Efficacy and Safety Study of Leukocyte Interleukin,Injection (LI) to Treat Cancer of the Oral Cavity

NCT ID: NCT01265849

Last Updated: 2022-08-19

Study Results

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Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

928 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-12-31

Study Completion Date

2020-12-04

Brief Summary

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The purpose of this study was to determine whether LI administered in combination with cyclophosphamide, indomethacin and zinc in a multivitamin (CIZ) combination prior to standard of care therapy (surgery followed by radiotherapy or concurrent radiochemotherapy) is safe and will increase the overall survival of subjects with previously untreated locally advanced primary squamous cell carcinoma of the oral cavity or soft palate at a median of 3 to 5 years

Detailed Description

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Head and neck carcinomas constitute about 5% of all cancers annually worldwide. In the US there are about 65,000 new cases annually. Ninety percent are squamous cell carcinoma of the head and neck (SCCHN). Approximately 2/3 of SCCHN patients present on their first visit with locally advanced disease. The median 3 year overall survival (OS) for these patients with existing standard of care (SOC) therapies - surgery followed by radiotherapy or concurrent radiochemotherapy - is estimated to be between 52 and 55%; the 5 year OS is approximately 43%. There are clearly many of SCCHN patients not well served by available modalities.

Regional intra or perilymphatic and/or intratumoral or peritumoral low dose cytokine therapy may have important therapeutic effects in SCCHN patients and constitute an additional anti-tumor mechanism of action different and distinct from current SOC. Leukocyte Interleukin Injection (LI) \[Multikine\] contains a defined mixture of naturally derived cytokines and chemokines with demonstrated safety and immunomodulatory activity in animals and in man in Phase I and Phase II clinical trials. LI is administered prior to SOC and in combination with low non-chemotherapeutic doses of cyclophosphamide, indomethacin, and zinc (CIZ) in studies with LI. The results of these studies indicate that the local/regional injection of mixed interleukins (LI) with CIZ prior to SOC can overcome local immunosuppression, break tumor tolerance to tumor antigens and allow for a sustainable and effective anti-tumor immune response.

LI was tested in this large, global, multinational Phase III clinical trial to develop definitive proof of its efficacy and safety in treating SCCHN. The trial is an open-label randomized multi-center controlled study of LI + CIZ + SOC in subjects with advanced primary SCCHN of the oral cavity/soft palate vs. SOC \[the comparator arm\]. OS is the primary efficacy endpoint.

Conditions

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Squamous Cell Carcinoma of the Oral Cavity Squamous Cell Carcinoma of the Soft Palate

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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LI + CIZ + SOC

LI plus CIZ (cyclophosphamide, indomethacin and zinc-multivitamins) was given as neoadjuvant therapy prior to standard of care (SOC).

Group Type EXPERIMENTAL

LI

Intervention Type BIOLOGICAL

LI 400 IU (2.0mL total daily) 1.0 mL peritumoral, 1.0 mL perilymphatic 5x weekly x3 consecutive weeks administered as neoadjuvant therapy prior to SOC, (surgery followed by radiation or concurrent radiochemotherapy with cisplatin 100 mg/m\^2 intravenously x3) to determine if LI plus CIZ affects the 3-5 year overall survival.

Cyclophosphamide

Intervention Type DRUG

Cyclophosphamide was administered IV bolus (one time only) at a dose of 300mg/m\^2 three days prior to beginning treatment with LI. Standard of care (SOC) for previously untreated squamous cell carcinoma of the head and neck is currently surgery followed by radiotherapy (60-70Gy in 30 to 35 fractions over 6 to 7 weeks) for higher risk subjects (subjects determined at surgery to have adverse features per the National Comprehensive Cancer Network (NCCN) guidelines, such as, positive surgical margins, 2 or more clinically positive nodes or extracapsular nodal spread, etc. that would pre-dispose them for higher risk of recurrence) radiotherapy is combined with concurrent chemotherapy (cisplatin 100mg/m\^2 intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Indomethacin

Intervention Type DRUG

One 25mg capsule of indomethacin was self administered orally (BID) beginning on day one of LI treatment daily until the day before surgery.

Zinc

Intervention Type DIETARY_SUPPLEMENT

One capsule daily self administered beginning on day one of treatment with LI until one day before surgery

Surgery

Intervention Type PROCEDURE

Excise tumor and nodes

Cisplatin

Intervention Type DRUG

Cisplatin was administered 100mg/m\^2 IV concurrent with radiotherapy. The chemotherapy agent (cisplatin 100mg/m\^2) was administered intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Radiotherapy

Intervention Type RADIATION

Total 60 to 70 Gy (2Gy per day) in 30 to 35 fractions over 6 to 7 weeks to subjects determined at surgery to be at lower risk for recurrence (per NCCN guidelines). For subjects determined at surgery to be at higher risk for recurrence due to having positive surgical margins, 2 or more clinically positive nodes or extracapsular nodal spread etc. (per NCCN guidelines), radiotherapy (as above) is combined with concurrent chemotherapy (cisplatin 100 mg/m\^2) intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Standard of Care (SOC) only

SOC for previously untreated SCCHN patients is currently surgery (with curative intent) followed by either radiotherapy or combined radiochemotherapy depending on the patient's risk status for recurrence as determined at surgery.

Group Type ACTIVE_COMPARATOR

Surgery

Intervention Type PROCEDURE

Excise tumor and nodes

Cisplatin

Intervention Type DRUG

Cisplatin was administered 100mg/m\^2 IV concurrent with radiotherapy. The chemotherapy agent (cisplatin 100mg/m\^2) was administered intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Radiotherapy

Intervention Type RADIATION

Total 60 to 70 Gy (2Gy per day) in 30 to 35 fractions over 6 to 7 weeks to subjects determined at surgery to be at lower risk for recurrence (per NCCN guidelines). For subjects determined at surgery to be at higher risk for recurrence due to having positive surgical margins, 2 or more clinically positive nodes or extracapsular nodal spread etc. (per NCCN guidelines), radiotherapy (as above) is combined with concurrent chemotherapy (cisplatin 100 mg/m\^2) intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

LI + SOC

LI was administered without CIZ to determine the contribution of CIZ to the effects of LI.

Group Type EXPERIMENTAL

LI

Intervention Type BIOLOGICAL

LI 400 IU (2.0mL total daily) 1.0 mL peritumoral, 1.0 mL perilymphatic 5x weekly x3 consecutive weeks administered as neoadjuvant therapy prior to SOC, (surgery followed by radiation or concurrent radiochemotherapy with cisplatin 100 mg/m\^2 intravenously x3) to determine if LI plus CIZ affects the 3-5 year overall survival.

Surgery

Intervention Type PROCEDURE

Excise tumor and nodes

Cisplatin

Intervention Type DRUG

Cisplatin was administered 100mg/m\^2 IV concurrent with radiotherapy. The chemotherapy agent (cisplatin 100mg/m\^2) was administered intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Radiotherapy

Intervention Type RADIATION

Total 60 to 70 Gy (2Gy per day) in 30 to 35 fractions over 6 to 7 weeks to subjects determined at surgery to be at lower risk for recurrence (per NCCN guidelines). For subjects determined at surgery to be at higher risk for recurrence due to having positive surgical margins, 2 or more clinically positive nodes or extracapsular nodal spread etc. (per NCCN guidelines), radiotherapy (as above) is combined with concurrent chemotherapy (cisplatin 100 mg/m\^2) intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Interventions

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LI

LI 400 IU (2.0mL total daily) 1.0 mL peritumoral, 1.0 mL perilymphatic 5x weekly x3 consecutive weeks administered as neoadjuvant therapy prior to SOC, (surgery followed by radiation or concurrent radiochemotherapy with cisplatin 100 mg/m\^2 intravenously x3) to determine if LI plus CIZ affects the 3-5 year overall survival.

Intervention Type BIOLOGICAL

Cyclophosphamide

Cyclophosphamide was administered IV bolus (one time only) at a dose of 300mg/m\^2 three days prior to beginning treatment with LI. Standard of care (SOC) for previously untreated squamous cell carcinoma of the head and neck is currently surgery followed by radiotherapy (60-70Gy in 30 to 35 fractions over 6 to 7 weeks) for higher risk subjects (subjects determined at surgery to have adverse features per the National Comprehensive Cancer Network (NCCN) guidelines, such as, positive surgical margins, 2 or more clinically positive nodes or extracapsular nodal spread, etc. that would pre-dispose them for higher risk of recurrence) radiotherapy is combined with concurrent chemotherapy (cisplatin 100mg/m\^2 intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Intervention Type DRUG

Indomethacin

One 25mg capsule of indomethacin was self administered orally (BID) beginning on day one of LI treatment daily until the day before surgery.

Intervention Type DRUG

Zinc

One capsule daily self administered beginning on day one of treatment with LI until one day before surgery

Intervention Type DIETARY_SUPPLEMENT

Surgery

Excise tumor and nodes

Intervention Type PROCEDURE

Cisplatin

Cisplatin was administered 100mg/m\^2 IV concurrent with radiotherapy. The chemotherapy agent (cisplatin 100mg/m\^2) was administered intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Intervention Type DRUG

Radiotherapy

Total 60 to 70 Gy (2Gy per day) in 30 to 35 fractions over 6 to 7 weeks to subjects determined at surgery to be at lower risk for recurrence (per NCCN guidelines). For subjects determined at surgery to be at higher risk for recurrence due to having positive surgical margins, 2 or more clinically positive nodes or extracapsular nodal spread etc. (per NCCN guidelines), radiotherapy (as above) is combined with concurrent chemotherapy (cisplatin 100 mg/m\^2) intravenously on day 1 of weeks 1, 4 and 7 of radiotherapy.

Intervention Type RADIATION

Other Intervention Names

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Multikine Leukocyte interleukin, injection Multivitamins

Eligibility Criteria

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Inclusion Criteria

* Untreated SCCHN of oral cavity (anterior tongue, floor of mouth, cheek)/soft palate, categories T1N1-2M0,T2N1-2M0,T3N0-2M0,T4N0-2M0 (T4 allowed only if invasion of mandible is negligible i. e. 5mm or less) scheduled for SOC
* Primary tumor and any positive node(s) measurable in 2 dimensions
* Normal immune function
* No immunosuppressives with 1 year of entry
* KPS\>70/100
* Age\>18
* Male or Female (non-pregnant)
* Life expectancy \>6 months
* Able to take oral medication
* Able to provide informed consent

* Tumor classifications T1N0, T2N0, T4N3, any TN classification with M1
* Active peptic ulcer (or on full-dose therapeutic anti-coagulants)
* Prior resection of jugular nodes ipsilateral to tumor
* Acute or chronic viral, bacterial immune or other disease associated with abnormal immune function
* Subjects on hemodialysis or peritoneal dialysis; or having a history of
* History of asthma, allergy to fluoroquinolone antibiotics, congestive heart failure, or on hemodialysis or peritoneal dialysis
* Any condition that in the opinion of the investigator would cause the subject to be unable to participate or tolerate the protocol regimen

Exclusion Criteria

* Subjects to be treated with other than SOC
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Teva Branded Pharmaceutical Products R&D, Inc.

INDUSTRY

Sponsor Role collaborator

Orient Europharma Co., Ltd.

