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An Open-label, Multicentre, Phase II/III RCT of PFLL Versus GP Combined With JS001 as the First-line Therapy for mNPC

Primary Purpose

Nasopharyngeal Carcinoma, Metastasis, Chemotherapy

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Triprilimab(JS001)
Cisplatin
5-Fluorouracil
Gemcitabine
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

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Nasopharyngeal carcinoma diagnosed by pathology or cytology.
  • Primarily metastatic (stage IVB as defined by the International Union against Cancer and American Joint Committee on Cancer staging system for NPC, eighth edition) is not amenable for local-regional treatment or curative treatment.
  • Has not received prior systemic treatment for metastatic nasopharyngeal carcinoma, except for neoadjuvant chemotherapy, concurrent chemoradiotherapy, or adjuvant chemotherapy 6 months prior to the first treatment.
  • The Karnofsky performance status score is at least 70 points (if the decreased score is caused by the tumor, the minimum score can be 50 points after the judgment of researchers.)
  • Has at least one measurable target lesion based on RECIST v1.1, which is never received local treatment like radiotherapy.
  • Life expectancy ≥ 3 months.
  • The lab examination results of the screening must fulfill all of the following (use of any blood components, hematopoietic stimulating factors, etc. are not allowed within 14 days before screening):

    1. absolute neutrophil count ≥1.5×10^9/ L;
    2. platelet count ≥ 100×10^9/ L;
    3. hemoglobin ≥ 8.0 g/dL;
    4. serum albumin ≥ 2.8g/dL;
    5. aspartate transferase(AST) and alanine transferase(ALT) ≤ 1.5 ×ULN; total bilirubin ≤ 1.5×ULN (if has liver metastasis, AST and ALT ≤ 5×ULN);
    6. creatinine clearance >50 mL/min.
  • Men with reproductive capacity or women of childbearing potential must use highly effective contraceptive methods during the trial (e.g., oral contraceptives, intrauterine device, sexual abstinence or barrier method combined with spermicide), and continue contraception for 3 months after the last injection of JS001 and 6 months after the end of chemotherapy.
  • Has signed the Informed Consent Form.

Exclusion Criteria:

  • Allergic to monoclonal antibodies, any JS001 components, gemcitabine, cisplatin, or 5-fluorouracil.
  • Has prior therapy including anti-PD-1, anti-PD-L1, or CTLA4.
  • Major surgery within 28 days prior to the randomization (not including diagnostic surgery) or plan to be conducted during the study.
  • Active autoimmune disease requiring systemic treatment or has a history of autoimmune disease.
  • Requiring the use of cortisol (>10mg/day Prednisone or equivalent dose) or other systematic immunosuppressive medications within 14 days before the study treatment.
  • Allergic to macromolecular protein preparation ingredients.
  • Has central nervous system (CNS) metastasis with clinical symptoms.
  • Had other invasive malignant diseases, except excised basal-cell skin carcinoma, cervical carcinoma in situ, or other cancers curatively treated more than 5 years before study entry.
  • Has cardiac clinical symptoms or disease out of control.
  • Has an active infection or unexplained fever with more than 38.5 ℃ during screening and prior to first administration.
  • Has acquired or congenital immune-deficient disease, or active hepatitis.
  • History of drug abuse or alcohol abuse.
  • The investigator judges other factors that may lead to the forced termination of this study, including but not limited to: other serious conditions (including mental disorder) that require concomitant treatment, severe laboratory test abnormalities, family or social factors that may affect the safety of patients or the collection of trial data and samples.
  • Pregnancy or breast feeding.

Sites / Locations

  • Department of Radiation Oncology, Sun Yat-Sen University Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Experimental group

Control group

Arm Description

5-fluorouracil intravenous infusion at 200mg/m2/d for 30 continuous days, and intravenous infusion of cisplatin 80 mg/m2 on day 1 and day 28, and intravenous infusion of JS001 240mg on day 1 and day 21, every 60 days.

gemcitabine at a dose of 1,000 mg/m2 by intravenous infusion on days 1, 8, and intravenous infusion of cisplatin at a dose of 80 mg/m2 on day 1, and intravenous infusion of JS001 240mg on day 1, every 21 days.

Outcomes

Primary Outcome Measures

PFS
Progression-free survival
OS
Overall survival
Severe drug-related adverse events
grade III-V according to CTCAE v4.0

Secondary Outcome Measures

ORR
Objective response rate
DCR
Disease control rate
DOR
Duration of response
Minor drug-related adverse events
grade I-II according to CTCAE v4.0
Quality-adjusted survival
Quality-adjusted Time Without Symptoms of disease or Toxicity of treatment (Q-TWiST), a measure involving the partitioning of survival duration into clinically relevant health states (e.g., treatment toxicity, disease progression, progression-free), assigning preference weights (or utilities) to these health states, and calculating quality of life-adjusted weighted sums of the mean duration of each health state to create the overall Q-TWiST scores.
Therapeutic gain
Calculated by dividing person-year rate of overall survival by person-year rate of serious toxicity.
Incremental Cost-Effectiveness Ratio (ICER)
To estimate the costs and health gains of different interventions, calculated as incremental cost divided by life years gained.

Full Information

First Posted
May 4, 2021
Last Updated
May 16, 2021
Sponsor
Sun Yat-sen University
Collaborators
Shanghai Junshi Bioscience Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04890522
Brief Title
An Open-label, Multicentre, Phase II/III RCT of PFLL Versus GP Combined With JS001 as the First-line Therapy for mNPC
Official Title
A Randomized, Open-label, Multicentre, Phase II/III Study of Low-dose Long-term Continuous Intravenous Infused 5-fluorouracil Versus Gemcitabine Combined With Cisplatin and JS001 as First-line Therapy for Metastatic Nasopharyngeal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Not yet recruiting
Study Start Date
July 1, 2021 (Anticipated)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
Collaborators
Shanghai Junshi Bioscience Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
The treatment of distant metastasis is a key challenge for nasopharyngeal carcinoma because of poor outcomes, among which, chemotherapy is the cornerstone. However, many studies reported the use of different chemotherapy regimens to prolong the survival of metastatic nasopharyngeal carcinoma, while few of them focused on how to reduce the side effects of chemotherapy or improve the life quality of patients. Blocking the immune checkpoint is one of the effective strategies of tumor immunotherapy. Thus, we sought to find a proper chemotherapy regimen combined with PD-1 antibody JS001.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Carcinoma, Metastasis, Chemotherapy, Immunotherapy, Survival

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
622 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental group
Arm Type
Experimental
Arm Description
5-fluorouracil intravenous infusion at 200mg/m2/d for 30 continuous days, and intravenous infusion of cisplatin 80 mg/m2 on day 1 and day 28, and intravenous infusion of JS001 240mg on day 1 and day 21, every 60 days.
Arm Title
Control group
Arm Type
Active Comparator
Arm Description
gemcitabine at a dose of 1,000 mg/m2 by intravenous infusion on days 1, 8, and intravenous infusion of cisplatin at a dose of 80 mg/m2 on day 1, and intravenous infusion of JS001 240mg on day 1, every 21 days.
Intervention Type
Drug
Intervention Name(s)
Triprilimab(JS001)
Intervention Description
Maximum 6 cycles for combined therapy and maintenance for up to 2 years.
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Maximum 6 cycles for combined therapy.
Intervention Type
Drug
Intervention Name(s)
5-Fluorouracil
Intervention Description
Maximum 6 cycles for combined therapy.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Maximum 6 cycles for combined therapy.
Primary Outcome Measure Information:
Title
PFS
Description
Progression-free survival
Time Frame
Up to 5 years
Title
OS
Description
Overall survival
Time Frame
Up to 5 years
Title
Severe drug-related adverse events
Description
grade III-V according to CTCAE v4.0
Time Frame
Up to 2 approximately years
Secondary Outcome Measure Information:
Title
ORR
Description
Objective response rate
Time Frame
Up to 2 approximately years
Title
DCR
Description
Disease control rate
Time Frame
Up to 2 approximately years
Title
DOR
Description
Duration of response
Time Frame
Up to 2 approximately years
Title
Minor drug-related adverse events
Description
grade I-II according to CTCAE v4.0
Time Frame
Up to 2 approximately years
Title
Quality-adjusted survival
Description
Quality-adjusted Time Without Symptoms of disease or Toxicity of treatment (Q-TWiST), a measure involving the partitioning of survival duration into clinically relevant health states (e.g., treatment toxicity, disease progression, progression-free), assigning preference weights (or utilities) to these health states, and calculating quality of life-adjusted weighted sums of the mean duration of each health state to create the overall Q-TWiST scores.
Time Frame
Up to 5 years
Title
Therapeutic gain
Description
Calculated by dividing person-year rate of overall survival by person-year rate of serious toxicity.
Time Frame
Up to 2 approximately years
Title
Incremental Cost-Effectiveness Ratio (ICER)
Description
To estimate the costs and health gains of different interventions, calculated as incremental cost divided by life years gained.
Time Frame
Up to 2 approximately years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Nasopharyngeal carcinoma diagnosed by pathology or cytology. Primarily metastatic (stage IVB as defined by the International Union against Cancer and American Joint Committee on Cancer staging system for NPC, eighth edition) is not amenable for local-regional treatment or curative treatment. Has not received prior systemic treatment for metastatic nasopharyngeal carcinoma, except for neoadjuvant chemotherapy, concurrent chemoradiotherapy, or adjuvant chemotherapy 6 months prior to the first treatment. The Karnofsky performance status score is at least 70 points (if the decreased score is caused by the tumor, the minimum score can be 50 points after the judgment of researchers.) Has at least one measurable target lesion based on RECIST v1.1, which is never received local treatment like radiotherapy. Life expectancy ≥ 3 months. The lab examination results of the screening must fulfill all of the following (use of any blood components, hematopoietic stimulating factors, etc. are not allowed within 14 days before screening): absolute neutrophil count ≥1.5×10^9/ L; platelet count ≥ 100×10^9/ L; hemoglobin ≥ 8.0 g/dL; serum albumin ≥ 2.8g/dL; aspartate transferase(AST) and alanine transferase(ALT) ≤ 1.5 ×ULN; total bilirubin ≤ 1.5×ULN (if has liver metastasis, AST and ALT ≤ 5×ULN); creatinine clearance >50 mL/min. Men with reproductive capacity or women of childbearing potential must use highly effective contraceptive methods during the trial (e.g., oral contraceptives, intrauterine device, sexual abstinence or barrier method combined with spermicide), and continue contraception for 3 months after the last injection of JS001 and 6 months after the end of chemotherapy. Has signed the Informed Consent Form. Exclusion Criteria: Allergic to monoclonal antibodies, any JS001 components, gemcitabine, cisplatin, or 5-fluorouracil. Has prior therapy including anti-PD-1, anti-PD-L1, or CTLA4. Major surgery within 28 days prior to the randomization (not including diagnostic surgery) or plan to be conducted during the study. Active autoimmune disease requiring systemic treatment or has a history of autoimmune disease. Requiring the use of cortisol (>10mg/day Prednisone or equivalent dose) or other systematic immunosuppressive medications within 14 days before the study treatment. Allergic to macromolecular protein preparation ingredients. Has central nervous system (CNS) metastasis with clinical symptoms. Had other invasive malignant diseases, except excised basal-cell skin carcinoma, cervical carcinoma in situ, or other cancers curatively treated more than 5 years before study entry. Has cardiac clinical symptoms or disease out of control. Has an active infection or unexplained fever with more than 38.5 ℃ during screening and prior to first administration. Has acquired or congenital immune-deficient disease, or active hepatitis. History of drug abuse or alcohol abuse. The investigator judges other factors that may lead to the forced termination of this study, including but not limited to: other serious conditions (including mental disorder) that require concomitant treatment, severe laboratory test abnormalities, family or social factors that may affect the safety of patients or the collection of trial data and samples. Pregnancy or breast feeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yun-fei Xia, MD
Phone
+8613602805461
Email
xiayf@sysucc.org.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Shuohan Zheng, MD
Phone
+8613826478924
Email
zhengsh1@sysucc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yun-fei Xia, MD
Organizational Affiliation
Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Radiation Oncology, Sun Yat-Sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yun-fei Xia, MD
Phone
+8613602805461
Email
xiayf@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Shuohan Zheng, MD
Phone
+8613826478924
Email
zhengsh1@sysucc.org.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

An Open-label, Multicentre, Phase II/III RCT of PFLL Versus GP Combined With JS001 as the First-line Therapy for mNPC

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