Neoadjuvant vs Adjuvant in Locally Advanced Recurrent NPC

NCT ID: NCT06235203

Last Updated: 2025-06-03

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

PHASE3

Total Enrollment

154 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-09

Study Completion Date

2027-06-30

Brief Summary

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A multicenter randomized controlled study of surgery combined with neoadjuvant and adjuvant therapy for locally advanced recurrent nasopharyngeal carcinoma in comparison to surgery combined with adjuvant therapy

Detailed Description

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Eligible patients are randomized into the control group and the experimental group.

Patients in the experimental group would be administrated 2 courses of neoadjuvant therapy before surgery.After endoscopic surgery, patients would continue to receive 2-4 courses of chemotherapy and 8 courses of immunotherapy.

Patients in the control group would firstly receive endoscopic surgery, followed by chemotherapy and immunotherapy. In total, 4 to 6 courses of chemotherapy and 10 courses of immunotherapy would be administrated.

Conditions

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Recurrent Nasopharyngeal Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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The control group

Endoscopic surgery + adjuvant therapy

Group Type ACTIVE_COMPARATOR

endoscopic surgery

Intervention Type PROCEDURE

The tumor was resected by endoscopic nasopharyngectomy.

Adjuvant therapy in control group,Toripalimab Injection and Gemcitabine based therapy

Intervention Type DRUG

Ten courses of Toripalimab Injection and four to six courses of chemotherapy,or until unacceptable side effects.

The experimental group

Neoadjuvant therapy +endoscopic surgery + adjuvant therapy

Group Type EXPERIMENTAL

endoscopic surgery

Intervention Type PROCEDURE

The tumor was resected by endoscopic nasopharyngectomy.

Neoadjuvant therapy,Toripalimab Injection and Gemcitabine based therapy

Intervention Type DRUG

Two courses of Toripalimab Injection and two courses of Toripalimab Injection and Gemcitabine based chemotherapy were given before endoscopic surgery.

Adjuvant therapy in experimental group,Toripalimab Injection and Gemcitabine based therapy

Intervention Type DRUG

Eight courses of Toripalimab Injection and two to four courses of chemotherapy, or until unacceptable side effects.

Interventions

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endoscopic surgery

The tumor was resected by endoscopic nasopharyngectomy.

Intervention Type PROCEDURE

Neoadjuvant therapy,Toripalimab Injection and Gemcitabine based therapy

Two courses of Toripalimab Injection and two courses of Toripalimab Injection and Gemcitabine based chemotherapy were given before endoscopic surgery.

Intervention Type DRUG

Adjuvant therapy in experimental group,Toripalimab Injection and Gemcitabine based therapy

Eight courses of Toripalimab Injection and two to four courses of chemotherapy, or until unacceptable side effects.

Intervention Type DRUG

Adjuvant therapy in control group,Toripalimab Injection and Gemcitabine based therapy

Ten courses of Toripalimab Injection and four to six courses of chemotherapy,or until unacceptable side effects.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Pathologically diagnosed with recurrent nasopharyngeal carcinoma;
2. Resectable disease staging rT2 (deep parapharyngeal space, or distance to the internal carotid ≤5mm) or rT3 (excluding the lesions confined to the basal wall of sphenoid sinus), rT4, according to AJCC 8th edition;
3. Cervical lymph node metastasis can be controlled locally;
4. Aged 18 to 75 years;
5. Informed consent forms signed to participate in the trial;
6. Without distant metastasis;
7. ≥6months from the accomplishment of radical radiation to recurrence
8. previously only 1 course of radiotherapy;
9. Sufficient organ function;
10. ECOG score 0-2 and can tolerate surgery,chemotherapy and immunotherapy.

Exclusion Criteria

1. Participate in other interventional clinical trials;
2. Uncontrolled illnesses that interfere with the therapy;
3. Suffering from another or multiple malignancy within 5 years (excluding fully treated basal cell or skin squamous cell carcinoma, cervical carcinoma in situ, etc.);
4. Any contradiction to surgery;
5. With serious autoimmune disease;
6. The patient is currently using immunosuppressive agents or systemic hormone therapy to achieve immunosuppressive effects (dosage\>10mg/day prednisone or other glucocorticoids), and continues to use them within 2 weeks before the first administration;
7. Severe allergic reactions to other monoclonal antibodies;
8. History of radioactive particle planting;
9. Vaccination with live vaccine within 4 weeks prior to initial administration or possibly during the study period;
10. Female patients who are at pregnancy or lactation;
11. Other situations that the researchers believe not suitable for enrollment
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Zhongshan Hospital

OTHER

Sponsor Role collaborator

Shanghai 6th People's Hospital

OTHER

Sponsor Role collaborator

Changhai Hospital

OTHER

Sponsor Role collaborator

Fujian Medical University Union Hospital

OTHER

Sponsor Role collaborator

People's Hospital of Guangxi Zhuang Autonomous Region

OTHER

Sponsor Role collaborator

Shenzhen Second People's Hospital

OTHER

Sponsor Role collaborator

Eye & ENT Hospital of Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Eye& ENT Hospital, Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Fujian Medical University Union Hospital

Fuzhou, , China

Site Status NOT_YET_RECRUITING

The People's Hospital of Guangxi Zhuang Autonomous Region

Nanning, , China

Site Status RECRUITING

Changhai Hospital

Shanghai, , China

Site Status NOT_YET_RECRUITING

Shanghai Sixth People's Hospital

Shanghai, , China

Site Status NOT_YET_RECRUITING

Shanghai Zhongshan Hospital

Shanghai, , China

Site Status NOT_YET_RECRUITING

Shenzhen Second People's Hospital

Shenzhen, , China

Site Status NOT_YET_RECRUITING

Countries

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China

Central Contacts

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Xiaole Song

Role: CONTACT

+8621 64377134

Facility Contacts

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Xiaole Song

Role: primary

15821388769

Desheng Wang

Role: primary

Shenhong Qu

Role: primary

Haihong Tang

Role: primary

Weitian Zhang

Role: primary

Xinsheng Huang

Role: primary

Yongtian Lu

Role: primary

Other Identifiers

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adv-rNPC-RCT-Neo-V1

Identifier Type: -

Identifier Source: org_study_id

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