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Nasopharyngeal CarcinomaPhase 3NCT02512315

A Trial On 4 Cycles Of Neoadjuvant Chemotherapy Plus Concurrent Chemoradiation In N2-3 Nasopharyngeal Carcinoma

A Phase 3 study testing Docetaxel (DOC), Cisplatin (DDP) and Concurrent chemoradiation (CCRT) in people with Nasopharyngeal Carcinoma, run by Sun Yat-sen University at 4 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The standard treatment strategy of locally advanced nasopharyngeal carcinoma (NPC) nowadays is concurrent chemoradiation (CCRT) based on intensity-modulated radiation therapy (IMRT). However, distant metastasis remains the major cause of treatment failure, especially in patients with T1-4N2-3M0 diseases (N2-3 NPC). Read more about this study

Who is it for?
Ages Up to 70 years
Conditions the study is for
Nasopharyngeal Carcinoma
What is being tested?
Docetaxel (DOC), Cisplatin (DDP) and Concurrent chemoradiation (CCRT)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
192 participants
Where
4 sitesChina
Study dates
Aug 2015to Dec 2024
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 Up to 70 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with pathological diagnosis of nasopharyngeal carcinoma
  • Union Internationale Contre le Cancer/American Joint Cancer Committee (UICC/AJCC) 2010 Stage T1-4 N2-3 M0 through magnetic resonance imaging of head and neck, whole-body bone scan and thoracoabdominal computed tomography
  • Male or female with age no older than 70 years old
  • Karnofsky Performance Scores ≥ 80
  • Expected survival ≥ 3 months

Who cannot join

  • Patients with distant metastasis before or during radiotherapy
  • Severe dysfunction of heart, lung, liver, kidney or hematopoietic system
  • Severe neurological, mental or endocrine diseases
  • History of other malignancies
  • Prior chemotherapy, radiotherapy or application of monoclonal antibodies
  • Patients participated in clinical trials of other drugs within last 3 months
  • Pregnant or lactating women
  • Those who are considered by the researchers unsuitable to participate

Trial locations and contacts

4 sites in 1 country.

Yuan-hong Gao, M.D contact

+86-13560182168

gaoyh@sysucc.org.cn

China4 sites, 4 recruiting
  • Cancer Center of Guangzhou Medical University

    Guangzhou, Guangdong, 510030

    Tong-chong Zhou, M.D, +86-13808841276, noveaie@163.com

    Hai-hua Peng, M.D, +86-15011978349, phhnihao@126.com

    Recruiting
  • First Affiliated Hospital of Sun Yat-sen University

    Guangzhou, Guangdong, 510060

    Bi-Xiu Wen, M.D, +86-18903056780, wenbix@mail.sysu.edu.cn

    Cheng-tao Wang, M.D, +86-13711132767, ct_wang@163.com

    Recruiting
  • Sun Yat-sen University Cancer Center

    Guangzhou, Guangdong, 510060

    Yuan-hong Gao, M.D, +86-13560182168, gaoyh@sysucc.org.cn

    Hui Chang, M.D, +86-13480295989, changhui@sysucc.org

    Recruiting
  • Shenzhen People's Hospital

    Shenzhen, Guangdong, 518020

    Ya-jie Liu, M.D, +86-13823394075, liuyj-dr@sohu.com

    Shi-hai Wu, M.D, +86-13632935732, jiangxiwu84@126.com

    Recruiting

Other trials in China

About this study

Official title: 4 Cycles Of Neoadjuvant Chemotherapy Plus Concurrent Chemoradiation Versus Concurrent Chemoradiation Alone In Patients With Stage N2-3 Nasopharyngeal Carcinoma: A Phase 3 Multicenter Randomised Controlled Trial

The standard treatment strategy of locally advanced nasopharyngeal carcinoma (NPC) nowadays is concurrent chemoradiation (CCRT) based on intensity-modulated radiation therapy (IMRT). However, distant metastasis remains the major cause of treatment failure, especially in patients with T1-4N2-3M0 diseases (N2-3 NPC). The investigators inferred that it was more appropriate to consider N2-3 NPC as a systemic disease instead of a local disease. NACT of sufficient intensity such as 4 cycles might be effective enough for control of the pre-existing micrometastases. Therefore, the objective of this phase 3 multicenter randomized controlled trial is to make a comparison between NACT of 4 cycles plus CCRT based on IMRT and CCRT alone in N2-3 NPC on distant metastasis, survival and adverse reaction.

