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Nimotuzumab Combined With Radiotherapy in High-risk Patients With HNSCC Not Suitable for Cisplatin After Surgery

Primary Purpose

Head and Neck Squamous Cell Carcinoma

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Nimotuzumab
Sponsored by
Eye & ENT Hospital of Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Squamous Cell Carcinoma focused on measuring Nimotuzumab, HNSCC

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years;
  2. Histology or imaging diagnosed as head and neck (oropharyngeal cancer, hypopharyngeal cancer, laryngeal cancer) squamous cell carcinoma; oropharyngeal cancer should be p16 negative (p16 positive defined as p16 ≥ 70%);
  3. The radical surgery has been completed and patients were suffered from any postoperative risk factors as follows: (1) extranodal extension (ENE); (2) pT3-4; pN2-3; (3) Nerve invasion (PNI) or vascular invasion (LVI); (4) Lymph node metastasis in zone IV or zone V (oral/oropharyngeal cancer); (5) Proximal margin (< 5mm);
  4. Immunohistochemical detection indicated the EGFR expressions were positive;
  5. The patients were not suitable for cisplatin chemotherapy: (1) Age>65 years; (2) ECOG PS score>2; (3) Renal dysfunction (creatinine clearance <60ml/min); (4) Severe tinnitus or hearing loss (need hearing aids or hearing tests show 25 decibels threshold or above at two consecutive frequencies); (5) peripheral neuropathy severer than 1 level ; (6) Unable to accept venous hydration, such as cardiac dysfunction or other comorbidities (judged by the investigator); (7) The patient refuses cisplatin chemotherapy;
  6. Imaging examination did not suggest distant metastasis;
  7. Expected survival time ≥ 6 months;
  8. The following criteria must be met (No transfusion of blood or blood products within 14 days prior to screening): Hb≥90g /L; ANC≥1.0×10*9 /L; PLT≥80×10*9 /L; white blood cell count ≥ 4×10*9 /L; Biochemical examination need to meet the following criteria: serum total bilirubin (TBIL) ≤1.5 ULN; aminotransferase (AST)/alanine aminotransferase (ALT) ≤2.5 ULN.
  9. For females of reproductive age, the patients must have a negative pregnancy test (serum or urine) within 14 days prior to enrollment and be willing to use a reliable method of contraception during the trial. Male subjects should use a reliable method of contraception from the beginning of treatment until 120 days after the last medication;
  10. The subjects voluntarily joined the study and signed the informed consent, with good compliance and follow-up.

Exclusion Criteria:

  1. The patients received chemotherapies, PD-1 inhibitors, monoclonal antibody against EGFR, EGFR-TKI, anti-angiogenic drugs within 4 weeks before enrollment;
  2. The patients participated in other interventional clinical trials within 30 days before screening;
  3. There was a history of other malignant tumors within the past 5 years, except for cured cervical carcinoma in situ, non-melanoma skin cancer, localized prostate cancer, ductal carcinoma in situ;
  4. Poorly controlled concurrent diseases (such as heart failure, diabetes, hypertension, thyroid disease, mental illness, etc.);
  5. Known to be infected with HIV virus or active viral hepatitis or tuberculosis;
  6. There is major surgery within 30 days before taking the trial drug for the first time or there is planned surgery;
  7. Allergic to the drugs or their components used in this program;
  8. Pregnancy (confirmed by blood or urine HCG test) or breastfeeding women, or subjects of childbearing age who are unwilling or unable to take effective contraceptive measures (applicable to both male and female subjects) until at least 6 months after the last trial treatment;
  9. Patients who are not suitable to participate in this research according to the evaluations of researchers;
  10. Those who are unwilling to participate in this study or unable to sign the informed consent form.

Sites / Locations

  • The First Affiliated Hospital of Zhejiang University
  • Zhejiang Cancer Hospital
  • Jiangsu Province Hospital
  • Ningbo Medical Center Lihuili Hospital
  • Huadong Hospital Affiliated to Fudan University
  • Shanghai General Hospital/First People's Hospital Affiliated with Shanghai Jiao Tong University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Study group

Control group

Arm Description

The study group received nimotuzumab (200mg, weekly, for 6 weeks) combined with concurrent radiotherapy.

