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Induction Chemotherapy and Chemoradiotherapy in Nasopharyngeal Cancers (NPC2006)

Primary Purpose

Nasopharyngeal Cancers

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Induction chemotherapy + concurrent radiochemotherapy vs. concurrent radiochemotherapy
Sponsored by
Groupe Oncologie Radiotherapie Tete et Cou
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasopharyngeal Cancers focused on measuring Nasopharyngeal cancers, induction chemotherapy, radiochemotherapy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. WHO II-III carcinoma of the nasopharynx, histologically proven by a nasal cavity biopsy, locally advanced T2b, T3, T4 and/or N1, N2 or N3 (UICC/AJCC2002).
  2. Absence of distant metastases, confirmed by a chest CT scan, abdominal ultrasound (or CT scan) in case of abnormal hepatic function, and bone scintigraphy required.
  3. Total absence of previous chemotherapy or radiotherapy, for whatever reason.
  4. Total absence of surgical procedures for nasopharyngeal carcinoma.
  5. Total absence of concurrent cancer treatment.
  6. Total absence of chronic treatment (>= 3 months) with corticosteroids with a daily dosage >= 20 mg/day of methylprednisolone or equivalent.
  7. Age between 18 and 70 years.
  8. Performance status 0 or 1 according to the WHO criteria.
  9. Hematological function parameters performed within 10 days before inclusion:

    • Neutrophils >= 1.5 * 109/l
    • Platelets: >= 100 * 109/l
    • Hemoglobin: >= 10 g/dl
  10. Hepatic function parameters performed within 10 days before inclusion:

    • Total bilirubin is normal
    • AST (SGOT) and ALT (SGPT) <= 2.5 * upper limit of normal (ULN) of each center.
    • Alkaline phosphatase <= 2.5 * ULN.
  11. Renal function parameters performed within 10 days before inclusion: Creatinine clearance must be <= 55 ml/min.
  12. Patient who has given his/her written consent before any specific procedure of the protocol.
  13. Patient having a Social Security (social policy-holders)

Exclusion Criteria:

  1. WHO I carcinoma of the nasopharynx, histologically proven by a nasal cavity biopsy.
  2. Other previous or concomitant cancer, except for in situ cervical cancer and cutaneous basal cell carcinoma.
  3. Histological diagnosis on a lymph node biopsy.
  4. Pregnant or breast-feeding females, or females and males of childbearing potential not taking adequate contraceptive measures.
  5. Symptomatic peripheral neuropathy with grade >= 2 according to the NCI-CTC criteria.
  6. Other serious concurrent medical disease (non-exhaustive list):

    • Unstable heart disease despite treatment.
    • Myocardial infarction within 6 months before inclusion in the trial.
    • A history of neurological or psychiatric events such as dementia, convulsions.
    • Severe uncontrolled infection.
    • Active gastroduodenal ulcer.
    • Obstructive Pulmonary Disease requiring hospitalization within the year prior to inclusion.
  7. Clinical impairment of auditory function.
  8. The presence, at time of screening, of psychological, familial, social or geographical factors that may have an effect on the compliance of the patient with the study protocol and monitoring comprises an exclusion criterion. These factors must be discussed with the patient before his or her inclusion in the trial.
  9. Hypersensitivity to the excipients.
  10. A patient already enrolled in another therapeutic trial on an investigational compound.
  11. A person deprived of liberty or in the care of a guardian.

    -

Sites / Locations

  • Hôpital de la Pitié-Salpétrière
  • Institut Gustave Roussy
  • University of Casablanca
  • University of Cluj
  • Hôpital Habib Bourguiba

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Induction chemotherapy + concurrent chemoradiotherapy

Concurrent radiochemotherapy alone

Arm Description

Induction chemotherapy (Docetaxel + Cisplatin + 5-FU): Docetaxel 75 mg/m² administered on D1 of each course, every 3 weeks, via one-hour IV infusion Cisplatin 75 mg/m² administered on D1 via one-hour infusion followed by 5-Fluorouracil (as a continuous infusion): 750 mg/m²/d administered as a continuous infusion from D1 to D5. The cycles will be repeated every 3 weeks up to a total of 3 courses. Followed by concurrent chemoradiotherapy with Cisplatin : weekly Cisplatin 40 mg/m2 starting on D1 of the radiation therapy (70 Gy/7 weeks).

Concurrent chemoradiotherapy with Cisplatin : weekly Cisplatin 40 mg/m2 starting on D1 of the radiation therapy (70 Gy/7 weeks).

