PD-1 Antibody Combined With Chemoradiotherapy in Recurrent Nasopharyngeal Carcinoma Patients
Primary Purpose
Recurrent Nasopharyngeal Carcinoma
Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
PD-1 blocking antibody
GP
IMRT
Sponsored by
About this trial
This is an interventional treatment trial for Recurrent Nasopharyngeal Carcinoma focused on measuring PD-1 antibody, Intensity-modulated Radiation Therapy, Efficacy, Adverse effect, chemotherapy
Eligibility Criteria
Inclusion Criteria:
- Diagnosed as local recurrence ± regional recurrence after ≥1 year of radical treatment;
- Not suitable for surgery;
- Newly histologic diagnosis of NPC (WHO II/III);
- Clinical stage rII-IVa (AJCC/UICC 8th);
- ECOG 0-1 point;
- No treatment to rNPC, such as radiotherapy, chemotherapy, immunotherapy or biotherapy;
- No contraindications to immunotherapy or radiotherapy;
- Adequate marrow function: WBC count ≥ 3×10E9/L, NE count ≥ 1.5×10E9/L, HGB ≥ 90g/L, PLT count ≥ 100×10E9/L;
- Adequate liver function: ALT/AST ≤ 2.5×ULN, TBIL ≤ 2.0×ULN;
- Adequate renal function: BUN/CRE ≤ 1.5×ULN or endogenous creatinine clearance ≥ 60ml/min (Cockcroft-Gault formula);
- Take effective contraceptions during and two months after treatment;
- Patients must be informed of the investigational nature of this study and give written informed consent.
Exclusion Criteria:
- Treated with anti-tumor Chinese medicine treatment;
- Have recurrence with local necrosis;
- Have ≥G3 late toxicities, except for skin, subcutaneous tissue or mucosa;
- Unexplained fever > 38.5 ℃, except for tumor fever;
- Treated with ≥ 5 days antibiotics one month before enrollment;
- Have active autoimmune disease (e.g., uveitis, enteritis, hepatitis, hypophysitis, nephritis, vasculitis, hyperthyroidism, and asthma requiring bronchodilator therapy); Have a known history of human immunodeficiency virus (HIV), active Hepatitis B (HBV-DNA ≥10E4copiers/ml) or hepatitis C virus (HCV) antibody positive; Have previously treated with PD-1 antibody or other immunotherapy for PD-1/PD-L1 pathway;
- Have New York Heart Association (NYHA) class 3 or 4, unstable angina, myocardial -infarction within 1 year, or clinically meaningful arrhythmia that requires treatment;
- Have known allergy to large molecule protein products or any compound of study therapy;
- Pregnant or breastfeeding;
- Prior malignancy except adequately treated non-melanoma skin cancer, in situ cervical cancer, and papillary thyroid carcinoma;
- Have received a live vaccine within 30 days of planned start of study therapy Has psychiatric drug or substance abuse disorders that would interfere with cooperation with the requirements of the trial;
- Any other condition, including mental illness or domestic/social factors, deemed by the investigator to be likely to interfere with a patient's ability to sign informed consent, cooperate and participate in the study, or interferes with the interpretation of the results.
Sites / Locations
- Sun Yat-sen University Cancer CenterRecruiting
- Peking University Third Hospital
- Sichuan Cancer Hospital
- Fujian Province Cancer Hospital
- Guizhou Cancer HospitalRecruiting
- Zhejiang Cancer Hospital
- Jiangxi Cancer Hospital
- The First Affiliated Hospital of Guangxi Medical UniversityRecruiting
- Fudan University Shanghai Cancer Center
- Zhongnan Hospital of Wuhan UniversityRecruiting
- Xijing HospitalRecruiting
- The First Affiliated Hospital of Xiamen University
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
PD-1 antibody plus chemoradiotherapy
Chemoradiotherapy
Arm Description
Patients randomized to this arm will receive three cycles of PD-1 antibody (JS001, 240mg every three weeks) combined with GP chemotherapy, then receive IMRT and PD-1 antibody maintenance for eight cycles.
Patients randomized to this arm will receive three cycles of GP chemotherapy, then receive IMRT alone.
Outcomes
Primary Outcome Measures
Overall survival
From date of randomisation to death
Secondary Outcome Measures
Progression free survival
From date of randomisation to disease progression
Short-term effects
Patient's objective response rate
Rate of patients with acute toxicities
Evaluating with CTCAE v5.0
Quality of life: EuroQoL 5 dimension
Evaluating with questionnaire of EuroQoL 5 dimension, 5 level health state utility index (EQ-5D-5L)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03907826
Brief Title
PD-1 Antibody Combined With Chemoradiotherapy in Recurrent Nasopharyngeal Carcinoma Patients
Official Title
PD-1 Antibody Combined With Chemoradiotheapy vs. Chemoradiotherapy in Recurrent Nasopharyngeal Carcinoma Patients: a Multicenter, Randomised Controlled, Phase III Clinical Trial
Study Type
Interventional
2. Study Status
Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 1, 2020 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2027 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a multicenter, randomized controlled, phase III clinical trial. The purpose of this study is to evaluate the efficacy and adverse effect of PD-1 antibody with chemoradiotherapy versus chemoradiotherapy alone in recurrent nasopharyngeal carcinoma patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Nasopharyngeal Carcinoma
Keywords
PD-1 antibody, Intensity-modulated Radiation Therapy, Efficacy, Adverse effect, chemotherapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
212 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
PD-1 antibody plus chemoradiotherapy
Arm Type
Experimental
Arm Description
Patients randomized to this arm will receive three cycles of PD-1 antibody (JS001, 240mg every three weeks) combined with GP chemotherapy, then receive IMRT and PD-1 antibody maintenance for eight cycles.
