The aim of this research is to study the feasibility of neoadjuvant treatment before chemoradiation in "high risk" HPV-driven Oropharynx cancer
Methodology: Patient screened wil be randomized 2:1 between 2 arms: * Experimental arm: Nivolumab 2 infusions (2 weeks part) before standard of care chemoradiation for 7 weeks with cisplatin at week 1, 4, and 7 * Control arm: Standard of care chemoradiation for 7 weeks with cisplatin at week 1, 4, and 7 Primary Objective: To assess the feasibility and tolerance of neoadjuvant nivolumab treatment before chemoradiation in "high-risk" HPV-driven Oropharynx Cancer
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
62
2 nivolumab infusion (240 mg IV) 2 weeks apart (on day 1 and day 15) followed by standard chemoradiation.
Standard of Care chemoradiation for 7 weeks (70 Gray delivered to the tumor by IMRT) with high-dose cisplatin (100mg/m2) at week 1, 4 and 7
Institut Sainte Catherine
Avignon, France
Hopital Beaujon
Clichy, France
Centre Léon Bérard
Lyon, France
Centre Antoine Lacassagne
Nice, France
The rate of patients that fulfill the 3 or 5 conditions as described below (Feasibility assessment of nivolumab neoadjuvant treatment before chemoradiation)
the rate of patients : (1) who can receive the 2 nivolumab infusions planned at D1 and between D14 to D16 among patients in the experimental arm And (2) who can receive chemoradiation at D30 (-2 /+7) after the second nivolumab infusion, without delay of more than 7 days with respect to the planned start of chemoradiation (RT-CT) among patients in the experimental arm And (3) with no radiotherapy break of one week or more, among patients in the experimental arm and patients in the control arm separately And (4) with minimal dose of radiotherapy (dose received \>95% of theoretical dose) among patients in the experimental arm and patients in the control arm separately And (5) with minimal dose of chemotherapy of ≥200 mg/m² of cisplatin (CDDP) among patients in the experimental arm and patients in the control arm separately
Time frame: Between baseline and until 3 months (at the end of chemoradiation)
The incidence of Adverse Events related or not related to chemoradiation and Nivolumab
Acute and delayed toxicities assessed according to national cancer institute (NCI) common terminology criteria for adverse events (CTCAE) version 5.0
Time frame: During treatment phase and until 90 days after the last fraction of radiotherapy
Objective Response Rate in the experimental arm
Radiological response will be assessed according to RECIST 1.1.
Time frame: Between baseline and up to 17 days after the second infusion of nivolumab
Tumor Response in both arms
Radiological response will be assessed according to RECIST 1.1.
Time frame: Between baseline and 3 months after the end of chemoradiation
Overall Survival (OS)
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Institut Curie
Paris, France
Hopital Europeen Georges Pompidou
Paris, France
Hopital Tenon
Paris, France
Centre Henri Becquerel
Rouen, France
Hopital Foch
Suresnes, France
Institut de cancerologie de Lorraine Alexis Vautrin
Vandœuvre-lès-Nancy, France
...and 1 more locations
the time from randomization to death from any cause
Time frame: Between baseline and 2 years after the end of chemoradiation
Locoregional control (LRC)
the absence of disease progression (radiological progression according to RECIST 1.1 or clinical progression) or recurrence at the site of the primary tumor and loco-regional lymph nodes.
Time frame: Between baseline and 2 years after the end of chemoradiation
Progression-Free Survival (PFS)
The time from randomization to progression or death from any cause
Time frame: Between baseline and 2 years after the end of chemoradiation
Objective Response Rate in the experimental arm
Standardized uptake value (SUV) evolution will be assessed by positron emission tomography (PET)-scan.
Time frame: Between baseline and up to 17 days after the second infusion of nivolumab
Tumor Response in both arms
SUV evolution will be assessed by PET-scan.
Time frame: Between baseline and 3 months after the end of chemoradiation