Cisplatin and RT With or Without Gemcitabine, Carboplatin, and Paclitaxel in Treating Patients With Locally Advanced NPC

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Terence Tan Wee Kiat, National Cancer Centre, Singapore
ClinicalTrials.gov Identifier:
NCT00997906
First received: October 17, 2009
Last updated: April 28, 2015
Last verified: April 2015

October 17, 2009
April 28, 2015
September 2009
July 2018   (final data collection date for primary outcome measure)
Overall survival at 5 years [ Time Frame: 5 years ] [ Designated as safety issue: No ]
Overall survival at 5 years [ Designated as safety issue: No ]
Complete list of historical versions of study NCT00997906 on ClinicalTrials.gov Archive Site
  • Metastases-free survival [ Time Frame: 10 years ] [ Designated as safety issue: No ]
  • Disease-free survival [ Time Frame: 10 years ] [ Designated as safety issue: No ]
  • Tumor recurrence [ Time Frame: 10 years ] [ Designated as safety issue: No ]
  • Toxicity according to the Common Toxicity Criteria [ Time Frame: 10 years ] [ Designated as safety issue: Yes ]
  • Quality of life as measured by the EORTC QLQ-C30 [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Metastases-free survival [ Designated as safety issue: No ]
  • Disease-free survival [ Designated as safety issue: No ]
  • Tumor recurrence [ Designated as safety issue: No ]
  • Second primary malignancy [ Designated as safety issue: No ]
  • Toxicity according to the Common Toxicity Criteria [ Designated as safety issue: Yes ]
  • Quality of life as measured by the EORTC QLQ-C30 [ Designated as safety issue: No ]
Not Provided
Not Provided
 
Cisplatin and RT With or Without Gemcitabine, Carboplatin, and Paclitaxel in Treating Patients With Locally Advanced NPC
A Randomised Phase II/III Study of Concurrent Cisplatin-Radiotherapy With or Without Induction Chemotherapy Using Gemcitabine, Carboplatin and Paclitaxel in Locally Advanced Nasopharyngeal Cancer

RATIONALE: Drugs used in chemotherapy, such as cisplatin, gemcitabine hydrochloride, carboplatin, and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving chemotherapy together with radiation therapy my kill more tumor cells. It is not yet known whether giving cisplatin together with radiation therapy is more effective with or without gemcitabine hydrochloride, carboplatin, and paclitaxel in treating patients with nasopharyngeal cancer.

PURPOSE: This randomized phase II/III trial is studying how well giving cisplatin together with radiation therapy works compared with giving cisplatin and radiation therapy together with gemcitabine hydrochloride, carboplatin, and paclitaxel in treating patients with locally advanced nasopharyngeal cancer.

OBJECTIVES:

Primary

  • To compare the 5-year overall survival of patients with locally advanced nasopharyngeal cancer treated with concurrent cisplatin and radiotherapy with vs without induction chemotherapy comprising gemcitabine hydrochloride, carboplatin, and paclitaxel.

Secondary

  • To assess and compare the disease-free survival, distant metastases rate, toxicities, and quality of life of patients treated with these regimens.

OUTLINE: Patients are stratified by N-stage (N0-1 vs N2-3) and are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive cisplatin IV over 2 hours once weekly on weeks 1-8 and undergo intensity-modulated radiotherapy once daily, 5 days a week, on weeks 1-7 (6½ weeks for a total of 33 fractions).
  • Arm II: Patients receive induction chemotherapy comprising gemcitabine hydrochloride IV over 30 minutes, carboplatin IV over 1 hour, and paclitaxel IV over 1 hour on days 1 and 8. Treatment repeats every 21 days for 3 courses. Beginning at least 3 weeks after the last dose of induction chemotherapy, patients receive cisplatin and undergo radiotherapy as in arm I.

Quality of life is assessed periodically.

After completion of study treatment, patients are followed every 2 months for 1 year, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.

Interventional
Phase 2
Phase 3
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Head and Neck Cancer
  • Drug: carboplatin,
    Given IV
  • Drug: cisplatin
    Given IV
  • Drug: gemcitabine hydrochloride
    Given IV
  • Drug: paclitaxel
    Given IV
  • Radiation: intensity-modulated radiation therapy
    Given once daily 5 days a week for 6½ weeks.
  • Experimental: Arm I
    Patients receive cisplatin IV over 2 hours once weekly on weeks 1-8 and undergo intensity-modulated radiotherapy once daily, 5 days a week, on weeks 1-7 (6½ weeks for a total of 33 fractions).
    Interventions:
    • Drug: cisplatin
    • Radiation: intensity-modulated radiation therapy
  • Experimental: Arm II
    Patients receive induction chemotherapy comprising gemcitabine hydrochloride IV over 30 minutes, carboplatin IV over 1 hour, and paclitaxel IV over 1 hour on days 1 and 8. Treatment repeats every 21 days for 3 courses. Beginning at least 3 weeks after the last dose of induction chemotherapy, patients receive cisplatin and undergo radiotherapy as in arm I.
    Interventions:
    • Drug: carboplatin,
    • Drug: cisplatin
    • Drug: gemcitabine hydrochloride
    • Drug: paclitaxel
    • Radiation: intensity-modulated radiation therapy
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
172
July 2023
July 2018   (final data collection date for primary outcome measure)

Inclusion criteria:

Patients are eligible for inclusion if all of the following criteria are fulfilled:

  1. Have given written informed consent, with the understanding that consent may be withdrawn at any time without prejudice.
  2. Loco-regional advanced NPC UICC (1997) Stages T3 - 4 any N, or any Stage T, N2 - 3.
  3. A histological diagnosis of WHO Type II or III NPC must have been established at some time and the investigator must review and confirm the diagnosis prior to randomization.
  4. No evidence of distant metastases in staging work up (including lung, liver and bone imaging).
  5. Cross sectional imaging of the primary and neck disease (MRI preferred)
  6. Evaluable disease must be present.
  7. Performance status of ECOG grade 0 or 1 (see Appendix I).
  8. No prior tumour therapy
  9. Adequate bone marrow, renal and hepatic function:

    Bone marrow : WBC > 3000 / mm3 (ANC > 1500 / mm3 ),

    • Platelets > 100 000 / mm3,
    • Hb > 10 gm/dl Renal : serum creatinine within institutional normal range (or) lower than the lower limit of institutional normal range
    • calculated creatinine clearance > 50 ml / min Hepatic : enzymes (SAP, SGOT) < 2x normal
    • bilirubin < 24 µmol / l.
  10. At least 18 years of age, of either sex.

Exclusion criteria:

Patients are to be excluded from the study if any of the following criteria is fulfilled:

  1. Uncontrolled hypercalcaemia: calcium ≥ 2.7 mmol/L (10.8 mg/dL).
  2. Second primary malignancy (except in situ carcinoma of the cervix or adequately treated basal cell carcinoma of the skin).
  3. Other serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator).
  4. Have serious active infection.
  5. Hepatitis B carrier
  6. Prior treatment including chemotherapy or radiotherapy.
  7. Pregnant or lactating female subjects and subjects with reproductive potential not implementing adequate contraceptive measures.
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Singapore
 
NCT00997906
CDR0000657121, SINGAPORE-NCC0901
Yes
Terence Tan Wee Kiat, National Cancer Centre, Singapore
National Cancer Centre, Singapore
Not Provided
Principal Investigator: Terence Tan, FRCR National Cancer Centre, Singapore
National Cancer Centre, Singapore
April 2015

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP