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Single-agent Capecitabine as Metronomic Chemotherapy in LAHNSCC (CMHN)

Primary Purpose

Head and Neck Squamous Cell Carcinoma

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Capecitabine
Sponsored by
Sun Yat-sen 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 head and neck squamous cell carcinoma, locoregionally advanced disease, metronomic capecitabine

Eligibility Criteria

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

Inclusion Criteria:

  1. Performance status of ECOG grade 0 or 1.
  2. Tumor staged as III-IV (as defined by the 8th AJCC edition), with newly histologically confirmed squamous cell carcinoma of oral cavity, oropharynx, larynx or hypopharynx.
  3. Complete one of the following treatments:

    1. Radical surgery plus radiotherapy or concurrent chemoradiotherapy
    2. Neoadjuvant therapy plus radical radiotherapy or concurrent chemoradiotherapy
    3. Concurrent chemoradiotherapy
  4. Postoperative radiotherapy started within 4 to 8 weeks after completion of radical surgery.
  5. Within 4 to 8 weeks after completion of the last radiation dose.
  6. No clinical evidence of persistent locoregional disease or distant metastases before enrollment.
  7. Adequate hematologic (neutrophil count > 1.5×10^9/L, hemoglobin > 90g/L and platelet count > 100×10^9/L), hepatic (alanine aminotransferase, aspartate aminotransferase ≤ 1.5×ULN, bilirubin ≤ 1.5×ULN, alkaline phosphatase ≤ 2.5×ULN) and renal function (creatinine clearance ≥ 50 ml/min).
  8. Patients must be appraised of the investigational nature of the study and provide written informed consent.

Exclusion Criteria:

  1. p16 positive.
  2. Patients who were known to be intolerable or allergic to capecitabine.
  3. Illness that would interfere with oral medication, including dysphagia, chronic diarrhea, or ileus.
  4. Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer.
  5. Pregnancy or lactation (consider pregnancy test in women of child-bearing age and emphasize effective contraception during the treatment period).
  6. Prior surgery, chemotherapy, radiotherapy or other anti-tumor treatments (except diagnostic) to primary tumor or nodes before the standard therapy.
  7. Patients who received surgery treatment, biotherapy or immunotherapy during radiotherapy.
  8. Patients who are receiving or highly likely to receive other chemotherapy treatment, biotherapy or immunotherapy after radiotherapy.
  9. Any severe intercurrent disease, which may bring unacceptable risk or affect the compliance of the trial, for example, unstable cardiac disease requiring treatment, renal disease, chronic hepatitis, diabetes with poor control (fasting plasma glucose > 1.5×ULN), and emotional disturbance.

Sites / Locations

  • Sun Yat-sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Clinical observation

Metronomic capecitabine

Arm Description

The standard treatment followed by clinical observation.

The standard treatment followed by a maintenance therapy with capecitabine (650 mg/m2 bid, d1-21, q3w) for 1 year.

Outcomes

Primary Outcome Measures

Progression-free survival
PFS will be measured from the day of randomization until treatment failure, death from any cause, or the last follow-up visit, whichever occurred first.

Secondary Outcome Measures

Overall survival
OS will be measured from the day of randomization until death due to any cause, or the last follow-up visit.
Distant failure-free survival
DFFS will be measured from the day of randomization until death until distant metastasis, or the last follow-up visit.
Locoregional failure-free survival
LRFFS will be measured from the day of randomization until death until local and/or regional recurrence, or the last follow-up visit.
Adverse events
The incidence of capecitabine-related and other adverse events.
Patient reported quality-of-life score
Patient reported quality of life would be evaluated using the Quality of Life Questionnaire-Core 30 module (QLQ-C30). The score is between 0-100, and the higher score means worse quality of life.

Full Information

First Posted
September 4, 2021
Last Updated
February 15, 2022
Sponsor
Sun Yat-sen University
Collaborators
Fujian Medical University Union Hospital, Guangzhou Panyu Central Hospital, The Central Hospital of Yongzhou, The First People's Hospital of Huaihua, Hanzhong Central Hospital, Yichang Central People's Hospital, Affiliated Hospital of Guangdong Medical University, Jiangmen Central Hospital, Xiang Yang No.1 Peoples Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05044117
Brief Title
Single-agent Capecitabine as Metronomic Chemotherapy in LAHNSCC (CMHN)
Official Title
Single-agent Capecitabine as Metronomic Chemotherapy in Locoregionally Advanced Head and Neck Squamous Cell Carcinoma (CMHN):A Phase III, Multicentre, Randomised Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 18, 2021 (Actual)
Primary Completion Date
October 2026 (Anticipated)
Study Completion Date
October 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
Collaborators
Fujian Medical University Union Hospital, Guangzhou Panyu Central Hospital, The Central Hospital of Yongzhou, The First People's Hospital of Huaihua, Hanzhong Central Hospital, Yichang Central People's Hospital, Affiliated Hospital of Guangdong Medical University, Jiangmen Central Hospital, Xiang Yang No.1 Peoples Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to investigate whether the addition of metronomic capecitabine to the standard treatment can improve prognosis in locoregionally advanced head and neck squamous cell carcinoma.
Detailed Description
The standard treatment for resectable locoregionally advanced squamous cell carcinoma of the head and the neck (LAHNSCC) is a regimen consisting of radical surgery plus radiotherapy or concurrent chemoradiotherapy. And induction chemotherapy plus radical radiotherapy or concurrent chemoradiotherapy is also recommended for locoregionally advanced squamous cell carcinoma of larynx and hypopharynx. With the extensive application of comprehensive treatment, the 5-year overall survival of LAHNSCC has not reached 50% yet. So, it is urgent to explore a regimen with high efficiency and low toxicity on the basis of existing standard treatment. Two retrospective studies found that the metronomic use of orally administered fluorouracil drugs following the reference treatment significantly improved prognosis in LAHNSCC. And capecitabine is one kind of the oral fluorouracil drugs, which has high efficiency and low toxicity. Indeed, metronomic capecitabine maintenance was shown to be effective in patients with breast cancer, colorectal cancer, and nasopharyngeal carcinoma in phase III trials. The abovementioned studies suggested the promising use of metronomic capecitabine in LAHNSCC. However, there has been no randomized trials in this field. Therefore, we initiated a randomized phase III trial to investigate the efficacy and safety of the addition of metronomic capecitabine to the standard treatment in LAHNSCC.