Outcomes

Primary Outcome Measures

Event free-survival

Secondary Outcome Measures

Survival
late and acute toxicity according to NCI-CTC and EORTC/RTOG criteria
Cumulative incidence of loco-regional progression
Cumulative rate of metastasis
Global response to chemo-radiotherapy
Global response to induction chemotherapy

Full Information

First Posted
January 22, 2009
Last Updated
January 17, 2019
Sponsor
Groupe Oncologie Radiotherapie Tete et Cou
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1. Study Identification

Unique Protocol Identification Number
NCT00828386
Brief Title
Induction Chemotherapy and Chemoradiotherapy in Nasopharyngeal Cancers
Acronym
NPC2006
Official Title
A Randomized, Multicenter, Phase III Trial Comparing Induction CT With Docetaxel, Cisplatin and 5-FU (TPF) Followed by Concurrent CT-RT to Concurrent CT Alone, in Nasopharyngeal Cancers Staged as T2b, T3, T4 and/or With Lymph Node Involvement (>N1)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Terminated
Why Stopped
Low accrual
Study Start Date
January 2009 (undefined)
Primary Completion Date
April 19, 2017 (Actual)
Study Completion Date
April 19, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Groupe Oncologie Radiotherapie Tete et Cou

4. Oversight

5. Study Description

Brief Summary
This is a randomized, multicenter, phase III trial comparing induction chemotherapy with Docetaxel, Cisplatin and 5-Fluorouracil (TPF) followed by concurrent chemoradiotherapy to concurrent chemoradiotherapy alone, in nasopharyngeal cancers staged as T2b, T3, T4 and/or with lymph node involvement (≥ N1. The main end point is the event free survival.
Detailed Description
This is a randomized, multicenter, phase III trial comparing induction chemotherapy with Docetaxel, Cisplatin and 5-Fluorouracil (TPF) followed by concurrent chemoradiotherapy (Arm A) to concurrent chemoradiotherapy alone (Arm B), in nasopharyngeal cancers staged as T2b, T3, T4 and/or with lymph node involvement (≥ N1. The main end point is the event free survival. The treatments are : Arm A: induction chemotherapy: Docetaxel (75 mg/m² administered on D1 of each course, every 3 weeks via one-hour IV infusion) + Cisplatin(75 mg/m² administered on D1 via one-hour infusion )+ 5-FU (750 mg/m²/d administered as a continuous infusion from D1 to D5. The cycles will be repeated every 3 weeks up to a total of 3 courses. followed by chemoradiotherapy with Cisplatin (40 mg/m2 starting on D1 of the radiation therapy) during 7 weeks Arm B: Chemoradiotherapy with Cisplatin alone (40 mg/m2 starting on D1 of the radiation therapy) during 7 weeks

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Cancers
Keywords
Nasopharyngeal cancers, induction chemotherapy, radiochemotherapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Induction chemotherapy + concurrent chemoradiotherapy
Arm Type
Experimental
Arm Description
Induction chemotherapy (Docetaxel + Cisplatin + 5-FU): Docetaxel 75 mg/m² administered on D1 of each course, every 3 weeks, via one-hour IV infusion Cisplatin 75 mg/m² administered on D1 via one-hour infusion followed by 5-Fluorouracil (as a continuous infusion): 750 mg/m²/d administered as a continuous infusion from D1 to D5. The cycles will be repeated every 3 weeks up to a total of 3 courses. Followed by concurrent chemoradiotherapy with Cisplatin : weekly Cisplatin 40 mg/m2 starting on D1 of the radiation therapy (70 Gy/7 weeks).
Arm Title
Concurrent radiochemotherapy alone
Arm Type
Active Comparator
Arm Description
Concurrent chemoradiotherapy with Cisplatin : weekly Cisplatin 40 mg/m2 starting on D1 of the radiation therapy (70 Gy/7 weeks).
Intervention Type
Procedure
Intervention Name(s)
Induction chemotherapy + concurrent radiochemotherapy vs. concurrent radiochemotherapy
Intervention Description
Induction chemotherapy (Docetaxel, Cisplatin and 5-Fluorouracil) + concurrent radiochemotherapy
Primary Outcome Measure Information:
Title
Event free-survival
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Survival
Time Frame
3 years
Title
late and acute toxicity according to NCI-CTC and EORTC/RTOG criteria
Time Frame
early and late
Title
Cumulative incidence of loco-regional progression
Time Frame
3 years
Title
Cumulative rate of metastasis
Time Frame
3 years
Title
Global response to chemo-radiotherapy
Time Frame
3 years
Title
Global response to induction chemotherapy
Time Frame
after the induction chemotherapy of the last patient included