Read the detailed description

The standard treatment strategy of locally advanced nasopharyngeal carcinoma (NPC) nowadays is concurrent chemoradiation (CCRT), which is based on intensity-modulated radiation therapy (IMRT) and achieves a satisfactory local-regional control and a 5-year overall survival (OS) of 83.0%. However, distant metastasis remains the major cause of treatment failure, especially in patients with T1-4N2-3M0 diseases (N2-3 NPC). The distant metastasis reaches 35-48% after CCRT alone.

To decrease distant metastasis of locally advanced NPC so as to improve survival, approaches on modifying timing of chemotherapy have been made to mainly 2 types: one was CCRT plus adjuvant chemotherapy (ACT), the other was neoadjuvant chemotherapy (NACT) plus CCRT. It was proved that CCRT plus ACT could not improve survival of locally advanced NPC further. Some clinical trials indicated that locally advanced NPC patients with 2-3 cycles of NACT plus CCRT had a better survival than those with CCRT alone though the roles of NACT remain controversial.

It is known that N stage is by far the most significant predicting factor of metastasis risk for NPC. N2-3 NPC was also proved to have a quite great risk of distant failure. 51.4% of distant metastases happened within 1 year after CCRT. The investigators inferred that subclinical micrometastases were already present before treatment starting. Hence, it was more appropriate to consider N2-3 NPC as a systemic disease instead of a local disease. NACT of sufficient intensity such as 4 cycles might be effective enough for control of the pre-existing micrometastases.

Therefore, this phase 3 multicenter randomized controlled trial is conducted to enroll 144 patients with N2-3 NPC. After stratification by N stage, the patients will be allocated into 2 treatment groups randomly at a ratio of 1:1 and applied with different treatment strategies to make a comparison between NACT of 4 cycles plus CCRT based on IMRT and CCRT alone in N2-3 NPC on distant metastasis, survival and adverse reaction.

Being tested
Docetaxel (DOC), Cisplatin (DDP), Concurrent chemoradiation (CCRT)
Keywords
Nasopharyngeal carcinoma, Neoadjuvant chemotherapy, Concurrent chemoradiation, Distant metastasis, Survival
Medical subject headings
Nasopharyngeal Carcinoma

What participants receive

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

  • Docetaxel (DOC)Drug

    Also called Docetaxel Injection

    Neoadjuvant chemotherapy (NACT) is administrated every 3 weeks with the regimen comprised of docetaxel plus cisplatin. A total of 4 cycles of NACT is applied. Docetaxel is given at a dose of 75mg/m2 on the first day of every cycle.

  • Cisplatin (DDP)Drug

    Also called Cisplatin Injection

    Neoadjuvant chemotherapy (NACT) is administrated every 3 weeks with the regimen comprised of docetaxel plus cisplatin. A total of 4 cycles of NACT is applied. Cisplatin is given at a dose of 75mg/m2 on the first day of every cycle.

  • Concurrent chemoradiation (CCRT)Radiation

    The technology of radiotherapy is intensity-modulated radiation therapy (IMRT). A total dose of 66-72Gy is given to gross tumor of nasopharynx (GTVnx), 60-70Gy to positive neck lymph nodes (GTVnd), 60Gy to high-risk region (CTV1), and 50-54Gy to prophylactic irradiation region (CTV2).

    The regimen of concurrent chemotherapy is single-agent cisplatin 40mg/m2 weekly.

Study groups in NCT02512315
Study groupRoleWhat they receive
CCRT group (Group A)Active comparatorPatients who are allocated into in this group will be treated with concurrent chemoradiation (CCRT).
Receives: Radiation: Concurrent chemoradiation (CCRT)
NACT-CCRT group (Group B)ExperimentalPatients who are allocated into in this group will be treated with 4 cycles of neoadjuvant chemotherapy (NACT, docetaxel plus cisplatin) followed by CCRT.
Receives: Drug: Docetaxel (DOC); Drug: Cisplatin (DDP); Radiation: Concurrent chemoradiation (CCRT)

What is being measured

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

  1. 5-year overall survival (5y-OS)

    Percentage of patients in a treatment group who are alive for a 5-year period of follow-up after the date of pathologic diagnosis

    Measured: 5 years after the date of pathologic diagnosis

  2. 5-year distant-metastasis-free survival (5y-MFS)

    Percentage of patients in a treatment group who are alive without distant metastasis for a 5-year period of follow-up after the date of pathologic diagnosis

    Measured: 5 years after the date of pathologic diagnosis

Secondary outcomes (3)
  1. 5-year local-relapse-free survival (5y-RFS)

    Percentage of patients in a treatment group who are alive without local recurrence for a 5-year period of follow-up after the date of pathologic diagnosis

    Measured: 5 years after the date of pathologic diagnosis

  2. 5-year disease-free survival (5y-DFS)

    Percentage of patients in a treatment group who are alive without disease-related events (local recurrence, distant metastasis) for a 5-year period of follow-up after the date of pathologic diagnosis

    Measured: 5 years after the date of pathologic diagnosis

  3. Incidence of grade 3/4 adverse event

    Incidence of patients in a treatment group who manifest a specific adverse event (such as myelosuppression) of grade 3/4. Incidence is calculated for each adverse event respectively and severity is evaluated on basis of Common Terminology Criteria for Adverse Events (CTCAE) 4.0 criteria.

    Measured: Once a week during therapy, up to 7 weeks (Group A) or 19 weeks (Group B)

Timeline

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

  1. First posted30 Jul 2015 (estimated)
  2. Study startAug 2015
  3. Primary completionDec 2024 (estimated)
  4. Study completionDec 2024 (estimated)

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
Parallel groups
Masking
None (open label)
Enrolment
192 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02512315
Sponsor's protocol ID
NACT4-NPC-5010
Status last verified
Aug 2021
First submitted
24 Jul 2015
Last updated
30 Aug 2021
Results posted
No
Data monitoring committee
Yes

Publications

  • Moss WT. Therapeutic radiology, 2nd ed. St Louis, MO: Mosby; 1965: 142-180.

  • Guigay J, Temam S, Bourhis J, Pignon JP, Armand JP. Nasopharyngeal carcinoma and therapeutic management: the place of chemotherapy. Ann Oncol. 2006 Sep;17 Suppl 10:x304-7. doi: 10.1093/annonc/mdl278. No abstract available.

    PubMed 17018743
  • 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
  • Lin JC, Jan JS, Hsu CY, Liang WM, Jiang RS, Wang WY. Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 2003 Feb 15;21(4):631-7. doi: 10.1200/JCO.2003.06.158.

    PubMed 12586799
  • Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, Chua ET, Yang E, Lee KM, Fong KW, Tan HS, Lee KS, Loong S, Sethi V, Chua EJ, Machin D. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol. 2005 Sep 20;23(27):6730-8. doi: 10.1200/JCO.2005.16.790.

    PubMed 16170180
  • Chen L, Hu CS, Chen XZ, Hu GQ, Cheng ZB, Sun Y, Li WX, Chen YY, Xie FY, Liang SB, Chen Y, Xu TT, Li B, Long GX, Wang SY, Zheng BM, Guo Y, Sun Y, Mao YP, Tang LL, Chen YM, Liu MZ, Ma J. Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial. Lancet Oncol. 2012 Feb;13(2):163-71. doi: 10.1016/S1470-2045(11)70320-5. Epub 2011 Dec 7.

