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Trial record 19 of 100 for:    Recruiting, Not yet recruiting, Available Studies | "Laryngeal Diseases"

Durvalumab and Tremelimumab With Radiotherapy for Adjuvant Treatment of Intermediate Risk SCCHN

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ClinicalTrials.gov Identifier: NCT03529422
Recruitment Status : Recruiting
First Posted : May 18, 2018
Last Update Posted : September 7, 2018
Sponsor:
Collaborator:
AstraZeneca
Information provided by (Responsible Party):
UNC Lineberger Comprehensive Cancer Center

Brief Summary:

The purpose of this study is to investigate other drugs that may be combined with radiation to treat cancer. The study focuses on determining whether a combination of two investigational immunotherapy drugs, durvalumab and tremelimumab, with radiation can both improve cure rate and at the same time have less serious side effects. Throughout this document, these investigational drugs will be referred to together as the" study drugs", or named individually (durvalumab or tremelimumab). The study drugs in this research are referred to as investigational because the U.S. Food and Drug Administration (FDA) has not yet approved them for the treatment of head and neck cancer. Durvalumab was FDA approved in 2017 for the treatment of certain types of bladder cancer, but has not been approved for use in Head and Neck cancer patients.

Durvalumab and Tremelimumab are experimental drugs that use the body's immune system to fight the cancer. The combination of these study drugs is being used in other ongoing clinical trials for other types of cancers. The doctor feels that a patient may experience fewer side effects using these study drugs with radiation rather than using cisplatin. The doctor is also investigating whether using these drugs can increase the effectiveness of treatment.


Condition or disease Intervention/treatment Phase
Larynx Lip Oral Cancer Digestive Organs--Diseases Drug: Durvalumab Radiation: Intensity Modulated Radiotherapy Treatments Drug: Tremelimumab Phase 1

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 24 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Study of Durvalumab (MEDI 4736) and Tremelimumab Together With Radiotherapy for the Adjuvant Treatment of Intermediate Risk Head and Neck Squamous Cell Carcinoma
Estimated Study Start Date : September 2018
Estimated Primary Completion Date : February 2021
Estimated Study Completion Date : February 2026


Arm Intervention/treatment
Open-label, single-arm
Durvalumab in combination with intensity modulated radiotherapy (IMRT) treatments and tremelimumab
Drug: Durvalumab
Durvalumab 1500mg IV every 3 weeks for 6 cycles
Other Name: Imfinzi

Radiation: Intensity Modulated Radiotherapy Treatments
Total dose will be 60 Gray (Gy) at 2Gy per fractions for 30 fractions delivered Monday through Friday for 6 weeks
Other Name: IMRT

Drug: Tremelimumab
Tremelimumab 75mg every 3 weeks for 4 cycles




Primary Outcome Measures :
  1. Safe immunotherapy regimen with radiation [ Time Frame: 12 weeks ]
    A safe adjuvant immunotherapy regimen that includes durvalumab with or without tremelimumab to combine with radiotherapy in intermediate-risk HNSCC patients based on dose limiting toxicities

  2. Acute toxicity [ Time Frame: 12 weeks ]
    Grade 3-5 acute toxicities of adjuvant durvalumab and tremelimumab with radiotherapy


Secondary Outcome Measures :
  1. Chronic toxicity [ Time Frame: 12 weeks ]
    Grade 3-4 chronic toxicities of adjuvant durvalumab and tremelimumab with radiotherapy

  2. All chronic toxicities [ Time Frame: 12 weeks ]
    All chronic toxicities of adjuvant durvalumab and tremelimumab with radiotherapy

  3. Disease free survival [ Time Frame: 5 years ]
    Median disease free survival (DFS) in patients with intermediate-risk HNSCC treated with adjuvant durvalumab and tremelimumab with radiotherapy

  4. Overall survival [ Time Frame: 5 years ]
    Median overall survival in patients with intermediate-risk HNSCC treated with adjuvant durvalumab and tremelimumab with radiotherapy

  5. PD-LI expression [ Time Frame: 12 weeks ]
    PD-LI expression with disease free survival



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
Criteria

Inclusion Criteria:

  • Written informed consent obtained to participate in the study and HIPAA authorization for release of personal health information. Consent for the use of any residual material from biopsy (archival tissue) and serial blood draws will be required for enrollment.
  • Age ≥ 18 years of age on day of signing informed consent
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 (See Appendix 12.4: ECOG Performance Status)
  • Histologically confirmed squamous cell carcinoma of the head and neck, including the following subtypes: oral cavity, oropharynx, hypopharynx, larynx
  • Must have undergone gross total resection of the primary tumor with curative intent within the past 8 weeks with surgical pathology demonstrating ≥ 1 of the following criteria for "intermediate" risk of recurrence:
  • perineural invasion
  • lymphovascular invasion
  • single lymph node > 3cm or at least 2 nodes without evidence of extracapsular extension
  • close margins defined as < 5 mm but not frankly positive (in the case of ambiguous, controversial, or superseded margins, final clinical assessment regarding margin status will prevail
  • pathologically confirmed T3 or T4 primary tumor
  • No prior therapy to primary tumor prior to surgical resection (no induction therapy or recurrent disease).
  • Demonstrate adequate organ function as defined in the table below; all screening labs to be obtained within 14 days prior to initiating study treatment
  • Women of childbearing potential (WOCBP) must have a negative serum pregnancy test within 24 days prior to registration. NOTE: Females are considered of child bearing potential unless they are surgically sterile (have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are naturally postmenopausal for at least 12 consecutive months. Documentation of postmenopausal status must be provided.
  • WOCBP must be willing to abstain from heterosexual activity or to use at least 1 highly effective method of contraception from the time of informed consent until 180 days after durvalumab and tremelimumab combination therapy is stopped; or 90 days after durvalumab monotherapy treatment is discontinued (whichever is longer).
  • Male patients with female partners must have had a prior vasectomy or agree to use an adequate method of contraception (i.e., double barrier method: condom plus spermicidal agent) starting with the first dose of study therapy through 6 months (180 days) after the last dose of durvalumab and tremelimumab combination therapy; or 90 days after durvalumab monotherapy is discontinued (whichever is longer).
  • Subjects are willing and able to comply with study procedures based on the judgment of the investigator or protocol designee.

