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Nasopharyngeal CarcinomaPhase 3NCT00379262

Therapeutic Gain by Induction-concurrent Chemoradiotherapy and/or Accelerated Fractionation for Nasopharyngeal Carcinoma

A Phase 3 study testing Capecitabine, Adjuvant chemotherapy using PF (5-Fluorouracil ) and Induction chemotherapy using PF (5-Fluorouracil) in people with Nasopharyngeal Carcinoma, run by Hong Kong Nasopharyngeal Cancer Study Group Limited at 7 sites in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objectives of this clinical study are threefold: 1. To compare the benefits in cancer control and survival obtained from adding induction-concurrent chemotherapy to radiation with those from adding concurrent-adjuvant chemotherapy to radiation. 2. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Nasopharyngeal Carcinoma
What is being tested?
Capecitabine, Adjuvant chemotherapy using PF (5-Fluorouracil ) and Induction chemotherapy using PF (5-Fluorouracil)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
803 participants
Where
7 sitesChina
Study dates
Sep 2006to Dec 2018
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • histologically proven nasopharyngeal carcinoma for primary treatment with radical intent
  • non-keratinizing or undifferentiated type
  • stage III-IVB (by AJCC/UICC 6th edition)
  • ECOG Performance status less or equal to 2
  • Marrow: WBC >= 4 and platelet >=100
  • Renal: creatinine clearance >=60
  • Informed consent

Who cannot join

  • Primary treatment with palliative intent
  • WHO type I squamous cell carcinoma or adenocarcinoma
  • Evidence of distant metastases
  • Patient is pregnant or lactating
  • Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer or other cancer for which the patient has been disease-free for 5 years

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

China7 sites
  • Cancer Center, Sun Yat Sen University

    Guangzhou

  • Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital

    Hong Kong

  • Department of Clinical Oncology, Prince of Wales Hospital

    Hong Kong

  • Department of Clinical Oncology, Princess Margaret Hospital

    Hong Kong

  • Department of Clinical Oncology, Queen Elizabeth Hospital

    Hong Kong

  • Department of Clinical Oncology, Queen Mary Hospital

    Hong Kong

  • Department of Clinical Oncology, Tuen Mun Hospital

    Hong Kong

Other trials in China

About this study

Official title: Randomized Trial to Evaluate Therapeutic Gain by Changing Chemoradiotherapy From Concurrent-adjuvant to Induction-concurrent Sequence, and Radiotherapy From Conventional to Accelerated Fractionation for Advanced Nasopharyngeal Carcinoma

The objectives of this clinical study are threefold:

  1. To compare the benefits in cancer control and survival obtained from adding induction-concurrent chemotherapy to radiation with those from adding concurrent-adjuvant chemotherapy to radiation.
  2. To test whether replacing fluorouracil with Xeloda in combining with cisplatin in the chemotherapy plan will maintain or improve further the chemotherapy benefits while reducing the duration of hospital stay.
  3. To see if accelerated fractionation radiotherapy can improve the outcome of patients as compared with conventional fractionation radiotherapy.
Read the detailed description
  1. primary objectives include
  2. comparing induction chemotherapy with Cisplatin + 5-Fluorouracil versus adjuvant chemotherapy with Cisplatin + 5-Fluorouracil(PF-Pvs P-PF)
  3. comparing induction chemotherapy with Cisplatin + Capecitabine versus adjuvant chemotherapy with Cisplatin + 5-Fluorouracil(PX-P vs P-PF)
  4. comparing accelerated fractionation versus conventional fractionation (AF vs CF)radiotherapy.
  5. secondary objectives include
  6. comparing induction chemotherapy with Cisplatin + Capecitabine versus induction chemotherapy with Cisplatin + 5-Fluorouracil(PX-P vs PX-P)
  7. Comparing concurrent-adjuvant (CA) versus induction-concurrent (IC) chemotherapy sequence.
Being tested
Capecitabine, Adjuvant chemotherapy using PF (5-Fluorouracil ), Induction chemotherapy using PF (5-Fluorouracil)
Keywords
Nasopharyngeal Carcinoma, Chemoradiotherapy, Accelerated Fractionation
Medical subject headings
Nasopharyngeal Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CapecitabineDrug

    Also called Xeloda

    Dose:1000 mg/m2, BD, Day 1-Day 14 Interval: 21 days Cycles: 3 cycles

  • Adjuvant chemotherapy using PF (5-Fluorouracil )Drug

    Cisplatin 80 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 96 hr every 28 days for 3 cycles

  • Induction chemotherapy using PF (5-Fluorouracil)Drug

    Cisplatin 100 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 120 hr every 21 days for 3 cycles

Study groups in NCT00379262
Study groupRoleWhat they receive
1AExperimentalConcurrent-Adjuvant CRT using P-PF regimen and conventional fractionation radiotherapy
Receives: Drug: Adjuvant chemotherapy using PF (5-Fluorouracil )
1BExperimentalConcurrent-Adjuvant CRT using P-PF regimen and accelerated fractionation radiotherapy
Receives: Drug: Adjuvant chemotherapy using PF (5-Fluorouracil )
2AExperimentalInduction-Concurrent CRT using PF-P regimen and conventional fractionation radiotherapy
Receives: Drug: Induction chemotherapy using PF (5-Fluorouracil)
2BExperimentalInduction-Concurrent CRT using PF-P regimen and accelerated fractionation radiotherapy
Receives: Drug: Induction chemotherapy using PF (5-Fluorouracil)
3AExperimentalInduction-Concurrent CRT using PX-P regimen and conventional fractionation radiotherapy
Receives: Drug: Capecitabine
3BExperimentalInduction-Concurrent CRT using PX-P regimen and accelerated fractionation radiotherapy
Receives: Drug: Capecitabine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-Free Survival, defined as the time to treatment failure at any site or death due to any cause, at 5-year.

    Measured: 5 years

  2. Overall Survival, defined as the time to death due to any cause, at 5-year.

    Measured: 5 years

Secondary outcomes (5)
  1. overall Failure-Free Rate, defined as time to failure at any site)

    Measured: 5 years

  2. Loco-regional Failure-Free Rate, defined as time to local or nodal failure)

    Measured: 5 years

  3. Distant Failure-Free Rate, defined as time to distant failure)

    Measured: 5 years

  4. Incidence of chemotherapy toxicity and acute RT toxicity grade > 3

    Measured: treatment

  5. Time to late toxicity (From the date of randomization to the earliest date of late toxicity grade > 3)

    Measured: 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Sep 2006 (estimated)
  2. Study startSep 2006
  3. Primary completionMay 2017
  4. Study completionDec 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Masking
None (open label)
Enrolment
803 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00379262
Sponsor's protocol ID
NPC-0501 Trial
Status last verified
Aug 2019
First submitted
20 Sep 2006
Last updated
7 Aug 2019
Results posted
No
Data monitoring committee
Yes

Publications

  • Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, Forastiere AA, Adams G, Sakr WA, Schuller DE, Ensley JF. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998 Apr;16(4):1310-7. doi: 10.1200/JCO.1998.16.4.1310.

    PubMed 9552031
  • Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, Siu L, Sze WM, Leung TW, Sham JS, Ngan RK, Law SC, Yau TK, Au JS, O'Sullivan B, Pang ES, O SK, Au GK, Lau JT; Hong Kong Nasopharyngeal Cancer Study Group. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol. 2005 Oct 1;23(28):6966-75. doi: 10.1200/JCO.2004.00.7542.

    PubMed 16192584
  • Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, Akazawa P, Weinberg V, Fu KK. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys. 2002 May 1;53(1):12-22. doi: 10.1016/s0360-3016(02)02724-4.

    PubMed 12007936
  • Le QT, Tate D, Koong A, Gibbs IC, Chang SD, Adler JR, Pinto HA, Terris DJ, Fee WE, Goffinet DR. Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2003 Jul 15;56(4):1046-54. doi: 10.1016/s0360-3016(03)00117-2.

    PubMed 12829140
  • Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, Kwong DL, Al-Sarraf M, Chi KH, Hareyama M, Leung SF, Thephamongkhol K, Pignon JP; MAC-NPC Collaborative Group. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys. 2006 Jan 1;64(1):47-56. doi: 10.1016/j.ijrobp.2005.06.037.

    PubMed 16377415
  • Hoff PM, Ansari R, Batist G, Cox J, Kocha W, Kuperminc M, Maroun J, Walde D, Weaver C, Harrison E, Burger HU, Osterwalder B, Wong AO, Wong R. Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol. 2001 Apr 15;19(8):2282-92. doi: 10.1200/JCO.2001.19.8.2282.

    PubMed 11304782
  • Twelves C, Boyer M, Findlay M, Cassidy J, Weitzel C, Barker C, Osterwalder B, Jamieson C, Hieke K; Xeloda Colorectal Cancer Study Group. Capecitabine (Xeloda) improves medical resource use compared with 5-fluorouracil plus leucovorin in a phase III trial conducted in patients with advanced colorectal carcinoma. Eur J Cancer. 2001 Mar;37(5):597-604. doi: 10.1016/s0959-8049(00)00444-5.

    PubMed 11290435
  • Chua DT, Sham JS, Au GK. A phase II study of capecitabine in patients with recurrent and metastatic nasopharyngeal carcinoma pretreated with platinum-based chemotherapy. Oral Oncol. 2003 Jun;39(4):361-6. doi: 10.1016/s1368-8375(02)00120-3.

    PubMed 12676255
  • Greene FL, et al. AJCC Cancer Staging Handbook from the AJCC cancer staging manual, 6th ed. New York: Springer, 2002.

  • Lee AW, Tung SY, Chan AT, Chappell R, Fu YT, Lu TX, Tan T, Chua DT, O'sullivan B, Xu SL, Pang ES, Sze WM, Leung TW, Kwan WH, Chan PT, Liu XF, Tan EH, Sham JS, Siu L, Lau WH. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006 Sep 1;66(1):142-51. doi: 10.1016/j.ijrobp.2006.03.054.

    PubMed 16904519
  • Freedman J, Furberg, C, DeMets D. Fundamentals of clinical trials. Springer-Verlag, NY, 1998.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Capecitabine, Adjuvant chemotherapy using PF (5-Fluorouracil ) and Induction chemotherapy using PF (5-Fluorouracil) in people with Nasopharyngeal Carcinoma, run by Hong Kong Nasopharyngeal Cancer Study Group Limited at 7 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-Free Survival, defined as the time to treatment failure at any site or death due to any cause, at 5-year. (time frame: 5 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00379262, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2019; AzTrials last refreshed its copy on 7 Nov 2026.

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