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Toripalimab Based Induction Chemotherapy Followed by De-escalation Protocols in HPV-related OPSCC

Not Applicable
Recruiting
Conditions
De-escalation
Immune Checkpoint Inhibitor
Oropharyngeal Carcinoma
Interventions
Other: Toxicities reduced treatment arm
Registration Number
NCT04867330
Lead Sponsor
Fudan University
Brief Summary

Human papillomavirus (HPV)-related oropharyngeal carcinoma are exquisitely radiosensitive. Several studies attempted to reduce the toxicities of treatments through reduced-dose radiation and showed promising results, but all data were collected from non-Chinese areas. Like nasopharyngeal carcinoma (NPC), oropharyngeal carcinoma may have different biological behavior and relationship with HPV infection. So the investigators studied whether toxicities reducing treatment with reduced radiation dose and omitted concurrent chemotherapy after good response to induction chemotherapy would maintain survival outcomes while improving tolerability for patients with HPV-positive oropharyngeal carcinoma. Immune checkpoint inhibitors (ICIs) have proved to improve outcomes of head and neck cancers including EBV-related NPC. Oropharyngeal carcinoma was considered to be similar with NPC in terms of immune environment. So we added anti-PD-1 antibody Toripalimab to induction chemotherapy in order to achieve better response rates to receive de-escalation chemoradiotherapy followed.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Histological diagnosis of squamous cell carcinoma of oropharynx with IHC p16
  • positive or PCR HPV16 positive
  • T1-2/N1-3M0(except T1N1M0 and single LN<3cm)or T3-4N0-3M0 according to UICC/AJCC 8th staging system
  • Age ≥18
  • No prior anti-tumor treatment
  • Karnofsky Performance Score (KPS)≥70
  • Adequate blood supply
  • Informed consent obtained
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Exclusion Criteria
  • Cannot take contrast-MRI imaging
  • Pregnant
  • Combined with other malignant tumor (except basal cell carcinoma of skin)
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
conventional treatment armToxicities reduced treatment armTwo cycles Toripalimab+docetaxel+cisplatin induction chemotherapy followed by concurrent cisplatin chemoradiotherapy with standard radiation dose (70Gy/35Fx) when responses to induction chemotherapy are less than 50% Partial Response(PR)
Primary Outcome Measures
NameTimeMethod
PFS PFS2 year

Progression Free Survival

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Fudan Universtiy Shanghai Cancer Centre

🇨🇳

Shanghai, China

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