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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01880359
Registration number
NCT01880359
Ethics application status
Date submitted
12/06/2013
Date registered
19/06/2013
Date last updated
10/05/2022
Titles & IDs
Public title
AF CRT +/- Nimorazole in HNSCC
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Scientific title
A Blind Randomized Multicenter Study of Accelerated Fractionated Chemo-radiotherapy With or Without the Hypoxic Cell Radiosensitizer Nimorazole (Nimoral), Using a 15-gene Signature for Hypoxia in the Treatment of Squamous Cell Carcinoma of the Head and Neck.
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Secondary ID [1]
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2013-002441-12
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Secondary ID [2]
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EORTC-1219
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Locally Advanced Head and Neck HPV Negative Squamous Cell Cancers
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Condition category
Condition code
Cancer
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Non melanoma skin cancer
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Skin
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Placebo comparator: Radiotherapy+ Cisplatin+ Placebo - Accelerated radiotherapy (Therapeutic Planning Target Volume (PTV): 70 Gray (Gy), 6 fractions/week, 35 fractions of 2 Gy, prophylactic PTV: 54.25 Gy, 6 fractions/week, 35 fractions of 1.55 Gy) + concomitant cisplatin (weekly schedule of 40mg/m2 (delivered on day 1, 8, 15, 22, 29) Patients will receive placebo (1.2 g/m2) 90 min (+/- 30 min) prior to each radiotherapy fraction but no more than 5 times a week (If the 6th radiotherapy fraction in a week is given on a separate day from the 5th fraction of radiotherapy, no nimorazole/placebo dose is received that day. If the 6th fraction of radiotherapy is given on the same day as the 5th fraction, nimorazole/placebo is given 90 minutes before the 5th radiotherapy fraction, only).
Experimental: Radiotherapy+ Cisplatin+ Nimorazole - Accelerated radiotherapy (Therapeutic PTV: 70 Gy, 6 fractions/week, 35 fractions of 2 Gy, prophylactic PTV: 54.25 Gy, 6 fractions/week, 35 fractions of 1.55 Gy) + concomitant cisplatin (weekly schedule of 40mg/m2 (delivered on day 1, 8, 15, 22, 29) .
Patients will receive nimorazole (1.2 g/m2) 90 min (+/- 30 min) prior to each radiotherapy fraction but no more than 5 times a week (If the 6th radiotherapy fraction in a week is given on a separate day from the 5th fraction of radiotherapy, no nimorazole/placebo dose is received that day. If the 6th fraction of radiotherapy is given on the same day as the 5th fraction, nimorazole/placebo is given 90 minutes before the 5th radiotherapy fraction, only).
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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locoregional control rate
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Assessment method [1]
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Timepoint [1]
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9 years after first patient in
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Secondary outcome [1]
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Time to distant metastasis
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Assessment method [1]
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Timepoint [1]
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9 years after first patient in
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Secondary outcome [2]
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Time to second cancer
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Assessment method [2]
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Timepoint [2]
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9 years after first patient in
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Secondary outcome [3]
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Overall survival
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Assessment method [3]
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Timepoint [3]
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9 years after first patient in
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Secondary outcome [4]
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Disease-specific free survival
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Assessment method [4]
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Timepoint [4]
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9 years after first patient in
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Secondary outcome [5]
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Acute and late morbidity
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Assessment method [5]
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Timepoint [5]
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9 years after first patient in
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Eligibility
Key inclusion criteria
* Newly diagnosed tumors classified as stage III-IV located in the larynx, oropharynx and hypopharynx (unknown primary should be excluded; oral cavity are not eligible)
* Human papillomavirus(HPV)/p16 negative (=70% positively stained cells), assessed locally for tumors of the oropharynx
* Tumors of the larynx and hypopharynx regardless of the HPV status
* Histopathological diagnosis of invasive squamous cell carcinoma in the primary tumor
* World Health Organization (WHO) performance 0-2
* All Hematology and biochemical investigations, should be done within 4 weeks before randomization (maximum 6 weeks before treatment starts)
* Normal bone marrow function based on routine blood samples, i.e. neutrophils = 1.0 x 109/L, platelets = 75 x 109/L, hemoglobin = 10.0 g/dL or 6.2 mmol/L
* Normal kidney function creatinine clearance = 60ml/min, and Electrolyte balance: calcium = 11.5 mg/dl or 2.9 mmol/l, magnesium = 1.2 mg/dl or 0.5 mmol/l
* Normal liver function assessed by routine laboratory examinations, i.e. bilirubin < 1.5 x Upper Limit of Normal (ULN), Aspartate aminotransferase (AST)< 3 x ULN, alkaline phosphatases < 3 x ULN
* No prior or current anticancer treatment to the head and neck area (e.g. radical attempted or tumor reductive surgery, neo-adjuvant chemotherapy, Epidermal Growth Factor Receptor (EGFR) inhibitors or radiotherapy).
* Patients must be candidate for curative intent external beam chemo-radiotherapy, and must be expected to complete the treatment.
