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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2020-05752 | Registry Identifier | CTRP (Clinical Trial Reporting Program) |
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| Name | Class |
|---|---|
| NRG Oncology | OTHER |
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This phase II trial investigates how well sodium thiosulfate works in preventing ototoxicity (hearing loss/damage) in patients with squamous cell cancer of the head and neck that has spread to nearby tissue or lymph nodes (locally advanced) who are undergoing a chemoradiation. Sodium thiosulfate is a type of medication used to treat cyanide poisoning and to help lessen the side effects from cisplatin. Chemotherapy drugs, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving chemotherapy with radiation therapy may kill more tumor cells. The purpose of this trial is to find out whether it is feasible to give sodium thiosulfate 4 hours after each cisplatin infusion along with standard of care radiation therapy in patients with head and neck cancer. Giving sodium thiosulfate after cisplatin may help decrease the risk of hearing loss.
PRIMARY OBJECTIVE:
I. To establish feasibility of intravenous sodium thiosulfate (STS) after each dose of concurrent cisplatin in patients with locally advanced head and neck squamous cell carcinoma undergoing definitive radiotherapy.
SECONDARY OBJECTIVES:
I. To determine the rate of grade >= 2 hearing impairment based on Common Terminology Criteria for Adverse Events (CTCAE) version 5 with use of STS after concurrent chemoradiation with cisplatin 3 months post-treatment.
II. To determine the rate of tinnitus measured by Patient Reported Outcomes (PRO)-CTCAE with use of STS 3 months post-treatment.
III. To describe patient reported outcomes with STS measured with PRO-CTCAE for selected oral, gastrointestinal (GI), neurologic and perceptual symptoms.
IV. To describe patient reported outcomes measured with Hearing Handicap Inventory for Adults - Screening (HHIA-S) compared to results from standard NRG Oncology head and neck trials (such as Radiation Therapy Oncology Group (RTOG) 1016).
OUTLINE:
Patients undergo standard of care radiation therapy in combination with cisplatin therapy for up to 6-7 weeks. Cisplatin treatment repeats weekly for up to 7 cycles, or every 21 days for up to 3 cycles. After each cisplatin infusion, patients also receive an infusion of sodium thiosulfate. The dosing schedule for cisplatin will be at the discretion of the treating physician.
After completion of study treatment, patients are followed up every 3 months for up to 3 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cisplatin, Radiotherapy, STS | Experimental | Patients undergo standard of care radiation therapy daily in combination with cisplatin on day 1. Between 4-5 hours after each cisplatin infusion, patients also receive sodium thiosulfate over 1-2 hours on day 1. Treatment will continue on either a 1 week or 3 week cycle per physician discretion for up to 6-7 weeks in the absence of disease progression or unacceptable toxicity. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cisplatin | Drug | Given IV |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Who Successfully Completed Planned Treatment | Evaluated as the successful completion of at least 5 weekly cisplatin or 2 high dose cisplatin without any extended treatment related delays more than 7 days. Overall successful completion is defined as completion by at least 75% of patients. | Up to 7 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Participants With Reported High Grade Ototoxicity | The proportion of participants with a reported change of grade >= 2 hearing impairments based on National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 (for patients on a monitoring program with audiogram) will be reported. | Up to 18 weeks |
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Inclusion Criteria:
Participants must have histologically or cytologically confirmed locoregionally advanced squamous cell carcinomas of mucosal surfaces of head and neck who are being treated with concurrent chemoradiation with cisplatin
Participants must be eligible for cisplatin-based concurrent chemotherapy in conjunction with at least 6 weeks of daily fractionated radiation therapy
Age >=18 years
Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 50%)
Demonstrates adequate organ function as defined below:
Ability to understand a written informed consent document, and the willingness to sign it
Individuals with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
The effects of sodium thiosulfate (STS) on the developing human fetus are unknown. For this reason and because cisplatin used in this trial are known to be teratogenic, women of childbearing potential and men must agree to use adequate contraception such as hormonal and/or barrier method of birth control for the duration of study participation and for 3 months after last administration of study treatment. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 3 months after last administration of study treatment
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hyunseok Kang, MD | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, San Francisco | San Francisco | California | 94143 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Cisplatin, Radiotherapy, STS | Participants undergo standard of care radiation therapy daily in combination with cisplatin on day 1. Between 4-5 hours after each cisplatin infusion, patients also receive sodium thiosulfate over 1-2 hours on day 1. Treatment will continue on either a 1 week or 3 week cycle per physician discretion for up to 6-7 weeks in the absence of disease progression or unacceptable toxicity. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Sep 9, 2022 |
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| Hearing Handicap Inventory for Adults - Screening | Other | Patient self-assessment questionnaire to measure probability of hearing impairment |
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| Radiation Therapy | Radiation | Radiation therapy will be delivered according to the standard of care |
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| Sodium Thiosulfate | Drug | Given IV |
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| Number of Participants Reporting Tinnitus by Severity | The frequency of tinnitus will be measured by participants' worst level response at any time point on the PRO-CTCAE® question "In the last 7 days, what was the severity of ringing in your ears at its worst?". Item responses were categorized as 'None', 'Mild', 'Moderate', 'Severe', and 'Very Severe'. | Up to 18 weeks |
| Percentage of Participants Reporting Sodium Thiosulfate (STS)-Specific Symptomology | The percentage of participants reporting STS specific adverse events will be measured by affirmative responses on the PRO-CTCAE® on any of the selected oral, gastrointestinal, neurologic and visual/perceptual symptoms. | Up to 18 weeks |
| Frequency of Hearing Handicap | The Hearing Handicap Inventory for Adults -Screener (HHIA-S), is a 10-item, self-assessment screening assessment developed to quickly determine the suggested level of hearing handicap. The participants respond to each of the items with a Yes (score of 4), Sometimes (score of 2), or No (score of 0). Total Scores are then summed for overall score (range 0-40) and then assigned a category for a suggested hearing handicap; 0-8 suggesting no handicap, 10-24 suggesting a mild-moderate handicap, and 26-40 suggesting significant hearing handicap. The frequency of participants for worse reported score will be reported | Up to 18 weeks |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Cisplatin, Radiotherapy, STS | Participants undergo standard of care radiation therapy daily in combination with cisplatin on day 1. Between 4-5 hours after each cisplatin infusion, patients also receive sodium thiosulfate over 1-2 hours on day 1. Treatment will continue on either a 1 week or 3 week cycle per physician discretion for up to 6-7 weeks in the absence of disease progression or unacceptable toxicity. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Count of Participants | Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| 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 | Number of Participants Who Successfully Completed Planned Treatment | Evaluated as the successful completion of at least 5 weekly cisplatin or 2 high dose cisplatin without any extended treatment related delays more than 7 days. Overall successful completion is defined as completion by at least 75% of patients. | Posted | Count of Participants | Participants | Up to 7 weeks |
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| Secondary | Proportion of Participants With Reported High Grade Ototoxicity | The proportion of participants with a reported change of grade >= 2 hearing impairments based on National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 (for patients on a monitoring program with audiogram) will be reported. | Posted | Number | proportion of participants | Up to 18 weeks |
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| Secondary | Number of Participants Reporting Tinnitus by Severity | The frequency of tinnitus will be measured by participants' worst level response at any time point on the PRO-CTCAE® question "In the last 7 days, what was the severity of ringing in your ears at its worst?". Item responses were categorized as 'None', 'Mild', 'Moderate', 'Severe', and 'Very Severe'. | Posted | Number | participants | Up to 18 weeks |
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| Secondary | Percentage of Participants Reporting Sodium Thiosulfate (STS)-Specific Symptomology | The percentage of participants reporting STS specific adverse events will be measured by affirmative responses on the PRO-CTCAE® on any of the selected oral, gastrointestinal, neurologic and visual/perceptual symptoms. | Posted | Number | percentage of participants | Up to 18 weeks |
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| Secondary | Frequency of Hearing Handicap | The Hearing Handicap Inventory for Adults -Screener (HHIA-S), is a 10-item, self-assessment screening assessment developed to quickly determine the suggested level of hearing handicap. The participants respond to each of the items with a Yes (score of 4), Sometimes (score of 2), or No (score of 0). Total Scores are then summed for overall score (range 0-40) and then assigned a category for a suggested hearing handicap; 0-8 suggesting no handicap, 10-24 suggesting a mild-moderate handicap, and 26-40 suggesting significant hearing handicap. The frequency of participants for worse reported score will be reported | Posted | Count of Participants | Participants | Up to 18 weeks |
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Up to 18 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 | Cisplatin, Radiotherapy, STS | Participants undergo standard of care radiation therapy daily in combination with cisplatin on day 1. Between 4-5 hours after each cisplatin infusion, patients also receive sodium thiosulfate over 1-2 hours on day 1. Treatment will continue on either a 1 week or 3 week cycle per physician discretion for up to 6-7 weeks in the absence of disease progression or unacceptable toxicity. | 0 | 16 | 1 | 16 | 16 | 16 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal Pain | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Allergic Reaction | Immune system disorders | CTCAE (5.0) | Systematic Assessment | Hives |
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| Anemia | Blood and lymphatic system disorders | CTCAE (5.0) | Systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | CTCAE (5.0) | Systematic Assessment |
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| Aphonia | Nervous system disorders | CTCAE (5.0) | Systematic Assessment |
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| Atrial fibrillation | Cardiac disorders | CTCAE (5.0) | Systematic Assessment |
