Trial of Neoadjuvant Therapy With Paclitaxel and Carboplatin in Operable Locally Advanced Head and Neck Cancer Patients

NCT05294900 | Completed Phase 2 Results

• 1 other identifier: 4-2022-0130
• Study Type: interventional
• Target: 79
• Locations: 1 country
• Sites: 1

Brief Summary

\- Objective: Primary objective: To evaluate the major pathologic response (mPR) of locally advanced head and neck cancer after paclitaxel and carboplatin-induction chemotherapy followed by surgery. Secondary objective: To evaluate the efficacy and safety of induction chemotherapy. Outcome metrics: Local relapse rate (LRR), Relapse-free survival (RFS), Overall survival (OS), Adverse reactions according to CTCAE 5.0 Exploratory Purpose: To evaluate changes in circulating tumor cells (CTC) and immunodynamics before and after paclitaxel and carboplatin-induction chemotherapy through blood, biopsy specimens, and surgical specimen analysis.

• background :
• Chemoradiation (CRT) or chemotherapy (Induction Chemotherapy (IC) + CRT) after induction chemotherapy has been performed for locally advanced head and neck cancer that cannot be operated immediately or for organ function preservation. .
• The efficacy of induction chemotherapy before chemotherapy has been controversial because the results of several phase 3 clinical studies are inconsistent. At present, it is difficult to assert the superiority of either the addition of induction chemotherapy or radiation therapy alone, but in certain subgroups (advanced N stage such as N2c/N3) induction chemotherapy is a useful option to lower distant metastases. I can do it.
• As a result of the TAX324 clinical trial, when weekly carboplatin-based chemotherapy or surgery was performed after adjuvant Docetaxel + Cisplatin + 5FU chemotherapy, overall survival was improved compared to Cisplatin + 5FU (HR 0.7, p=0.0058), It resulted in improvement of institutional retention rate (3 year LFS: 52% vs 32%). However, it is difficult to apply this TPF therapy to all patients in actual clinical practice due to the toxicity (neutropenia, nephrotoxicity) and the limitation of anticancer radiation.
• In a retrospective study, in the case of adjuvant paclitaxel + carboplatin, there was no difference in progression-free survival compared to TPF (p=0.15), and there was no statistically significant decrease in the local recurrence rate (HR 0.27, p = 0.04). Confirmed.
• Therefore, in this study, when paclitaxel and carboplatin-induction chemotherapy followed by surgery and chemotherapy after surgery, compared to standard TPF-induced chemotherapy, it is expected that the clinical outcome will be improved with less toxicity.
• Hypothesis: Paclitaxel and carboplatin-induction chemotherapy followed by surgery, followed by chemo-radiation after surgery according to standard guidelines Compared with the existing standard treatment (TCF), improvement of clinical outcome with less toxicity
• Study procedure
• Induction chemotherapy Paclitaxel 175mg/m2 + Carboplatin AUC5 (calculated by Cockcroft - Gault formula) Combination therapy A total of 2 intravenous infusions every 3 weeks Surgery performed within 2-9 weeks after induction chemotherapy
• surgery The surgery in this study means a complete resection for the purpose of a complete cure, and aims for a minimally invasive surgery.

Conditions

Head and Neck Squamous Cell Carcinoma

Keywords

HNSCC; Neo-adjuvant chemotherapy

Outcome Measures

Primary Outcomes (1)

• Major Pathologic Response

  Major Pathologic Response (MPR) was defined as ≤10% residual viable tumor cells in the resected primary tumor specimen following completion of two cycles of neoadjuvant paclitaxel-carboplatin chemotherapy. Pathologic evaluation was performed by two independent board-certified pathologists in a blinded manner. MPR reflects the extent of tumor regression induced by neoadjuvant therapy and serves as a key indicator of treatment efficacy in resectable head and neck squamous cell carcinoma.

  At the time of surgery following two cycles of neoadjuvant paclitaxel-carboplatin chemotherapy (approximately 6-9 weeks after treatment initiation).

