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Rituximab Plus Chemotherapy in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma

Primary Purpose

Head and Neck Squamous Carcinoma

Status
Completed
Phase
Phase 1
Locations
Taiwan
Study Type
Interventional
Intervention
Rituximab
Cisplatin
Gemcitabine
Sponsored by
China Medical University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Squamous Carcinoma focused on measuring head and neck squamous cell carcinoma, Rituximab, recurrent or metastatic

Eligibility Criteria

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

Inclusion Criteria:

  1. Histologically confirmed squamous cell carcinoma of head and neck.
  2. Locoregional recurrence and/or metastases after primary curative local treatment and unsuitable for further radiotherapy and surgery; or primary distant metastases at diagnosis.
  3. Measurable disease. Defined as presence of at least one lesion as being ≥10 mm in at least one dimension measured with conventional computed tomography (CT) or ≥10 mm in at least one dimension measured with spiral CT scan or magnetic resonance imaging (MRI)
  4. Eastern Cooperative Oncology Group performance status ≤2;
  5. Age between 20 and 65 years; and life expectancy of at least 12 weeks.
  6. Prior treatments with radiation therapy for palliative management of non-target lesion metastatic disease is permitted provided that at least 2 weeks have relapsed since the last fraction of radiation therapy, disease progression has been documented and all treatment related adverse events are ≦ grade 1 at the time of registration.
  7. Negative pregnancy test, Fertile patients must use effective contraception
  8. No history of allergic reactions attributed to Rituximab/cisplatin/gemcitabine
  9. Patient consent must be obtained

Exclusion Criteria:

  1. Presence of central nervous system (CNS) metastases;
  2. Presence of other malignancy with the exception of curatively treated non-melanoma skin cancer or cervical carcinoma in situ prior to entry into the study
  3. Presence of bone-only metastasis
  4. The organ function measured within 14 days prior to study entry as defined below: White blood cell (WBC) less than 2,000/mm3, absolute neutrophil count (ANC) less than 1,500/mm3, or platelets less than 100,000/mm3; serum bilirubin greater than 1.5 times the upper limit of normal range (ULN); alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 2.5 times the ULN if no demonstrable liver metastases, or greater than 5 times the ULN in the presence of liver metastases; creatinine clearance ≤60 ml/min (based upon urine collection);
  5. Concomitant illness including uncontrolled infection or other active, uncontrolled disease such as congestive heart failure, angina pectoris, respiratory insufficiency, and arrhythmia.
  6. Documented hypersensitivity to platinum compounds or compounds of similar chemical or biologic composition
  7. Pregnant or lactating women.
  8. Under rituximab treatment or have ever received rituximab within six months.
  9. Ongoing other concurrent investigational agents or anticancer therapy

Sites / Locations

  • China medical University hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Rituximab plus chemotherapy

Arm Description

Drug:Rituximab Drug:Cisplatin Drug:Gemcitabine

Outcomes

Primary Outcome Measures

feasibility of the combination of Rituximab with Gemcitabin/cisplatin in R/M HNSCC
Unexpected adverse event. An AE that is not listed in the drug's current labeling, or An AE that is more severe or more specific than indicated in the labeling.

Secondary Outcome Measures

Response rate
CT scan according to the RECIST 1.1 criteria.
progression survival
The time from the study registration date to the first day of disease progression at any site or of death by any cause.
Adverse event
Record adverse event