Exclusion Criteria:

Subjects meeting any of the following exclusion criteria will not be able to participate in this study:

  • Is currently participating in or has participated in a study of an investigational agent or an investigational device within 4 weeks of the first dose of treatment.
  • Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study.
  • Has evidence of metastatic disease at time of diagnosis
  • Is receiving concurrent chemotherapy, investigational drug, biologic, or hormonal therapy for cancer treatment. Concurrent use of hormonal therapy for non-cancer-related conditions (e.g., hormone replacement therapy) is acceptable.
  • Treatment with any investigational drug within 28 days or 5 half-lives of Day 1 of treatment on this study.
  • Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
  • Prior randomization or treatment in a previous durvalumab and/or tremelimumab clinical study regardless of treatment arm assignment.
  • Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab or tremelimumab. The following are exceptions to this criterion:
  • Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection)
  • Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent
  • Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication)
  • Has received systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
  • Active infection requiring systemic therapy including tuberculosis (TB) (clinical evaluation that includes clinical history, physical examination and radiographic findings, and TB testing in line with local practice), hepatitis B (known positive HBV surface antigen (HBsAg) result), hepatitis C, or human immunodeficiency virus (positive HIV 1/2 antibodies).
  • Patients with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible.
  • Patients positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA.
  • Has a known contraindication to radiation therapy, including inherited syndromes associated with hypersensitivity to ionizing radiation such as Ataxia-Telangiectasia and Nijmegen Breakage Syndrome
  • Has a history of liver disease (including but not limited to cirrhosis)
  • Subjects with baseline weight ≤ 40kg (88 lbs). Female patients who are pregnant or breastfeeding (NOTE: breast milk cannot be stored for future use while the mother is being treated on study) or male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of durvalumab monotherapy or 180 days after the last dose of durvalumab + tremelimumab combination therapy.
  • History of another primary malignancy except for.
  • Malignancy treated with curative intent and with no known active disease ≥5 years before the first dose of investigational product (IP) and of low potential risk for recurrence
  • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
  • Adequately treated carcinoma in situ without evidence of disease
  • History of leptomeningeal carcinomatosis.
  • Has an active autoimmune disease (or inflammatory disorders) requiring systemic treatment within the past 3 months or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents. Subjects with inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc]).

The following are exceptions to this criterion:

  • Subjects with vitiligo or alopecia or resolved childhood asthma/atopy
  • Subjects that require intermittent use of bronchodilators or local steroid injections would not be excluded from the study.
  • Subjects with hypothyroidism stable on hormone replacement or Sjorgen's syndrome will not be excluded from the study
  • Subjects with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement
  • Any chronic skin condition that does not require systemic therapy
  • Subjects without active disease in the last 5 years may be included but only after consultation with the study physician
  • Subjects with celiac disease controlled by diet alone
  • Has a history of non-infectious pneumonitis that required steroids or evidence of interstitial lung disease or current active, non-infectious pneumonitis.
  • Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of IP. Note: Local surgery of isolated lesions for palliative intent is acceptable.
  • Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent.
  • Receipt of live attenuated vaccine within 30 days prior to the first dose of study drug. Note: Patients, if enrolled, should not receive live vaccine whilst receiving study treatment and up to 30 days after the last dose of study treatment.

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): NCT03529422


Contacts
Contact: Dan Goldin (919) 445-6241 dan_goldin@med.unc.edu
Contact: Rachel Munoz (919) 445-4188 rachel_munoz@med.unc.edu

Locations
United States, North Carolina
UNC Lineberger Comprehensive Cancer Center Recruiting
Chapel Hill, North Carolina, United States, 27599
Contact: Dan Goldin    919-445-6241    dan_goldin@med.unc.edu   
Principal Investigator: Jared Weiss, MD         
Sponsors and Collaborators
UNC Lineberger Comprehensive Cancer Center
AstraZeneca
Investigators
Principal Investigator: Jared Weiss, MD UNC Lineberger Comprehensive Cancer Center

Additional Information:
Responsible Party: UNC Lineberger Comprehensive Cancer Center
ClinicalTrials.gov Identifier: NCT03529422     History of Changes
Other Study ID Numbers: LCCC 1725
First Posted: May 18, 2018    Key Record Dates
Last Update Posted: September 7, 2018
Last Verified: September 2018

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

Keywords provided by UNC Lineberger Comprehensive Cancer Center:
Head and Neck
Larynx
Lip
Oral Cancer

Additional relevant MeSH terms:
Mouth Neoplasms
Head and Neck Neoplasms
Neoplasms by Site
Neoplasms
Mouth Diseases
Stomatognathic Diseases
Antibodies, Monoclonal
Tremelimumab
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents