Personalized Neck Radiation Therapy Directed by Sentinel Lymph Node Biopsy for the Treatment of Oral Cavity Squamous Cell Carcinoma, PRECEDENT Trial

NCT ID: NCT07121595

Last Updated: 2025-08-13

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-17

Study Completion Date

2030-07-01

Brief Summary

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This phase II trial studies how well personalized neck radiation therapy directed by sentinel lymph node biopsy (SLNB) works in treating patients with oral cavity squamous cell carcinoma (OCSCC). SLNB can be performed as part of standard care for OCSCC. During SLNB, a radiotracer is injected around the tumor. The lymph nodes are then biopsied and tested to see if the tracer injected into the tumor traveled to and is present in the sentinel lymph nodes (SLNs). Results of the SLNB are used to determine whether lymph nodes should be removed in both sides of the neck or just on the same side as the primary tumor. Standard treatment then involves radiation therapy to both sides of the neck, regardless of SLNB results. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill tumor cells and shrink tumors. Studies have shown only a small number of patients develop a return of the cancer (recurrence) in the opposite side of the neck after radiation therapy. In addition, radiation therapy can negatively impact patient outcomes like saliva production, speech and swallow function, increased risk of radiation induced cancers, and chronic pain. Standard of care SLNBs may be effective in determining whether radiation therapy only needs to be administered to one side of the neck or both sides. This may help spare tissue on the opposite side of the neck from receiving radiation if there is no indication of lymph node involvement there.

Detailed Description

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Conditions

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Oral Cavity Squamous Cell Carcinoma Stage I Lip and Oral Cavity Cancer AJCC v8 Stage II Lip and Oral Cavity Cancer AJCC v8 Stage III Lip and Oral Cavity Cancer AJCC v8 Stage IVA Lip and Oral Cavity Cancer AJCC v8

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment (SLN mapping, SLNB, RT, chemotherapy)

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Group Type EXPERIMENTAL

Biospecimen Collection

Intervention Type PROCEDURE

Undergo blood sample collection

Carboplatin

Intervention Type DRUG

Given IV

Cisplatin

Intervention Type DRUG

Given IV

Computed Tomography

Intervention Type PROCEDURE

Undergo CT and/or SPECT-CT

Modified Barium Swallow

Intervention Type PROCEDURE

Undergo video fluoroscopic swallow study

Paclitaxel

Intervention Type DRUG

Given IV

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo PET-CT

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Radiation Therapy

Intervention Type RADIATION

Undergo RT

Sentinel Lymph Node Biopsy

Intervention Type PROCEDURE

Undergo SLNB

Single Photon Emission Computed Tomography

Intervention Type PROCEDURE

Undergo SPECT-CT

Technetium Tc 99m-labeled Tilmanocept

Intervention Type RADIATION

Given via injection

Technetium Tc-99m Sulfur Colloid

Intervention Type OTHER

Given via injection

Interventions

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Biospecimen Collection

Undergo blood sample collection

Intervention Type PROCEDURE

Carboplatin

Given IV

Intervention Type DRUG

Cisplatin

Given IV

Intervention Type DRUG

Computed Tomography

Undergo CT and/or SPECT-CT

Intervention Type PROCEDURE

Modified Barium Swallow

Undergo video fluoroscopic swallow study

Intervention Type PROCEDURE

Paclitaxel

Given IV

Intervention Type DRUG

Positron Emission Tomography

Undergo PET-CT

Intervention Type PROCEDURE

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Radiation Therapy

Undergo RT

Intervention Type RADIATION

Sentinel Lymph Node Biopsy

Undergo SLNB

Intervention Type PROCEDURE

Single Photon Emission Computed Tomography

Undergo SPECT-CT

Intervention Type PROCEDURE

Technetium Tc 99m-labeled Tilmanocept

Given via injection

Intervention Type RADIATION

Technetium Tc-99m Sulfur Colloid

Given via injection

Intervention Type OTHER

Other Intervention Names

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Biological Sample Collection Biospecimen Collected Specimen Collection Blastocarb Carboplat Carboplatin Hexal Carboplatino Carboplatinum Carbosin Carbosol Carbotec CBDCA Displata Ercar JM-8 JM8 Nealorin Novoplatinum Paraplatin Paraplatin AQ Paraplatine Platinwas Ribocarbo Abiplatin Blastolem Briplatin CDDP Cis-diammine-dichloroplatinum Cis-diamminedichloridoplatinum Cis-diamminedichloro Platinum (II) Cis-diamminedichloroplatinum Cis-dichloroammine Platinum (II) Cis-platinous Diamine Dichloride Cis-platinum Cis-platinum II Cis-platinum II Diamine Dichloride Cismaplat Cisplatina Cisplatinum Cisplatyl Citoplatino Citosin Cysplatyna DDP Lederplatin Metaplatin Neoplatin Peyrone's Chloride Peyrone's Salt Placis Plastistil Platamine Platiblastin Platiblastin-S Platinex Platinol Platinol- AQ Platinol-AQ Platinol-AQ VHA Plus Platinoxan Platinum Platinum Diamminodichloride Platiran Platistin Platosin CAT CAT Scan Computed Axial Tomography Computerized Axial Tomography Computerized axial tomography (procedure) Computerized Tomography Computerized Tomography (CT) scan CT CT Scan tomography MBS VFSS Videofluoroscopic Swallowing Study Anzatax Asotax Bristaxol Praxel Taxol Taxol Konzentrat Medical Imaging, Positron Emission Tomography PET PET Scan Positron emission tomography (procedure) Positron Emission Tomography Scan Positron-Emission Tomography PT Cancer Radiotherapy Energy Type ENERGY_TYPE Irradiate Irradiated Irradiation Radiation Radiation Therapy, NOS Radiotherapeutics Radiotherapy RT Therapy, Radiation Sentinel Node Biopsy Sentinel node biopsy alone SLNB SNB Medical Imaging, Single Photon Emission Computed Tomography Single Photon Emission Tomography Single-Photon Emission Computed single-photon emission computed tomography SPECT SPECT imaging SPECT SCAN SPET ST tomography, emission computed, single photon Tomography, Emission-Computed, Single-Photon 99mTc-Diethylenetriamine Pentaacetic Acid-Mannosyl-Dextran 99mTc-DTPA-Mannosyl-Dextran Lymphoseek Tc99m Tilmanocept TECHNETIUM TC-99M TILMANOCEPT Tc 99m Sulfur Colloid Tc-99m SC Technetium Tc 99m Sulfur Colloid

Eligibility Criteria

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Inclusion Criteria

* Patient must have biopsy-proven squamous cell carcinoma of the oral cavity
* Clinical stage cT1-4a N0-2b M0 within 42 days of study enrollment based on the following work-up:

* History and physical examination within 42 days of study enrollment; must include documentation of lateralized primary tumor site
* Cross-sectional imaging of the head and neck within 42 days of study enrollment
* Cross-sectional imaging of the chest within 42 days of study enrollment
* Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2 within 42 days of study enrollment
* Age \> 18
* Recommended treatment plan is surgical resection with ipsilateral neck dissection and SPECT-CT-guided sentinel node biopsy. Flap reconstruction is allowed
* Patient is willing and able to provide informed consent. Patient provides study-specific informed consent prior to study entry
* Women of childbearing potential and male participants must agree to use medically effect means of birth control throughout their participation in the treatment phase of the study

Exclusion Criteria

* Evidence of distant metastatic disease based on clinical or radiologic evaluation
* Evidence of contralateral neck disease on staging imaging
* Prior non-head and neck invasive malignancy (except non-melanomatous skin cancer, including effectively treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or cervix) unless disease free for ≥ 2 years
* Diagnosis of head and neck squamous cell carcinoma (SCC) in the oropharynx, nasopharynx, hypopharynx, and larynx
* Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowed. Prior immunotherapy for the study cancer is allowed.
* Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
* Patient with severe, active co-morbidity that would preclude an elective or completion neck dissection
* Pregnant and breast-feeding patients
* Excisional biopsy for study cancer
* Prior surgery involving the lateral neck, including neck dissection or gross injury to the neck that would preclude surgical dissection for this trial. Prior thyroid and central neck surgery is permissible; incisional biopsy is permitted
* Underlying or documented history of hematologic malignancy (e.g., chronic lymphocytic leukemia \[CLL\]) or other active disease capable of causing lymphadenopathy (sarcoidosis or untreated mycobacterial infection)
* Actively receiving systemic cytotoxic chemotherapy, immunosuppressive, anti-monocyte or immunomodulatory therapy
* Currently participating in another investigational therapeutic trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Michigan Rogel Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jennifer L Shah

Role: PRINCIPAL_INVESTIGATOR

University of Michigan Rogel Cancer Center

Locations

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University of Michigan Comprehensive Cancer Center

Ann Arbor, Michigan, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Cancer AnswerLine

Role: CONTACT

1-800-865-1125

Facility Contacts

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Cancer AnswerLine

Role: primary

800-865-1125

Other Identifiers

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NCI-2025-01191

Identifier Type: REGISTRY

Identifier Source: secondary_id

HUM00258370

Identifier Type: OTHER

Identifier Source: secondary_id

UMCC 2023.022

Identifier Type: -

Identifier Source: org_study_id

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