    PubMed 22154591
  • J. Y. Hsiang, K. Liu, S. Iganej, et al. Concurrent chemoradiation with and without adjuvant chemotherapy in advanced stage nasopharyngeal carcinoma: A retrospective analysis. J Clin Oncol. 2004, 22(Supp 114): 5619.

  • Pignon JP, le Maitre A, Maillard E, Bourhis J; MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009 Jul;92(1):4-14. doi: 10.1016/j.radonc.2009.04.014. Epub 2009 May 14.

    PubMed 19446902
  • Tan T, Lim WT, Fong KW, Cheah SL, Soong YL, Ang MK, Ng QS, Tan D, Ong WS, Tan SH, Yip C, Quah D, Soo KC, Wee J. Concurrent chemo-radiation with or without induction gemcitabine, Carboplatin, and Paclitaxel: a randomized, phase 2/3 trial in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2015 Apr 1;91(5):952-60. doi: 10.1016/j.ijrobp.2015.01.002.

    PubMed 25832687
  • Hui EP, Ma BB, Leung SF, King AD, Mo F, Kam MK, Yu BK, Chiu SK, Kwan WH, Ho R, Chan I, Ahuja AT, Zee BC, Chan AT. Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol. 2009 Jan 10;27(2):242-9. doi: 10.1200/JCO.2008.18.1545. Epub 2008 Dec 8.

    PubMed 19064973
  • Loong HH, Ma BB, Leung SF, Mo F, Hui EP, Kam MK, Chan SL, Yu BK, Chan AT. Prognostic significance of the total dose of cisplatin administered during concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. Radiother Oncol. 2012 Sep;104(3):300-4. doi: 10.1016/j.radonc.2011.12.022. Epub 2012 Jan 31.

    PubMed 22300609
  • Honkoop AH, Luykx-de Bakker SA, Hoekman K, Meyer S, Meyer OW, van Groeningen CJ, van Diest PJ, Boven E, van der Wall E, Giaccone G, Wagstaff J, Pinedo HM. Prolonged neoadjuvant chemotherapy with GM-CSF in locally advanced breast cancer. Oncologist. 1999;4(2):106-11.

    PubMed 10337380
  • da Costa Miranda V, de Souza Fede AB, Dos Anjos CH, da Silva JR, Sanchez FB, da Silva Bessa LR, de Paula Carvalho J, Filho EA, de Freitas D, Del Pilar Estevez Diz M. Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients unsuitable for primary surgery: Safety and effectiveness. Gynecol Oncol. 2014 Feb;132(2):287-91. doi: 10.1016/j.ygyno.2013.12.002. Epub 2013 Dec 9.

    PubMed 24333355
  • Sun XM, Huang Y, Chen CY, et al. Long-term outcomes of patients with advanced N-stage nasopharyngeal carcinoma treated by intensity-modulated radiotherapy alone or with chemotherapy. Chinese Journal of Radiation Oncology. 2013, 22(3): 225-229.

  • Ghossein RA, Bhattacharya S, Rosai J. Molecular detection of micrometastases and circulating tumor cells in solid tumors. Clin Cancer Res. 1999 Aug;5(8):1950-60.

    PubMed 10473071

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Docetaxel (DOC), Cisplatin (DDP) and Concurrent chemoradiation (CCRT) in people with Nasopharyngeal Carcinoma, run by Sun Yat-sen University at 4 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 5 inclusion and 8 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: status not confirmed, as of the sponsor's last update on 30 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 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?

Results are not available in the source record.

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

Contact Yuan-hong Gao, M.D (+86-13560182168, gaoyh@sysucc.org.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

5-year overall survival (5y-OS) (time frame: 5 years after the date of pathologic diagnosis). 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 NCT02512315, which also lists 18 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 30 Aug 2021.

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