RATIONALE: Cancers of the oral cavity represent 30% of head and neck carcinomas in the western world. The oropharynx is the posterior continuation of the oral cavity and connects with the nasopharynx (above) and laryngopharynx (below). It is also a frequent site of primary head and neck cancers. These structures play a crucial role in swallowing, breath and speech. Locally advanced oropharyngeal cancers can obstruct the air flow or infiltrate muscles or nerves, which significantly disturb local functions. The incidence of Head and Neck Squamous Cell Cancer in patients older 65 years is high, 47% occurred in this population as recorded by the Surveillance, Epidemiology, and End Results registries in the United States. Regarding the therapeutic strategies, the association of radiotherapy with chemotherapy or biologics has demonstrated significant improvement of outcomes with the drawback of higher toxicity, or as demonstrated by 2 meta-analyses, without survival improvement in older patients. NBTXR3 and radiation therapy may increase the cancer cell killing and complete tumor shrinkage allowing a definitive treatment and preservation of local structures and functions in patients older 65 years, who cannot receive cisplatin.
Patients will receive a single administration of NBTXR3 on day 1,as an intratumor injection, followed by Intensity Modulated Radiation Therapy starting 24 hours later (Day 2), and up to completion of 7 weeks, i.e. 70 Grays, 2Grays/fraction. Patients whose tumor has completely shrunk will be followed for the post-radiotherapy evaluation up to the End of Treatment visit. Those patients whose tumor has not shrunk more than 50% of the baseline size, will stop the radiotherapy and may have a salvage tumor surgery. Then, all patients will be followed every 8 weeks, for the safety evaluation and cancer disease status until the end of the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
75
Centre Francois Baclesse
Caen, France
Centre Oscar Lambret
Lille, France
Hôpital La Timone
Marseille, France
Centre Antoine Lacassagne
Nice, France
Institut Curie
Paris, France
CHU Pontchaillou
Rennes, France
Institut de Cancérologie de la Loire Lucien Neuwirth
Saint-Priest-en-Jarez, France
Institut Gustave Roussy
Villejuif, France
Hungarian Defense Forces Hospital
Budapest, Hungary
National Institute of Oncology
Budapest, Hungary
...and 10 more locations
Dose Escalation: Incidence of DLTs and determination of the Recommended Phase 2 Dose
The incidence of early DLTs (early adverse effects related to NBTXR3, as an intratumor injection, activated by IMRT)
Time frame: 12 months
Dose Escalation: Determination of the Recommended Phase 2 Dose
The recommended Phase II dose (RD) of NBTXR3 administered as intratumor injection, activated by Intensity Modulated Radiation Therapy (IMRT)
Time frame: 12 months
Dose Expansion: Overall Response Rate
The Objective Response Rate (ORR) of the primary tumor, by imaging according to RECIST 1.1
Time frame: 12-24 months
Dose Expansion: Complete Response Rate
The Complete Response Rate (CRR) of the primary tumor, by imaging according to RECIST 1.1
Time frame: 12-24 months
Dose Escalation: Objective Response Rate (ORR) of the primary tumor
The Objective Response Rate (ORR) of the primary tumor, by imaging according to RECIST 1.1
Time frame: 12-24 months
Dose Escalation: Complete Response Rate
The Complete Response Rate (CRR) of the primary tumor, by imaging according to RECIST 1.1
Time frame: 12 months
Dose Expansion: Local Progression Free Survival
Local Progression Free Survival (LPFS) defined as any recurrence at the site of the primary tumor
Time frame: 12-24 months
Dose Expansion: Progression Free Survival
Progression Free Survival (PFS) defined as the time to any progression at the site of the primary tumor, in regional lymph nodes and/or distant metastasis
Time frame: 12-24 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.