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TRYHARD: Radiation Therapy Plus Cisplatin With or Without Lapatinib in Treating Patients With Head and Neck Cancer.

Phase 2
Completed
Conditions
Non-HPV Locally Advanced Head and Neck Cancer
Interventions
Radiation: IMRT
Drug: placebo
Registration Number
NCT01711658
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

PURPOSE: This trial is studying if and how well lapatinib adds to the effectiveness of radiation therapy plus cisplatin in patients who have head and neck cancer that is not related to the human papillomavirus (HPV).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
142
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IMRT + cisplatin + lapatinibIMRTIMRT with cisplatin and lapatinib
IMRT + cisplatin + placeboIMRTIntensity Modulated Radiation Therapy (IMRT) with cisplatin and placebo
IMRT + cisplatin + placeboplaceboIntensity Modulated Radiation Therapy (IMRT) with cisplatin and placebo
IMRT + cisplatin + lapatinibLapatinibIMRT with cisplatin and lapatinib
IMRT + cisplatin + lapatinibCisplatinIMRT with cisplatin and lapatinib
IMRT + cisplatin + placeboCisplatinIntensity Modulated Radiation Therapy (IMRT) with cisplatin and placebo
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Alive Without Progression (Progression-free Survival)From randomization to last follow-up. Maximum follow-up at time of analysis was 7.1 years.

An event for progression-free survival is local, regional, or distant disease progression or death due to any cause. Progression-free survival time is defined as time from randomization to the date of progression/death or last known follow-up (censored). Rates are estimated by the Kaplan-Meier method. The protocol specifies that the distributions of survival times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided. Analysis occurred after 67 progressions or deaths were reported.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Treatment-related Grade 3 or Higher Adverse EventsFrom start of treatment to last follow-up. Maximum follow-up at time of analysis was 7.1 years.

Adverse events (AE) were graded using the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Grade refers to the severity of the AE. The CTCAE v4.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild, Grade 2 Moderate, Grade 3 Severe, Grade 4 Life-threatening or disabling, Grade 5 Death related to adverse event. "Treatment-related" is defined definitely, probably, or possibly related to treatment.

Percentage of Participants With Local-regional ProgressionFrom randomization to last follow-up. Maximum follow-up at time of analysis was 7.1 years.

Failure for local-regional control endpoint was defined as local or regional progression, salvage surgery of the primary tumor with tumor present/unknown, salvage neck dissection with tumor present/unknown \> 20 weeks after the end of radiation therapy, death due to study cancer without documented progression, or death due to unknown causes without documented progression; distant metastasis and death due to other causes were considered competing risks. Local-regional failure time is defined as time from randomization to the date of progression/death or last known follow-up (censored). Failure rates are estimated by the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided.

HER2, EGFR, EMT as Biomarkers of Response.End of Study
Percentage of Participants With Distant MetastasesFrom randomization to last follow-up. Maximum follow-up at time of analysis was 7.1 years.

Failure for distant metastasis endpoint was defined as distant progression; local-regional failure and death due to any cause were considered competing risks. Distant metastasis time is defined as time from randomization to the date of progression/death or last known follow-up (censored). Rates are estimated by the cumulative incidence method. The protocol specifies that the distributions of failure times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided.

Performance Status Scale for Head & Neck Cancer.3 months, 1 year, and 2 years
University of Michigan Xerostomia-Related Quality of Life Scale.3 months, 1 year, and 2 years.
Percentage of Participants Alive (Overall Survival)From randomization to last follow-up. Maximum follow-up at time of analysis was 7.1 years.

An event for overall survival is death due to any cause. Overall survival time is defined as time from randomization to the date of death or last known follow-up (censored). Rates are estimated by the Kaplan-Meier method. The protocol specifies that the distributions of survival times be compared between the arms, which is reported in the statistical analysis results. Five-year rates are provided.

Functional Assessment of Cancer Therapy - Head & Neck.3 months, 1 year, and 2 years.
Percentage of Participants Who Complied With Protocol TreatmentFrom start of treatment to end of treatment (approximately 5 months from randomization).

Compliance with protocol treatment is defined as "per protocol" or "acceptable variation" per study chair review for IMRT, cisplatin, pre-IMRT lapatinib/placebo, concurrent lapatinib/placebo, and maintenance lapatinib/placebo. Rates of treatment compliance were compared between groups by a 2-sided Fisher's exact test.

Trial Locations

Locations (16)

University of California, San Diego

🇺🇸

La Jolla, California, United States

Sutter General Hospital

🇺🇸

Sacramento, California, United States

McGill Cancer Centre at McGill University

🇨🇦

Montreal, Quebec, Canada

University of Wisconsin Comprehensive Cancer Center

🇺🇸

Madison, Wisconsin, United States

Fox Chase Cancer Center Buckingham

🇺🇸

Furlong, Pennsylvania, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

James Graham Brown Cancer Center at University of Louisville

🇺🇸

Louisville, Kentucky, United States

University of California San Francisco

🇺🇸

San Francisco, California, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

University Hospitals of Cleveland

🇺🇸

Cleveland, Ohio, United States

Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

University of Texas Southwestern Medical School

🇺🇸

Dallas, Texas, United States

University of Texas - MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

University of Alabama at Birmingham Comprehensive Cancer Center

🇺🇸

Birmingham, Alabama, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

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