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TPF Followed by Cetuximab and IMRT Plus Carbon Ion Boost for Locally Advanced Head and Neck Tumors (TPF-C-HIT)

Primary Purpose

Locally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN): Oro-, Hypopharyngeal and Laryngeal Cancer

Status
Terminated
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
carbon ion boost
Sponsored by
Heidelberg University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN): Oro-, Hypopharyngeal and Laryngeal Cancer focused on measuring SCCHN, squamous cell carcinoma of the head and neck, oropharyngeal carcinoma, hypopharyngeal carcinoma, laryngeal carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Signed written informed consent,
  • Age of 18 to 70 years,
  • Life expectancy of at least 6 month,
  • Ability of subject to understand character and individual consequences of clinical trial,
  • Histologically confirmed locally advanced (stage III or IV), non-metastatic squamous cell carcinoma of oro-, hypopharynx and larynx (T2-4, any N, M0),
  • Oral cavity or oro- , hypopharynx or laynx as the primary tumor site,
  • At least one uni-measurable lesion according to the RECIST criteria, Karnofsky Performances Status > 70%,
  • Adequate bone marrow function: neutrophils > 1.5 x 109/L, platelets > 100 x 109/L, hemoglobin > 10.0 g/dL,
  • Adequate liver function: Bilirubin < 1.5 mg/dL, SGOT, SGPT < 3 x ULN, GGT < 5 x ULN,
  • Adequate renal function: GFR> 70 ml/min,
  • Negative serum/urine Beta-HCG test in women of childbearing potential,
  • Women of childbearing potential: willingness to use effective contraceptive method, defined as the concomitant use of either an intrauterine pessary (IUP) or contraceptive pill and in both cases, condoms for the treatment duration and 2 months thereafter. Women of non-childbearing potiential are those who are post-menopausal for at least 1 year or sterilized,
  • Men of procreative potential: willingness for effective prevention of procreation, defined as a use of condoms and a use of either an intrauterine pessary (IUP) or a contraceptive pill by his partner for the treatment duration and 2 months thereafter,
  • Subject's consent to collect blood and/or tumor tissue samples for proteomics and genomics. If a patient does not consent, no samples for proteomics and genomics will be taken. Nonetheles, he/she may be enroled in the study

Exclusion Criteria:

  • Previous systemic chemotherapy, radiotherapy or surgery for carcinoma of the head, neck and larynx,
  • Nasopharyngeal Carcinoma,
  • Prior exposure to EGFR pathway targeting therapy,
  • Evidence of distant metastases.
  • Other serious illness or medical conditions:
  • Unstable cardiac disease despite treatment, congestive heart failure NYHA grade 3 and 4,
  • Significant neurologic or psychiatric disorders including dementia or seizures,
  • Active disseminated intravascular coagulation,
  • Other serious underlying medical conditions which in the opinion of investigator could impair the ability of the patient to participate in the study,
  • Symptomatic peripheral neuropathy Common Toxicity Criteria (CTC) grade 2 or higher,
  • ototoxicity CTC grade 2 or higher, except if due to trauma or mechanical impairment due to tumor mass,
  • Participation in other interventional trial within the last 30 days§§,
  • Surgery within the last 30 days,
  • Known allergic/hypersensitivity reaction to any drugs scheduled for the study treatment,
  • Women: pregnant or breast-feeding,
  • Known drug abuse,
  • Other previous malignancy within 5 years, with exception of a history of a previous, adequately treated, basal cell carcinoma of the skin or pre-invasive carcinoma of the cervix,
  • Legal incapacity or limited legal capacity,
  • Medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent.

Sites / Locations

  • Dept of Radiation Oncology, University of Heidelberg

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment arm

Arm Description

patients receive induction chemotherapy with TPF for a maximum of 3 cycles followed by radioimmunotherapy with cetuximab as intensity-modulated radiotherapy (IMRT) plus carbon ion boost

Outcomes

Primary Outcome Measures

Local-Regional Control (LRC)
The primary endpoint of the study is the Local-Regional Control (LRC) at 1 year

Secondary Outcome Measures

disease-free survival (DFS)
progression-free survival (PFS)
overall survival (OS)
acute radiation effects
late radiation effects
adverse events
includes any adverse events attributable to the combined treatment not otherwise specified
proteomic and genomic analyses
proteomic and genomic analyses designed to investigate changes during therapy, therefore analyses are carried out at 6 measuring points: days 50, 64, 73, 106 of treatment; 6 weeks post completion of radioimmunotherapy; 3 months post completion of radioimmunotherapy

Full Information

First Posted
November 22, 2010
Last Updated
April 23, 2013
Sponsor
Heidelberg University
Collaborators
University Hospital Heidelberg
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1. Study Identification

Unique Protocol Identification Number
NCT01245985
Brief Title
TPF Followed by Cetuximab and IMRT Plus Carbon Ion Boost for Locally Advanced Head and Neck Tumors
Acronym
TPF-C-HIT
Official Title
Induction Chemotherapy With TPF Followed by Radioimmunotherapy With Cetuximab and Intensity Modulated Radiotherapy (IMRT) Plus Carbon Ion Boost for Locally Advanced Tumors of the Oro-, Hypopharynx and Larynx: TPF-C-HIT
Study Type
Interventional

2. Study Status

Record Verification Date
April 2013
Overall Recruitment Status
Terminated
Why Stopped
slow recruitment (only 8 patients recruited and treated until 12/2012)
Study Start Date
November 2010 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
November 2013 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Heidelberg University
Collaborators
University Hospital Heidelberg

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
TPF-C-HIT investigates the combination of induction chemotherapy with TPF followed by radioimmunotherapy with cetuximab and IMRT plus carbon ion boost with regard to efficacy and toxicity of the combination regimen.
Detailed Description
TPF-C-HIT is a prospective, monocentric phase II trial efficacy, as measured by control and survival rates, as well as toxicity (acute and late effects) of the combined treatment with TPF-induction followed by radioimmunotherapy with the EGFR-antibody cetuximab and carbon ion boost in locally advanced squamous cell carcinoma of the head and neck (SCCHN). As long-term local control remains a therapeutic challenge in advanced head and neck cancer, locoregional control was chosen as the primary endpoint. Secondary endpoints are survival rates (disease-free survival, PFS, OS), acute and late radiation effects as well as adverse events. For development of prognostic markers, proteomic and genomic analyses are also included in the secondary endpoints.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN): Oro-, Hypopharyngeal and Laryngeal Cancer
Keywords
SCCHN, squamous cell carcinoma of the head and neck, oropharyngeal carcinoma, hypopharyngeal carcinoma, laryngeal carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
treatment arm
Arm Type
Experimental
Arm Description
patients receive induction chemotherapy with TPF for a maximum of 3 cycles followed by radioimmunotherapy with cetuximab as intensity-modulated radiotherapy (IMRT) plus carbon ion boost
Intervention Type
Radiation
Intervention Name(s)
carbon ion boost
Intervention Description
patients receive induction chemotherapy with TPF for a maximum of 3 cycles followed by radioimmunotherapy with cetuximab as intensity-modulated radiotherapy (IMRT) plus carbon ion boost
Primary Outcome Measure Information:
Title
Local-Regional Control (LRC)
Description
The primary endpoint of the study is the Local-Regional Control (LRC) at 1 year
Time Frame
12 months
Secondary Outcome Measure Information:
Title
disease-free survival (DFS)
Time Frame
12 months
Title
progression-free survival (PFS)
Time Frame
12 months
Title
overall survival (OS)
Time Frame
12 months
Title
acute radiation effects
Time Frame
6 weeks post completion of radiotherapy
Title
late radiation effects
Time Frame
12 months
Title
adverse events
Description
includes any adverse events attributable to the combined treatment not otherwise specified
Time Frame
12 months
Title
proteomic and genomic analyses
Description
proteomic and genomic analyses designed to investigate changes during therapy, therefore analyses are carried out at 6 measuring points: days 50, 64, 73, 106 of treatment; 6 weeks post completion of radioimmunotherapy; 3 months post completion of radioimmunotherapy
Time Frame
6 measuring points: days 50, 64, 73, 106 of treatment; 6 weeks post completion of radioimmunotherapy; 3 months post completion of radioimmunotherapy

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: Signed written informed consent, Age of 18 to 70 years, Life expectancy of at least 6 month, Ability of subject to understand character and individual consequences of clinical trial, Histologically confirmed locally advanced (stage III or IV), non-metastatic squamous cell carcinoma of oro-, hypopharynx and larynx (T2-4, any N, M0), Oral cavity or oro- , hypopharynx or laynx as the primary tumor site, At least one uni-measurable lesion according to the RECIST criteria, Karnofsky Performances Status > 70%, Adequate bone marrow function: neutrophils > 1.5 x 109/L, platelets > 100 x 109/L, hemoglobin > 10.0 g/dL, Adequate liver function: Bilirubin < 1.5 mg/dL, SGOT, SGPT < 3 x ULN, GGT < 5 x ULN, Adequate renal function: GFR> 70 ml/min, Negative serum/urine Beta-HCG test in women of childbearing potential, Women of childbearing potential: willingness to use effective contraceptive method, defined as the concomitant use of either an intrauterine pessary (IUP) or contraceptive pill and in both cases, condoms for the treatment duration and 2 months thereafter. Women of non-childbearing potiential are those who are post-menopausal for at least 1 year or sterilized, Men of procreative potential: willingness for effective prevention of procreation, defined as a use of condoms and a use of either an intrauterine pessary (IUP) or a contraceptive pill by his partner for the treatment duration and 2 months thereafter, Subject's consent to collect blood and/or tumor tissue samples for proteomics and genomics. If a patient does not consent, no samples for proteomics and genomics will be taken. Nonetheles, he/she may be enroled in the study Exclusion Criteria: Previous systemic chemotherapy, radiotherapy or surgery for carcinoma of the head, neck and larynx, Nasopharyngeal Carcinoma, Prior exposure to EGFR pathway targeting therapy, Evidence of distant metastases. Other serious illness or medical conditions: Unstable cardiac disease despite treatment, congestive heart failure NYHA grade 3 and 4, Significant neurologic or psychiatric disorders including dementia or seizures, Active disseminated intravascular coagulation, Other serious underlying medical conditions which in the opinion of investigator could impair the ability of the patient to participate in the study, Symptomatic peripheral neuropathy Common Toxicity Criteria (CTC) grade 2 or higher, ototoxicity CTC grade 2 or higher, except if due to trauma or mechanical impairment due to tumor mass, Participation in other interventional trial within the last 30 days§§, Surgery within the last 30 days, Known allergic/hypersensitivity reaction to any drugs scheduled for the study treatment, Women: pregnant or breast-feeding, Known drug abuse, Other previous malignancy within 5 years, with exception of a history of a previous, adequately treated, basal cell carcinoma of the skin or pre-invasive carcinoma of the cervix, Legal incapacity or limited legal capacity, Medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc W Muenter, MD
Organizational Affiliation
Heidelberg University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dept of Radiation Oncology, University of Heidelberg
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany

12. IPD Sharing Statement

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TPF Followed by Cetuximab and IMRT Plus Carbon Ion Boost for Locally Advanced Head and Neck Tumors

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