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
head and neck squamous cell carcinoma, locoregionally advanced disease, metronomic capecitabine

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Clinical observation
Arm Type
No Intervention
Arm Description
The standard treatment followed by clinical observation.
Arm Title
Metronomic capecitabine
Arm Type
Experimental
Arm Description
The standard treatment followed by a maintenance therapy with capecitabine (650 mg/m2 bid, d1-21, q3w) for 1 year.
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
Metronomic capecitabine (650 mg/m2 bid, d1-21, q3w) for 1 year
Primary Outcome Measure Information:
Title
Progression-free survival
Description
PFS will be measured from the day of randomization until treatment failure, death from any cause, or the last follow-up visit, whichever occurred first.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
OS will be measured from the day of randomization until death due to any cause, or the last follow-up visit.
Time Frame
2 years
Title
Distant failure-free survival
Description
DFFS will be measured from the day of randomization until death until distant metastasis, or the last follow-up visit.
Time Frame
2 years
Title
Locoregional failure-free survival
Description
LRFFS will be measured from the day of randomization until death until local and/or regional recurrence, or the last follow-up visit.
Time Frame
2 years
Title
Adverse events
Description
The incidence of capecitabine-related and other adverse events.
Time Frame
Up to 2 years
Title
Patient reported quality-of-life score
Description
Patient reported quality of life would be evaluated using the Quality of Life Questionnaire-Core 30 module (QLQ-C30). The score is between 0-100, and the higher score means worse quality of life.
Time Frame
Up to 2 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: Performance status of ECOG grade 0 or 1. Tumor staged as III-IV (as defined by the 8th AJCC edition), with newly histologically confirmed squamous cell carcinoma of oral cavity, oropharynx, larynx or hypopharynx. Complete one of the following treatments: Radical surgery plus radiotherapy or concurrent chemoradiotherapy Neoadjuvant therapy plus radical radiotherapy or concurrent chemoradiotherapy Concurrent chemoradiotherapy Postoperative radiotherapy started within 4 to 8 weeks after completion of radical surgery. Within 4 to 8 weeks after completion of the last radiation dose. No clinical evidence of persistent locoregional disease or distant metastases before enrollment. Adequate hematologic (neutrophil count > 1.5×10^9/L, hemoglobin > 90g/L and platelet count > 100×10^9/L), hepatic (alanine aminotransferase, aspartate aminotransferase ≤ 1.5×ULN, bilirubin ≤ 1.5×ULN, alkaline phosphatase ≤ 2.5×ULN) and renal function (creatinine clearance ≥ 50 ml/min). Patients must be appraised of the investigational nature of the study and provide written informed consent. Exclusion Criteria: p16 positive. Patients who were known to be intolerable or allergic to capecitabine. Illness that would interfere with oral medication, including dysphagia, chronic diarrhea, or ileus. Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer. Pregnancy or lactation (consider pregnancy test in women of child-bearing age and emphasize effective contraception during the treatment period). Prior surgery, chemotherapy, radiotherapy or other anti-tumor treatments (except diagnostic) to primary tumor or nodes before the standard therapy. Patients who received surgery treatment, biotherapy or immunotherapy during radiotherapy. Patients who are receiving or highly likely to receive other chemotherapy treatment, biotherapy or immunotherapy after radiotherapy. Any severe intercurrent disease, which may bring unacceptable risk or affect the compliance of the trial, for example, unstable cardiac disease requiring treatment, renal disease, chronic hepatitis, diabetes with poor control (fasting plasma glucose > 1.5×ULN), and emotional disturbance.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ying Sun, M.D.
Phone
+86-(020)-87343816
Email
sunying@sysucc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ying Sun, M.D.
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
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ying Sun, M.D.
Phone
+86-(020)-87343816
Email
sunying@sysucc.org.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Single-agent Capecitabine as Metronomic Chemotherapy in LAHNSCC (CMHN)

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