* All patients should have an oral and dental examination including preferably clinical and radiological examination. Whenever indicated, extraction of dental elements should be carried out at least 10 days before treatment start;for 1-2 (max 2) monoradicular single tooth extractions (if not continous a max of 4) without bone resection 5 days (as a minimum) are allowed.
* Radiotherapy planned to start within acceptable delay (preferably within 2 weeks and a maximum of 4 weeks from randomization).
* Radiotherapy planned to start within 8 weeks from baseline imaging tumor assessment.
* Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before randomization in the trial
* All subjects must agree to abstain from donating blood while receiving therapy and for four weeks following discontinuation of therapy.
* All subjects must agree not to share study medication with another person and to return all unused study drug to the investigator.
* Before patient registration, written informed consent must be given according to International Conference on Harmonisation /Good Clinical Practice (ICH/GCP), and national/local regulations (including material acquisition for central testing of the hypoxic signature)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patients who have received treatment with any investigational drug substance within 4 weeks prior to randomization;
* Current participation in any other interventional clinical study;
* Pregnant or breast-feeding female patient. Pregnancy test should be done within 72 hours from treatment start;
* Female subjects of childbearing potential (defined as a sexually mature woman who 1) has not undergone a hysterectomy or bilateral oophorectomy or 2) has not been naturally post-menopausal (amenorrhoea following cancer therapy does not rule out childbearing potential) for at least 12 consecutive months (i.e. has had menses at any time in the preceding 12 consecutive months)) not willing to use adequate contraception during study and for 6 month after last dose of study drug;
* Male subjects not willing to use condoms throughout study drug therapy, and for 6 months after cessation of study therapy if their partner is of childbearing potential and has no contraception;
* Known or suspected HIV infection;
* Second malignancies in the 3 years prior to study entry with the exception of surgically cured carcinoma in situ of the cervix, in situ breast cancer, incidental finding of stage T1a or T1b prostate cancer, and basal/squamous cell carcinoma of the skin;
* Uncontrolled or chronic bacterial, fungal or viral infection;
* Known or suspected hypersensitivity to component(s) of investigational product or cisplatin contraindication;
* All indicated timelines and absolute values requested by the eligibility criteria must be adhered to. However, a maximum of +/- 10% of the reference value for laboratory parameters and a maximum of +/- 3 days for timelines may be acceptable. Discussion with EORTC Headquarters and study coordinator is encouraged.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
25/07/2014
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
9/01/2023
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Actual
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Sample size
Target
640
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Royal Brisbane And Women's Hospital - Brisbane
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Recruitment hospital [2]
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Princess Alexandra Hospital - University Of Queensland - Brisbane
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Recruitment hospital [3]
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Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
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QLD 4029 - Brisbane
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Recruitment postcode(s) [2]
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QLD 4102 - Brisbane
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Recruitment postcode(s) [3]
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NSW 2065 - St Leonards
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Recruitment outside Australia
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Belgium
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Brussels
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Belgium
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Leuven
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France
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Dijon
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France
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Tours
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France
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Villejuif
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Germany
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Berlin
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Germany
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Muenchen
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Netherlands
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Amsterdam
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Netherlands
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Nijmegen
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Poland
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Gdansk
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Poland
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Poznan
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Poland
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Warsaw
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Poland
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Wroclaw
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Switzerland
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Geneva
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Switzerland
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State/province [15]
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Zurich
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Funding & Sponsors
Primary sponsor type
Other
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Name
European Organisation for Research and Treatment of Cancer - EORTC
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Danish Head and Neck Cancer Group
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The drug nimorazole belongs to a class of chemicals known as 5-nitroimidazoles. Drugs from this class are used against infection. In addition, nimorazole makes tumor cells more sensitive to radiotherapy. Therefore, the investigators want to find out whether the addition of nimorazole to the standard treatment with radiotherapy in combination with chemotherapy with cisplatin shows activity against your type of head and neck cancer and is safe. Furthermore the investigators will investigate if a specific examination done with your tumor tissue will help to predict whether the treatment will work or not. To find out if the activity observed with this treatment is not caused by chance alone, the investigators need to obtain data from patients who receive this treatment and from patients who receive other treatments. The data from these two groups of patients will be compared to see which treatment is better. Participants will be split into 2 groups. Each group will receive different treatments. The treatment each group receives is determined by chance using a computer program. This works like flipping a coin and is called randomization. This helps to make sure that groups of patients are similar when the study starts. Neither you, your study doctor, nor the study staff can influence in which group you will be placed or which treatment you will receive. If allocated to group 1, Patient will receive radiotherapy in combination with chemotherapy with cisplatin and nimorazole as a pill. This is considered the 'experimental' treatment. If allocated to group 2, patient will receive radiotherapy in combination with chemotherapy with cisplatin and a so called 'placebo' as a pill. The placebo is a dummy treatment. It looks like the real one, but it is not. It contains no active ingredient/medicine.
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Trial website
https://clinicaltrials.gov/study/NCT01880359
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Jens Overgaard
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Address
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Aarhus University Hospital
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Contact person for public queries
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01880359
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