INDUSTRY

Sponsor Role collaborator

CEL-SCI Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eyal Talor, PhD

Role: STUDY_DIRECTOR

CEL-SCI Corporation

Locations

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Simmons Cancer Institute at Southern Illinois University

Springfield, Illinois, United States

Site Status

Henry Ford Health System Henry Ford Hospital

Detroit, Michigan, United States

Site Status

University of Cincinnati Medical Center

Cincinnati, Ohio, United States

Site Status

Medical College Of South Carolina MSC550

Charleston, South Carolina, United States

Site Status

VA Puget Sound Healthcare System & University of WA

Seattle, Washington, United States

Site Status

HNO-Klinik der medizinischen Universitat Graz

Graz, , Austria

Site Status

N.N. Alexandrov Research Istitute of Oncology and Medical Radiology

Lyasny, Minsk Oblast, Belarus

Site Status

Vitebsk Regional Oncology Dispensary

Vitebsk, , Belarus

Site Status

University Clinical Centre Tuzla

Trnovac, Tuzla, Bosnia and Herzegovina

Site Status

Clinical Center Banja Luka

Banja Luka, , Bosnia and Herzegovina

Site Status

University Clinical Hospital Mostar

Mostar, , Bosnia and Herzegovina

Site Status

Clinical Centre University of Sarejevo Clinic for ENT

Sarajevo, , Bosnia and Herzegovina

Site Status

St. Josephs Healthcare Department of Surgery

Hamilton, Ontario, Canada

Site Status

Centre Hospitalier Universitaire de Sherbrooke

Sherbrooke, Quebec, Canada

Site Status

CHU de Quebec - L'Hotel Dieu de Quebec

Québec, , Canada

Site Status

CHC Osijek

Osijek, , Croatia

Site Status

General Hospital Dr. Josip Bencevic

Slavonski Brod, , Croatia

Site Status

CH Dubrava

Zagreb, , Croatia

Site Status

Clinical Hospital Center Zagreb Kispaticeva 12

Zagreb, , Croatia

Site Status

KBC Sestre Milosrdnice

Zagreb, , Croatia

Site Status

KBC Zagreb

Zagreb, , Croatia

Site Status

ICL 6 avenue Bourgogne CS30519

Vandœuvre-lès-Nancy, , France

Site Status

University of Debrecen Medical and Health Scioence Centre

Debrecen, Hajdú-Bihar, Hungary

Site Status

National institute of Oncology

Budapest, Rath Gyorgy, Hungary

Site Status

Semmelweis University

Budapest, , Hungary

Site Status

University of Pecs Institute of Oncotherapy

Pécs, , Hungary

Site Status

University of Szeged Dept of Oral and Maxillofacial Surgery

Szeged, , Hungary

Site Status

Markusovsky Teaching Hospital

Szombathely, , Hungary

Site Status

Bibi General Hospital and Cancer Centre

Malkapet, Andhra Pradesh, India

Site Status

Amrita Institute of Medical Sciences

Kochi, Kerala, India

Site Status

Sujan Regional Cancer Hospital & Amravati Cancer Foundation

Amravati, Maharashtra, India

Site Status

Government Medical College and Hospital

Aurangabad, Maharashtra, India

Site Status

Tata Memorial Hospital

Mumbai, Maharashtra, India

Site Status

Curie Manavata Cancer Center

Mumbai, Naka Nashik, India

Site Status

Searoc Cancer Center

Jaipur, Rajashlan, India

Site Status

V.N. Cancer Center G. Kuppuswamy Naidu Memorial Hospital

Coimbatore, Tamil Nadu, India

Site Status

Meenakshi Mission Hospital and Research Centre

Madurai, Tamil Nadu, India

Site Status

Regional Cancer Center

Kerola, Thiruvananthapuram, India

Site Status

Galaxy Cancer Center

Ghaziabad, Uttar Pradesh, India

Site Status

Rambam Health Care Campus

Sha‘ar Ha‘Aliya, Saint Haifa, Israel

Site Status

Rabin Medical Center

Petah Tikva, Tikva, Israel

Site Status

National Tumor Institute of Italy

Naples, , Italy

Site Status

Ospedale S.G. Moscati Santissima Annunziata

Taranto, , Italy

Site Status

Dept of Head and Neck Surgery School of Medical Sciences Univ. Sains

Kuantan, Pulau Pinang, Malaysia

Site Status

University Kabangsan Medical Center

Kuala Lumpur, , Malaysia

Site Status

Wojewodzki Szpital Specjalistyczny im Kopernika

Lodz, Ul Paderewskiego 4, Poland

Site Status

Swietokrzyskie Centrum Onkologii

Kielce, Ul. Artwinskiego 3, Poland

Site Status

Centrum Onkologi-Instytut im. Marie Sklodowskiej-Curie

Warsaw, Ul. Roentgena 5, Poland

Site Status

Centrum Onkologii im. Prof. Lukaszcyka

Warsaw, Ul. Roentgena 5, Poland

Site Status

ul. M. Sklodowskiej-Curie 24A

Bialystok, , Poland

Site Status

Szpital Specialistyczny im. Ludwika Rydgiera

Krakow, , Poland

Site Status

Samodzielny Publiczny Szpital Kliniczny Klinika Otolarryngologii I Onkologii Laryngologicznej

Lublin, , Poland

Site Status

Weilkopolskie Centrum Onkologii Klinika Chirurgii Glowy Szye Onkologii Laryngologiczne

