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Effect and Safety Study of GP/FP Regimens in Advanced Nasopharyngeal Carcinoma

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. Identifier: NCT01528618
Recruitment Status : Unknown
Verified January 2016 by Li Zhang, Sun Yat-sen University.
Recruitment status was:  Active, not recruiting
First Posted : February 8, 2012
Last Update Posted : January 12, 2016
Information provided by (Responsible Party):
Li Zhang, Sun Yat-sen University

Brief Summary:
The present study will be a randomized, control, multicenter phase III study of recurrent or metastatic (R/M) nasopharyngeal carcinoma (NPC) treated with Gemcitabine (Gemzar, Lilly) and cisplatin regimen (GP) or 5-Fluorouracil plus cisplatin regimen (FP). The population consists of recurrent or metastatic nasopharyngeal carcinoma (NPC) that failed the radical radiotherapy or chemotherapy-naïve advanced NPC (stage IV). The effectiveness and side effects will be evaluated according to Standard WHO response criteria and NCI-CTC AE V3.0.

Condition or disease Intervention/treatment Phase
Nasopharyngeal Neoplasms Drug: gemcitabine and cisplatin Drug: 5-Fluorouracil and cisplatin Phase 3

Detailed Description:

Nasopharyngeal carcinoma (NPC) is most commonly seen in Southeast Asia, especially in southern and southeastern China ,where the incidence rate has been documented between 10 and 150 cases per 100,000 population per year. NPC is a radiosensitive tumor, and radiotherapy is considered to be the treatment of choice for most cases. The 5-year survival rate (all stages) is around 50% .In other words, more than half of the NPC cases will eventually fail radiotherapy and reasons of the failure are both local relapse and remote metastasis.

For these advanced or metastatic NPC, chemotherapy is the most important therapeutics,and they are relatively responsive to chemotherapy compared to other head and neck cancers. The backbone of the treatment for recurrent/metastatic (R/M) NPC is cisplatin containing regimen, which is also regarded as the standard regimen for other squamous cell carcinoma of head and neck (SCCHN). The FP regimen is widely used in R/M NPC patients now and its response rate is around 40%-65%,but the response period is usually short and the adverse reaction is frequent and badly tolerant, which influent the treatment compliance seriously. What's more, the catheters and pumps are necessary for continuous infusion of 5-Fluorouracil, which add to the cost, immobility and inconvenience of the treatment.

Preclinical and clinical data show synergistic activity between gemcitabine and cisplatin without overlapping toxicity. Several clinical trials enrolling a minority of advanced NPC patients suggest GP regimen has promising effectiveness and well tolerated side effects, and they indicated a potential possibility that the GP regimen comes to the standard first line choice instead of the FP regimen

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 362 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized, Multicenter Phase III Clinical Trial Comparing Gemcitabine and Cisplatin With 5-Fluorouracil and Cisplatin in the Treatment of Recurrent or Metastatic Nasopharyngeal Carcinoma (NPC)
Study Start Date : October 2015
Estimated Primary Completion Date : June 2016
Estimated Study Completion Date : June 2017

Arm Intervention/treatment
Experimental: gemcitabine and cisplatin
gemcitabine 1,000 mg/m2 over 30 to 60 minutes on days 1, 8, and plus cisplatin 80 mg/m2 on day 1, every 3 weeks.
Drug: gemcitabine and cisplatin
The GP regimen consists of gemcitabine at a dose of 1,000 mg/m2 by intravenous (i.v.) infusion over 30 min on day 1 and day 8, and cisplatin 80 mg/m2 by i.v. infusion for 4 h on day 1 only
Other Name: GP

Active Comparator: 5-Fluorouracil and cisplatin
5-Fluorouracil 4,000 mg/m2 CIV over 96 hours and plus cisplatin 80 mg/m2 on day 1, every 3 weeks.
Drug: 5-Fluorouracil and cisplatin
The FP regimen consists of 5-Fluorouracil 1,000 mg/m2/day which was administered as a continuous intravenous infusion for 96 hours after completion of the cisplatin on days 1( 80 mg/m2 i.v. infusion for 4 h)
Other Name: FP

Primary Outcome Measures :
  1. Progression free survival (PFS) assessed by independent image committee and the investigators [ Time Frame: 36 months ]

Secondary Outcome Measures :
  1. Overall survival (OS) [ Time Frame: 36 months ]
  2. Objective response rate (ORR) [ Time Frame: 36 months ]
  3. Number of Participants with Adverse Events [ Time Frame: 36 months ]
  4. Quality of life [ Time Frame: 36 months ]

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:

  • Histologically proven NPC diagnosis
  • Elder than 18 years old are inclusive
  • Recurrence or metastatic nasopharyngeal carcinoma with evidence of unsuitable for local treatment
  • Amenable to regular follow-up
  • Subjects with at least one measurable lesion (Tumor lesions that are situated in a previously irradiated area could not be considered measurable).
  • Performance status: 0-1(ECOG)
  • WBC > 4.0X109/L, PLT > 100X109/L, with normal hepatic function(AST, ALT < 2.5 x upper limit of normal , and bilirubin < 1.5 x upper limit of normal), with normal renal function (Creatinine < 1.5 x upper limit of normal)
  • No chemotherapy or radical radiotherapy received within 6 months prior to enrollment
  • Life expectancy over twelve weeks
  • Signed and dated informed consent before the start of specific protocol procedures
  • Ability to comply with trial requirements.

Exclusion Criteria:

  • Patient suitable for local treatment (eg. radiotherapy)
  • Active clinically serious infections (> grade 2 NCI-CTC version 3.0)
  • Patient with central nervous system metastasis
  • Patient life threatening medical condition
  • Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial and two weeks after the completion of trial.
  • Performance status ≥ 2
  • With a pre-existing peripheral neuropathy (National Cancer Institute Common Toxicity Criteria for Adverse Events [NCI CTC] grade ≥ 2)
  • Serious concurrent illness
  • Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors[Ta, Tis & T1] or any cancer curatively treated > 3 years prior to study entry.
  • Patient refusing participation

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): NCT01528618

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China, Guangdong
Department of Medical Oncology,Cancer Center of Sun Yat-Sen University
Guangzhou, Guangdong, China, 510060
Sponsors and Collaborators
Sun Yat-sen University
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Principal Investigator: li zhang, doctor Sun Yat-sen University
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Li Zhang, Professor, Sun Yat-sen University Identifier: NCT01528618    
Other Study ID Numbers: GEM20110714
First Posted: February 8, 2012    Key Record Dates
Last Update Posted: January 12, 2016
Last Verified: January 2016
Keywords provided by Li Zhang, Sun Yat-sen University:
Advanced Nasopharyngeal Carcinoma
Additional relevant MeSH terms:
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Nasopharyngeal Carcinoma
Nasopharyngeal Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Pharyngeal Neoplasms
Otorhinolaryngologic Neoplasms
Head and Neck Neoplasms
Neoplasms by Site
Nasopharyngeal Diseases
Pharyngeal Diseases
Stomatognathic Diseases
Otorhinolaryngologic Diseases
Antineoplastic Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs