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The poor survival of Veterans with oral cancer underscores the significance of identifying new treatment approaches. The proposed studies will test a new 2 pronged immunotherapeutic approach for oral cancer patients which lessen the immune inhibitory environment while maturing cells that can stimulate T cell reactivity against oral cancer cells.
The hypothesis of this study is beneficial T cell reactivity in oral squamous cell carcinoma (OSCC) tumors can be synergistically stimulated by blocking suppressor endothelial cells and their induction of other inhibitory cell populations while also maturing immune inhibitory CD34+ cells into antigen-presenting dendritic cells.
To test this hypothesis, newly diagnosed OSCC patients will be administered the cyclooxigenase 2 inhibitor celecoxib and/or Calcitriol for the 3 week duration between cancer diagnosis and surgical treatment. The following aims will test the immunological and clinical effectiveness of the combination treatment:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1: Celecoxib | Experimental | Celecoxib treatment prior to surgery |
|
| Arm 2: Calcitriol | Experimental | Treatment with Calcitriol prior to surgery |
|
| Arm 3: Celecoxib plus Calcitriol | Experimental | Treatment with Celecoxib plus Calcitriol prior to surgery. |
|
| Arm 4: No Treatment | No Intervention | no treatment prior to surgery |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Celecoxib | Drug | Celecoxib (400 mg twice daily) |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in IL-2 Levels | Change in IL-2 stimulatory cytokine levels within tumor tissue. | baseline and 3 weeks |
| Change in IFN-gamma Levels | Change in IFN-gamma stimulatory cytokine levels within tumor tissue. | baseline and 3 weeks |
| Change in GM-CSF | Change in GM-CSF stimulatory cytokine levels within tumor tissue. | baseline and 3 weeks |
| Change in IL-6 Levels. | Change in levels of immune inhibitory/inflammatory mediator IL-6 in tumor tissue. | baseline and 3 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| M. Rita I Young, PhD | Ralph H. Johnson VA Medical Center, Charleston, SC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ralph H. Johnson VA Medical Center, Charleston, SC | Charleston | South Carolina | 29401-5799 | United States |
Publication of deidentified results.
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| ID | Title | Description |
|---|---|---|
| FG000 | Arm 1: Celecoxib | Treatment with Celecoxib |
| FG001 | Arm 2: Calcitriol | Treatment with Calcitriol |
| FG002 | Arm 3: Celecoxib Plus Calcitriol | Treatment with Celecoxib + Calcitriol |
| FG003 | Arm 4: No Treatment | no treatment prior to surgery |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm 1: Celecoxib | Celecoxib: Celecoxib (400 mg twice daily) oral cancer patients receiving new immunotherapy prior to surgery |
| BG001 | Arm 2: Calcitriol | Calcitriol Calcitriol (1,25-dihydroxyvitamin D3): 3 week pre-surgical enteral treatment of Calcitriol (3 cycles of 4 microg Calcitriol for each of 3 sequential days followed by 4 days of no treatment) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in IL-2 Levels | Change in IL-2 stimulatory cytokine levels within tumor tissue. | Patients with head and neck squamous cell carcinoma. | Posted | Mean | Standard Error | pg/100 gm protein | baseline and 3 weeks |
|
3 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Arm 1: Celecoxib | oral cancer patients receiving Celecoxib prior to surgery |
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Difficulty in recruiting subjects that are eligible for the combination Celecoxib + Calcitriol treatment.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| M. Rita I. Young, Ph.D. | Ralph H. Johnson VA Medical Center, Charleston, SC | 843-792-9953 | rita.young@va.gov |
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| ID | Term |
|---|---|
| D009062 | Mouth Neoplasms |
| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D009059 | Mouth Diseases |
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| ID | Term |
|---|---|
| D000068579 | Celecoxib |
| D002117 | Calcitriol |
| ID | Term |
|---|---|
| D000096926 | Benzenesulfonamides |
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
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| Calcitriol | Drug | 3 week pre-surgical enteral treatment of Calcitriol (1,25-dihydroxyvitamin D3) (3 cycles of 4 microg Calcitriol 3 for each of 3 sequential days followed by 4 days of no treatment) |
|
|
| Celecoxib plus Calcitriol | Drug | 3 week pre-surgical enteral treatment of Calcitriol (1,25-dihydroxyvitamin D3) (3 cycles of 4 microg Calcitriol for each of 3 sequential days followed by 4 days of no treatment) plus Celecoxib (400 mg twice daily) |
|
|
| BG002 | Arm 3: Celecoxib Plus Calcitriol | Celecoxib + Calcitriol 3 week pre-surgical enteral treatment of Calcitriol (3 cycles of 4 microg 1,25-dihydroxyvitamin D3) for each of 3 sequential days followed by 4 days of no treatment) plus Celecoxib (400 mg twice daily) |
| BG003 | Arm 4: No Treatment | oral cancer patients receiving no immunotherapy prior to surgery |
| BG004 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| OG002 | Arm 3: Celecoxib Plus Calcitriol | Treatment with Celecoxib plus Calcitriol prior to surgery. Celecoxib plus Calcitriol: 3 week pre-surgical enteral treatment of Calcitriol (1,25-dihydroxyvitamin D3) (3 cycles of 4 microg Calcitriol for each of 3 sequential days followed by 4 days of no treatment) plus Celecoxib (400 mg twice daily) |
| OG003 | Arm 4: No Treatment | no treatment prior to surgery |
|
|
|
| Primary | Change in IFN-gamma Levels | Change in IFN-gamma stimulatory cytokine levels within tumor tissue. | Patients with head and neck squamous cell carcinoma. | Posted | Mean | Standard Error | pg/100 gm protein | baseline and 3 weeks |
|
|
|
|
| Primary | Change in GM-CSF | Change in GM-CSF stimulatory cytokine levels within tumor tissue. | Patients with head and neck squamous cell carcinoma. | Posted | Mean | Standard Error | pg/100 gm protein | baseline and 3 weeks |
|
|
|
|
| Primary | Change in IL-6 Levels. | Change in levels of immune inhibitory/inflammatory mediator IL-6 in tumor tissue. | Patients with head and neck squamous cell carcinoma. | Posted | Mean | Standard Error | pg/100 gm protein | baseline and 3 weeks |
|
|
|
|
| 0 |
| 6 |
| 0 |
| 6 |
| EG001 | Arm 2: Calcitriol | oral cancer patients receiving Calcitriol prior to surgery | 0 | 6 | 0 | 6 |
| EG002 | Arm 3: Celecoxib Plus Calcitriol | oral cancer patients receiving Celecoxib + Calcitriol prior to surgery | 0 | 4 | 0 | 4 |
| EG003 | Arm 4: No Treatment | oral cancer patients receiving no treatment prior to surgery | 0 | 5 | 0 | 5 |
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| D009057 |
| Stomatognathic Diseases |
| D001555 |
| Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D011720 | Pyrazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D004100 | Dihydroxycholecalciferols |
| D006887 | Hydroxycholecalciferols |
| D002762 | Cholecalciferol |
| D002782 | Cholestenes |
| D002776 | Cholestanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013261 | Sterols |
| D014807 | Vitamin D |
| D012632 | Secosteroids |
| D008563 | Membrane Lipids |
| D008055 | Lipids |