NCT02388932

Brief Summary

This phase I trial studies the side effects and best dose of stereotactic body radiation therapy (SBRT) in treating participants with head and neck cancer that has spread from where it started to nearby tissue or lymph nodes and is at high risk for continuing to spread because the participant cannot undergo standard chemotherapy. Stereotactic body radiation therapy is a specialized radiation therapy that delivers radiation directly to the tumor in smaller doses over several days, which may kill more tumor cells and cause less damage to normal tissue.

Trial Health

57
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
3

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Mar 2015

Typical duration for not_applicable

Geographic Reach
1 country

2 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 3, 2015

Completed
6 days until next milestone

First Submitted

Initial submission to the registry

March 9, 2015

Completed
8 days until next milestone

First Posted

Study publicly available on registry

March 17, 2015

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 6, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 6, 2017

Completed
1.8 years until next milestone

Results Posted

Study results publicly available

November 16, 2018

Completed
Last Updated

January 24, 2019

Status Verified

January 1, 2019

Enrollment Period

1.9 years

First QC Date

March 9, 2015

Results QC Date

October 15, 2018

Last Update Submit

January 2, 2019

Conditions

Outcome Measures

Primary Outcomes (2)

  • Maximum Tolerated Dose (MTD) of Head and Neck SBRT

    Maximum tolerated dose of SBRT in this patient population determined by the dose escalation design with doses '40Gy' and '45Gy all in 5 fractions'.

    3 months

  • Incidence of Dose Limiting Toxicities (DLTs)

    Number of patients with dose limiting toxicity events graded according to CTCAE Version 4.0

    3 months from start of treatment

Secondary Outcomes (5)

  • Overall Survival

    Up to 12 months

  • Local Progression Free Survival

    Up to 12 months

  • Response Measured According to Standard Response Evaluation Criteria in Solid Tumors

    Up to 12 months

  • Incidence of SBRT Related Morbidity

    Up to 12 months

  • Quality of Life Assessed by Functional Assessment of Cancer Therapy-Head and Neck Questionnaire

    Up to 12 months

Study Arms (1)

Treatment (SBRT)

EXPERIMENTAL

Participants undergo Stereotactic Body Radiation Therapy in 5 fractions at least 40 hours apart over 10-18 days. Three dose levels: 40Gy and 45Gy all in 5 fractions. Each initial dose level will have 6 participants allocated to them. All participants are assessed at their 3 month post SBRT visit for Dose-Limiting Toxicities (DLTs). If ≤1 participant experiences a DLT, participants will be enrolled at the next dose level. If ≥3 participants experience a DLT, further accrual will be permanently halted and the study stopped. If 2 participants experience a DLT, then an additional 6 participants will be enrolled at the same dose level. In this setting, if ≤ 3/12 participants have a DLT, participants will be enrolled at the next dose level. If ≥ 4/12 participants have a DLT, further accrual will be permanently halted and the study stopped and 35 Gy will not be recommended as safe. The dosing strategy for the 2nd (45Gy) cohort will be identical to the first.

Radiation: Stereotactic Body Radiation TherapyDevice: Positron Emission TomographyDevice: Computed TomographyOther: Quality-of-Life Assessment

Interventions

Undergo SBRT

Also known as: SBRT
Treatment (SBRT)

Undergo PET/CT

Also known as: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron Emission Tomography Scan
Treatment (SBRT)

Undergo PET/CT

Also known as: CAT, CAT Scan, CT
Treatment (SBRT)

Ancillary studies

Also known as: Quality of Life Assessment
Treatment (SBRT)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • The participant must have squamous cell carcinoma proven by histologic diagnosis; for cancers of the oropharynx, p16 staining by immunohistochemistry must be negative; for cancers of the larynx, hypopharynx, oral cavity, nasopharynx, paranasal sinuses, p16 staining is not required
  • The participant must have clinical stage T1-4, N0-3, M0-1, stage II-IVC carcinoma as per the 7th edition of the American Joint Committee on Cancer (AJCC) staging manual; participants with T1N0M0 will be ineligible; participants with metastatic disease with a limited metastatic burden are eligible if obtaining local control is determined by their treating oncologist to be an important therapeutic goal
  • The participant must have imaging documenting a primary tumor, or involved lymph node, ≥ 2.5 cm in greatest dimension
  • PET/CT is required for all participants, unless contraindicated; this may be acquired prior to study entry or after enrollment prior to SBRT planning
  • The participant must have a history and physical documented within four weeks of registration and be deemed by a medical oncologist to be ineligible for standard continuous course chemoradiotherapy with cisplatin
  • Karnofsky performance status (PS) ≥ 40
  • Female participants cannot be of childbearing age, or if they are, must have a negative pregnancy test prior to enrollment and be willing to use contraceptives during treatment and continue for 6 additional months
  • Participants must have the ability to understand and the willingness to sign a written informed consent document

You may not qualify if:

  • Participants with T1N0M0 stage I disease
  • Participants who are receiving any other investigational agents
  • Participants with non-squamous cell histology
  • Participants with life expectancy \< 6 months
  • Participants who cannot lie flat for 20 minutes
  • Participants with prior history of head and neck radiotherapy (\> 40 Gy) with significant areas of anticipated overlap

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University Hospitals Cleveland Medical Center, Seidman Cancer Center, Case Comprehensive Cancer Center

Cleveland, Ohio, 44106, United States

Location

Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center

Cleveland, Ohio, 44195, United States

Location

MeSH Terms

Conditions

Squamous Cell Carcinoma of Head and Neck

Interventions

RadiosurgeryPositron-Emission TomographyTomography, X-Ray Computed

Condition Hierarchy (Ancestors)

Carcinoma, Squamous CellCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasmsHead and Neck NeoplasmsNeoplasms by Site

Intervention Hierarchy (Ancestors)

RadiotherapyTherapeuticsStereotaxic TechniquesNeurosurgical ProceduresSurgical Procedures, OperativeInvestigative TechniquesTomography, Emission-ComputedImage Interpretation, Computer-AssistedDiagnostic ImagingDiagnostic Techniques and ProceduresDiagnosisImage EnhancementPhotographyRadionuclide ImagingTomographyDiagnostic Techniques, RadioisotopeRadiographic Image EnhancementRadiographyTomography, X-Ray

Limitations and Caveats

Due to slow accrual the study was terminated early.

Results Point of Contact

Title
Shlomo Koyfman, MD
Organization
Cleveland Clinic, Case Comprehensive Cancer Center

Study Officials

  • Shlomo Koyfman

    Case Comprehensive Cancer Center

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 9, 2015

First Posted

March 17, 2015

Study Start

March 3, 2015

Primary Completion

February 6, 2017

Study Completion

February 6, 2017

Last Updated

January 24, 2019

Results First Posted

November 16, 2018

Record last verified: 2019-01

Locations