De-ESCALaTE HPV: Determination of Epidermal growth factor receptor-inhibitor (cetuximab) versus Standard Chemotherapy (cisplatin) early And Late Toxicity Events in Human Papillomavirus-positive oropharyngeal squamous cell carcinoma
ISRCTN | ISRCTN33522080 |
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DOI | https://doi.org/10.1186/ISRCTN33522080 |
EudraCT/CTIS number | 2011-005165-21 |
ClinicalTrials.gov number | NCT01874171 |
Secondary identifying numbers | 11723 |
- Submission date
- 20/02/2012
- Registration date
- 20/02/2012
- Last edited
- 29/10/2021
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Cancer
Plain English summary of protocol
Contact information
Scientific
Warwick Clinical Trials Unit
Division of Health Sciences
Warwick Medical School
The University of Warwick
Coventry
CV4 7AL
United Kingdom
Phone | +44 2476 574 880 |
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M.T.Fulton-Lieuw@warwick.ac.uk |
Study information
Study design | Both; Interventional; Design type: Treatment |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
Scientific title | De-ESCALaTE HPV: Determination of Epidermal growth factor receptor-inhibitor (cetuximab) versus Standard Chemotherapy (cisplatin) early And Late Toxicity Events in Human Papillomavirus-positive oropharyngeal squamous cell carcinoma: a randomised controlled trial |
Study acronym | De-ESCALaTE HPV |
Study objectives | Oropharyngeal squamous cell carcinoma (OPSCC) incidence is increasing rapidly in the developed world. This has been attributed to a rise in Human Papillomavirus (HPV) infection. HPV+ OPSCC is considered a distinct disease entity, affecting younger patients and has a good prognosis following treatment. Subsequently, patients can live with the considerable side effects for several decades. Radiotherapy and cetuximab have demonstrated similar efficacy to platin chemoradiotherapy in head and neck cancer, but is potentially less toxic. Results of this trial will be used to determine the optimum treatment of this debilitating cancer, with the primary aim of decreasing toxicity and improving quality of life for HPV+OPSCC patients. |
Ethics approval(s) | NRES Committee West Midlands Coventry & Warwickshire, 29/11/2011, ref: 11/WM/0381 |
Health condition(s) or problem(s) studied | Topic: National Cancer Research Network; Subtopic: Head and Neck Cancer; Disease: Head and Neck |
Intervention | HPV positive patients will be randomised to receive either cisplatin + radiotherapy (Arm A) or cetuximab + radiotherapy (Arm B) and will be followed up for two years. Patients that are HPV negative will enter into the Registration Cohort Study. Cetuximab, Initial dose of 400mg/m2, administered intravenously, 1 week before start of radiotherapy followed by 7 weekly doses of 250mg/m2, administered intravenously. during radiotherapy. Cisplatin, Three doses of cisplatin 100mg/m2, administered intravenously, on days 1, 22 and 43 of radiotherapy. |
Intervention type | Drug |
Pharmaceutical study type(s) | |
Phase | Phase III |
Drug / device / biological / vaccine name(s) | Cetuximab, cisplatin |
Primary outcome measure | Current primary outcome as of 13/03/2012: Severe toxicity (acute and late) (Grade 3-5); Timepoint(s): Two years from end of treatment Previous primary outcome: Severe toxicity (Grade 3-5); Timepoint(s): Two years from end of treatment |
Secondary outcome measures | 1. Acute severe toxicity; Timepoint(s): 3 months from end of treatment 2. Late severe toxicity; Timepoint(s): Two years from end of treatment 3. Quality of Life; Timepoint(s): Two years from end of treatment 4. Dysphagia; Timepoint(s): Two years from end of treatment 5. Cost effectiveness; Timepoint(s): Two years from end of treatment 6. Overall survival, recurrence and metastasis; Timepoint(s): Two years from end of treatment |
Overall study start date | 01/09/2011 |
Completion date | 31/07/2019 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 18 Years |
Sex | Both |
Target number of participants | Planned Sample Size: 304; UK Sample Size: 304; Description: Depending on the number of participants recruited by international sites, the UK sample size may be smaller. |
Total final enrolment | 334 |
Key inclusion criteria | Current inclusion criteria as of 13/03/2012: 1. Stage III-IVa oropharyngeal squamous cell tumours 2. Clinical multidisciplinary team decision to treat with primary curative chemoradiotherapy 3. No previous treatment for the primary tumour, including surgery, neck dissection or tracheostomy [except node biopsies or diagnostic tonsillectomy] 4. Medically fit Eastern Cooperative Oncology Group (ECOG) 0, 1 or 2 5. Adequate cardiovascular, haematological, renal and hepatic function 6. Age 18 years or over 7. Written informed consent given 8. Using adequate contraception [male and female participants]. Must take contraceptive measures during, and for at least three months after treatment. Previous inclusion criteria: 1. Stage III-IVa oropharyngeal squamous cell tumours 2. Clinical multidisciplinary team decision to treat with primary curative chemoradiotherapy 3. No previous treatment for the primary tumour, including surgery, neck dissection or tracheostomy [except node biopsies or diagnostic tonsillectomy] 4. Medically fit Eastern Cooperative Oncology Group (ECOG) 0, 1 or 2 5. Adequate cardiovascular, haematological, renal and hepatic function 6. Age 18 years or over 7. Written informed consent given 8. Using adequate contraception [male and female participants] |
Key exclusion criteria | Current exclusion criteria as of 13/03/2012: 1. Distant metastasis (i.e. stage IVc disease) 2. Tumor, Node, Metastasis (TNM) Stage T1-2N0 disease 3. Treated with primary radical surgery to the primary site e.g. resection 4. Concurrent use of CYP3A4 inducers or inhibitors 5. Serious cardiac illness or other medical conditions precluding the use of cisplatin or cetuximab 6. HPV+ patients who have p16+ tumours who also have N2b, N2c or N3 nodal disease and who also smoke more than 10 pack years (i.e. have both risk factors) 7. Pregnant or lactating 8. Previous treatment for any other cancer with cytotoxics, radiotherapy or antiEGFR therapies 9. Inadequate renal, haematological or liver functions 10. Patients with clinically significant hearing impairment. 11. Life expectancy less than three months 12. Other malignancy within the past three years except basal cell skin cancer or preinvasive carcinoma of the cervix Previous exclusion criteria: 1. Distant metastasis (i.e. stage IVc disease) 2. Tumor, Node, Metastasis (TNM) Stage T1-2N0 disease 3. Treated with primary radical surgery to the primary site e.g. resection 4. Concurrent use of CYP3A4 inducers or inhibitors 5. Serious cardiac illness or other medical conditions precluding the use of cisplatin or cetuximab 6. HPV+ patients who have p16+ tumours who also have N2b, N2c or N3 nodal disease and who also smoke more than 10 pack years (i.e. have both risk factors) 7. Pregnant or lactating 8. Previous treatment for any other cancer with cytotoxics, radiotherapy or antiEGFR therapies 9. Inadequate renal, haematological or liver functions 10. Life expectancy less than three months 11. Other malignancy within the past three years except basal cell skin cancer or preinvasive carcinoma of the cervix |
Date of first enrolment | 09/10/2012 |
Date of final enrolment | 28/10/2016 |
Locations
Countries of recruitment
- Belgium
- England
- Ireland
- Italy
- Netherlands
- Scotland
- United Kingdom
- Wales
Study participating centres
Coventry
CV4 7AL
United Kingdom
Aberdeen
AB25 2ZN
United Kingdom
Dublin
-
Ireland
Bradford Royal Infirmary
Bradford
BD9 6RJ
United Kingdom
Bristol
BS2 8ED
United Kingdom
Cottingham
HU16 5JQ
United Kingdom
Cheltenham
GL53 7AN
United Kingdom
Bebington
Wirral
CH63 4JY
United Kingdom
Colchester
Essex
CO4 5JL
Colchester
CO4 5JL
United Kingdom
Glan Clwyd Hospital
Bodelwyddan
Denbighshire
Bodelwyddan
LL18 5UJ
United Kingdom
Middlesbrough
TS4 3BW
United Kingdom
Leicester
LE1 5WW
United Kingdom
Taunton
TA1 5DA
United Kingdom
WV10 9PQ
United Kingdom
Nottingham
NG5 1PB
United Kingdom
Birmingham
B15 2TH
United Kingdom
Derby
DE22 3NE
United Kingdom
London
SW3 6JJ
United Kingdom
Sutton
Surrey
Sutton
SM2 5PT
United Kingdom
Guildford
GU2 7XX
United Kingdom
Bath
BA1 3NG
United Kingdom
Swansea
SA2 8QA
United Kingdom
Leeds
LS9 7TF
United Kingdom
Rathgar
Dublin 6
Dublin
-
Ireland
Coventry
CV2 2DX
United Kingdom
Cardiff
CF14 2TL
United Kingdom
1081 HV
Netherlands
Walsall
WS2 9PS
United Kingdom
Edinburgh
EH4 2XU
United Kingdom
Sheffield
S10 2SJ
United Kingdom
Northampton
NN1 5BD
United Kingdom
Norwich
NR4 7UY
United Kingdom
Sponsor information
University/education
Warwick Medical School
Medical School Building
Coventry
CV4 7AL
England
United Kingdom
https://ror.org/01a77tt86 |
Funders
Funder type
Charity
Private sector organisation / Other non-profit organizations
- Alternative name(s)
- CR_UK, Cancer Research UK - London, CRUK
- Location
- United Kingdom
Results and Publications
Intention to publish date | 31/12/2019 |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Data sharing statement to be made available at a later date |
Publication and dissemination plan | Planned publication in a high-impact peer reviewed journal. |
IPD sharing plan | The current data sharing plans for the current study are unknown and will be made available at a later date. |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
---|---|---|---|---|---|
Results article | results | 05/01/2019 | Yes | No | |
Plain English results | 06/02/2019 | 29/10/2021 | No | Yes | |
HRA research summary | 28/06/2023 | No | No |
Editorial Notes
29/10/2021: The following changes have been made:
1. The Cancer Research UK lay results summary has been added.
2. The total final enrolment number has been added.
20/11/2018: Publication reference added.
20/01/2017: Overall trial dates were updated from 01/03/2012 - 28/02/2015 to 01/09/2011 - 31/07/2019. Recruitment dates were updated from 01/03/2012 - 28/02/2015 to 09/10/2012 - 28/10/2016. Added trial participation centres.
17/01/2017: No publications found in PubMed, verifying study status with principal investigator.