodeficiency virus (HIV). Has hepatitis B surface antigen (HBsAg) positive or hepatitis C virus (HCV) antibody positive Has received a live vaccine within 4 weeks of planned start of study therapy Pregnancy or breast feeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ming-Yuan Chen, MD,PhD
Organizational Affiliation
Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
34782428
Citation
Hua Y, You R, Wang Z, Huang P, Lin M, Ouyang Y, Xie Y, Zou X, Liu Y, Duan C, Liu Y, Gu C, Liu R, Yang Q, Jiang R, Zhang M, Ding X, Chen S, Lin C, Sun R, Chen M. Toripalimab plus intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma: an open-label single-arm, phase II trial. J Immunother Cancer. 2021 Nov;9(11):e003290. doi: 10.1136/jitc-2021-003290.
Results Reference
derived

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IMRT Combined With Toripalimab in Unresectable Locally Recurrent Nasopharyngeal Carcinoma.

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