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Clinical Trials in China / NCT02135042
Active, not recruiting Phase 2/3

Individualized Treatment in Treating Patients With Stage II-IVB Nasopharyngeal Cancer Based on EBV DNA

NCT02135042 · tracked via the Priya Life Science China tracker
Sponsor
NRG Oncology
Phase
Phase 2/3
Started
2014-07-01
Last updated
2026-09-10

Condition(s) studied

EBV InfectionStage II Nasopharyngeal Carcinoma AJCC v7Stage III Nasopharyngeal Carcinoma AJCC v7Stage IVA Nasopharyngeal Carcinoma AJCC v7Stage IVB Nasopharyngeal Carcinoma AJCC v7

Investigational drug(s) / intervention(s)

Bone ScanCisplatinClinical ObservationComputed TomographyFluorouracilGemcitabine HydrochlorideIntensity-Modulated Radiation TherapyLaboratory Biomarker AnalysisMagnetic Resonance ImagingPaclitaxelPositron Emission TomographyQuality-of-Life Assessment

Bone Scan: Undergo bone scan

Cisplatin: Given IV

Clinical Observation: Undergo clinical observation

Computed Tomography: Undergo CT scan

Fluorouracil: Given IV

Gemcitabine Hydrochloride: Given IV

Intensity-Modulated Radiation Therapy: Undergo IMRT

Laboratory Biomarker Analysis: Correlative studies

Magnetic Resonance Imaging: Undergo MRI

Paclitaxel: Given IV

Positron Emission Tomography: Undergo PET scan

Quality-of-Life Assessment: Ancillary studies

Study summary

There are two study questions we are asking in this randomized phase II/III trial based on a blood biomarker, Epstein Barr virus (EBV) deoxyribonucleic acid (DNA) for locoregionally advanced non-metastatic nasopharyngeal cancer. All patients will first undergo standard concurrent chemotherapy and radiation therapy. When this standard treatment is completed, if there is no detectable EBV DNA in their plasma, then patients are randomized to either standard adjuvant cisplatin and fluorouracil chemotherapy or observation. If there is still detectable levels of plasma EBV DNA, patients will be randomized to standard cisplatin and fluorouracil chemotherapy versus gemcitabine and paclitaxel. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Drugs used in chemotherapy, such as cisplatin, fluorouracil, gemcitabine hydrochloride, and paclitaxel 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. It is not yet known whether giving cisplatin and fluorouracil is more effective than gemcitabine hydrochloride and paclitaxel after radiation therapy in treating patients with nasopharyngeal cancer.

Eligibility

Sex
ALL
Min age
18 Years
Max age
Healthy volunteers
No
Inclusion Criteria: * Biopsy proven (from primary lesion and/or lymph nodes) diagnosis of cancer of the nasopharynx * Sites are required to complete Step 1 registration before submitting specimens for EBV DNA analysis * Patients must have detectable pretreatment plasma EBV DNA, determined by the central lab prior to Step 2 registration * For patients who have detectable plasma EBV DNA tested at one of the credentialed central labs within 28 days prior to Step 1 registration: that test result can be used for eligibility without the need for re-testing; to use this test result for eligibility, the central lab must enter the test result through the pathology portal * Stage II-IVB disease (American Joint Committee on Cancer \[AJCC\], 7th edition \[ed.\]) with no evidence of distant metastasis, based upon the following minimum diagnostic workup: * History/physical examination by a Medical Oncologist or Clinical Oncologist or Radiation Oncologist or Ear, Nose, Throat specialist (ENT), which must include an endoscopic evaluation, a complete list of current medications, and assessment of weight and weight loss in the past 6 months within 21 days prior to registration * Evaluation of tumor extent required within 28 days prior to registration: * Magnetic resonance imaging (MRI) of the nasopharynx and neck; or computed tomography (CT) of the nasopharynx and neck with =\< 3 mm contiguous slices with contrast and bone windows (to evaluate base of skull involvement). * Note: If a treatment planning CT scan is used, it must be with =\< 3 mm contiguous slices with contrast and be read by a radiologist * To rule out distant metastasis, patients must undergo the following imaging within 28 days prior to registration: * A CT scan with contrast of the chest and abdomen (required), and the pelvis (optional), or a total body PET/CT scan (non-contrast PET/CT is acceptable) * A bone scan only when there is suspicion of bone metastases (a PET/CT scan can substitute for the bone scan) * Zubrod performance status 0-1 within 21 days prior to registration * Age \>= 18 * Absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3 (within 21 days prior to registration) * Platelets \>= 100,000 cells/mm\^3 (within 21 days prior to registration) * Hemoglobin \>= 8.0 g/dl (within 21 days prior to registration) (Note: the use of transfusion or other intervention to achieve hemoglobin \[Hgb\] \>= 8.0 g/dl is acceptable) * Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) (within 21 days prior to registration) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 1.5 x institutional ULN (within 21 days prior to registration) * Alkaline phosphatase =\< 1.5 x institutional ULN (within 21 days prior to registration) * Serum creatinine =\< 1.5 mg/dl or calculated creatinine clearance (CC) \>= 50 ml/min determined by 24-hour urine collection or estimated by Cockcroft-Gault formula (within 21 days prior to registration) * Negative serum pregnancy test within 14 days prior to registration for women of childbearing potential * Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control throughout protocol treatment * Patient must provide study specific informed consent prior to study entry, including the mandatory pre-treatment plasma EBV DNA assay Exclusion Criteria: * Prior invasive malignancy (except node negative, non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years) (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) * Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable; however, at least 6-weeks recovery is necessary if the last regimen included nitrosourea or mitomycin * Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields * 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 (CTCAE, v. 4.0) * Severe, active co-morbidity, defined as follows: * Major medical or psychiatric illness, which in the investigator's opinion would interfere with the completion of therapy and follow up or with full understanding of the risks and potential complications of the therapy * Unstable angina and/or uncontrolled congestive heart failure within past 6 months * Myocardial infarction within the last 6 months * Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration; note that patients switched from IV antibiotics and currently on oral antibiotics whose infection is assessed to be adequately treated or controlled are eligible * Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days prior to registration * Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that human immunodeficiency virus (HIV) testing is not required for entry into this protocol * Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception * Prior allergic reaction to the study drug(s) involved in this protocol * Patients with undetectable pre-treatment plasma EBV DNA

