Pharmacokinetics and Pharmacogenetics-based Adaptive Dosing of 5-fu (5-Fluorouracile) in Head & Neck Cancer Patient Undergoing Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) Therapy (5-FU)
Primary Purpose
Patients With Head and Neck Cancer (ORL)
Status
Completed
Phase
Phase 4
Locations
France
Study Type
Interventional
Intervention
Cisplatin
Docetaxel
5-Fluorouracile
Sponsored by
About this trial
This is an interventional treatment trial for Patients With Head and Neck Cancer (ORL)
Eligibility Criteria
Inclusion Criteria:
- Age > 18 and ≤ 80 years.
- Squamous cell carcinoma of the head and neck (oral cavity, oropharynx, hypopharynx, larynx, nasopharynx).
- Locally advanced stage (III, IVa or IVb).
- The patient must have received the information note and signing the informed consent, as well as being spent in multidisciplinary meeting after which treatment with TPF (Docetaxel, Cisplatin, 5-Fluorouracile) induction chemotherapy was proposed.
- Performance Status less than or equal to 2 (WHO performance index).
- The patient must be affiliated to a social security scheme and followed in one of the participating centers.
- Patients polymorphonuclear neutrophil greater than or equal to 1000 / mm3, platelets greater than or equal to 100 000 / mm3, hemoglobin greater than or equal to 8 g / dl, transaminases less than or equal to 1.5 times the normal, total bilirubin or equal 1.5 times the normal creatinine clearance in the upper or equal to 50 ml / min Modification of Diet in Renal Disease (MDRD)
- Satisfactory heart function
- Patients must be able to submit to the rhythm of visits, treatment plan, laboratory balances and other study procedures.
Exclusion Criteria:
- Patient > 80 years.
- Patients with uncontrolled infection that could compromise participation in the study.
- Patients with other serious concomitant diseases and / or uncontrolled that could compromise participation in the study.
- Patients with serum bilirubin> under limit normal and / or Alanine Transaminase (ALAT) and Aspartate Transaminase (AST) 3.5 times the under limit normal with alkaline phosphatase greater than 6 times the under limit normal.
- Cardiovascular disease or clinically significant cardiovascular disorder in the judgment of the investigator, such as, but not limited to uncontrolled hypertension, congestive heart failure The New York Heart Association (NYHA) classification> III), unstable angina, myocardial infarction in 6 months prior to treatment, uncontrolled arrhythmias, chronic liver or renal disease, severely impaired lung function.
- Disorders significant acute gastrointestinal or recent with a major symptom of diarrhea, such as Crohn's disease, malabsorption syndrome or diarrhea Common toxicity Criteria for Adverse Events (CTCAE) grade> 1 whatever aetiology.
- Performance Status and / or laboratory tests incompatible with chemotherapy using cisplatin, docetaxel and 5-fluorouracile (5-FU)
- Inability to submit to medical monitoring test for geographical reasons, family, social or psychological.
- Patients refusing to participate in biological assessments.
- Persons deprived of liberty or guardianship.
- Pregnant women or likely to be at the time of enrollment or during breastfeeding.
- Free, informed and signed not obtained.
Sites / Locations
- Assistance Publique Hôpitaux de Marseille
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Head and neck cancer patient
Arm Description
Association of Docetaxel, Cisplatin, 5-Fluorouracile for pharmacokinetic evaluation
Outcomes
Primary Outcome Measures
Determination of 5-FU (5-Fluorouracile)
Concentration of 5-FU in nanograms per milliliter. Circulating 5-FU will be quantified by immunoassay.
Toxicities
will be graded according to Common toxicity Criteria (CTC) 2.0 standards.
Secondary Outcome Measures
Full Information
NCT ID
NCT02484677
First Posted
June 22, 2015
Last Updated
May 25, 2023
Sponsor
Assistance Publique Hopitaux De Marseille
1. Study Identification
Unique Protocol Identification Number
NCT02484677
Brief Title
Pharmacokinetics and Pharmacogenetics-based Adaptive Dosing of 5-fu (5-Fluorouracile) in Head & Neck Cancer Patient Undergoing Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) Therapy
Acronym
5-FU
Official Title
Pharmacokinetics and Pharmacogenetics-based Adaptive Dosing of 5-fu (5-Fluorouracile) in Head & Neck Cancer Patient Undergoing Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
July 15, 2015 (Actual)
Primary Completion Date
January 25, 2017 (Actual)
Study Completion Date
May 25, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique Hopitaux De Marseille
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) is a mainstay for treating head and neck cancers, but elderly or fragile patients are often precluded because of the risk of severe toxicities associated with this protocol. DPD (Dihydro Pyrimidine Dehydrogenase) deficiency is a pharmacogenetic syndrome responsible for most of the severe/lethal toxicities showing in 5-FU (5-Fluorouracile)-treated patients, and our institute has developed a strategy for the routine determination of Dihydro Pyrimidine Dehydrogenase (DPD) status prior to starting giving the 5-FU so as to roughly adapt drug dosage according to the Dihydro Pyrimidine Dehydrogenase (DPD) status. This project aims at developing a Bayesian strategy to further individualize 5-FU dosing to reach a target exposure of area under curve (AUC). To this end, 100 patients with head and neck cancer and scheduled for a Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) regimen will be included.
