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| ID | Type | Description | Link |
|---|---|---|---|
| 2009-011902-41 | EudraCT Number |
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A combination therapy of Docetaxel, Cisplatin und 5-Fluorouracil (= TPF) will be used in patients with resectable oropharyngeal and cavity of the mouth cancer. To improve the compatibility of the TPF-induction without decreasing the efficacy the dose will be given on day 1 and 8 instead of applying the whole dose on day 1 every 3 weeks.
In the phase I-part of the trial the optimal therapeutic dose of Docetaxel and Cisplatin will be defined.
In the phase II-part the progression-free survival after 2 years will be assessed in patients treated with the optimal therapeutic dose.
Local advanced Oropharyngeal and cavity of the mouth Cancer are often treated with a combination of surgery and/or radiation and /or chemotherapy.
Despite of therapy improvement there are only little advances in progression-free survival and overall survival.
Therefore new therapy concepts are needed. The advantage of the induction chemotherapy is the possibility of tumor response assessment during chemotherapy and may present a selection criterion for organ preservation.
In order to minimize the time between chemotherapy and surgery it is important to have an early answer for the tumor response. In this study response will be assessed after the first cycle of chemotherapy. Patients showing no tumor response will be operated at once. The other patients will receive further cycles of chemotherapy.
Toxicity of the induction chemotherapy have to be moderate because surgery should not be delayed.
To improve the tolerance of induction therapy the medication dose isn't given on day 1 every 3 weeks, but is dispersed on day 1 and day 8, q3weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Taxotere, Cisplatin, 5-Fluorouracil (5-FU) | Experimental | Phase 1: Intravenous infusion of 40 mg/m² Taxotere and 40 mg/m² Cisplatin followed by 24 h-infusion of 2000 mg/m² 5-FU on day 1 and day 8 every 3 weeks. If possible an escalation to 50 mg/m² Taxotere and 50 mg/m² Cisplatin can be carried out. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Taxotere, Cisplatin, 5-Fluorouracil (5-FU) | Drug | Phase 1: Intravenous infusion of 40 mg/m² Taxotere and 40 mg/m² Cisplatin followed by 24 h-infusion of 2000 mg/m² 5-FU on day 1 and day 8 every 3 weeks. If possible an escalation to 50 mg/m² Taxotere and 50 mg/m² Cisplatin can be carried out. Phase 2: Optimal dose of phase 1 will be given. |
| Measure | Description | Time Frame |
|---|---|---|
| Determination of progression-free survival after 2 years | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival after 2 years | after 2 years | |
| Determination of the efficacy of the induction therapy | CT or magnetic resonance tomography (MRT) of the neck region | after 1, 12 and 24 months |
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Inclusion Criteria:
Histological proven, resectable squamous epithelial carcinoma of the oropharynx and the cavity of the mouth
R0-resection possible
All T N2 M0 / all T N3 M0 / if T3 or T4a also N0-1 M0
Leucocytes > 4000/mm³ bzw. neutrophils > 2000/mm³, thrombocytes > 100000/mm³
adequate kidney function, defined as serum creatinine und urea in normal range, Creatinine clearance > 60 ml/min
adequate liver function with glutamate oxaloacetate transaminase (SGOT), glutamate pyruvate transaminase (SGPT) and bilirubin in normal range
electrolytes in normal range
risks of anesthesia complications normal or minor increased
Eastern Cooperative Oncology Group (ECOG) 0-2 / Karnofsky >= 60%
Age 18 - 80 years
signed written informed consent
effective contraception for both male and female subjects if the risk of conception exists
Exclusion Criteria:
T1 N0 M0 / T1 N1 M0 / T2 N0 M0 / T2 N1 M0
Resection without curative intention: primary tumor is not treatable with resection methods
Infiltration of the lower jaw
M1 status
Tumor not measurable with Innovation Center Computer Assisted Surgery (ICCAS) methods
No prior chemotherapy or radiation (a primary surgery is allowed)
Metachronous or oder synchronous malignoma (Exception: basal cell carcinoma)
Life expectance < 3 months
ECOG > 2; Karnofsky < 60%
acute infections or fever
known HIV-infection or other immune suppression
