This trial is to determine what dose of a drug called AZD1775 can safely be given in combination with cisplatin before surgery and with chemo-radiotherapy after surgery in patients with Head and Neck Cancer. The Investigators will also get some preliminary information regarding the effectiveness of this combined treatment.
Patients with head and neck cancer with high-risk features are at increased risk of relapse after surgery. Surgery, often followed by cisplatin chemotherapy and radiotherapy is currently the standard treatment offered. Whilst chemo-radiotherapy improves cure rates, outcomes remain poor, and treatment has a significant impact on quality of life. Chemotherapy has yet to find a definitive role prior to surgery. There is therefore an urgent need to develop more effective treatments which improve cure rates for this patient population. The purpose of this trial is to see whether incorporating a drug called AZD1775 into the management of head and neck cancer offers the possibility of addressing these clinical issues. AZD1775 is a drug that has been shown to increase the effect of cisplatin and of radiotherapy when tested in the laboratory. The blood samples and tumour biopsies taken during the trial will be important in learning as much as possible about the effects of AZD1775 on the body and to investigate how the tumour might develop resistance to the drug. The WISTERIA trial is for patients aged between 18 and 70 years with cancer of the oral cavity, larynx and hypopharynx who are to undergo surgery. Patients recruited to Group A must have accessible tumours for re-biopsy, whilst patients recruited to Group B will be at high risk of relapse after surgery. The primary objective of this trial is to see what dose of AZD1775 can safely be given in combination with cisplatin before surgery (Group A) and with chemo-radiotherapy after surgery (Group B). The Investigators will also get some preliminary information regarding the effectiveness of this combined treatment. To find the safe and effective dose of AZD1775, different doses will be tested for each Group.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
9
AZD1775 is a potent, selective small molecule inhibitor of WEE1
Chemotherapy drug
Intensity Modulated Radiotherapy
University Hospital Birmingham Nhs Foundation Trust
Birmingham, West Midlands, United Kingdom
Beatson West of Scotland Cancer Centre
Glasgow, United Kingdom
St. James' University Hospital, Leeds Teaching Hospital NHS Trust
Leeds, United Kingdom
The Royal Marsden Hospital
London, United Kingdom
Recommended dose(s) of AZD1775
Group A: The highest safe dose of AZD1775 in combination with cisplatin with a predefined target Dose Limiting Toxicity probability of 25% for up to 42 days from start of treatment. Group B: The maximum tolerated dose of AZD1775 in combination with cisplatin/radiotherapy with a target DLT of 30% for up to 12 weeks from the start of treatment.
Time frame: Group A - Up to 42 days from start of treatment; Group B - Up to 12 weeks from the start of treatment
Safety profile of AZD1775 for Group A and Group B by reporting of all Adverse Events, Serious Adverse Events, Suspected Unexpected Adverse Reactions, deaths, deviations and withdrawal as assessed by the Safety Committee.
Safety profile of AZD1775 in combination with cisplatin in Group A and cisplatin/radiotherapy in Group B.
Time frame: From registration, while on treatment and during follow up periods
Disease-free survival in Groups A and B
Disease-free survival is defined as the time from trial entry to date of disease recurrence, progression or patient death until end of follow up period.
Time frame: Patients will be followed-up clinically for 12 weeks in Group A and for 12 months in Group B.
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University College London Hospitals
London, United Kingdom
Clatterbridge Cancer Centre
Metropolitan Borough of Wirral, United Kingdom