Trial of Induction TPF therapy in Advanced head & Neck cancer

ISRCTN ISRCTN74465582
DOI https://doi.org/10.1186/ISRCTN74465582
EudraCT/CTIS number 2010-023195-22
Secondary identifying numbers 10000
Submission date
10/08/2011
Registration date
10/08/2011
Last edited
23/06/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

http://cancerhelp.cancerresearchuk.org/trials/a-trial-tpf-chemotherapy-before-surgery-and-radiotherapy-for-locally-advanced-head-and-neck-cancer-titan

Study website

Contact information

Miss Gemma Simpson
Scientific

University of Liverpool Cancer Research Centre
200 London Road
Liverpool
L3 9TA
United Kingdom

Study information

Study designRandomised, interventional
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not provided at time of registration
Scientific titleRandomised controlled open-label trial of TPF (taxane cisplatin 5-fluorouracil) induction chemotherapy in the surgical management of locally advanced head and neck cancer
Study acronymTITAN
Study objectivesThis is a trial of treatment intensification in a high-risk population of potentially curable patients. Induction chemotherapy is a significant recent advance in the management of locally advanced squamous cell carcinoma of the head and neck (SCCHN), although its use in combination with surgery and postoperative radiotherapy (PORT) is under-researched. Induction chemotherapy (ICT) offers the potential for better delivery of drugs to "treatment naïve" tumours with an intact blood supply and, at the same time, provides maximal treatment to eradicate micro-metastasis, with the prospect of both better local and local systemic control of disease.

Thus the rationale is to study the effects of intensification of treatment using induction TPF in locally advanced SCCHN in those anatomical sites treated by primary surgery.
Ethics approval(s)First MREC, 11/04/2011, ref: 11/NW/0149
Health condition(s) or problem(s) studiedHead and neck cancer
InterventionPatients will be randomised in a 1:1 ratio across 2 arms

Arm A: surgery and post operative conformal radiation therapy (CRT) (PO(C)RT)
Conventional treatment for the stage and site of disease is performed as per the original (pre-randomisation) imaging, examination under anaesthetic and clinical findings.

Arm B: Induction Chemotherapy
Patients will recieve 3 cycles of induction chemotherapy at 21 days intervals, prior to recieving surgery and PO(C)RT

To be followed up at 60 month(s)
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase II/III
Drug / device / biological / vaccine name(s)Taxane, cisplatin, 5-fluorouracil
Primary outcome measureFeasibility of recruitment into the TITAN trial (specifically the number of participants)
Secondary outcome measures1. Randomisation: screening ratio
2. The percentage of patients in the TPF arm who complete the full course of treatment
Overall study start date01/09/2011
Completion date01/09/2011

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsUK Sample Size: 50
Total final enrolment7
Key inclusion criteria1. Age >18 years
2. Histopathological diagnosis of head and neck squamous cell carcinoma
3. Tumour (T) stage in one of the following site categories:
3.1. Lip/ Oral cavity: stage T3 or T4a (and >=4cm in largest dimension)
3.2. Paranasal /nasal: stage T4a
3.3. Larynx: stage T4a
3.4. Hypopharynx: stage T3 or T4a
3.5. Cervical oesophagus: stage T3 or T4a
3.6. Oropharynx: stage T3 or T4a and HPV-ve
4. Any lymph node (N) stage
5. No metastases (M0)
6. An multidisciplinary team (MDT) decision to offer surgery as primary modality of treatment
7. World Health Organisation (WHO) performance status 0 or 1
8. Resectable by conventional criteria in both primary site and any cervical lymph node involvement
9. Male or female paticipants
10. Lower age limit: 18 years
Key exclusion criteria1. Those tumours staged to T4a on the basis of early mandibular invasion alone, i.e. <4cm in the maximum dimension
2. Unresectable disease on clinical staging (including imaging) of primary tumour or cervical metastasis
3. Distant metastases (note: positron emission tomography - computed tomography [PET-CT] is necessary investigation for all patients entering trial - as such additional CT chest will usually not be required to exclude pulmonary or hepatic metastases)
4. Nasopharynx site
5. Human papillomavirus (HPV) - positive oropharyngeal cancer (OPC)
6. Pregnancy or lactation
7. Patients with haemoglobin of <10g/dl
8. Patients with neutrophil counts of <1.5 x 109/l.
9. Patients with thrombocyte counts of <100 x 109/l.
10. Patients with significant hepatic impairment (Bilirubin >1.5x upper limit of normal range; ALT >2.5x upper limit of normal range; ALP >5x upper limit of normal range)
11. Patients with significant renal impairment (For the purpose of the study, significant renal impairment is classed as GFR <50ml/min>. However, sites may use their local policy if a higher threshold is dictated.)
12. Patients who lack mental capacity to give informed consent
13. Patients whose co morbidities or concomitant medications otherwise preclude TPF chemotherapy
14. All men or women of reproductive potential, unless using at least two contraceptive precautions, one of which must be a condom
Date of first enrolment01/09/2011
Date of final enrolment01/09/2011

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Liverpool Cancer Research Centre
Liverpool
L3 9TA
United Kingdom

Sponsor information

Aintree University Hospitals NHS Foundation Trust (UK)
Hospital/treatment centre

Aintree University Hospitals
Fazakerley Hospital
Lower Lane
Liverpool
L9 7AL
England
United Kingdom

Website http://www.aintreehospitals.nhs.uk/
ROR logo "ROR" https://ror.org/02h67vt10

Funders

Funder type

Charity

Cancer Research UK
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
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 23/06/2020 No No
HRA research summary 28/06/2023 No No

Editorial Notes

23/06/2020: The following changes were made to the trial record:
1. Added clinicaltrialsregister.eu link to basic results (scientific).
2. The total final enrollment was added.
04/07/2017: No publications found in PubMed, verifying study status with principal investigator.