Poznan, , Poland

Site Status

Uniwersitecki Szpital Kliniczny Klinika Otolaryngologii Chirugii Glowy i Szxyi

Wroclaw, , Poland

Site Status

Regional Institute of Oncology IASI

Iași, , Romania

Site Status

Spital Clinic Judetean Mures

Târgu Mureş, , Romania

Site Status

Sverdlovsk Regional Cancer Center

Sverdlov, Ekaterinberg, Russia

Site Status

Leningrad Regional Oncology Center

Saint Petersburg, Leningradskaya, Russia

Site Status

Kursk Regional Clinical Oncology Dispensary

Kursk, , Russia

Site Status

Blokhin Cancer Research Center

Moscow, , Russia

Site Status

N.N. Blokhin Russian Cancer Research Center

Moscow, , Russia

Site Status

Budget Institution of Healthcare of Omsk Region Clincal Oncology Dispensary

Omsk, , Russia

Site Status

Ryazan Clinical oncology Dispensary

Ryazan, , Russia

Site Status

Serbia Clinic for ENT and Maxillofacial Surgery

Belgrade, Pasterova 14, Serbia

Site Status

Clincal Center Serbia Clinic for Oral and Maxillofacial Surgery

Belgrade, , Serbia

Site Status

Faculty of Dental Medicine Clinic for Maxillofacial Surgery

Belgrade, , Serbia

Site Status

Military Medical Academy Clinic for Maxillofacial Surgery

Belgrade, , Serbia

Site Status

Clinical Center Nis center for Oncology

Niš, , Serbia

Site Status

Clinic for Stomatology department for maxillofacial Surgery

Niš, , Serbia

Site Status

Clinical center Vojvodina Clinic for ORL

Novi Sad, , Serbia

Site Status

Clinical Centre Vojvodina Clinic for Maxillofacial Surgery

Novi Sad, , Serbia

Site Status

Hospital Universitari Vall d'Hebron

Barcelona, , Spain

Site Status

Hospital Universitario de Princesa

Madrid, , Spain

Site Status

Hospital Universitario Ramon y Cajal

Madrid, , Spain

Site Status

Hospital Madrid North Universitaro de Sanchinnaro

Madrid, , Spain

Site Status

Complejo Hospitalario Univ. de Santiago

Santiago de Compostela, , Spain

Site Status

Consorsio Hospital General Universitario de valencia

Valencia, , Spain

Site Status

National Cancer Institute Dept of Clinical Oncology & Radiotherapy

Colombo, , Sri Lanka

Site Status

Oncology Unit Teaching Hospital Karapitya

Galle, , Sri Lanka

Site Status

Kaohsiung Branch Chang Gung Memorial Hospital

Niaosong, Kaohsiung, Taiwan

Site Status

National Cheng Kung University Hospital

Taipei, Tainan, Taiwan

Site Status

National Taiwan Research Hospital

Chengshan, Taipei, Taiwan

Site Status

Linkou Branch Chang Gung Memorial Hospital

Guishan, Taoyuan, Taiwan

Site Status

Changua Christian Hospital

Chang-hua, , Taiwan

Site Status

Buddhist Tzu Chi General Hospital, Hualien Branch

Hualien City, , Taiwan

Site Status

China Medical University Hospital

Taichung, , Taiwan

Site Status

Taichung Veterans General Hospital

Taichung, , Taiwan

Site Status

Shin-Kong Wu Ho-Su Memorial Hospital

Taipei, , Taiwan

Site Status

Khon Kaen University Dept of Otolaryngology

Nai Muang, , Thailand

Site Status

Haceteppe University Dept of Otolaryngology - Head and Neck Surgery

Ankara, , Turkey (Türkiye)

Site Status

Acibadem University Maslak Hospital ENT Department

