Sometimes, cancer patients receive an initial treatment, followed by additional treatment to lower the chance of cancer coming back. The standard or usual treatment for this type of disease is initially having radiation therapy at the same time as chemotherapy (with a drug called cisplatin), with no additional therapy afterwards
This study is looking at whether a type of drug called durvalumab can be used with radiation during the initial treatment, (instead of cisplatin) and also afterwards as additional therapy. Durvalumab is an immunotherapy drug . It has been tested in many different types of cancers. Durvalumab works by allowing the immune system to detect the cancer and reactivate the immune response. This may help to slow down the growth of cancer or may cause cancer cells to die. Durvalumab has been shown to shrink tumours in animals. It has been studied in more than 5000 people, approved for use in other cancers and seems promising. This clinical trial will also test another type of immunotherapy drug called tremelimumab, which would also be given as additional treatment. Tremelimumab works in a different way to durvalumab to enhance the immune system reaction against cancer cells and may improve the effect of durvalumab. Tremelimumab may also help slow the growth of the cancer cells or may cause cancer cells to die. It has been shown to shrink tumours in animals. Tremelimumab has been studied in over 1200 people, approved for use in other cancers and seems promising. As of February 2019, tremelimumab will no longer be tested with new participants joining the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
129
70 Gy in 35 fractions over 7 weeks (i.e. 2 Gy per fraction)
100 mg/m2 days 1, 22, 43 concurrently with RT
Given in concurrent and adjuvant phase
ARM CLOSED TO ACCRUAL - 2019
Cliniques Universitaires Saint-Luc
Brussels, Belgium
University Hospital of Antwerp
Edegem, Belgium
University Hospital of Gent
Ghent, Belgium
University Hospital Leuven
Leuven, Belgium
Clinique St. Elizabeth
Namur, Belgium
AZ Sint Augustinus
Wilrijk, Belgium
Cross Cancer Institute
Edmonton, Alberta, Canada
CancerCare Manitoba
Winnipeg, Manitoba, Canada
QEII Health Sciences Centre
Halifax, Nova Scotia, Canada
Health Sciences North
Greater Sudbury, Ontario, Canada
...and 16 more locations
3 year event-free survival
Event-free survival (EFS), is defined as the time from randomization to the time when a failure event is observed. Failure is define by Local-regional progression or recurrence, Distant metastasis, Non-protocol RT, chemotherapy, Surgery or death.
Time frame: 3 years
Functional Assessment of Cancer Therapy-Head and Neck Version (FACT-HN) score.
The FACT-H\&N is a multidimensional, self-report QoL instrument specifically designed for use with head and neck cancer patients (1-3). It consists of 27 core items which assess patient function in four domains: Physical, Social/Family, Emotional, and Functional well-being, which is further supplemented by 12 site specific items to assess for head and neck related symptoms. Each item is rated on a 0 to 4 Likert type scale, and then combined to produce subscale scores for each domain, as well as an global QoL score. Higher scores represent better QoL.
Time frame: 6 years
Local regional failure
Locoregional control defined as time from randomization to the time of first documented local (primary site) or regional (lymph node) recurrence
Time frame: 6 years
Distant metastasis-free survival
Distant metastasis-free survival defined as time from randomization to the time of first documented distant metastasis or death from any cause
Time frame: 6 years
Overall survival
Overall Survival defined as time from randomization to the time of death from any cause
Time frame: 6 years
Cost-effectiveness of immunotherapy-based treatment arm vs standard of RT and cisplatin in patients with intermediate risk LA-OSC using the EQ-5D-5L
Time frame: 6 years
Number and severity of adverse events
Time frame: 6 years
Cost-utility will be used to abstract indirect costs at the end of RT and at 6 and 12 months post RT
Time frame: 6 & 12 months
Lost productivity questionnaire will be used to abstract indirect costs at the end of RT and at 6 and 12 months post RT
Time frame: 6 & 12 months
Incidence of second cancer
Time frame: 6 years
PRO-CTCAE baseline, last week of treatment, 3 months, 6 months and 12, 24 and 36 months from the end of RT
Time frame: 3, 6, 12, 24 and 36 months
Dysphagia: PSS-HN swallowing subscale at 36 months from the end of RT
Time frame: 36 months
Dysphagia: using MDADI Global at 36 months from the end of RT
Time frame: 36 months
Number and severity of radiation-related late toxicity at 3 months, 6 months and 1 year from the end of RT
Time frame: 3 months, 6 months & 1 year
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