Hypoxia Analysis in Head and/or Neck Cancer

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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT02414048
Recruitment Status : Recruiting
First Posted : April 10, 2015
Last Update Posted : June 17, 2016
Information provided by (Responsible Party):
Marius Gustav Bredell, University of Zurich

Brief Summary:

The primary objective is the prospective determination of disease-specific and overall survival in head and neck cancer patients who have undergone surgery, correlated to non-invasive methods of measuring tumour hypoxia.

The secondary objective is to define tumour hypoxia using non-invasive methodology.

Condition or disease Intervention/treatment Phase
Head and Neck Cancer Drug: Pimonidazole Phase 2

Detailed Description:

The incidence of head and neck squamous cell cancer (HNSCC) is around 600 000 cases per year worldwide. The main sites for HNSCC are the larynx, the pharynx and the oral cavity. Head and neck cancers, however, also include salivary gland tumours, as well as nasopharyngeal cancer and paranasal and nasal sinus cancer but these are rare. The major risk factors are smoking, alcohol abuse and Human Papillomavirus (HPV) infection. In spite of radical surgical treatment and aggressive neo-adjuvant and adjuvant therapies, the prognosis of head and neck cancer is very poor due to the fact that the tumours are often hypoxic.

Tumour hypoxia is heterogenous and results from an imbalance between oxygen supply and oxygen consumption. Acute hypoxia is caused by abnormal structure and function of the microvasculature supplying the tumour. Chronic hypoxia is caused by the increased distance through which the oxygen has to diffuse to get from the blood vessels to the tumour cells and by the reduced oxygen caused by the anaemia which can be treatment or disease-related. These hypoxic regions have been shown to affect the metabolism of the cells, making them more aggressive with increased risk of metastasis and a worse prognosis. Also, because radiotherapy relies on oxygen to cause maximal cytotoxicity, a lack of oxygen to the cells or even a lack of oxygen consumption by the cells would cause a decrease in the effectiveness of the radiotherapy and the cytotoxicity. Hypoxic cells have an acidic environment which affects drug delivery and drug activity, so chemotherapy is compromised.

In order to predict outcome and identify patients with a worse prognosis or patients that would benefit from appropriate treatments, in vivo measurement of tumour hypoxia is required. Numerous methods have been explored but there is no accepted gold standard. Imaging and biomarker analysis have been shown to have potential but the data are insufficient. In this project the investigators would prospectively use existing imaging techniques and analysis of various bodily fluids to predict outcome. This is a collaboration between 5 different departments so that as much information as possible can be analysed and used to come to a possible solution.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 10 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Predictive Methods Determining Tumour Hypoxia in Head and Neck Cancer Patients - a Prospective Project
Study Start Date : April 2015
Estimated Primary Completion Date : October 2022
Estimated Study Completion Date : October 2022

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
All patients will receive Pimonidazole to demarcate hypoxia regions in the tumour
Drug: Pimonidazole
Pimonidazole will be administered orally and will serve to demarcate the hypoxic areas in the tumour
Other Name: Oral Hypoxyprobe

Primary Outcome Measures :
  1. Disease-specific and overall survival correlated with tumour hypoxia [ Time Frame: 5-years ]
    Tumour hypoxia will be determined from the Pimonidazole staining and this will be correlated to disease-specific survival and overall survival. The study has been approved for 10 participants to be increased by the ethical committee to 100 once the study is going.

Information from the National Library of Medicine

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

Inclusion Criteria:

  • Malignancy in head and/or neck region only
  • Interdisciplinary Head and neck tumour board (USZ) confirmed inclusion in the project
  • For patients with reproductive potential (e.g. female participants who are surgically sterilised/hysterectomised or post-menopausal for longer than 2 years are not considered as beig of child bearing potential), a willingness to use adequate contraceptive measures to prevent pregnancy during the project.

Exclusion Criteria:

  • Pregnant or breastfeeding
  • Suffers from claustrophobia
  • Known allergy to Pimonidazole
  • Participation in a study with an investigational drug within the 30 days preceding and during this project
  • Tumour size smaller than 1cm
  • Has symptomatic Chronic Obstructive Pulmonary Disease (COPD)
  • Patient refuses or is unable to give a written informed consent
  • Previous treatment for head and/or neck cancer
  • Inability to follow the procedures of the project e.g. due to language problems, psychological disorders, dementia, etc. of the participant.

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 identifier (NCT number): NCT02414048

Contact: Christine Hager

Department of Cranio-, Maxillofacial and Oral Surgery Recruiting
Zürich, Switzerland, 8090
Contact: Christine Hager   
Sponsors and Collaborators
Marius Gustav Bredell
Principal Investigator: Marius Bredell Department of Cranio-, Maxillofacial and Oral Surgery, University Hospital Zurich

Additional Information:
Responsible Party: Marius Gustav Bredell, Dr, University of Zurich Identifier: NCT02414048     History of Changes
Other Study ID Numbers: KEK-Nr.2014-0393
First Posted: April 10, 2015    Key Record Dates
Last Update Posted: June 17, 2016
Last Verified: June 2016

Keywords provided by Marius Gustav Bredell, University of Zurich:
Head and neck cancer

Additional relevant MeSH terms:
Head and Neck Neoplasms
Neoplasms by Site
Signs and Symptoms, Respiratory
Signs and Symptoms