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Nivolumab in Nasopharyngeal Cancer With Progression During or After Platinum-based Treatment (NIVONASO-21)

Primary Purpose

Nasopharyngeal Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
Poland
Study Type
Interventional
Intervention
Opdivo
Sponsored by
Maria Sklodowska-Curie National Research Institute of Oncology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasopharyngeal Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Age > 18 years old
  2. Histological or cytological documentation of squamous cell carcinoma.
  3. Primary tumor location in nasopharynx
  4. Previous, documented failure on platinum-based chemotherapy or progression of the disease during platinum-based chemotherapy
  5. Tumor recurrence (local or nodal) or generalization (metastasis) occurence during or within 6 months after previous platinum-based chemotherapy
  6. ECOG(Eastern Cooperative Oncology Group) performance scale 0-1
  7. Participant is willing and able to give informed consent for participation in the study and agrees to undergo all follow up visit and planned procedures.

Exclusion Criteria:

  1. Known active central nervous system metastases.
  2. Presence of renal insufficiency defined as eGFR(estimated glomerular filtration rate) < 30 ml/min/m2
  3. Presence of liver disfunction, defined as level of AST(aspartate aminotransferase) and /or ALT(alanine aminotransferase) > 2,5 x ULN(upper limits of normal) (> 5 x ULN in patients with documented liver metastases); total bilirubin > 1,5 xULN ( bilirubin > 1,5 x ULN is acceptable if bilirubin is fractionated and direct bilirubin is < 35%) or albumin < 2,5 g/dL
  4. Abnormalities in blood count such as: hemoglobin < 9 g/dl, platelets < 100 x 109 /L, Absolute Neutrophil Count (ANC) <1,0 x 109 /L
  5. Ejection fraction in echocardiography < 50%
  6. History of active autoimmune diseases except for type I diabetes, hypothyroidism (treated only with hormone supplementation), psoriasis, albinism.
  7. Patient with diagnosed mental disorder preventing, in Investigator's opinion, from participating in a clinical trial.
  8. Pregnancy or breastfeeding.
  9. Female with childbearing potential or male participant with female partner of childbearing potential, who is unwilling or unable to use an acceptable method of contraception to avoid pregnancy throughout the entire clinical trial period and for 5 months after the end of treatment (last infusion)
  10. Prior therapy with an anti-PD-1/L1/L2 and/or anti-ICOS directed agent
  11. Patient is currently participating in another clinical trial.
  12. Active infection, which significantly affects the patient's clinical condition and requires treatment.
  13. Patient with prior bone marrow or solid organ transplantation.
  14. Patient requires immunosuppressive agents, including steroids (daily dose of prednisone or equivalent > 10 mg)
  15. Known immunodeficiency including HIV/AIDS(human immunodeficiency virus/acquired immunodeficiency syndrome) infection.
  16. Patient received any live vaccine within 28 days before enrollment.
  17. Heart Failure - NYHA(New York Heart Association functional classification system) III or IV
  18. Coexistence of active malignant tumor or history of malignant tumor after radical treatment with disease-free period > 2 years, except: cervical cancer in situ/ basocellular skin cancer/prostate cancer, after radical treatment.
  19. Other comorbidities symptoms or conditions that in Investigator's judgement prevent patient from participation in clinical trial.

Sites / Locations

  • Klinika Hematologii z Pododziałem Chorób Naczyń Uniwersyteckiego Szpitala Klinicznego w Białymstoku
  • Klinika Hematologii i Transplantologii Gdańskiego Uniwersytetu Medycznego
  • Klinika Transplantacji Szpiku i Onkohematologii Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie Państwowy Instytut Badawczy, Oddział w Gliwicach
  • Klinika Hematologii i Transplantacji Szpiku, Świętokrzyskie Centrum Onkologii

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental therapy:OPDIVO (Nivolumab)

Arm Description

Outcomes

Primary Outcome Measures

Objective response rate (ORR)
Percentage of objective responses (partial and complete responses combined /partial response (PR)+ complete response(CR)/ by immune Response Evaluation Criteria in Solid Tumours (iRECIST) response criteria) in MRI (Magnetic Resonance Imaging) after 12 weeks. Partial response - at least a 30% decrease in the sum of the LD(longest diameter) of target lesions, taking as reference the baseline sum LD(longest diameter) Complete response (CR)- disappearance of all target lesions and short dimension of all lymph nodes < 10 mm

