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The use of multiple drugs in a single clinical trial or as a therapeutic strategy has become common, particularly in the treatment of cancer. Because traditional trials are designed to evaluate one agent at a time, the evaluation of therapies in combination requires specialized trial designs. In place of the traditional separate phase I and II trials, this trial uses a single phase I/II clinical trial to evaluate simultaneously the safety and efficacy of combination dose levels, and select the optimal combination dose.
Therefore, this is a two part trial of Debio 1143 combined with concurrent cisplatin and radiotherapy (CRT) in participants with previously untreated stage III, IVa or IVb head and neck cancer. The trial begins with an initial period of dose escalation (Phase I) to investigate the maximum tolerated dose (MTD) of Debio 1143 that can safely be given in combination with CRT.
Using the MTD determined in the Phase I portion, the randomized phase II trial in 94 participants compares Debio 1143 to placebo, both with concomitant CRT. The aim is to evaluate the efficacy and safety of Debio 1143.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Debio 1143 | Experimental | In addition to Cisplatin and Radiotherapy, Debio 1143 in solution form will be administered orally or by feeding tube (while fasting) daily for 14 days every three weeks (on days 1-14, 22-35 and 43-56). |
|
| Placebo | Placebo Comparator | In addition to Cisplatin and Radiotherapy, matching placebo in solution form will be administered orally or by feeding tube (while fasting) daily for 14 days every three weeks (on days 1-14, 22-35 and 43-56). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cisplatin | Drug | A total of three cycles of cisplatin will be administered in a 1-hour IV infusion on days 2, 23 and 44. Cisplatin will be administered 0.5 hours after Debio 1143. |
| Measure | Description | Time Frame |
|---|---|---|
| Phase II: Percentage of participants achieving Locoregional Control (LRC) at 18 months from the end of chemo-radiation therapy (CRT) | within 4 years |
| Measure | Description | Time Frame |
|---|---|---|
| Phase II: Complete Response Rate (by RECIST version 1.1) at six months after completion of chemo-radiation therapy (CRT) therapy | within 5 years | |
| Phase II: Best Overall response rate, Disease Control rate and Response Rate after 10 weeks from the end of CRT |
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Inclusion Criteria:
Exclusion Criteria:
Has history or current use of over-the-counter medications, dietary supplements, or drugs (including nicotine and alcohol) outside protocol-specified parameters
Has signs, symptoms or history of any condition that, per protocol or in the opinion of the investigator, might compromise:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier de Bretagne Sud - HÔPITAL DU SCORFF | Lorient | BP 2233 | 56322 | France | ||
| C.H.U. Sud Amiens |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37777832 | Derived | Vugmeyster Y, Ravula A, Rouits E, Diderichsen PM, Kleijn HJ, Koenig A, Wang X, Schroeder A, Goteti K, Venkatakrishnan K. Model-Informed Selection of the Recommended Phase III Dose of the Inhibitor of Apoptosis Protein Inhibitor, Xevinapant, in Combination with Cisplatin and Concurrent Radiotherapy in Patients with Locally Advanced Squamous Cell Carcinoma of the Head and Neck. Clin Pharmacol Ther. 2024 Jan;115(1):52-61. doi: 10.1002/cpt.3065. Epub 2023 Oct 23. | |
| 37439181 |
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|
| Radiotherapy | Radiation | Standard fraction radiotherapy to the primary tumour will be delivered daily for 5 days per week over 7 weeks. |
|
|
| Debio 1143 | Drug | Debio 1143 solution |
|
| Placebo | Drug | Matching placebo solution |
|
| within 5 years |
| Phase II: Best Overall response rate, Disease Control rate and Response Rate after 6 months from the end of CRT | within 5 years |
| Phase II: Locoregional control rate at 6 months and one year after completion of CRT | within 5 years |
| Phase II: Progression free survival rate at one year, 18 months and at 2 years as of initiation of CRT | within 5 years |
| Phase II: Distant relapse rate at six months, one year and 18 months after completion of CRT | within 5 years |
