Phase II Evaluation of Adjuvant Hyperfractionated Radiation and Docetaxel for HPV Associated Oropharynx Cancer
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- Mayo Clinic
- 入组人数
- 81
- 试验地点
- 2
- 主要终点
- 2-year Loco-regional Tumor Control (LRC) Rate
研究概览
简要总结
This phase II trial studies how well radiation therapy and docetaxel work in treating patients with human papillomavirus (HPV)-related oropharyngeal cancer. Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving radiation therapy with docetaxel my kill more tumor cells.
详细描述
PRIMARY OBJECTIVES:
I. To assess the cumulative incidence of local/regional failure at 2 years after study registration.
SECONDARY OBJECTIVES:
I. To characterize the rate of acute grade 3 or higher functional mucosal adverse events (up to 1 month post-radiation therapy [XRT]) associated with adjuvant docetaxel + hyperfractionated radiotherapy (key secondary endpoint).
II. To assess changes in overall survival, disease-free survival, distant failure rates, and quality of life (QOL) associated with adjuvant docetaxel and hyperfractionated radiation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •PRE-REGISTRATION
- •Provide written informed consent
- •Submission of research blood draw to be stored until after surgical resection of the primary tumor and confirmation of human papilloma virus (HPV) positivity (Mayo Clinic Rochester patients only)
- •Patients with oropharynx carcinoma with a smoking history of ˂ 10 pack-year or equivalent 10 year history of tobacco product use and no recent history (within last 5 years) of tobacco use
- •REGISTRATION
- •Histological confirmation of HPV+ squamous cell carcinoma of the oropharynx; HPV positivity will be defined as positive staining for p16 on immunohistochemistry (IHC)
- •Gross total surgical resection with curative intent of the primary tumor and at least unilateral neck dissection within 7 weeks of registration
- •Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
- •Smoking history < 10 pack years or equivalent 10 year history of tobacco product use
- •Absence of distant metastases on standard diagnostic work-up =< 10 weeks prior to registration; (chest computed tomography [CT], chest x-ray [CXR], positron emission tomography [PET]/CT, etc.)
- •Must have one of the following risk factors:
- •Lymph node > 3 cm
- •2 or more positive lymph nodes
- •Perineural invasion
- •Lymphovascular space invasion
- •T3 or microscopic T4a primary disease
- •Lymph node extracapsular extension
- •Absolute neutrophil count (ANC) >= 1500/mm^3
- •Platelet count >= 100,000/mm^3
- •Hemoglobin >= 9.0 g/dL
- •Direct bilirubin within upper limit of normal (ULN)
- •Creatinine =< ULN x 1.5
- •Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
- •Ability to complete questionnaire(s) by themselves or with assistance
- •Provide informed written consent
- •Willingness to return to enrolling institution for follow-up (during the active monitoring phase of the study)
排除标准
- •Any significant tobacco history within the past five years
- •Any of the following:
- •Pregnant women
- •Nursing women
- •Men or women of childbearing potential who are unwilling to employ adequate contraception
- •Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
- •Immunocompromised patients and patients known to be human immunodeficiency virus (HIV) positive
- •Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- •Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
- •Other active malignancy =< 5 years prior to registration; EXCEPTIONS: non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: if there is a history or prior malignancy, they must not be receiving other specific treatment for their cancer
- •History of myocardial infarction =< 180 days prior to registration, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias
- •Prior history of radiation therapy to the affected site
- •History of connective tissue disorders such as rheumatoid arthritis, lupus, or Sjogren's disease
- •Presence of any of the following risk factors after surgery:
- •Any positive surgical margin
- •Adenopathy below the clavicles
- •Prior systemic chemotherapy for the study cancer; NOTE: prior chemotherapy for a different cancer is allowable
- •History of allergic reaction to docetaxel
- •Receiving any medications or substances that are strong or moderate inhibitors of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4)
- •Use of strong or moderate inhibitors is prohibited =< 7 days prior to registration
- •Receiving any medications or substances that are inducers of CYP3A4
- •Use of inducers is prohibited =< 12 days prior to registration
研究组 & 干预措施
Treatment (docetaxel, hyperfractionated IMRT)
Patients receive docetaxel IV over 1 hour on days 1 and 8 and undergo hyperfractionated IMRT BID 5 days a week on days 1-12 for a total of 20 fractions.
干预措施: Docetaxel (Drug)
Treatment (docetaxel, hyperfractionated IMRT)
Patients receive docetaxel IV over 1 hour on days 1 and 8 and undergo hyperfractionated IMRT BID 5 days a week on days 1-12 for a total of 20 fractions.
干预措施: Hyperfractionation (Radiation)
Treatment (docetaxel, hyperfractionated IMRT)
Patients receive docetaxel IV over 1 hour on days 1 and 8 and undergo hyperfractionated IMRT BID 5 days a week on days 1-12 for a total of 20 fractions.
干预措施: Intensity-Modulated Radiation Therapy (Radiation)
Treatment (docetaxel, hyperfractionated IMRT)
Patients receive docetaxel IV over 1 hour on days 1 and 8 and undergo hyperfractionated IMRT BID 5 days a week on days 1-12 for a total of 20 fractions.
干预措施: Laboratory Biomarker Analysis (Other)
Treatment (docetaxel, hyperfractionated IMRT)
Patients receive docetaxel IV over 1 hour on days 1 and 8 and undergo hyperfractionated IMRT BID 5 days a week on days 1-12 for a total of 20 fractions.
干预措施: Quality-of-Life Assessment (Other)
结局指标
主要结局
2-year Loco-regional Tumor Control (LRC) Rate
时间窗: 2 years
The 2-year loco-regional tumor control (LRC) rate (percentage) is defined as the percentage of patients with no local/regional recurrence or death 2 years after study registration.
次要结局
- 2-year Distant Metastasis-free Survival Rate(2 years)
- 2-year Progression-free Survival (PFS)(From registration to the first of either disease recurrence or death, assessed up to 2 years)
- Incidence of Grade 3 or Higher Mucositis Oral(4 months post-hyperfractionated radiation therapy)
- 2-year Overall Survival (OS) Rate(2 years)
- Change From Mean Baseline Score to Mean Score at 12 Months Post-RT in Swallow Function as Measured by the Pharyngeal Total Modified Barium Swallow Impairment Profile.(12 months)
- European Organization for Research and Treatment for Cancer QOL Questionnaire for Head and Neck Cancer Module 35 (EORTC-QLQ HN35)(1 year post-treatment)
- EuroQol Five-dimensional Instrument (EQ-5D-3L)(1 year post-treatment)
- Functional Assessment of Cancer Therapy Head and Neck (FACT H& N) (Version 4)(1 year)
