NCT03396718 De-escalation of Adjuvant Radio (Chemo) Therapy for HPV-positive Head-neck Squamous Cell Carcinomas
| NCT ID | NCT03396718 |
| Status | Recruiting |
| Phase | — |
| Sponsor | Technische Universität Dresden |
| Condition | Head-and-neck Squamous Cell Carcinoma |
| Study Type | INTERVENTIONAL |
| Enrollment | 304 participants |
| Start Date | 2018-11-29 |
| Primary Completion | 2029-11-30 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
This trial targets 304 participants in total. It began in 2018-11-29 with a primary completion date of 2029-11-30.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
In patients with squamous cell carcinoma of the oral cavity, the oropharynx and larynx with local advanced tumors (pathologic stage T3 = pT3) and or lymph node involvement (pN+) postoperative radio - or radiochemotherapy is the standard of care. Postoperative radiochemotherapy is indicated in patients with multiple lymph node metastasis, lymph node metastasis with extracapsular spread and / or residual tumor (R1-Status) after resection. Oropharyngeal cancer caused by HPV (human papillomavirus 16) is a distinct subgroup with a known sensitivity to radiotherapy (RTx) or radiochemotherapy (RCTx). Additionally a superior outcome after R(C)Tx over HPV negative patients was shown for patients treated with primary or adjuvant RCTx. To date it is unknown if the total dose of the radiotherapy can be safely reduced with the aim to decrease the therapy associated late effects. Patients with a HPV associated carcinoma that take part in the study will be treated with a reduced radiotherapy dose, chemotherapy will be prescribed based on clinical factors (number of affected lymph node, presence of extracapsular spread or residual tumor). Radiation dose will be reduced in two steps.
Eligibility Criteria
Inclusion Criteria: * Condition after surgical removal of a squamous cell carcinoma of the oropharynx and adequate lymph node dissection * Indication for adjuvant radiotherapy or radiochemotherapy in the interdisciplinary tumor board * Good general state (ECOG performance status 0 or 1) * Adequate compliance to ensure closely follow-up * Patient's consent and written consent * Neck dissection of at least the tumor bearing side Additional Inclusion Criteria Arm intermediate risk (at least one of the criteria must be fulfilled): * pT3 and R0 and / or * histologically confirmed involvement of lymph nodes (n = 1-3) and no extracapsular extension of the lymph node metastasis Additional Inclusion Criteria Arm high risk (at least one of the criteria must be fulfilled): * residual tumor (R1 status) and / or * pathologic stage T4 (pT4) status and / or * more than 3 infected lymph nodes and / or * extracapsular extension of at least one lymph node metastasis Exclusion Criteria: * Patients with a cumulative nicotine abuse \> 30 packyears. These patients are not included in the intervention arms, but are always included in the observation arms (regardless of HPV status). * radiologically presumed or histologically confirmed distant metastasis * R2 resection or macroscopically visible residual tumor after surgery * no neck dissection * interval between last operation and planned irradiation start \> 7 weeks * contraindication against a guideline-appropriate adjuvant radiation or radiochemotherapy according to the clinical risk constellation * tumor disease in the last five years before the beginning of the study (except basaliomas of the skin, in-situ carcinoma of the cervix uteri or breast, or tumors with similar prognosis which are considered to be very likely to be cured) * malignant tumor disease in the head and neck region, regardless of interval and prognosis * Pre-irradiation with risk of dose overlap * participation in another clinical trial if further experimental therapy is necessary or the treatments/ protocols are mutually exclusive (e.g. altered chemotherapy, additional consolidation chemotherapy). Allowed is the additional participation in observation studies or supportive therapy studies. * diseases or conditions which do not allow the person concerned to assess the nature and scope and possible consequences of the clinical trial * pregnant or lactating women * evidence that the participant is not expected to comply with the study protocol (e.g. lack of cooperation) * missing written consent
Contact & Investigator
Mechthild Krause, Prof.
STUDY CHAIR
University of Technology, University Hospital Carl Gustav Carus, Department of Radiation Therapy and Radiation Oncology, German Consortium for Translational Cancer Research (DKTK)
Frequently Asked Questions
Who can join the NCT03396718 clinical trial?
This trial is open to participants of all sexes, aged 18 Years or older, studying Head-and-neck Squamous Cell Carcinoma. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
Is NCT03396718 currently recruiting?
Yes, NCT03396718 is actively recruiting participants. Contact the research team at mechthild.krause@uniklinikum-dresden.de for enrollment information.
Where is the NCT03396718 trial being conducted?
This trial is being conducted at Tübingen, Germany, Essen, Germany, Dresden, Germany, Berlin, Germany and 6 additional locations.
Who is sponsoring the NCT03396718 clinical trial?
NCT03396718 is sponsored by Technische Universität Dresden. The principal investigator is Mechthild Krause, Prof. at University of Technology, University Hospital Carl Gustav Carus, Department of Radiation Therapy and Radiation Oncology, German Consortium for Translational Cancer Research (DKTK). The trial plans to enroll 304 participants.