| Phase II: Disease specific survival rate one year and at 2 years as of initiation of CRT | within 5 years |
| Phase II: Overall survival rate at one year and at 2 years as of initiation of CRT | within 5 years |
| Phase II: Number of participants with clinically significant change in vital signs during participation in the trial | within 5 years |
| Phase II: Number of participants with Serious Adverse Events | within 5 years |
| Phase II: Number of participants with Adverse Events (AEs) | Categories will be based on severity graded according to NCI-CTCAE version 4 criteria | within 5 years |
| Phase II: Number of participants with Laboratory Abnormalities | Categories will be based on severity graded according to NCI-CTCAE version 4 criteria | within 5 years |
| Phase II: Number of participants with Late Toxicity as of initiation of CRT | Categories: at 1 year, at 2 years | within 5 years |
| Phase II: Number of participants with treatment changes due to AEs | Categories: Treatment discontinuation, Treatment modification | within 5 years |
| Amiens |
| 80054 |
| France |
| Institut Sainte-Catherine | Avignon | 84918 | France |
| Centre Jean Perrin | Clermont-Ferrand | BP 392 | France |
| CHU Grenoble | Grenoble | BP 217 | France |
| CHD Vendée | La Roche-sur-Yon | F- 85925 | France |
| Centre Guillaume le Conquérant | Le Havre | 76600 | France |
| Centre Jean Bernard | Le Mans | France |
| Hôpital Nord Franche-Comté | Montbéliard | 25200 | France |
| ICM - Val D'Aurelle | Montpellier | 34298 | France |
| Institut Curie | Paris | 75248 | France |
| Centre Henri Becquerel | Rouen | 76038 | France |
| Institut de Cancérologie de l'Ouest (ICO) René Gauducheau | Saint-Herblain | BP 217 | France |
| Institut de Cancérologie Lucien Neuwirth (ICLN) | Saint-Priest-en-Jarez | BP 60008 | France |
| Institut Claudius Regaud | Toulouse | 31052 | France |
| L'Institut de Cancérologie de Lorraine (ICL) Alexis Vautrin | Vandœuvre-lès-Nancy | CS 30519 | France |
| Institut Gustave Roussy | Villejuif | 94000 | France |
| Inselspital Bern, Universitätsklinik für Radio-Onkologie, Freiburgstrasse 4 | Bern | 3010 | Switzerland |
| Centre Hospitalier Universitaire Vaudois (CHUV) | Lausanne | 1011 | Switzerland |
| Derived |
| Tao Y, Sun XS, Pointreau Y, Tourneau CL, Sire C, Gollmer K, Crompton P, Bourhis J. Long-term results from a clinical study of xevinapant plus chemoradiotherapy in people with high-risk locally advanced squamous cell carcinoma of the head and neck: a plain language summary. Future Oncol. 2023 Aug;19(26):1769-1776. doi: 10.2217/fon-2023-0322. Epub 2023 Jul 13. |
| 36796234 | Derived | Tao Y, Sun XS, Pointreau Y, Le Tourneau C, Sire C, Kaminsky MC, Coutte A, Alfonsi M, Calderon B, Boisselier P, Martin L, Miroir J, Ramee JF, Delord JP, Clatot F, Rolland F, Villa J, Magne N, Elicin O, Gherga E, Nguyen F, Lafond C, Bera G, Calugaru V, Geoffrois L, Chauffert B, Damstrup L, Crompton P, Ennaji A, Gollmer K, Nauwelaerts H, Bourhis J. Extended follow-up of a phase 2 trial of xevinapant plus chemoradiotherapy in high-risk locally advanced squamous cell carcinoma of the head and neck: a randomised clinical trial. Eur J Cancer. 2023 Apr;183:24-37. doi: 10.1016/j.ejca.2022.12.015. Epub 2023 Jan 9. |
| 32758455 | Derived | Sun XS, Tao Y, Le Tourneau C, Pointreau Y, Sire C, Kaminsky MC, Coutte A, Alfonsi M, Boisselier P, Martin L, Miroir J, Ramee JF, Delord JP, Clatot F, Rolland F, Villa J, Magne N, Elicin O, Gherga E, Nguyen F, Lafond C, Bera G, Calugaru V, Geoffrois L, Chauffert B, Zubel A, Zanna C, Brienza S, Crompton P, Rouits E, Gollmer K, Szyldergemajn S, Bourhis J. Debio 1143 and high-dose cisplatin chemoradiotherapy in high-risk locoregionally advanced squamous cell carcinoma of the head and neck: a double-blind, multicentre, randomised, phase 2 study. Lancet Oncol. 2020 Sep;21(9):1173-1187. doi: 10.1016/S1470-2045(20)30327-2. Epub 2020 Aug 3. |
| ID | Term |
|---|---|
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| ID | Term |
|---|---|
| D002294 | Carcinoma, Squamous Cell |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D002945 | Cisplatin |
| D011878 | Radiotherapy |
| C559144 | N-benzhydryl-5-(2-(methylamino)propanamido)-3-(3-methylbutanoyl)-6-oxodecahydropyrrolo(1,2-a)(1,5)diazocine-8-carboxamide |
| ID | Term |
|---|---|
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D013812 | Therapeutics |
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