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Boronophenylalanine (BPA)-Based Boron Neutron Capture Therapy (BNCT) in the Treatment Head and Neck Tumors

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00114790
First Posted: June 20, 2005
Last Update Posted: May 6, 2013
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Professor Heikki Joensuu, Helsinki University Central Hospital
  Purpose
Boron Neutron Capture Therapy (BNCT) is an experimental radiation therapy technique which is based on the principle of irradiating boron atoms with neutrons. When neutrons have relatively low energy, boron atoms that have been targeted to cancerous tissue using a suitable boron carrier (an amino acid derivative called BPA, boronophenylalanine) will capture the neutrons. As a result from the neutron capture the boron atoms will split into two, producing helium and lithium ions. The helium and lithium ions, in turn, have only a short pathlength in tissue (about 5 micrometers) and will deposit their cell damaging effect mainly within the tumor provided that the boron carrier (BPA) has accumulated in the tumor. In practice, the study participants will receive BPA as an approximately 2-hour intravenous infusion, following which the tumor is irradiated with low energy (epithermal) neutrons obtained from a nuclear reactor at the BNCT facility. BNCT requires careful radiation dose planning, but neutron irradiation will last approximately only for one hour. In this study BNCT will be repeated, and the 2 treatments will be given 3 to 5 weeks apart. The study hypothesis is that head and neck cancers that have recurred following conventional radiotherapy might accumulate the boron carrier compound, and might respond to BNCT.

Condition Intervention Phase
Head and Neck Cancer Radiation: boronophenylalanine-based BNCT Phase 1 Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Boronophenylalanine (BPA)-Based Boron Neutron Capture Therapy (BNCT) in the Treatment of Inoperable and Irradiated Head and Neck Tumors: A Feasibility Study

Resource links provided by NLM:


Further study details as provided by Professor Heikki Joensuu, Helsinki University Central Hospital:

Primary Outcome Measures:
  • treatment response [ Time Frame: 1 year ]

Secondary Outcome Measures:
  • time to progression [ Time Frame: 2 years ]
  • safety [ Time Frame: 2 years ]

Enrollment: 30
Study Start Date: December 2003
Study Completion Date: January 2012
Primary Completion Date: October 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: BNCT.
Boronophenylalanine-based BNCT.
Radiation: boronophenylalanine-based BNCT
Boronophenylalanine is infused into a peripheral vein prior to neutron irradiation.

Detailed Description:

This is a single BNCT-facility, non-randomized, non-comparative, open-label, phase I to II trial to determine the value of BNCT in the treatment of inoperable, irradiated, locally advanced cancers of the head and neck region. An attempt to perform 18F-labeled boronophenylalanine (18F-BPA) SPECT or PET imaging will be made before BNCT. Patients whose tumor uptake is >2.5 times that of the corresponding normal head and neck tissue will be enrolled, and treated with a single fraction BPA-based BNCT twice, 3 to 5 weeks apart. Another 18F-BPA SPECT or PET study may be performed 1 to 3 months after BNCT to determine the SPECT/PET response.

The neutron irradiation site is the FiR 1 reactor site, located at Otaniemi, Espoo, Finland, about 6 kilometers from the Helsinki University Central Hospital, Helsinki, where patient evaluation and post-irradiation care will take place.

Prior to BNCT, BPA is infused as a fructose complex (l-BPA-F) into a peripheral vein over 2 hours. Blood samples will be taken for monitoring whole blood boron concentration before starting the BPA infusion, and thereafter at 20 to 40 minute intervals during the infusion, following infusion, and after delivering neutron irradiation. The blood samples will be analyzed for blood boron concentration to estimate the average blood boron concentration during neutron irradiation.

All patients will be evaluated for response using CT or magnetic resonance imaging (MRI).

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically confirmed, malignant head and neck cancer.
  • Inoperable tumor, prior surgery may or may not have been done.
  • Prior radiotherapy or chemoradiotherapy has been given.
  • If prior SPECT or PET with 18F-BFA has been done, BPA needs to accumulate at least 2.5 times more in the tumor than in the corresponding contralateral normal tissue.
  • WHO performance status <3.
  • WBC >2,500/mm3, platelets >75,000/mm3, serum creatinine <180 umol/L.
  • A written informed consent.

Exclusion Criteria:

  • Lymphoma or other tumor type that is expected to respond to cancer chemotherapy or to a dose of conventional radiation therapy that can be safely given.
  • A non-experimental, effective treatment option is available.
  • Expected survival less than 3 months.
  • Concomitant systemic chemotherapy (prior cancer chemotherapy is allowed).
  • Other concurrent experimental therapy, or such therapy is being planned to be given.
  • Less than 3 months since prior radiation therapy.
  • Untreated or severe, treated congestive heart failure or renal failure.
  • A cardiac pace-maker or an unremovable metal implant present in the head and neck region that will interfere with MRI-based dose-planning.
  • Restlessness or inability to lie in a cast for 30 to 60 minutes.
  • Clinical follow-up after therapy cannot be arranged or the patient is not willing to participate in follow-up.
  • Pregnancy.
  • Age less than 18.
  • The patient is not able to understand the treatment options.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00114790


Locations
Finland
Department of Oncology, Helsinki University Central Hospital
Helsinki, Finland, FIN-00029
Sponsors and Collaborators
Boneca Corporation
Investigators
Principal Investigator: Heikki T Joensuu, M.D., prof. Helsinki University Central Hospital
  More Information

Additional Information:
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Professor Heikki Joensuu, professor, Helsinki University Central Hospital
ClinicalTrials.gov Identifier: NCT00114790     History of Changes
Other Study ID Numbers: HN-BPA-01-2003
First Submitted: June 17, 2005
First Posted: June 20, 2005
Last Update Posted: May 6, 2013
Last Verified: May 2013

Keywords provided by Professor Heikki Joensuu, Helsinki University Central Hospital:
head and neck cancer
boron neutron capture therapy
radiation therapy
boronophenylalanine

Additional relevant MeSH terms:
Head and Neck Neoplasms
Neoplasms by Site
Neoplasms
Boron
Trace Elements
Micronutrients
Growth Substances
Physiological Effects of Drugs