22 Participants Needed

Neck Radiation +/− Cisplatin for Oropharyngeal Cancer

RR
Overseen ByRyan Romasko
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Fox Chase Cancer Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a combination of neck radiation and the chemotherapy drug Cisplatin to evaluate their effectiveness in treating oropharyngeal cancer, particularly in patients with p16-positive cancer. Researchers aim to determine how well these treatments work for patients with cancer confined to one side of the neck or with specific lymph node involvement. Suitable candidates for this trial have been diagnosed with squamous cell carcinoma in the oropharynx, have a history of smoking, and have specific lymph node conditions without cancer crossing the midline of the neck. As a Phase 2 trial, the research focuses on assessing the treatment's effectiveness in an initial, smaller group of participants.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Previous studies have shown that cisplatin plays an important role in treating HPV-positive oropharyngeal cancer. While effective, it can cause side effects such as painful mouth sores, nausea, vomiting, and a decrease in white blood cells, which help fight infections.

Radiation therapy, another component of this trial, also causes side effects. Patients often experience soreness or dryness in their mouths. Despite these effects, radiation therapy remains a well-established treatment for this type of cancer.

Both treatments have a well-documented safety record. Although side effects are known, they can usually be managed. Joining the trial will help researchers learn more about balancing the benefits and side effects for patients.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about this trial because it explores combining neck radiation with cisplatin for treating oropharyngeal cancer. Unlike standard treatments that often use radiation alone or chemotherapy separately, this approach investigates the potential benefits of using them together, which might enhance effectiveness against cancer cells. Cisplatin is a powerful chemotherapy drug that can damage the DNA of cancer cells, potentially making them more sensitive to radiation. This trial aims to determine whether this combination can improve outcomes, especially for patients with more extensive neck cancer involvement.

What evidence suggests that this trial's treatments could be effective for oropharyngeal cancer?

This trial will compare the effectiveness of neck radiation with or without the addition of cisplatin for treating oropharyngeal cancer. Research has shown that cisplatin effectively treats p16+ oropharyngeal cancer. Studies have found that patients have better survival rates when they receive the right amount of cisplatin. Specifically, those who received a total dose of 200 mg or more had higher overall survival rates, with 89.7% having no detectable cancer afterward.

Radiation therapy, particularly intensity-modulated radiation therapy (IMRT), plays a crucial role in treating oropharyngeal cancer. It protects organs while effectively managing the cancer. Survival rates are high, and it has a strong record of preventing cancer recurrence. Together, these treatments offer a promising approach for people with p16+ oropharyngeal cancer. Participants in this trial will receive either radiation therapy alone or in combination with cisplatin, depending on their assigned cohort.36789

Who Is on the Research Team?

Thomas J. Galloway | Fox Chase Cancer ...

Thomas Galloway, MD

Principal Investigator

Fox Chase Cancer Center

Are You a Good Fit for This Trial?

This trial is for adults with p16+ oropharyngeal cancer, who have not had prior systemic therapy or neck surgery for the cancer. They should be in good physical condition (ECOG 0-1), without metastatic disease, bilateral neck adenopathy, or a history of severe allergic reactions to Technetium-99m-tilmanocept. Tumors must not cross midline and patients should have adequate organ function.

Inclusion Criteria

My blood, kidney, and liver tests are normal.
CT with contrast and/or MRI with contrast performed within 56 days prior to registration showing no bilateral neck adenopathy
PET/CT performed within 28 days prior to registration showing no bilateral neck adenopathy
See 6 more

Exclusion Criteria

Pregnant or breastfeeding
I have received systemic therapy for my cancer.
History of allergic reaction to Technetium-99m-tilmanocept
See 8 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-treatment

Patients positive for p16 status are approached for consent during the pre-treatment intake process

1 week

Treatment

Participants receive unilateral neck radiation for 6-7 weeks or until unacceptable toxicity or withdrawal of consent

6-7 weeks

Follow-up

Participants are monitored for disease free survival (DFS) and overall survival (OS) until 24 months after completion of study treatment

24 months

What Are the Treatments Tested in This Trial?

Interventions

  • Cisplatin
  • Radiation Therapy
Trial Overview The study tests elective neck radiation directed by lymphoscintigraphy in p16+ favorable risk oropharynx cancer patients. It's a phase II trial where participants receive either 6 weeks of daily radiation with cisplatin, or an extended 7-week course if needed based on tumor mapping.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Cohort B (N0 or N1 <3cm)Experimental Treatment1 Intervention
Group II: Cohort A (>N1 or single node > 3cm )Experimental Treatment2 Interventions

Cisplatin is already approved in European Union, United States, Canada, Japan for the following indications:

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Approved in European Union as Platinol for:
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Approved in United States as Platinol for:
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Approved in Canada as Platinol for:
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Approved in Japan as Platinol for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Fox Chase Cancer Center

Lead Sponsor

Trials
236
Recruited
39,300+

Cardinal Health

Industry Sponsor

Trials
12
Recruited
2,800+

Published Research Related to This Trial

In a study of 21 patients with advanced oropharyngeal carcinoma, selective intraarterial chemoradiation therapy using high-dose cisplatin (300 mg/m²) resulted in a 2-year overall survival rate of 71.3% for those who completed the treatment.
The therapy also achieved a high locoregional control rate of 95.0% and a disease-free survival rate of 67.7%, indicating its efficacy while potentially reducing the number of treatment procedures compared to traditional methods.
Selective intraarterial chemoradiation therapy for oropharyngeal carcinoma with high-dose cisplatin.Nishio, R., Saito, K., Ito, H., et al.[2021]
In a phase III trial involving 891 patients with stage III or IV head and neck carcinoma, adding cetuximab to the radiation-cisplatin treatment did not improve progression-free survival (PFS) or overall survival (OS) compared to radiation-cisplatin alone.
Patients with p16-positive oropharyngeal carcinoma had significantly better PFS and OS compared to those with p16-negative tumors, indicating that p16 status is a more important factor for outcomes than the addition of cetuximab.
Randomized phase III trial of concurrent accelerated radiation plus cisplatin with or without cetuximab for stage III to IV head and neck carcinoma: RTOG 0522.Ang, KK., Zhang, Q., Rosenthal, DI., et al.[2022]
Modern radiation therapy, particularly intensity-modulated radiation therapy (IMRT), significantly reduces xerostomia (dry mouth) and improves the quality of life for patients with oropharyngeal cancer.
Intensity-modulated proton therapy may offer even greater benefits by minimizing radiation-related toxicities, which is crucial for patients with HPV-positive oropharyngeal carcinoma who are likely to have long-term survival after treatment.
Advances in radiation oncology for the management of oropharyngeal tumors.Gunn, GB., Frank, SJ.[2018]

Citations

Concurrent chemotherapy in oropharyngeal cancerThe study findings demonstrated that when compared to concurrent CDDP, CTX did not meet criteria for non-inferiority as OS was significantly worse (p = 0.0163) ...
Weekly Cisplatin Cycles and Outcomes for Chemoradiation ...These findings suggest that missing several cycles of weekly cisplatin is associated with worse survival, even among those with p16-negative tumors.
Retrospective study of cisplatin plus radiotherapy toxicities ...A total of 274 (84%) patients were compliant and received the planned dose of cisplatin. Overall, 957 adverse events were reported in 98.2% of ...
Effectiveness of Cisplatin in P16+ Oropharyngeal Cancer ...The effectiveness of cisplatin in p16+ OPSCC increased with higher omega score but not with standard risk group.
Efficacy and safety of definitive low-dose weekly cisplatin ...The 2- and 5-year overall survival (OS) rates were 81.0% and 63.5%, respectively, with a complete response rate of 89.7%. A cumulative cisplatin dose of ≥200 mg ...
Efficacy and safety of cisplatin for the management of adult ...The findings of this study will provide convinced evidence of cisplatin for adult patients with OC, and provide recommendations for clinical practice.
The important role of cisplatin in the treatment of HPV ...This study using causal inference of retrospective patient data confirms the important role of cisplatin in the treatment of HPV-positive OPSCC.
Radiotherapy plus cisplatin or cetuximab in low-risk human ...Concomitant cisplatin and radiotherapy should remain the standard of care for patients with low-risk HPV-positive oropharyngeal cancer. Our ...
Adjuvant Therapy for HPV-Positive Oropharyngeal CancerCisplatin is a standard treatment for oropharyngeal squamous cell carcinoma, but it is associated with significant toxicity. Studies have explored alternative ...
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