Adjuvant Treatment of Apatinib in Nasopharyngeal Carcinoma

NCT ID: NCT03612219

Last Updated: 2018-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-01

Study Completion Date

2021-07-28

Brief Summary

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The study is to evaluate the efficacy and safety of apatinib for adjuvant treatment of High-risk metastasis of nasopharyngeal carcinoma after IMRT with concurrent chemotherapy,including progression-free survival (PFS),evaluation of drug safety.,and overall survival (OS),distant metastasisfree survival (DMFS),locoregional relapse-free survival (LRRFS),and quality of life score (QoL).

Detailed Description

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PRIMARY OBJECTIVES:

Ⅰ.To determine if adjuvant apatinib after IMRT with concurrent chemotherapy is better to only obeservation after IMRT with concurrent chemotherapy for progression-free survival in High-risk metastasis of nasopharyngeal carcinoma.

SECONDARY OBJECTIVES:

Ⅰ.To explore the adjuvant medication regimen of local advanced nasopharyngeal carcinoma after IMRT with concurrent chemotherapy.

Ⅱ.Provide high-level evidence-based medical evidence for the new individualized treatment strategy of nasopharyngeal carcinoma patients.

OUTLINE:

Patients are randomized to one of the two treatment arms.

ARM 1: treat with apatinib(the dose was 250 mg,orally,qd,28 days for an observation period,Six cycles) for adjuvant treatment of local advanced nasopharyngeal carcinoma after IMRT with concurrent chemotherapy.

ARM 2:only obeservation after IMRT with concurrent chemotherapy. IMRT: GTVnx 69.69Gy, GTVnd 60-68Gy, PTV1 59.4Gy and PTV2 54Gy in 33 fractions, 5 days/week.

Concurrent chemotherapy:Cisplatin 80mg/m2(D1-3), 3-week chemotherapy for 3 cycles.

After completion of study therapy, patients are followed up every 3-4 months for 2 years, then every 6 months for 3 years.

Conditions

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Nasopharyngeal Carcinoma

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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IMRT with CC+Adjuvant Apatinib

Treat with Apatinib mesylate tablet for adjuvant treatment(the dose was 250 mg,orally,qd,28 days for an observation period,Six cycles)of local advanced nasopharyngeal carcinoma after Intensity-modulated radiation therapy (IMRT) with concurrent chemotherapy(cisplatin).

Group Type EXPERIMENTAL

Apatinib mesylate tablet

Intervention Type DRUG

Adjuvant treatment by apatinib mesylate tablet to local advanced nasopharyngeal carcinoma after IMRT with concurrent chemotherapy.the dose of apatinib mesylate tablet was 250 mg,orally,qd,28 days for an observation period,six cycles.

Intensity-modulated radiation therapy (IMRT)

Intervention Type RADIATION

Intensity-modulated radiation therapy (IMRT):GTVnx 69.69Gy, GTVnd 60-68Gy, PTV1 59.4Gy and PTV2 54Gy in 33 fractions, 5 days/week.

Cisplatin

Intervention Type DRUG

Concurrent chemotherapy: patients received intravenous cisplatin 80mg/m2(D1-3), 3-week chemotherapy for 3 cycles.

IMRT with CC

Only obeservation after Intensity-modulated radiation therapy (IMRT) with concurrent chemotherapy(cisplatin).

Group Type ACTIVE_COMPARATOR

Intensity-modulated radiation therapy (IMRT)

Intervention Type RADIATION

Intensity-modulated radiation therapy (IMRT):GTVnx 69.69Gy, GTVnd 60-68Gy, PTV1 59.4Gy and PTV2 54Gy in 33 fractions, 5 days/week.

Cisplatin

Intervention Type DRUG

Concurrent chemotherapy: patients received intravenous cisplatin 80mg/m2(D1-3), 3-week chemotherapy for 3 cycles.

Interventions

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Apatinib mesylate tablet

Adjuvant treatment by apatinib mesylate tablet to local advanced nasopharyngeal carcinoma after IMRT with concurrent chemotherapy.the dose of apatinib mesylate tablet was 250 mg,orally,qd,28 days for an observation period,six cycles.

Intervention Type DRUG

Intensity-modulated radiation therapy (IMRT)

Intensity-modulated radiation therapy (IMRT):GTVnx 69.69Gy, GTVnd 60-68Gy, PTV1 59.4Gy and PTV2 54Gy in 33 fractions, 5 days/week.

Intervention Type RADIATION

Cisplatin

Concurrent chemotherapy: patients received intravenous cisplatin 80mg/m2(D1-3), 3-week chemotherapy for 3 cycles.

Intervention Type DRUG

Other Intervention Names

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No. No. No.