The control group received radiotherapy alone.

Outcomes

Primary Outcome Measures

Disease free survival (DFS)

Secondary Outcome Measures

Overall survival (OS)
Local area recurrence free survival (LRRFS)
Distant metastasis free survival (DMFS)
Quality of life assessed by EORTC QLQ-H&N35
Quality of life assessed by EORTC QLQ-H&N35 [EORTC QLQ-H&N35 is a specific quality of life assessment scale based on EORTC QLQ-C 30, with 35 items. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level.]
Incidence of treatment-emergent adverse events
Including the incidence of treatment-emergent adverse events[Safety and Tolerability]. Adverse events should be reported and graded according to CTCAE version 5.0.

Full Information

First Posted
August 15, 2021
Last Updated
August 20, 2021
Sponsor
Eye & ENT Hospital of Fudan University
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1. Study Identification

Unique Protocol Identification Number
NCT05024019
Brief Title
Nimotuzumab Combined With Radiotherapy in High-risk Patients With HNSCC Not Suitable for Cisplatin After Surgery
Official Title
A Multicenter Clinical Study of Nimotuzumab Combined With Concurrent Radiotherapy Versus Radiotherapy Alone in High-risk Patients With Head and Neck Squamous Cell Carcinoma Not Suitable for Cisplatin After Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Not yet recruiting
Study Start Date
August 21, 2021 (Anticipated)
Primary Completion Date
August 21, 2025 (Anticipated)
Study Completion Date
August 21, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eye & ENT Hospital of Fudan University

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
This study is a prospective, open label, multicenter, randomized controlled clinical trial. The main purpose of the study is to evaluate the efficacy and safety of nimotuzumab combined with concurrent radiotherapy versus radiotherapy alone in high-risk patients with HNSCC not suitable for cisplatin after surgery. The subjects were randomly divided into study group (nimotuzumab combined with concurrent radiotherapy) and control group (radiotherapy alone) by 1∶1 stratified random method.
Detailed Description
This study is a prospective, open label, multicenter, randomized controlled clinical trial. The main purpose of the study is to evaluate the efficacy and safety of nimotuzumab combined with concurrent radiotherapy versus radiotherapy alone in high-risk patients with HNSCC not suitable for cisplatin after surgery. The subjects were randomly divided into study group and control group by 1∶1 stratified random method. The study group received nimotuzumab (200mg, weekly, for 6 weeks) combined with concurrent radiotherapy, while the control group received radiotherapy alone. The main endpoint is 2 year disease free survival (DFS) rate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Squamous Cell Carcinoma
Keywords
Nimotuzumab, HNSCC