Secondary Outcome Measures

1.Progression- free survival (PFS) by iRECIST( immune Response Evaluation Criteria in Solid Tumours) criteria- from the beginning of treatment to the progression of disease or death.
Progression will be evaluated in MRI(Magnetic Resonance Imaging) and defined according to iRECIST(immune Response Evaluation Criteria in Solid Tumours) criteria: least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study) and the sum must also demonstrate an absolute increase of at least 5 mm. the appearance of one or more new lesions
Overall survival (OS) rate- time of total survival
DCR(disease control rate) per RECIST (Response Evaluation Criteria in Solid Tumours)
Defined as not meeting the criteria for progression and PR(partial response)
DoR(duration of response) per RECIST (Response Evaluation Criteria in Solid Tumours)
Measured in MRI(Magnetic Resonance Imaging) from the time when measurement criteria for complete/ partial response are met till time when progression of the disease is documented.
Change in quality of life in EORTC QLQ-C30(European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) (version 3.0) .A high scale score represents a higher response level.
Safety assessment of treatment with Nivolumab measured by excesive toxity

Full Information

First Posted
April 25, 2021
Last Updated
June 21, 2021
Sponsor
Maria Sklodowska-Curie National Research Institute of Oncology
Collaborators
KCRI
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1. Study Identification

Unique Protocol Identification Number
NCT04875611
Brief Title
Nivolumab in Nasopharyngeal Cancer With Progression During or After Platinum-based Treatment
Acronym
NIVONASO-21
Official Title
Phase II Study Evaluating the Efficacy of Nivolumab in the Treatment of Patients With Nasopharyngeal Cancer Who Progressed During or After Platinum-based Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 30, 2021 (Anticipated)
Primary Completion Date
September 30, 2023 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Maria Sklodowska-Curie National Research Institute of Oncology
Collaborators
KCRI

