Concurrent Chemoradiotherapy With Nimotuzumab for High Risk Nasopharyngeal Carcinoma

  • STATUS
    Recruiting
  • End date
    Dec 28, 2026
  • participants needed
    150
  • sponsor
    Sun Yat-sen University
Updated on 19 February 2024
cancer
induction chemotherapy
nasopharyngeal carcinoma
chemoradiotherapy
carcinoma
renal function test
concurrent radiochemotherapy
epstein-barr virus dna
nimotuzumab
egfr blocker
EGFR

Summary

This is the first phase II randomized clinical trial of concurrent chemoradiotherapy with or without EGFR blocker Nimotuzumab for high risk advanced nasopharyngeal carcinoma(NPC) , determining whether concurrent chemoradiotherapy(CCRT) combined with nimotuzumab can improve the survival rate of high-risk patients and may provide new evidence for individualized comprehensive treatment of locally advanced NPC.

Description

Currently, although NCCN(National Comprehensive Cancer Network) guidelines recommend induction chemotherapy combined with concurrent chemoradiotherapy as IIA level-evidenced treatment for locally advanced nasopharyngeal carcinoma (stage II-IVa),there is still about 20-30% of patients with locally advanced nasopharyngeal carcinoma experienced recurrence and metastasis after radical treatment.

Our previous results showed that patients with plasma Epstein-Barr virus(EBV) DNA> 0 copy/mL or stable disease/progressive disease(SD/PD) after induction chemotherapy had a significantly higher risk of disease progression than patients with plasma EBV DNA=0 copy/mL and complete response/partial response(CR/PR),according to Response Evaluation Criteria in Solid Tumors (RECIST). As for these high-risk patients, the urgent clinical problem to be solved is whether increased treatment intensity during concurrent chemoradiotherapy can improve their survival rates.

Epidermal growth factor (EGFR) is an important therapeutic target for nasopharyngeal carcinoma.Multiple retrospective studies have shown that chemoradiotherapy combined with the EGFR blocker nimotuzumab improved the survival rate of patients with locally advanced nasopharyngeal carcinoma compared with chemoradiotherapy alone. However, phase II randomized clinical trial about the incorporation of nimotuzumab into concurrent chemoradiotherapy is still limited.

This is the first phase II randomized clinical trial of concurrent chemoradiotherapy with or without Nimotuzumab for high risk locally advanced NPC patients, determining whether concurrent chemoradiotherapy combined with nimotuzumab can improve the survival rate of high-risk patients and may provide new evidence for individualized comprehensive treatment of locally advanced nasopharyngeal carcinoma.

Details
Condition Carcinoma, Nasopharyngeal Cancer, Nasopharyngeal Cancer
Age 18-70 years
Treatment CCRT+Nimotuzumab, CCRT alone
Clinical Study IdentifierNCT04223024
SponsorSun Yat-sen University
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Age 18-70, regardless of sex
Patients with newly histologically confirmed non-keratinizing nasopharyngeal carcinoma, type of WHO II or III, clinical stage II-IVa (according to the 8th American Joint Committee on Cancer[AJCC] edition)
Patients with plasma EBV DNA> 0 copy/mL or SD/PD according to RECIST after two cycle induction chemotherapy
ECOG (Eastern Cooperative Oncology Group) score: 0-1
Women in their reproductive years should ensure that they use contraception during the study period
Hemoglobin (HGB) 90 g/L, white blood cell (WBC) 4109 /L, platelet (PLT) 100109 /L
Liver function: Alanine transaminase(ALT), Aspartate aminotransferase(AST)< 2.5 times the upper limit of normal value (ULN), total bilirubin <2.0ULN
Renal function: serum creatinine <1.5ULN
Patients must sign informed consent and be willing and able to comply with the requirements of visits, treatment, laboratory tests and other research requirements stipulated in the research schedule

Exclusion Criteria

Histologically confirmed keratinizing squamous cell carcinoma (WHO I)
Receiving radiotherapy or chemotherapy or targeted therapy previously
Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the preparative chemotherapy on the fetus or infant
Suffered from other malignant tumors (except the cure of basal cell carcinoma or uterine cervical carcinoma in situ) previously
Patients with significantly lower heart, liver, lung, kidney and bone marrow function
Severe, uncontrolled medical conditions and infections
At the same time using other test drugs or in other clinical trials
Refusal or inability to sign informed consent to participate in the trial
Other treatment contraindications
Emotional disturbance or mental illness, no civil capacity or limited capacity for civil conduct
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