Postoperative Management for HNSCC Based on Pathological Response of Induction Chemotherapy and Immunotherapy

NCT ID: NCT05777824

Last Updated: 2023-10-11

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-01

Study Completion Date

2027-12-30

Brief Summary

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To develop postoperative stratification treatment for patients who have received induction chemotherapy and immunotherapy in locally advanced head and neck cancers. Risk stratification is based on clinical characteristics and pathological responses. In order to achieve no inferior survival rate and a lower treatment-related toxicity rate than the standard treatment.

Detailed Description

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Induction chemotherapy combined with immunotherapy has shown promising efficacy in the treatment of patients with locally advanced head and neck cancers. However, how to choose a proper postoperative treatment remains unknown. Eligibility patients were assigned to two arms, each divided into three groups: observation, immunotherapy maintenance, and radiotherapy (50 Gy dose) plus immunotherapy maintenance group for low-risk arm; radiotherapy (50 Gy or 60Gy dose) plus immunotherapy maintenance groups, concurrent chemotherapy plus immunotherapy maintenance group for a high-risk arm. Disease-free survival, overall survival, and treatment-related toxicity would be calculated to evaluate the efficacy of treatments.

Conditions

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Head and Neck Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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low-risk and PCR

Observation

Group Type NO_INTERVENTION

No interventions assigned to this group

low-risk and MPR

immunotherapy maintenance

Group Type EXPERIMENTAL

anti-PD-1 or PD-L1 antibody

Intervention Type COMBINATION_PRODUCT

immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy

low-risk and IPR

postoperative radiotherapy (50 Gy) and immunotherapy maintenance

Group Type EXPERIMENTAL

anti-PD-1 or PD-L1 antibody

Intervention Type COMBINATION_PRODUCT

immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy

postoperative radiaotherapy

Intervention Type RADIATION

postoperative radiotherapy (60Gy or 50Gy)

high-risk and PCR

postoperative radiotherapy (50 Gy) and immunotherapy maintenance

Group Type EXPERIMENTAL

anti-PD-1 or PD-L1 antibody

Intervention Type COMBINATION_PRODUCT

immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy

postoperative radiaotherapy

Intervention Type RADIATION

postoperative radiotherapy (60Gy or 50Gy)

high-risk and MPR

postoperative radiotherapy (60 Gy) and immunotherapy maintenance

Group Type EXPERIMENTAL

anti-PD-1 or PD-L1 antibody

Intervention Type COMBINATION_PRODUCT

immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy

postoperative radiaotherapy

Intervention Type RADIATION

postoperative radiotherapy (60Gy or 50Gy)

high-risk and IPR

postoperative concurrent chemoradiotherapy (60 Gy) and immunotherapy maintenance

Group Type EXPERIMENTAL

anti-PD-1 or PD-L1 antibody

Intervention Type COMBINATION_PRODUCT

immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy

postoperative radiaotherapy

Intervention Type RADIATION

postoperative radiotherapy (60Gy or 50Gy)

Interventions

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anti-PD-1 or PD-L1 antibody

immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy

Intervention Type COMBINATION_PRODUCT

postoperative radiaotherapy

postoperative radiotherapy (60Gy or 50Gy)

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

1. The subjects are not limited by gender, age from 18 to 75 years old;
2. Histopathologically confirmed squamous cell carcinoma of the head and neck cancer;
3. Locally advanced squamous cell carcinoma diagnosed as T3-4 or N+ stage according to AJCC 8th edition staging;
4. ECOG score 0-1;
5. without distant metastasis;
6. received induction chemotherapy plus immunotherapy, followed by surgery
7. The expected survival is expected to be no less than 6 months.
8. No contraindications to chemotherapy, immunotherapy, and radiotherapy;

Exclusion Criteria

1. Past malignancies history (except for stage I non-melanoma skin cancer or cervical carcinoma in situ)
2. Received any systemic anti-tumor therapy for target lesions before induction chemotherapy and immunotherapy;
3. Previously experienced head and neck radiation therapy;
4. Subjects who have used corticosteroids (\>10 mg/day prednisone or other equivalent hormones) or other immunosuppressive agents for systemic treatment within 1 month before enrollment. In the absence of active autoimmune disease, inhaled or topical corticosteroids and adrenal hormone replacement therapy at therapeutic doses of prednisone ≤10 mg/day are permitted;
5. Patients with pleural effusion, pericardial effusion or ascites that need to be drained with clinical symptoms, or who have received serous cavity effusion drainage for the purpose of treatment within 2 weeks before enrollment;
6. Severe comorbidities including myocardial infarction, arrhythmia, cerebral vascular disease, ulceration disease, mental disease and uncontrolled diabetes
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cancer Institute and Hospital, Chinese Academy of Medical Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Junlin Yi, Doctor

Role: STUDY_CHAIR

National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS & PUMC

Locations

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National Cancer Center /National Clinical Research Center for Cancer/Cancer Hospital, CAMS & PUMC

Beijin, Beijing Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yi Xu

Role: CONTACT

15811166516

Facility Contacts

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Wang Jingbo

Role: primary

15811166516

Xu Yi

Role: backup

15811166516

Other Identifiers

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22/523-3725

Identifier Type: -

Identifier Source: org_study_id

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