Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2025-00939 | Registry Identifier | National Cancer Institute Clinical Trials Reporting Program |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The purpose of the research is to test the safety and efficacy of the investigational drug in human subjects with cancer.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gemcitabine, Docetaxel and Capecitabine | Experimental | Patients will receive three q 21-day cycles of gemcitabine 1000 mg/m2 plus docetaxel 75 mg/m2 plus toripalimab 240 mg, followed by radiation to 70 Gy plus concurrent weekly cisplatin, 40 mg/m2 up to 7 doses, followed by adjuvant capecitabine 650 mg/m2 BID for one year plus toripalimab 240 mg q 21 days for 9 doses. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Toripalimab | Drug | Toripalimab will be administered 240 mg intravenously every three weeks in combination with the induction chemotherapy regimen for 3 cycles, and for 9 cycles as adjuvant treatment following radiation as specified in the overall sequential treatment plan. |
| Measure | Description | Time Frame |
|---|---|---|
| Induction chemotherapy completion rate | Induction chemotherapy completion rate, defined as the proportion of patients who complete three cycles of chemoimmunotherapy within 12 weeks of initiation. Completion is defined for induction as receiving all 3 cycles as planned, including protocol specified dose reduction and delays. . | 3 years |
| Radiation completion rate | Radiation completion rate, defined as the proportion of patients who complete specified radiation within 8 weeks of radiation initiation. Radiation completion is defined as completion of planned doses of radiation. | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Response (ORD) rate following induction | OR rate following induction, defined as the proportion of patients who achieve at least a RECIST defined PR within 12 weeks of induction chemotherapy initiation. | 3 years |
| Complete Response (CR) rate following radiation |
Not provided
Inclusion Criteria:
Eligible disease(s) / stage(s): Locoregionally advanced EBV positive NPC (T3-4, any N OR any T, N1-3. No M1) per AJCC v 8
Prior therapy: None for NPC permitted
Life expectancy: 3 months at least
Contraception requirements: Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control during treatment with toripalimab and for 4 months after the last dose.
ECOG Performance Status of 0,1, or 2
Age: At least 18 years old.
CBC/differential obtained within 21 days prior to day 1 of treatment, with adequate bone marrow function defined as follows:
Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3
Platelets ≥ 100,000 cells/mm3;
Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable.);
Adequate hepatic function within 21 days prior to day 1 of treatment, defined as follows:
Total bilirubin ≤ 1.5 x institutional ULN;
AST and ALT ≤ 1.5 x institutional ULN;
Adequate renal function within 21 days prior to day 1 of treatment, defined as follows:
Serum creatinine ≤ 1.5 mg/dl or calculated or measured creatinine clearance (CC) ≥ 50 ml/min
Negative serum pregnancy test within 14 days prior to day 1 of treatment for women of childbearing potential
Ability to understand and the willingness to personally sign the written IRB approved informed consent document.
Exclusion Criteria:
Prior systemic anticancer treatment for NPC
Prior radiation to head and neck region or regions necessitating overlapping fields
Concurrent use of any anti- cancer treatment, standard, alternative or investigational.
History of allergic reactions to any agents in this study
Autoimmune disease or organ transplant which in the judgment of the PI would increase the risk of immune checkpoint inhibition.
Pregnant or breastfeeding
Severe, active co-morbidity, defined as follows:
Acquired Immune Deficiency Syndrome (AIDS) based upon current CDC definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive
Patients with hearing loss assessed to be primarily sensorineural in nature, requiring a hearing aid, or intervention (i.e. interfering in a clinically significant way with activities of daily living); a conductive hearing loss that is tumor-related is allowed
≥ grade 2 peripheral sensory neuropathy
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Elizabeth Winters | Contact | (650) 723-6372 | ewinters@stanford.edu | |
| A. Dimitrios Colevas, MD | Contact | 650-704-8563 | colevas@stanford.edu |
| Name | Affiliation | Role |
|---|---|---|
| A. Dimitrios Colevas, MD | Stanford University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University | Recruiting | Palo Alto | California | 94304 | United States |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Concurrent Chemoradiation and Adjuvant treatment following Chemoradiation | Radiation | Radiation treatment will be initiated 3-6 weeks following day 1 of the last induction cycle using institutional standards of care and support as follows: Intensity modulated radiotherapy, 70 Gy in 33 fractions M-F once daily plus cisplatin 40 mg/m2 IV weekly for up to 7 doses. Following the completion of concurrent chemoradiation, capecitabine will be administered using institutional standards of care as follows: Capecitabine 650 mg/m2 PO BID x 12 months beginning 12 to 16 weeks following the end of radiation treatment. Dose reductions and discontinuance of capecitabine will be according to the standard of care applied at the treating institution. Adjuvant Toripalimab 240 mg IV q 21d x 9 maximum doses will be initiated concurrently with the initiation of adjuvant capecitabine, beginning 12-16 weeks following the end of radiation. |
|
CR rate following radiation, defined as the proportion of patients who achieve a RECIST defined CR within 16 weeks following the end of radiation therapy. |
| 3 years |
| ID | Term |
|---|---|
| D000077274 | Nasopharyngeal Carcinoma |
| ID | Term |
|---|---|
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009303 | Nasopharyngeal Neoplasms |
| D010610 | Pharyngeal Neoplasms |
| D010039 | Otorhinolaryngologic Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
| D009302 | Nasopharyngeal Diseases |
| D010608 | Pharyngeal Diseases |
| D009057 | Stomatognathic Diseases |
| D010038 | Otorhinolaryngologic Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C000656314 | toripalimab |
Not provided
Not provided
Not provided