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Study group
Arm Type
Experimental
Arm Description
The study group received nimotuzumab (200mg, weekly, for 6 weeks) combined with concurrent radiotherapy.
Arm Title
Control group
Arm Type
No Intervention
Arm Description
The control group received radiotherapy alone.
Intervention Type
Drug
Intervention Name(s)
Nimotuzumab
Intervention Description
The study group received nimotuzumab (200mg, weekly, for 6 weeks) in combination with radiotherapy.
Primary Outcome Measure Information:
Title
Disease free survival (DFS)
Time Frame
2 year
Secondary Outcome Measure Information:
Title
Overall survival (OS)
Time Frame
2 year
Title
Local area recurrence free survival (LRRFS)
Time Frame
2 year
Title
Distant metastasis free survival (DMFS)
Time Frame
2 year
Title
Quality of life assessed by EORTC QLQ-H&N35
Description
Quality of life assessed by EORTC QLQ-H&N35 [EORTC QLQ-H&N35 is a specific quality of life assessment scale based on EORTC QLQ-C 30, with 35 items. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level.]
Time Frame
2 year
Title
Incidence of treatment-emergent adverse events
Description
Including the incidence of treatment-emergent adverse events[Safety and Tolerability]. Adverse events should be reported and graded according to CTCAE version 5.0.
Time Frame
2 year
Other Pre-specified Outcome Measures:
Title
The change of tumor related markers
Description
The correlation of the value of EGFR, SCC-Ag, CEA and therapeutic effect [The changes of serum tumor markers (such as SCC-Ag and CEA were observed before and after treatment. The baseline EGFR levels on the prognosis of patients should also be explored]
Time Frame
2 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years; Histology or imaging diagnosed as head and neck (oropharyngeal cancer, hypopharyngeal cancer, laryngeal cancer) squamous cell carcinoma; oropharyngeal cancer should be p16 negative (p16 positive defined as p16 ≥ 70%); The radical surgery has been completed and patients were suffered from any postoperative risk factors as follows: (1) extranodal extension (ENE); (2) pT3-4; pN2-3; (3) Nerve invasion (PNI) or vascular invasion (LVI); (4) Lymph node metastasis in zone IV or zone V (oral/oropharyngeal cancer); (5) Proximal margin (< 5mm); Immunohistochemical detection indicated the EGFR expressions were positive; The patients were not suitable for cisplatin chemotherapy: (1) Age>65 years; (2) ECOG PS score>2; (3) Renal dysfunction (creatinine clearance <60ml/min); (4) Severe tinnitus or hearing loss (need hearing aids or hearing tests show 25 decibels threshold or above at two consecutive frequencies); (5) peripheral neuropathy severer than 1 level ; (6) Unable to accept venous hydration, such as cardiac dysfunction or other comorbidities (judged by the investigator); (7) The patient refuses cisplatin chemotherapy; Imaging examination did not suggest distant metastasis; Expected survival time ≥ 6 months; The following criteria must be met (No transfusion of blood or blood products within 14 days prior to screening): Hb≥90g /L; ANC≥1.0×10*9 /L; PLT≥80×10*9 /L; white blood cell count ≥ 4×10*9 /L; Biochemical examination need to meet the following criteria: serum total bilirubin (TBIL) ≤1.5 ULN; aminotransferase (AST)/alanine aminotransferase (ALT) ≤2.5 ULN. For females of reproductive age, the patients must have a negative pregnancy test (serum or urine) within 14 days prior to enrollment and be willing to use a reliable method of contraception during the trial. Male subjects should use a reliable method of contraception from the beginning of treatment until 120 days after the last medication; The subjects voluntarily joined the study and signed the informed consent, with good compliance and follow-up. Exclusion Criteria: The patients received chemotherapies, PD-1 inhibitors, monoclonal antibody against EGFR, EGFR-TKI, anti-angiogenic drugs within 4 weeks before enrollment; The patients participated in other interventional clinical trials within 30 days before screening; There was a history of other malignant tumors within the past 5 years, except for cured cervical carcinoma in situ, non-melanoma skin cancer, localized prostate cancer, ductal carcinoma in situ; Poorly controlled concurrent diseases (such as heart failure, diabetes, hypertension, thyroid disease, mental illness, etc.); Known to be infected with HIV virus or active viral hepatitis or tuberculosis; There is major surgery within 30 days before taking the trial drug for the first time or there is planned surgery; Allergic to the drugs or their components used in this program; Pregnancy (confirmed by blood or urine HCG test) or breastfeeding women, or subjects of childbearing age who are unwilling or unable to take effective contraceptive measures (applicable to both male and female subjects) until at least 6 months after the last trial treatment; Patients who are not suitable to participate in this research according to the evaluations of researchers; Those who are unwilling to participate in this study or unable to sign the informed consent form.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Tao
Phone
64377134
Email
doctortaolei@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yang Guo
Email
guoyangls@126.com
Facility Information:
Facility Name
The First Affiliated Hospital of Zhejiang University
City
Hangzhou
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaoli Sun
Facility Name
Zhejiang Cancer Hospital
City
Hangzhou
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaozhong Chen
Facility Name
Jiangsu Province Hospital
City
Nanjing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuandong Cao
Facility Name
Ningbo Medical Center Lihuili Hospital
City
Ningbo
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Miaozhen Lu
Facility Name
Huadong Hospital Affiliated to Fudan University
City
Shanghai
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiangpeng Zheng
Facility Name
Shanghai General Hospital/First People's Hospital Affiliated with Shanghai Jiao Tong University
City
Shanghai
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yong Liu

12. IPD Sharing Statement

Learn more about this trial

Nimotuzumab Combined With Radiotherapy in High-risk Patients With HNSCC Not Suitable for Cisplatin After Surgery

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