Eligibility Criteria

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Inclusion Criteria

1. Patients with newly histologically confirmed non-keratinizing (according to WHO histologically type) Tumor staged as T4 or N2-3 or lymph node\>3cm and M0(according to the 8th AJCC edition).
2. Adequate hematological function: hemoglobin \>80 g/L, neutrophil count \> 1.5×10\^9/L, platelet count 80×10\^9/L.
3. Adequate liver function (serum transminase ≤ 2.5 times higher than upper limit),adequate renal function (creatinine clearance ≥ 60 mL/min).
4. Karnofsky performance status (KPS) score of at least 70 or Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
5. Patients must give signed informed consent.

Exclusion Criteria

1. Other or mixed pathological type.
2. age \> 70 years.
3. Severe heart, liver and kidney damage.
4. History of other malignancy.
5. Prior chemotherapy or radiation of the primary tumor.
6. History of psychiatric disorders.
7. Positive urine protein.
8. A healed wound for long time or incomplete fracture.
9. Before treatment,MRI showed that the tumor might be an important risk factor (for example, wrapping around the internal carotid artery / vein); or researchers judged that the tumor is a high risk of serious blood vessel bleeding during the treatment.
10. Patient who has high blood pressure can not be controlled by a single antihypertensive drug treatment (Systolic pressure \> 140 mmHg, diastolic pressure \> 90 mmHg.
11. Any unstable angina pectoris;with a history of angina pectoris were newly diagnosed with angina pectoris within 3 months before screening; any myocardial infarction events occurred within 6 months before screening; arrhythmia (including QTcF: male ≥ 450ms, female ≥ 470 ms) need long time use of antiarrhythmic drugs and heart function insufficiency ≥II according to New York Heart Association class.
12. Medical history of arteriovenous thrombosis event within the past year, such as cerebral vascular accident (including transient ischemic attack) and deep venous thrombosis (venous catheter thrombosis caused by chemotherapy and investigator judged that the patient had recovered, these patients should be except) and pulmonary embolism.
13. Patient who has serious hemorrhages, any serious bleeding events classification at 3 degree or more (according to CTCAE4.0) within the last 4 weeks.
14. Patient who has abnormal coagulation and bleeding tendency (signed informed consent before 14 days, and must be satisfied: INR is in the normal range without the use of anticoagulants); Application of anticoagulants or vitamin K antagonists such as Hua Falin, heparin or its analogues, with international normalized ratio (INR) is less than 1.5, allows the use of small dose Hua Falin (1 mg orally, once daily) or small dose aspirin (total dose ≤ 100 mg daily).
15. For females:patients should be surgical sterilization or postmenopausal patients, or willing to receive a medical approved contraception during treatment and 6 months after the end of the treatment; serum or urine pregnancy test must be negative, and must be non lactating period within 7 days before study; for males: patients should be treated with surgical sterilization or willing to receive a medical approved contraception during treatment and 6 months after the end of the treatment.
16. Any factors that affect the oral drug, such as the inability to swallow, diarrhea and intestinal obstruction.
17. Medical history of immunodeficiency, or other acquired, congenital immunodeficiency disease, or history of organ transplantation.
18. Any serious harm to the subject's safety or evidence of significant medical illness that in the investigator's judgment will substantially increase the risk associated with the subject's participation in and completion of the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wuzhou Red Cross Hospital

OTHER

Sponsor Role collaborator

Guangxi Minzu Hospital

UNKNOWN

Sponsor Role collaborator

People's Hospital of Lingshan

UNKNOWN

Sponsor Role collaborator

Guangxi Naxishan Hospital

OTHER

Sponsor Role collaborator

People's Hospital of Baise

UNKNOWN

Sponsor Role collaborator

Laibin People's Hospital

OTHER

Sponsor Role collaborator

Wei Jiang

OTHER

Sponsor Role lead

Responsible Party

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Wei Jiang

Wei Jiang, MD, PhD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Wei Jiang, Ph.D.

Role: STUDY_DIRECTOR

Guilin Medical University, China

Locations

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People's Hospital of Baise

Baise City, Guangxi, China

Site Status ENROLLING_BY_INVITATION

Guangxi Naxishan Hospital

Guilin, Guangxi, China

Site Status ENROLLING_BY_INVITATION

Guilin Medical University

Guilin, Guangxi, China

Site Status RECRUITING

People's Hospital of Laibin

Laibin, Guangxi, China

Site Status ENROLLING_BY_INVITATION

People's Hospital of Lingshan

Linshan, Guangxi, China

Site Status ENROLLING_BY_INVITATION

Wuzhou Red Cross Hospital

Wuzhou, Guangxi, China

Site Status ENROLLING_BY_INVITATION

Countries

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China

Central Contacts

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Wei Jiang, Ph.D.

Role: CONTACT

+86-773-2882906

Facility Contacts

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Wei Jiang, Ph.D

Role: primary

+8613788561863

Other Identifiers

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GLMU-04

Identifier Type: -

Identifier Source: org_study_id

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