4. Oversight

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

5. Study Description

Brief Summary
Multicentre , non-randomized, prospective clinical trial to assess efficacy of Nivolumab in treatment of nasopharyngeal cancer who progressed during or after platinum-based chemotherapy . Patients disqualified from radical therapy . The total number of patients was estimated for 32.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Experimental therapy:OPDIVO (Nivolumab)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Opdivo
Other Intervention Name(s)
Nivolumab
Intervention Description
Dose of Nivolumab is constant and is 240 mg .All patients will undergo maximum of 12 cycles of investigation product's infusion ( around 6 month of treatment).Each cycle will be done in intervals of 14 day (no less than 12 days after previous infusion and no longer than 42 day/6 weeks after previous infusion).
Primary Outcome Measure Information:
Title
Objective response rate (ORR)
Description
Percentage of objective responses (partial and complete responses combined /partial response (PR)+ complete response(CR)/ by immune Response Evaluation Criteria in Solid Tumours (iRECIST) response criteria) in MRI (Magnetic Resonance Imaging) after 12 weeks. Partial response - at least a 30% decrease in the sum of the LD(longest diameter) of target lesions, taking as reference the baseline sum LD(longest diameter) Complete response (CR)- disappearance of all target lesions and short dimension of all lymph nodes < 10 mm
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
1.Progression- free survival (PFS) by iRECIST( immune Response Evaluation Criteria in Solid Tumours) criteria- from the beginning of treatment to the progression of disease or death.
Description
Progression will be evaluated in MRI(Magnetic Resonance Imaging) and defined according to iRECIST(immune Response Evaluation Criteria in Solid Tumours) criteria: least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study) and the sum must also demonstrate an absolute increase of at least 5 mm. the appearance of one or more new lesions
Time Frame
6 month of treatment phase
Title
Overall survival (OS) rate- time of total survival
Time Frame
at 6 months (treatment phase), 12 months and 18 months (6th month and 12th month of long term follow up)
Title
DCR(disease control rate) per RECIST (Response Evaluation Criteria in Solid Tumours)
Description
Defined as not meeting the criteria for progression and PR(partial response)
Time Frame
through study completion, an average of 6 months
Title
DoR(duration of response) per RECIST (Response Evaluation Criteria in Solid Tumours)
Description
Measured in MRI(Magnetic Resonance Imaging) from the time when measurement criteria for complete/ partial response are met till time when progression of the disease is documented.
Time Frame
through study completion, an average of 1 year
Title
Change in quality of life in EORTC QLQ-C30(European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) (version 3.0) .A high scale score represents a higher response level.
Time Frame
from first infusion to last follow up ( 3 month, 6 month, 9 month,12month follow up)
Title
Safety assessment of treatment with Nivolumab measured by excesive toxity
Time Frame
Each visit during treatment phase -12 cycles of investigation product's infusion (around 6 month of treatment).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 years old Histological or cytological documentation of squamous cell carcinoma. Primary tumor location in nasopharynx Previous, documented failure on platinum-based chemotherapy or progression of the disease during platinum-based chemotherapy Tumor recurrence (local or nodal) or generalization (metastasis) occurence during or within 6 months after previous platinum-based chemotherapy ECOG(Eastern Cooperative Oncology Group) performance scale 0-1 Participant is willing and able to give informed consent for participation in the study and agrees to undergo all follow up visit and planned procedures. Exclusion Criteria: Known active central nervous system metastases. Presence of renal insufficiency defined as eGFR(estimated glomerular filtration rate) < 30 ml/min/m2 Presence of liver disfunction, defined as level of AST(aspartate aminotransferase) and /or ALT(alanine aminotransferase) > 2,5 x ULN(upper limits of normal) (> 5 x ULN in patients with documented liver metastases); total bilirubin > 1,5 xULN ( bilirubin > 1,5 x ULN is acceptable if bilirubin is fractionated and direct bilirubin is < 35%) or albumin < 2,5 g/dL Abnormalities in blood count such as: hemoglobin < 9 g/dl, platelets < 100 x 109 /L, Absolute Neutrophil Count (ANC) <1,0 x 109 /L Ejection fraction in echocardiography < 50% History of active autoimmune diseases except for type I diabetes, hypothyroidism (treated only with hormone supplementation), psoriasis, albinism. Patient with diagnosed mental disorder preventing, in Investigator's opinion, from participating in a clinical trial. Pregnancy or breastfeeding. Female with childbearing potential or male participant with female partner of childbearing potential, who is unwilling or unable to use an acceptable method of contraception to avoid pregnancy throughout the entire clinical trial period and for 5 months after the end of treatment (last infusion) Prior therapy with an anti-PD-1/L1/L2 and/or anti-ICOS directed agent Patient is currently participating in another clinical trial. Active infection, which significantly affects the patient's clinical condition and requires treatment. Patient with prior bone marrow or solid organ transplantation. Patient requires immunosuppressive agents, including steroids (daily dose of prednisone or equivalent > 10 mg) Known immunodeficiency including HIV/AIDS(human immunodeficiency virus/acquired immunodeficiency syndrome) infection. Patient received any live vaccine within 28 days before enrollment. Heart Failure - NYHA(New York Heart Association functional classification system) III or IV Coexistence of active malignant tumor or history of malignant tumor after radical treatment with disease-free period > 2 years, except: cervical cancer in situ/ basocellular skin cancer/prostate cancer, after radical treatment. Other comorbidities symptoms or conditions that in Investigator's judgement prevent patient from participation in clinical trial.
Facility Information:
Facility Name
Klinika Hematologii z Pododziałem Chorób Naczyń Uniwersyteckiego Szpitala Klinicznego w Białymstoku
City
Białystok
Country
Poland
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ewa Sierko, dr hab.n. med.
Email
esierko@onkologia.bialystok.pl
Facility Name
Klinika Hematologii i Transplantologii Gdańskiego Uniwersytetu Medycznego
City
Gdańsk
Country
Poland
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rafał Dziadziuszko, Prof.dr hab.n.med.
Email
rafald@gumed.edu.pl
Facility Name
Klinika Transplantacji Szpiku i Onkohematologii Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie Państwowy Instytut Badawczy, Oddział w Gliwicach
City
Gliwice
ZIP/Postal Code
44-101
Country
Poland
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tomasz Rutkowski, Dr hab. n.med.
Email
Tomasz.rutkowski@io.gliwice.pl
Facility Name
Klinika Hematologii i Transplantacji Szpiku, Świętokrzyskie Centrum Onkologii
City
Kielce
Country
Poland
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Piotr Kędzierawski, dr n. med.
Email
piotrkedzierawski@wp.pl

12. IPD Sharing Statement

Learn more about this trial

Nivolumab in Nasopharyngeal Cancer With Progression During or After Platinum-based Treatment

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