Full Information

First Posted
August 21, 2013
Last Updated
April 25, 2020
Sponsor
China Medical University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04361409
Brief Title
Rituximab Plus Chemotherapy in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma
Official Title
A Phase I Pilot Study of B Cell Depletion With Rituximab Following by Chemotherapy With Cisplatin Plus Gemcitabine for Recurrent Unresectable or Metastatic Head and Neck Cancer Squamous Cell Carcinoma Patients.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
May 2013 (Actual)
Primary Completion Date
November 2016 (Actual)
Study Completion Date
January 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
China Medical University Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Head and neck squamous cell carcinoma (HNSCC) is an important disease with the incidence of 6th all over the world. In Taiwan it is the fifth of male cancer mortality. Most of the patients were middle age and the impact for economy and society was incredible. For recurrent or metastatic HNSCC, the average life span was around 4-6 months. Most patients just can receive chemotherapy. However the chemotherapy can't have any survival benefit. Recently a study showed the Cetuximab plus chemotherapy with cisplatin and 5-fluorouracil had survival benefit in the recurrent or metastatic HNSCC. However in Taiwan, the cetuximab can't be given by health insurance for the patients of the situation. A lot of investigations recently showed the B lymphocytes got involvements in the squamous cell carcinoma carcinogenesis and tumor progression. In addition the B cell will influence the tumor associated macrophages and myeloid derived suppressor cells. Those immune cells could decrease the affect of chemotherapy and radiotherapy. Thus the B cell depletion has the possibility to develop a new treatment policy. Therefore investigators create a pilot clinical trial using Rituximab plus chemotherapy with cisplatin and gemcitabine for recurrent or metastatic HNSCC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Squamous Carcinoma
Keywords
head and neck squamous cell carcinoma, Rituximab, recurrent or metastatic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rituximab plus chemotherapy
Arm Type
Experimental
Arm Description
Drug:Rituximab Drug:Cisplatin Drug:Gemcitabine
Intervention Type
Drug
Intervention Name(s)
Rituximab
Other Intervention Name(s)
Mab thera
Intervention Description
375mg/m2 on Day-14 and Day-7
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
Platinex
Intervention Description
70mg/m2 on Day1
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
1000mg/m2 on Day8
Primary Outcome Measure Information:
Title
feasibility of the combination of Rituximab with Gemcitabin/cisplatin in R/M HNSCC
Description
Unexpected adverse event. An AE that is not listed in the drug's current labeling, or An AE that is more severe or more specific than indicated in the labeling.
Time Frame
One week after Rituximab and chemotherapy administration.
Secondary Outcome Measure Information:
Title
Response rate
Description
CT scan according to the RECIST 1.1 criteria.
Time Frame
through study completion, an average of 1 years
Title
progression survival
Description
The time from the study registration date to the first day of disease progression at any site or of death by any cause.
Time Frame
through study completion, an average of 6 months
Title
Adverse event
Description
Record adverse event
Time Frame
through study completion, an average of 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed squamous cell carcinoma of head and neck. Locoregional recurrence and/or metastases after primary curative local treatment and unsuitable for further radiotherapy and surgery; or primary distant metastases at diagnosis. Measurable disease. Defined as presence of at least one lesion as being ≥10 mm in at least one dimension measured with conventional computed tomography (CT) or ≥10 mm in at least one dimension measured with spiral CT scan or magnetic resonance imaging (MRI) Eastern Cooperative Oncology Group performance status ≤2; Age between 20 and 65 years; and life expectancy of at least 12 weeks. Prior treatments with radiation therapy for palliative management of non-target lesion metastatic disease is permitted provided that at least 2 weeks have relapsed since the last fraction of radiation therapy, disease progression has been documented and all treatment related adverse events are ≦ grade 1 at the time of registration. Negative pregnancy test, Fertile patients must use effective contraception No history of allergic reactions attributed to Rituximab/cisplatin/gemcitabine Patient consent must be obtained Exclusion Criteria: Presence of central nervous system (CNS) metastases; Presence of other malignancy with the exception of curatively treated non-melanoma skin cancer or cervical carcinoma in situ prior to entry into the study Presence of bone-only metastasis The organ function measured within 14 days prior to study entry as defined below: White blood cell (WBC) less than 2,000/mm3, absolute neutrophil count (ANC) less than 1,500/mm3, or platelets less than 100,000/mm3; serum bilirubin greater than 1.5 times the upper limit of normal range (ULN); alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 2.5 times the ULN if no demonstrable liver metastases, or greater than 5 times the ULN in the presence of liver metastases; creatinine clearance ≤60 ml/min (based upon urine collection); Concomitant illness including uncontrolled infection or other active, uncontrolled disease such as congestive heart failure, angina pectoris, respiratory insufficiency, and arrhythmia. Documented hypersensitivity to platinum compounds or compounds of similar chemical or biologic composition Pregnant or lactating women. Under rituximab treatment or have ever received rituximab within six months. Ongoing other concurrent investigational agents or anticancer therapy
Facility Information:
Facility Name
China medical University hospital
City
Taichung
ZIP/Postal Code
404
Country
Taiwan

12. IPD Sharing Statement

Citations:
PubMed Identifier
35168547
Citation
Hsieh CY, Lien MY, Lin CY, Lo WJ, Hua CH, Chang WC, Chiu CF, Lin CC. Rituximab in combination with gemcitabine plus cisplatin in patients with recurrent and metastatic head and neck squamous cell carcinoma: a phase I trial. BMC Cancer. 2022 Feb 15;22(1):169. doi: 10.1186/s12885-022-09258-0.
Results Reference
derived

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Rituximab Plus Chemotherapy in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma

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