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: WHO II-III carcinoma of the nasopharynx, histologically proven by a nasal cavity biopsy, locally advanced T2b, T3, T4 and/or N1, N2 or N3 (UICC/AJCC2002). Absence of distant metastases, confirmed by a chest CT scan, abdominal ultrasound (or CT scan) in case of abnormal hepatic function, and bone scintigraphy required. Total absence of previous chemotherapy or radiotherapy, for whatever reason. Total absence of surgical procedures for nasopharyngeal carcinoma. Total absence of concurrent cancer treatment. Total absence of chronic treatment (>= 3 months) with corticosteroids with a daily dosage >= 20 mg/day of methylprednisolone or equivalent. Age between 18 and 70 years. Performance status 0 or 1 according to the WHO criteria. Hematological function parameters performed within 10 days before inclusion: Neutrophils >= 1.5 * 109/l Platelets: >= 100 * 109/l Hemoglobin: >= 10 g/dl Hepatic function parameters performed within 10 days before inclusion: Total bilirubin is normal AST (SGOT) and ALT (SGPT) <= 2.5 * upper limit of normal (ULN) of each center. Alkaline phosphatase <= 2.5 * ULN. Renal function parameters performed within 10 days before inclusion: Creatinine clearance must be <= 55 ml/min. Patient who has given his/her written consent before any specific procedure of the protocol. Patient having a Social Security (social policy-holders) Exclusion Criteria: WHO I carcinoma of the nasopharynx, histologically proven by a nasal cavity biopsy. Other previous or concomitant cancer, except for in situ cervical cancer and cutaneous basal cell carcinoma. Histological diagnosis on a lymph node biopsy. Pregnant or breast-feeding females, or females and males of childbearing potential not taking adequate contraceptive measures. Symptomatic peripheral neuropathy with grade >= 2 according to the NCI-CTC criteria. Other serious concurrent medical disease (non-exhaustive list): Unstable heart disease despite treatment. Myocardial infarction within 6 months before inclusion in the trial. A history of neurological or psychiatric events such as dementia, convulsions. Severe uncontrolled infection. Active gastroduodenal ulcer. Obstructive Pulmonary Disease requiring hospitalization within the year prior to inclusion. Clinical impairment of auditory function. The presence, at time of screening, of psychological, familial, social or geographical factors that may have an effect on the compliance of the patient with the study protocol and monitoring comprises an exclusion criterion. These factors must be discussed with the patient before his or her inclusion in the trial. Hypersensitivity to the excipients. A patient already enrolled in another therapeutic trial on an investigational compound. A person deprived of liberty or in the care of a guardian. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jamel Daoud, Pr
Organizational Affiliation
Hôpital Habib Bourguiba-3029 Sfax-Tunisie
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mounir FRIKHA, Pr
Organizational Affiliation
Hôpital Habib Bourguiba-3029 Sfax-Tunisie
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jean BOURHIS, Pr
Organizational Affiliation
Institut Gustave Roussy, 39 rue Camille Desmoulin, Villejuif, France
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital de la Pitié-Salpétrière
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
Institut Gustave Roussy
City
Villejuif
ZIP/Postal Code
94805
Country
France
Facility Name
University of Casablanca
City
Casablanca
Country
Morocco
Facility Name
University of Cluj
City
Cluj
Country
Romania
Facility Name
Hôpital Habib Bourguiba
City
Sfax
Country
Tunisia

12. IPD Sharing Statement

Citations:
PubMed Identifier
28688693
Citation
Tao Y, Auperin A, Graff P, Lapeyre M, Gregoire V, Maingon P, Geoffrois L, Verrelle P, Calais G, Gery B, Martin L, Alfonsi M, Deprez P, Bardet E, Pignon T, Rives M, Sire C, Bourhis J. Very accelerated radiotherapy or concurrent chemoradiotherapy for N3 head and neck squamous cell carcinoma: Pooled analysis of two GORTEC randomized trials. Oral Oncol. 2017 Aug;71:61-66. doi: 10.1016/j.oraloncology.2017.06.002. Epub 2017 Jun 9.
Results Reference
derived
PubMed Identifier
22261362
Citation
Bourhis J, Sire C, Graff P, Gregoire V, Maingon P, Calais G, Gery B, Martin L, Alfonsi M, Desprez P, Pignon T, Bardet E, Rives M, Geoffrois L, Daly-Schveitzer N, Sen S, Tuchais C, Dupuis O, Guerif S, Lapeyre M, Favrel V, Hamoir M, Lusinchi A, Temam S, Pinna A, Tao YG, Blanchard P, Auperin A. Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial. Lancet Oncol. 2012 Feb;13(2):145-53. doi: 10.1016/S1470-2045(11)70346-1. Epub 2012 Jan 18.
Results Reference
derived

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Induction Chemotherapy and Chemoradiotherapy in Nasopharyngeal Cancers

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