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| Blood and lymphatic system disorders, Other | Blood and lymphatic system disorders | CTCAE (5.0) | Systematic Assessment |
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| Blood bilirubin increased | Investigations | CTCAE (5.0) | Systematic Assessment |
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| Confusion | Psychiatric disorders | CTCAE (5.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Creatinine increased | Investigations | CTCAE (5.0) | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | CTCAE (5.0) | Systematic Assessment |
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| Dry Mouth | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | CTCAE (5.0) | Systematic Assessment |
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| Dysphagia | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Ear Pain | Ear and labyrinth disorders | CTCAE (5.0) | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Fatigue | General disorders | CTCAE (5.0) | Systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | CTCAE (5.0) | Systematic Assessment |
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| Gastrointestinal disorders, Other | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Headaches | Nervous system disorders | CTCAE (5.0) | Systematic Assessment |
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| Hearing impaired | Ear and labyrinth disorders | CTCAE (5.0) | Systematic Assessment |
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| Hiccups | Respiratory, thoracic and mediastinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Hyperhidrosis | Skin and subcutaneous tissue disorders | CTCAE (5.0) | Systematic Assessment |
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| Hypertension | Vascular disorders | CTCAE (5.0) | Systematic Assessment |
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| Hypoalbuminemia | Metabolism and nutrition disorders | CTCAE (5.0) | Systematic Assessment |
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| Hypokalemia | Metabolism and nutrition disorders | CTCAE (5.0) | Systematic Assessment |
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| Hypomagnesemia | Metabolism and nutrition disorders | CTCAE (5.0) | Systematic Assessment |
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| Infusion Related Reaction | Injury, poisoning and procedural complications | CTCAE (5.0) | Systematic Assessment |
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| Investigations, Other | Investigations | CTCAE (5.0) | Systematic Assessment |
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| Laryngeal inflammation | Respiratory, thoracic and mediastinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Lymph Node Pain | Blood and lymphatic system disorders | CTCAE (5.0) | Systematic Assessment |
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| Lymphocyte count decreased | Investigations | CTCAE (5.0) | Systematic Assessment |
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| Memory impairment | Nervous system disorders | CTCAE (5.0) | Systematic Assessment |
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| Mucositis oral | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Musculoskeletal, Other | Musculoskeletal and connective tissue disorders | CTCAE (5.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Neutrophil Count Decreased | Investigations | CTCAE (5.0) | Systematic Assessment |
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| Oral pain | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Paresthesia | Nervous system disorders | CTCAE (5.0) | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | CTCAE (5.0) | Systematic Assessment |
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| Rectal hemorrhage | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Tinnitus | Ear and labyrinth disorders | CTCAE (5.0) | Systematic Assessment |
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| Sore throat | Respiratory, thoracic and mediastinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Trismus | Musculoskeletal and connective tissue disorders | CTCAE (5.0) | Systematic Assessment |
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| Voice alteration | Respiratory, thoracic and mediastinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | CTCAE (5.0) | Systematic Assessment |
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| Weight Loss | Metabolism and nutrition disorders | CTCAE (5.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Hyunseok Kang, MD | University of California, San Francisco | (888) 689-8273 | hyunseok.kang@ucsf.edu |
| Apr 26, 2024 |
| Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D009959 | Oropharyngeal Neoplasms |
| D007012 | Hypopharyngeal Neoplasms |
| D007822 | Laryngeal Neoplasms |
| D009062 | Mouth Neoplasms |
| D002277 | Carcinoma |
| ID | Term |
|---|---|
| D010610 | Pharyngeal Neoplasms |
| D010039 | Otorhinolaryngologic Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D010608 | Pharyngeal Diseases |
| D009057 | Stomatognathic Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D007818 | Laryngeal Diseases |
| D012140 | Respiratory Tract Diseases |
| D012142 | Respiratory Tract Neoplasms |
| D009059 | Mouth Diseases |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| D002945 | Cisplatin |
| C044245 | 1,2-diaminocyclohexaneplatinum II citrate |
| D011878 | Radiotherapy |
| D011827 | Radiation |
| C017717 | sodium thiosulfate |
| ID | Term |
|---|---|
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D013812 | Therapeutics |
| D055585 | Physical Phenomena |
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| Title | Measurements |
|---|---|
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| 70-79 years old |
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| Unknown or Not Reported |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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