Istanbul, , Turkey (Türkiye)

Site Status

Cherkasky Regional Oncological Dyspensary Dept. Head and Neck tumour

Cherkasy, , Ukraine

Site Status

Clinical Diagnostic Laboratory of Dnepropetrovsk Municipal Institution City Multidisciplinary Clinical Hospital No. 4

Dnipro, , Ukraine

Site Status

Donetsk Regional Antitumor Center

Donetsk, , Ukraine

Site Status

Grigoriev Institute for Medical Radiology of National Academy of Medical Science of Ukraine Dept. of Remote, Combined Radiation and Complex Therapy

Kharkiv, , Ukraine

Site Status

Kharkiv Regional Clinical Oncology Center Dept. Of Head and Neck Tumour

Kharkiv, , Ukraine

Site Status

Kiev City Clinical Oncology Center of the Main Health Care Dept of Kiev Day Hospital Radiotherapy Dept.

Kiev, , Ukraine

Site Status

Kiev City Clinical Oncology Center of the Main Health Care Dept. of the Kiev Day Hospital

Kiev, , Ukraine

Site Status

Lviv State OncologyRegional treatment and Diagnostic Center

Lviv, , Ukraine

Site Status

Sumy Regional Clinical Oncology Dyspensary

Sumy, , Ukraine

Site Status

Zaporiz'ka Regional Clinical Oncology Dispensary

Zaporiz'ka Oblast', , Ukraine

Site Status

Aintree University Hospital

Liverpool, , United Kingdom

Site Status

Countries

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United States Austria Belarus Bosnia and Herzegovina Canada Croatia France Hungary India Israel Italy Malaysia Poland Romania Russia Serbia Spain Sri Lanka Taiwan Thailand Turkey (Türkiye) Ukraine United Kingdom

References

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Talor E, Timar J, Lavin P, Cipriano J, Markovic D, Ladanyi A, Karpenko A, Bondarenko I, Stosic S, Sobat H, Zhukavets A, Imamovic N, Chien CY, Bankowska-Wozniak M, Kisely M, Jovic R, Young JEM, Hao SP. Neoadjuvant leukocyte interleukin injection immunotherapy improves overall survival in low-risk locally advanced head and neck squamous cell carcinoma -the IT-MATTERS study. Pathol Oncol Res. 2025 Mar 21;31:1612084. doi: 10.3389/pore.2025.1612084. eCollection 2025.

Reference Type DERIVED
PMID: 40191245 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan: SAP main text

View Document

Document Type: Statistical Analysis Plan: CS001P3 Note to File 1

View Document

Document Type: Statistical Analysis Plan: CS001P3 Note to file 2

View Document

Document Type: Statistical Analysis Plan: Note to file 3

View Document

Document Type: Statistical Analysis Plan: Note to file 4

View Document

Document Type: Statistical Analysis Plan: Note to file 5

View Document

Related Links

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http://www.cel-sci.com

Click here for more information about this study: Phase 3 Efficacy and Safety Study of Leukocyte Interleukin,Injection (LI) to Treat Cancer of the Oral Cavity (IT-MATTERS)

Other Identifiers

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2010-019952-35

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

CS001P3

Identifier Type: -

Identifier Source: org_study_id

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