Arm Title
Chemoradiotherapy
Arm Type
Active Comparator
Arm Description
Patients randomized to this arm will receive three cycles of GP chemotherapy, then receive IMRT alone.
Intervention Type
Drug
Intervention Name(s)
PD-1 blocking antibody
Other Intervention Name(s)
JS001
Intervention Description
Toripalimab 240mg, D1, every 3 weeks per cycle
Intervention Type
Drug
Intervention Name(s)
GP
Intervention Description
Gemcitabine 1.0g/m2, D1 and D8; Cisplatin 80mg/m2, D1, every 3 weeks per cycle, total three cycles
Intervention Type
Radiation
Intervention Name(s)
IMRT
Intervention Description
IMRT 60-66Gy, 1.8-2.0Gy/f/day
Primary Outcome Measure Information:
Title
Overall survival
Description
From date of randomisation to death
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Progression free survival
Description
From date of randomisation to disease progression
Time Frame
3 years
Title
Short-term effects
Description
Patient's objective response rate
Time Frame
through study completion, an average of 2 months
Title
Rate of patients with acute toxicities
Description
Evaluating with CTCAE v5.0
Time Frame
through study completion, an average of 2 months
Title
Quality of life: EuroQoL 5 dimension
Description
Evaluating with questionnaire of EuroQoL 5 dimension, 5 level health state utility index (EQ-5D-5L)
Time Frame
through whole study, an average of 3 years
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:
Diagnosed as local recurrence ± regional recurrence after ≥1 year of radical treatment;
Not suitable for surgery;
Newly histologic diagnosis of NPC (WHO II/III);
Clinical stage rII-IVa (AJCC/UICC 8th);
ECOG 0-1 point;
No treatment to rNPC, such as radiotherapy, chemotherapy, immunotherapy or biotherapy;
No contraindications to immunotherapy or radiotherapy;
Adequate marrow function: WBC count ≥ 3×10E9/L, NE count ≥ 1.5×10E9/L, HGB ≥ 90g/L, PLT count ≥ 100×10E9/L;
Adequate liver function: ALT/AST ≤ 2.5×ULN, TBIL ≤ 2.0×ULN;
Adequate renal function: BUN/CRE ≤ 1.5×ULN or endogenous creatinine clearance ≥ 60ml/min (Cockcroft-Gault formula);
Take effective contraceptions during and two months after treatment;
Patients must be informed of the investigational nature of this study and give written informed consent.
Exclusion Criteria:
Treated with anti-tumor Chinese medicine treatment;
Have recurrence with local necrosis;
Have ≥G3 late toxicities, except for skin, subcutaneous tissue or mucosa;
Unexplained fever > 38.5 ℃, except for tumor fever;
Treated with ≥ 5 days antibiotics one month before enrollment;
Have active autoimmune disease (e.g., uveitis, enteritis, hepatitis, hypophysitis, nephritis, vasculitis, hyperthyroidism, and asthma requiring bronchodilator therapy); Have a known history of human immunodeficiency virus (HIV), active Hepatitis B (HBV-DNA ≥10E4copiers/ml) or hepatitis C virus (HCV) antibody positive; Have previously treated with PD-1 antibody or other immunotherapy for PD-1/PD-L1 pathway;
Have New York Heart Association (NYHA) class 3 or 4, unstable angina, myocardial -infarction within 1 year, or clinically meaningful arrhythmia that requires treatment;
Have known allergy to large molecule protein products or any compound of study therapy;
Pregnant or breastfeeding;
Prior malignancy except adequately treated non-melanoma skin cancer, in situ cervical cancer, and papillary thyroid carcinoma;
Have received a live vaccine within 30 days of planned start of study therapy Has psychiatric drug or substance abuse disorders that would interfere with cooperation with the requirements of the trial;
Any other condition, including mental illness or domestic/social factors, deemed by the investigator to be likely to interfere with a patient's ability to sign informed consent, cooperate and participate in the study, or interferes with the interpretation of the results.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jingjing Miao
Phone
02087342638
Email
miaojingjing90@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Chong Zhao
Phone
02087342638
Email
zhaochong@sysucc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chong Zhao
Organizational Affiliation
Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chong Zhao, M.D
Phone
+86-13902206160
Email
zhaochong@sysucc.org.cn
Facility Name
Peking University Third Hospital
City
Beijing
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Suqing Tian
Facility Name
Sichuan Cancer Hospital
City
Chengdu
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shun Lu
Facility Name
Fujian Province Cancer Hospital
City
Fuzhou
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shaojun Lin
Facility Name
Guizhou Cancer Hospital
City
Guiyang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Feng Jin
Facility Name
Zhejiang Cancer Hospital
City
Hangzhou
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaozhong Chen
Facility Name
Jiangxi Cancer Hospital
City
Nanchang
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jingao Li
Facility Name
The First Affiliated Hospital of Guangxi Medical University
City
Nanning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rengshen Wang
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chaosu Hu
Facility Name
Zhongnan Hospital of Wuhan University
City
Wuhan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Conghua Xie
Facility Name
Xijing Hospital
City
Xi'an
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mei Shi
Facility Name
The First Affiliated Hospital of Xiamen University
City
Xiamen
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qin Lin
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Links:
URL
http://www.sysucc.org.cn
Description
Home Page of Sun Yat-sen University Cancer Center
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PD-1 Antibody Combined With Chemoradiotherapy in Recurrent Nasopharyngeal Carcinoma Patients
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