Primary outcome measure(s)

Trial sites (213)

FacilityCityRegionStatus
University of Alabama at Birmingham Cancer Center Birmingham Alabama
The Kirklin Clinic at Acton Road Birmingham Alabama
Banner University Medical Center - Tucson Tucson Arizona
Sutter Cancer Centers Radiation Oncology Services-Auburn Auburn California
Alta Bates Summit Medical Center-Herrick Campus Berkeley California
Mills-Peninsula Medical Center Burlingame California
Sutter Cancer Centers Radiation Oncology Services-Cameron Park Cameron Park California
City of Hope Comprehensive Cancer Center Duarte California
Kaiser Permanente Dublin Dublin California
Fresno Cancer Center Fresno California
UC San Diego Moores Cancer Center La Jolla California
Memorial Medical Center Modesto California
Kaiser Permanente Oakland-Broadway Oakland California
UC Irvine Health/Chao Family Comprehensive Cancer Center Orange California
Palo Alto Medical Foundation Health Care Palo Alto California
Stanford Cancer Institute Palo Alto Palo Alto California
Kaiser Permanente-Rancho Cordova Cancer Center Rancho Cordova California
Rohnert Park Cancer Center Rohnert Park California
Sutter Cancer Centers Radiation Oncology Services-Roseville Roseville California
The Permanente Medical Group-Roseville Radiation Oncology Roseville California
Sutter Medical Center Sacramento Sacramento California
University of California Davis Comprehensive Cancer Center Sacramento California
South Sacramento Cancer Center Sacramento California
California Pacific Medical Center-Pacific Campus San Francisco California
UCSF Medical Center-Mount Zion San Francisco California
UCSF Medical Center-Mission Bay San Francisco California
Kaiser Permanente Medical Center - Santa Clara Santa Clara California
City of Hope South Pasadena South Pasadena California
Kaiser Permanente Cancer Treatment Center South San Francisco California
Palo Alto Medical Foundation-Sunnyvale Sunnyvale California
Lutheran Hospital - Cancer Centers of Colorado Golden Colorado
Banner North Colorado Medical Center Greeley Colorado
Banner North Colorado Medical Center - Loveland Campus Loveland Colorado
AdventHealth Parker Parker Colorado
Intermountain Health Lutheran Hospital Wheat Ridge Colorado
Yale University New Haven Connecticut
Helen F Graham Cancer Center Newark Delaware
Christiana Care Health System-Christiana Hospital Newark Delaware
Baptist MD Anderson Cancer Center Jacksonville Florida
Moffitt Cancer Center Tampa Florida

+ 173 more sites — see the full list on the official registry below.

Other trials for the same condition

Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT02135042 on ClinicalTrials.gov ↗ ← All trials in China