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A Study of Cisplatin Plus Radiotherapy Compared to Cetuximab Plus Radiotherapy in Locally Advanced Head and Neck Cancer. (ARTSCANIII)

Primary Purpose

Locally Advanced Head and Neck Cancer

Status
Completed
Phase
Phase 3
Locations
Sweden
Study Type
Interventional
Intervention
cetuximab
cisplatin
Sponsored by
Lund University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Locally Advanced Head and Neck Cancer focused on measuring Head and neck cancer, Cetuximab, Cisplatin, Radiotherapy, Quality of life, Human papilloma virus, Health economy, Biomarker investigations

Eligibility Criteria

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

Inclusion Criteria:

  • Age at least 18 years
  • Histologically or cytologically confirmed , previous untreated head and neck squamous cell cancer of the oral cavity, hypopharynx, larynx or of the oral cavity aimed for unimodal treatment with radiotherapy with curative intent
  • Tumor stage III and IV , but no evidence of distant metastases beyond the regional nodes in the neck
  • WHO/Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • The patient must be expected to withstand radiotherapy combined with cisplatin or cetuximab
  • The patient must be able to understand the information about the treatment and give a written informed concent to participate in the trial
  • Adequate follow-up study must be possible; this will exclude a patient who is uncooperative
  • Adequate renal function, creatinine clearance over 50 ml/min/1.73 estimated according to local practice at each study centre

Exclusion Criteria:

  • Previous malignant disease in the head and neck region, with exception for basal cell carcinoma or curatively treated squamous cell carcinoma of the skin with follow-up time of at least 3 years
  • Concomitant or previous malignancies. Exceptions are adequately treated basal cell carcinoma or squamous cell carcinoma of the skin, or in situ carcinoma of the cervix uteri, or other previous malignancy with a disease-free interval of at least 5 years
  • Two or more synchronous primary head and neck squamous cell cancer at time of diagnosis
  • Co-existing disease prejudicing survival (expected survival less than 6 months)
  • Absolute neutrophil count less than 1.5 x 109/L
  • Platelet count less than 100 x 109/L
  • Bilirubin over 1.5 times upper limit of normal
  • Aspartate aminotransferase (ASAT) or Alanine aminotransferase (ALAT) more than 3 times upper limit of normal
  • Pregnancy or lactation
  • Allergy to study drug or to the excipients in their formulation
  • Neuropathy grade 2 or more according to Common terminology criteria for adverse events (CTCAE) v.4.0
  • Hearing loss/tinnitus is a relative exclusion criteria; the responsible physician decides whether the patient may be included in the study
  • Severe cardiac illness; myocardial infarction within 6 months prior to randomization, severe congestive heart failure, severe cardiomyopathy, ventricular arrythmia, unstable angina, uncontrolled hypertension

Sites / Locations

  • Gävle Hospital
  • Sahlgrenska University Hospital
  • County Hospital Ryhov
  • Central Hospital
  • University Hospital Linköping
  • Karolinska Universityhospital
  • Norrland University Hospital
  • Västmanlands Hospital Västerås
  • University Hospital Örebro

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Arm 1

Arm 2

Arm 3

Arm 4

Arm Description

Radiotherapy with a dose of 68.0 Gy in 34 fractions, and cetuximab with a loading dose of 400 mg/m2 one week before start of radiotherapy, then 250 mg/m2 weekly during radiotherapy (tumor stage 1-4).

Radiotherapy with a dose of 73.1 Gy in 34 fractions, and cetuximab with a loading dose of 400 mg/m2 one week before start of radiotherapy, then 250 mg/m2 weekly during radiotherapy (tumor stage 3-4).

Radiotherapy with a dose of 68.0 Gy in 34 fractions, and cisplatin weekly with a dose of 40 mg/m2 (tumor stage 1-4).

Radiotherapy with a dose of 73.1 Gy in 34 fractions, and cisplatin weekly with a dose of 40 mg/m2 (tumor stage 3-4).

Outcomes

Primary Outcome Measures

Overall survival

Secondary Outcome Measures

Full Information

First Posted
October 16, 2013
Last Updated
September 1, 2020
Sponsor
Lund University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT01969877
Brief Title
A Study of Cisplatin Plus Radiotherapy Compared to Cetuximab Plus Radiotherapy in Locally Advanced Head and Neck Cancer.
Acronym
ARTSCANIII
Official Title
A Randomized Multicenter Phase III Study of Cisplatin Plus Radiotherapy Compared to Cetuximab Plus Radiotherapy in Locally Advanced Head and Neck Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
November 2013 (Actual)
Primary Completion Date
April 2018 (Actual)
Study Completion Date
April 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lund University Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary endpoint in this study is to investigate if there is a difference in overall survival in patients with locally advanced head and neck cancer, randomized to either radiotherapy and cetuximab or radiotherapy and cisplatin. A second randomization is performed in patients with T3-T4 tumors; allocated radiotherapy either 68.0 Gy or 73.1 Gy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Head and Neck Cancer
Keywords
Head and neck cancer, Cetuximab, Cisplatin, Radiotherapy, Quality of life, Human papilloma virus, Health economy, Biomarker investigations