Study Arms (1)

paclitaxel/carboplatin

EXPERIMENTAL

paclitaxel+carboplatin

Drug: paclitaxel/carboplatin

Interventions

paclitaxel/carboplatin DRUG

Induction chemotherapy : total 2 cycle every 3weeks as below: * Paclitaxel 175mg/m2 * Carboplatin AUC5

paclitaxel/carboplatin

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• A patient whose potentially surgical, teletransfer-free HNSCC of oral, hypodermic, occipital, and larynx has been tissue-confirmed Oral cancer of III-IV, laryngeal cancer, hypodermic cancer, HPV-negative head cancer II-III HPV positive head cancer
• A disease that can be measured, defined as a lesion that can be accurately measured pursuant to RECIST 1.1
• Where the candidate subject to the test prepares the consent of the person subject to the test after obtaining approval required by region before the commencement of any plan-related procedures, including screening evaluation
• Adult men and women over 20 years old at the time of participation in clinical trials
• Eastern Cancer Cooperation Research Group (Eastern Cooperative Oncology Group, ECOG) Activity Status 0 or 1
• A patient with a life expectancy of at least 12 weeks
• Proper and normal organ and bone marrow functions as defined below:
• hemoglobin test 9.0 g/dL
• Absolute neutropenic number (ANC) set 109/L (1500 per mm3)
• Platelet count 75,000 per mm3
• times the total ULN of serum biliubine test institution
• times the ULN of the AST (SGOT)/ALT (SGPT) test institute.
• Creatinine cleaning rate measured by 24-hour urine collection samples \> 40 mL/min or calculated by Cockcroft Gault formula (Cockcroft and Gault 1976) \>40 mL/min:
• Women who have evidence after menopause or pre-menopausal women whose urine or serum pregnancy test results are negative. Women who have amenorrhea for 12 months without other medical reasons are considered after menopause. The following age requirements apply:
• Even under the age of 50, she is in amenorrhea for at least 12 months after discontinuing exogenous hormone treatment, and if the LH and FSH levels are the menopause levels of the test institute, or if she underwent a surgical infertility operation (bilateral ovarian resection or complete hysterectomy), she is considered a menopause woman.

You may not qualify if:

• Direct involvement in the planning and/or implementation of this clinical trial
• Patients with nasopharyngeal cancer
• A patient who has experienced previous treatment for head and neck cancer (including a history of radiation treatment)
• Patients who have participated in other clinical trials using clinical drugs within the past month
• A patient registered simultaneously in a clinical trial other than an observation (non-mediate) clinical trial or an intermediary clinical trial tracer
• Patients who need to use additional chemotherapy, clinical medicine, biological medicine, or hormone therapy for chemotherapy: Provided, That the simultaneous use of hormone therapy (e.g. hormone replacement therapy) for conditions unrelated to cancer is allowed.
• The toxicity of at least NCI CTCAE Level 2 of the previous anti-cancer treatment, which has not yet been resolved: Provided, That laboratory values defined as hair loss, vitiligo, and selection criteria shall be excluded.
• Neuropathy of grade 2 or higher is determined after consultation with a clinical trial doctor on a case-by-case basis.
• Patients with irreversible toxicity that is not expected to worsen due to the administration of clinical trials can participate in the test only after consultation with a clinical trial doctor.
• Patients who undergo a major operation (according to the tester's definition) within 28 days before the initial administration of clinical medication. Note: Local surgery on independent lesions for the purpose of conventional treatment is acceptable.
• Intractable diseases, but not limited to the following: ongoing or active infections; symptom congestive heart failure; uncontrolled high blood pressure; unstable angina; heart veins; epileptic lung disease; Major chronic gastrointestinal conditions with diarrhea; All mental/social conditions that may restrict compliance with clinical trial requirements or significantly increase the risk of adverse reactions or hinder the subject's ability to write consent
• A patient who has a history of another primary malignant tumor: Provided, That the following shall not apply:
• A past malignant tumor that was treated for the purpose of complete cure and has no history of a known active disease within five years before the initial administration of clinical medication and has a low risk of recurrence
• non-black skin cancer treated properly or malignant black spots without evidence of disease
• Carcinoma that has been properly treated and has no evidence of disease

Sponsors & Collaborators

• Yonsei University: lead

Study Sites (1)

Yonsei University Health System, Severance Hospital

Seoul, South Korea

Location

MeSH Terms

Conditions

Squamous Cell Carcinoma of Head and Neck

Interventions

CP protocol

Condition Hierarchy (Ancestors)

Carcinoma, Squamous Cell; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Head and Neck Neoplasms; Neoplasms by Site

Results Point of Contact

• Title: Principal Investigator
• Organization: Yonsei University

nobelg@yuhs.ac

02-2228-8125

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: March 15, 2022
• First Posted: March 24, 2022
• Study Start: May 26, 2023
• Primary Completion: October 22, 2025
• Study Completion: October 22, 2025
• Last Updated: May 26, 2026
• Results First Posted: May 26, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

KR (1)