Detailed Description
Crop the plasma exposure of 5-FU (5-Fluorouracile) around a predefined target area under the curve 30 (AUC30) in patients with head and neck cancer treated with Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) protocols and correlate adaptive Bayesian procedure to tolerability.
Develop a population die from a group of 20 patients for which a pharmacokinetic study will be carried out
Evaluate obtaining effective concentration of 5-FU in the context of a Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) protocol adapted by the Bayesian procedure.
Compare recommendations in terms of dosage adjustment of Bayesian approach with the recommendations of a simplified graphical approach.
Test the measure of Dihydro Pyrimidine Dehydrogenase (DPD) activity Dihydrouracil/Uracile (UH2 / U ratio) as a co-variable adjustment of 5-Fluorouracile (5-FU) regimens in Pharmacogenomics/Pharmacokinetic (PGx / PK) model.
Evaluate a prototype of urinary dipsticks for the early detection of toxicity from the assay as a marker of Dihydro Pyrimidine Dehydrogenase (DPD) activity.
Assess the cost-benefit of dosage targeting, in terms of reduction resulting costs to the management of chemotherapy-induced toxicities.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Patients With Head and Neck Cancer (ORL)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Head and neck cancer patient
Arm Type
Experimental
Arm Description
Association of Docetaxel, Cisplatin, 5-Fluorouracile for pharmacokinetic evaluation
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Antineoplastic cytostatic. Blood sampling for pharmacokinetic evaluation
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Description
Taxanes. Blood sampling for pharmacokinetic evaluation
Intervention Type
Drug
Intervention Name(s)
5-Fluorouracile
Intervention Description
Antineoplastic and immunomodulating agents. Blood sampling for pharmacokinetic evaluation
Primary Outcome Measure Information:
Title
Determination of 5-FU (5-Fluorouracile)
Description
Concentration of 5-FU in nanograms per milliliter. Circulating 5-FU will be quantified by immunoassay.
Time Frame
24 months
Title
Toxicities
Description
will be graded according to Common toxicity Criteria (CTC) 2.0 standards.
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age > 18 and ≤ 80 years.
Squamous cell carcinoma of the head and neck (oral cavity, oropharynx, hypopharynx, larynx, nasopharynx).
Locally advanced stage (III, IVa or IVb).
The patient must have received the information note and signing the informed consent, as well as being spent in multidisciplinary meeting after which treatment with TPF (Docetaxel, Cisplatin, 5-Fluorouracile) induction chemotherapy was proposed.
Performance Status less than or equal to 2 (WHO performance index).
The patient must be affiliated to a social security scheme and followed in one of the participating centers.
Patients polymorphonuclear neutrophil greater than or equal to 1000 / mm3, platelets greater than or equal to 100 000 / mm3, hemoglobin greater than or equal to 8 g / dl, transaminases less than or equal to 1.5 times the normal, total bilirubin or equal 1.5 times the normal creatinine clearance in the upper or equal to 50 ml / min Modification of Diet in Renal Disease (MDRD)
Satisfactory heart function
Patients must be able to submit to the rhythm of visits, treatment plan, laboratory balances and other study procedures.
Exclusion Criteria:
Patient > 80 years.
Patients with uncontrolled infection that could compromise participation in the study.
Patients with other serious concomitant diseases and / or uncontrolled that could compromise participation in the study.
Patients with serum bilirubin> under limit normal and / or Alanine Transaminase (ALAT) and Aspartate Transaminase (AST) 3.5 times the under limit normal with alkaline phosphatase greater than 6 times the under limit normal.
Cardiovascular disease or clinically significant cardiovascular disorder in the judgment of the investigator, such as, but not limited to uncontrolled hypertension, congestive heart failure The New York Heart Association (NYHA) classification> III), unstable angina, myocardial infarction in 6 months prior to treatment, uncontrolled arrhythmias, chronic liver or renal disease, severely impaired lung function.
Disorders significant acute gastrointestinal or recent with a major symptom of diarrhea, such as Crohn's disease, malabsorption syndrome or diarrhea Common toxicity Criteria for Adverse Events (CTCAE) grade> 1 whatever aetiology.
Performance Status and / or laboratory tests incompatible with chemotherapy using cisplatin, docetaxel and 5-fluorouracile (5-FU)
Inability to submit to medical monitoring test for geographical reasons, family, social or psychological.
Patients refusing to participate in biological assessments.
Persons deprived of liberty or guardianship.
Pregnant women or likely to be at the time of enrollment or during breastfeeding.
Free, informed and signed not obtained.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Urielle DESALBRES, Director
Organizational Affiliation
Assistance Publique Hôpitaux de Marseille
Official's Role
Study Director
Facility Information:
Facility Name
Assistance Publique Hôpitaux de Marseille
City
Marseille
ZIP/Postal Code
13354
Country
France
12. IPD Sharing Statement
Learn more about this trial
Pharmacokinetics and Pharmacogenetics-based Adaptive Dosing of 5-fu (5-Fluorouracile) in Head & Neck Cancer Patient Undergoing Docetaxel, Cisplatin, 5-Fluorouracile (=TPF) Therapy
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