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
298 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Radiotherapy with a dose of 68.0 Gy in 34 fractions, and cetuximab with a loading dose of 400 mg/m2 one week before start of radiotherapy, then 250 mg/m2 weekly during radiotherapy (tumor stage 1-4).
Arm Title
Arm 2
Arm Type
Experimental
Arm Description
Radiotherapy with a dose of 73.1 Gy in 34 fractions, and cetuximab with a loading dose of 400 mg/m2 one week before start of radiotherapy, then 250 mg/m2 weekly during radiotherapy (tumor stage 3-4).
Arm Title
Arm 3
Arm Type
Experimental
Arm Description
Radiotherapy with a dose of 68.0 Gy in 34 fractions, and cisplatin weekly with a dose of 40 mg/m2 (tumor stage 1-4).
Arm Title
Arm 4
Arm Type
Experimental
Arm Description
Radiotherapy with a dose of 73.1 Gy in 34 fractions, and cisplatin weekly with a dose of 40 mg/m2 (tumor stage 3-4).
Intervention Type
Drug
Intervention Name(s)
cetuximab
Intervention Type
Drug
Intervention Name(s)
cisplatin
Primary Outcome Measure Information:
Title
Overall survival
Time Frame
Every 3 month for 2 years, and every 6 month until 5 years for evaluation of overall survival

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age at least 18 years Histologically or cytologically confirmed , previous untreated head and neck squamous cell cancer of the oral cavity, hypopharynx, larynx or of the oral cavity aimed for unimodal treatment with radiotherapy with curative intent Tumor stage III and IV , but no evidence of distant metastases beyond the regional nodes in the neck WHO/Eastern Cooperative Oncology Group (ECOG) performance status 0-2 The patient must be expected to withstand radiotherapy combined with cisplatin or cetuximab The patient must be able to understand the information about the treatment and give a written informed concent to participate in the trial Adequate follow-up study must be possible; this will exclude a patient who is uncooperative Adequate renal function, creatinine clearance over 50 ml/min/1.73 estimated according to local practice at each study centre Exclusion Criteria: Previous malignant disease in the head and neck region, with exception for basal cell carcinoma or curatively treated squamous cell carcinoma of the skin with follow-up time of at least 3 years Concomitant or previous malignancies. Exceptions are adequately treated basal cell carcinoma or squamous cell carcinoma of the skin, or in situ carcinoma of the cervix uteri, or other previous malignancy with a disease-free interval of at least 5 years Two or more synchronous primary head and neck squamous cell cancer at time of diagnosis Co-existing disease prejudicing survival (expected survival less than 6 months) Absolute neutrophil count less than 1.5 x 109/L Platelet count less than 100 x 109/L Bilirubin over 1.5 times upper limit of normal Aspartate aminotransferase (ASAT) or Alanine aminotransferase (ALAT) more than 3 times upper limit of normal Pregnancy or lactation Allergy to study drug or to the excipients in their formulation Neuropathy grade 2 or more according to Common terminology criteria for adverse events (CTCAE) v.4.0 Hearing loss/tinnitus is a relative exclusion criteria; the responsible physician decides whether the patient may be included in the study Severe cardiac illness; myocardial infarction within 6 months prior to randomization, severe congestive heart failure, severe cardiomyopathy, ventricular arrythmia, unstable angina, uncontrolled hypertension
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maria Gebre-Medhin, MD, PhD
Organizational Affiliation
Lund University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Gävle Hospital
City
Gävle
Country
Sweden
Facility Name
Sahlgrenska University Hospital
City
Göteborg
Country
Sweden
Facility Name
County Hospital Ryhov
City
Jönköping
Country
Sweden
Facility Name
Central Hospital
City
Karlstad
Country
Sweden
Facility Name
University Hospital Linköping
City
Linköping
Country
Sweden
Facility Name
Karolinska Universityhospital
City
Stockholm
Country
Sweden
Facility Name
Norrland University Hospital
City
Umeå
Country
Sweden
Facility Name
Västmanlands Hospital Västerås
City
Västerås
Country
Sweden
Facility Name
University Hospital Örebro
City
Örebro
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
33052757
Citation
Gebre-Medhin M, Brun E, Engstrom P, Haugen Cange H, Hammarstedt-Nordenvall L, Reizenstein J, Nyman J, Abel E, Friesland S, Sjodin H, Carlsson H, Soderkvist K, Thomasson M, Zackrisson B, Nilsson P. ARTSCAN III: A Randomized Phase III Study Comparing Chemoradiotherapy With Cisplatin Versus Cetuximab in Patients With Locoregionally Advanced Head and Neck Squamous Cell Cancer. J Clin Oncol. 2021 Jan 1;39(1):38-47. doi: 10.1200/JCO.20.02072. Epub 2020 Oct 14.
Results Reference
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A Study of Cisplatin Plus Radiotherapy Compared to Cetuximab Plus Radiotherapy in Locally Advanced Head and Neck Cancer.

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