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A Randomized Phase III Trial Comparing Sequential Therapy With TPF/Chemoradiation (ST) To Cisplatin-Based Chemoradiotherapy with Accelerated Concomitant Boost Radiotherapy (CRT) For Locally Advanced Squamous Cell Cancer of the Head and Neck - The Paradigm Trial

Conditions
Squamous cell carcinoma of the head and neck [SCCHN].
MedDRA version: 9.1Level: LLTClassification code 10060121Term: Squamous cell carcinoma of head and neck
Registration Number
EUCTR2006-007076-15-DE
Lead Sponsor
Dana Farber Cancer Institute
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
330
Inclusion Criteria

1. Histologically or cytologically proven squamous cell carcinoma of the head and neck.

2. Primary tumor sites eligible: oral cavity, oropharynx, hypopharynx or larynx. Although they are admittedly of squamous cell types, the following tumors will be excluded because their responsiveness to chemotherapy may differ: tumors of the nasal and paranasal cavities and of the nasopharynx. Oral cavity tumors with mandible invasion are excluded because the tumor biology and management of these tumors is more complex and will likely include upfront surgical resection. Subjects with unknown primary sites will not be eligible for this study.

3. Stage 3 or 4 disease without evidence of distant metastases verified by chest X-Ray, abdominal ultrasound, PET/CT or CAT scan (liver function test abnormalities); bone scan in case of local symptoms.

4. At least one uni- or bidimensionally measurable lesion

5. No previous chemotherapy for any reason and no previous surgery for SCCHN (other than biopsy) are allowed at time of study entry (Prior tonsillectomy is allowed). No radiotherapy to the head and neck area is allowed. Patient who had radiotherapy for other cancers more than 5 years ago may be potential candidates for this trial; however each case must be discussed with the Overall PI, Dr. Robert Haddad.

6. Age > 18 years.

7. WHO performance status of 0 or 1

8. No active alcohol addiction that will interfere with participation in this study, as documented by the caregiver.

9. Signed informed consent prior to beginning protocol specific procedures.

10. Adequate bone marrow, hepatic and renal functions

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1. Pregnant or breast feeding women, or women and men of childbearing potential not willing to use adequate contraception while on treatment and for at least 3 months thereafter.

2. Previous or current malignancies at other sites, with the exception of adequately treated in situ carcinoma of the cervix uteri, basal or squamous cell carcinoma of the skin or other cancer curatively treated by surgery and with no evidence of disease for at least 5 years. Any prior treatment with chemotherapy is an exclusion criterion.

3. Symptomatic peripheral neuropathy > grade 2 by National Cancer Institute Common Toxicity Criteria (NCIC-CTC Version 3.0).

4. Symptomatic altered hearing > grade 2 by NCIC-CTC v3.0 criteria.

5. Other serious illnesses or medical conditions including but not limited to:

• Unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry
• History of significant neurologic or psychiatric disorders including dementia or seizures.
• Active clinically significant uncontrolled infection.
• Active peptic ulcer disease defined as unhealed or clinically active and clinically significant, as documented by the investigator.
• Clinically significant hypercalcemia.
• Active drug addiction including cocaine or intravenous drug use defined as occurring within the 6 months preceding diagnosis, which may interfere with study treatment, as documented by investigator.
• Chronic Obstructive Pulmonary Disease, defined as being associated with a hospitalization for pneumonia or respiratory decompensation within 12 months of diagnosis. This does not include obstruction from tumor.
• Autoimmune disease requiring therapy, prior organ transplant, or HIV infection

6. Patients who experienced an involuntary weight loss of more than 25% of their body weight in the 2 months preceding study entry.

7. Concurrent treatment with any other anticancer therapy.

8. Participation in an investigational trial within 30 days of study entry.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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