severe cardio pulmonary concomitant diseases
chronic disease with continuous therapy (uncontrolled diabetes, rheumatoid arthritis) especially continuous therapy with steroids
other concomitant diseases which, in the investigator's opinion, would exclude the patient from the study
Contraindications which permit a therapy with Docetaxel, Cisplatin, 5-FU or radiation therapy
missing patient's compliance
regular Follow-up visits not possible
Pregnancy or lactation period
legal incapacity or limited legal capacity
Participation in another clinical trial or administration of a not approved substance within 30 days before registration
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| Name | Affiliation | Role |
|---|---|---|
| Orlando Guntinas-Lichius, Prof. Dr. | Friedrich-Schiller-University Jena | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Städt. Kliniken Bielefeld gem. GmbH | Bielefeld | 33604 | Germany | |||
| Friedrich-Schiller-University Jena |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28498880 | Derived | Inhestern J, Schmalenberg H, Dietz A, Rotter N, Maschmeyer G, Jungehulsing M, Grosse-Thie C, Kuhnt T, Gorner M, Sudhoff H, Wittekindt C, Guntinas-Lichius O. A two-arm multicenter phase II trial of one cycle chemoselection split-dose docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy before two cycles of split TPF followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1). Ann Oncol. 2017 Aug 1;28(8):1917-1922. doi: 10.1093/annonc/mdx202. | |
| 26186556 |
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| ID | Term |
|---|---|
| D009959 | Oropharyngeal Neoplasms |
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| ID | Term |
|---|---|
| D010610 | Pharyngeal Neoplasms |
| D010039 | Otorhinolaryngologic Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D000077143 | Docetaxel |
| D002945 | Cisplatin |
| D005472 | Fluorouracil |
| ID | Term |
|---|---|
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
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|
|
| Function of swallowing according the penetration-aspiration-scale | assessed according the penetration-aspiration-scale (PAS, Rosenbek et al. 1996) and according measuring after Prosiegel (Prosiegel et al. 2002). | 0,1, 6, 12, 18, 24 months |
| Adverse events as a measure of safety and tolerability | The number of patients with adverse events will be evaluated. Adverse events will be assessed according Common Terminology Criteria of Adverse Events (CTCAE) v.3.0 and analysed as number per patient and number per cycle. | once a week |
| Quality of life | European Organisation for Research and Treatment of Cancer (EORTC) Quality of life questionnaire (QLQ) for head and neck cancer patients (HN35) questionnaire filled in by the patients | 0,1, 6, 12, 18, 24 months |
| Jena |
| 07740 |
| Germany |
| Universitätsklinikum Leipzig - Klinik und Poliklinik für HNO-Heilkunde | Leipzig | 04103 | Germany |
| Klinikum Ernst von Bergmann | Potsdam | 14467 | Germany |
| Derived |
| Inhestern J, Oertel K, Stemmann V, Schmalenberg H, Dietz A, Rotter N, Veit J, Gorner M, Sudhoff H, Junghanss C, Wittekindt C, Pachmann K, Guntinas-Lichius O. Prognostic Role of Circulating Tumor Cells during Induction Chemotherapy Followed by Curative Surgery Combined with Postoperative Radiotherapy in Patients with Locally Advanced Oral and Oropharyngeal Squamous Cell Cancer. PLoS One. 2015 Jul 17;10(7):e0132901. doi: 10.1371/journal.pone.0132901. eCollection 2015. |
| 23083061 | Derived | Oertel K, Spiegel K, Schmalenberg H, Dietz A, Maschmeyer G, Kuhnt T, Sudhoff H, Wendt TG, Guntinas-Lichius O. Phase I trial of split-dose induction docetaxel, cisplatin, and 5-fluorouracil (TPF) chemotherapy followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1). BMC Cancer. 2012 Oct 20;12:483. doi: 10.1186/1471-2407-12-483. |
| D009369 | Neoplasms |
| D010608 | Pharyngeal Diseases |
| D009057 | Stomatognathic Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D002294 | Carcinoma, Squamous Cell |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D006844 |
| Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D004224 | Diterpenes |
| D013729 | Terpenes |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D014498 | Uracil |
| D011744 | Pyrimidinones |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |