Head and Neck CancerPhase 3Paccis-RCTNCT01126216
Reduced Radiotherapy With Pac/Cis vs Standard Radiotherapy With 5-FU/Cis in Locally Advanced Head and Neck Cancer
A Phase 3 study testing Paclitaxel/Cisplatin, Reduced RT and 5-FU/Cisplatin in people with Head and Neck Cancer, run by University of Erlangen-Nürnberg Medical School at 13 sites in Germany.
Trial summary
Reduced RT with Pac/Cis vs. standard RCT with 5-FU/Cis Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Head and Neck Cancer
- What is being tested?
- Paclitaxel/Cisplatin, Reduced RT and 5-FU/Cisplatin
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 221 participants
- Where
- 13 sitesGermany
- Study dates
- Jun 2010to Jun 2019
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically proven, locally advanced stage III-IV A-B (UICC 2002) primary squamous cell carcinoma of the oral cavity, the oropharynx, the hypopharynx, the supraglottic larynx
- Age ≥ 18
- Written informed consent for the participation in the clinical trial
Who cannot join
- Inadequate hepatic function: Bilirubin > 2,0 mg/dl, SGOT, SGPT, AP, Gamma-GT > 3 x ULN
- Inadequate bone marrow function: leukocytes < 3,5 x 10^9/l, platelets < 100 x 10^9/l or neutrophils < 1,5 x 10^9/l
- Serum creatinine > 1,5 mg/dl, creatinine clearance < 60ml/min
- Uncontrolled severe somatic or psychological disease: e.g. unstable angina pectoris; myocardial infarction during the last 6 months; significant cardial rhythm disorders; apoplexy; high grade stenosis of the carotis; neurological or psychiatric disorders including convulsive disorders; dementia; psychosis; active uncontrolled infection or sepsis; liver cirrhosis; Child stage B,C; severe liver function disorders; marginal changes in the blood count; severe kidney damage; HIV-infection
- Acute infections
- Fertile women without adequate contraception during and up to 6 months after therapy (the method of contraception has to be high effective as described in the Note for guidance on non-clinical safety studies for the conduct of human clinical trials for pharmaceuticals (CPMP/ICH/286/95 mod) and it has to be discussed with the investigator)
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- Pregnant or breast feeding women
- Men, who are not willing to use adequate contraception during and up to 6 months after therapy, that is discussed with the investigator
- ECOG-Status > 1
- Reduced hearing function (especially higher frequencies)
- Exsiccosis
- Neuropathy, caused by cisplatin
- Concurrent malignancies, with exception of adequately treated basal cell carcinoma of the skin or in situ carcinoma or the cervix
- Prior radiotherapy of the neck or chemotherapy
- Distant metastasis
- Recurrent carcinoma in the head and neck region
- Prior neck-dissection or surgical intervention exceeding an exploratory excision
- Known intolerance to 5-Fluorouracil
- Known deficit of Dihydropyrimidine dehydrogenase (DPD)
- Simultaneous therapy with Brivudin or other inhibitors of DPD
- Known intolerance to Cisplatin or other substances that contain platin
- Known intolerance to Paclitaxel or one of the included substances, especially to Poly(oxyethylene)Rhizinusöl/Macrogolglycerol ricinoleate
Trial locations and contacts
13 sites in 1 country.
13 sites in 1 country
Germany13 sites
Klinikum Coburg, Strahlentherapie, DiaCura
Coburg, 96450
Universitätsklinikum Düsseldorf, Klinik und Poliklinik für Strahlentherapie und Radiologische Onkologie
Düsseldorf, 40225
Universitätsklinikum Erlangen, Strahlenklinik
Erlangen, 91054
Universitätsklinikum Frankfurt, Klinik für Strahlentherapie und Radioonkologie
Frankfurt/M., 60590
Klinikum am Eichert, Praxis für Strahlentherapie und Klinik für Radioonkologie
Göppingen, 73035
Universitätsklinikum des Saarlandes, Klinik für Strahlentherapie und Radioonkologie,
Homburg/Saar, 66421
Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik und Poliklinik für Hals-Nasen- und Ohrenkranke
Lübeck, 23538
Kliniken Maria Hilf GmbH Mönchengladbach, Klinik für Strahlentherapie
Mönchengladbach, 41063
Klinikum München Pasing und Perlach, Klinik für HNO
München, 81241
Brüderkrankenhaus st. Josef Paderborn, Klinik für Strahlentherapie
Paderborn, 33098
Universitätsklinikum Regensburg, Klinik und Poliklinik für Strahlentherapie
Regensburg, 93053
Klinikum St. Elisabeth Straubing, Klinik für Hals-Nasen-Ohren-Heilkunde
Straubing, 94315
MVZ am Klinikum Mutterhaus der Borrmäerinnen, Strahlentherapie
Trier, 54290
About this study
Official title: Randomised Phase-III-trial of Simultaneous Radiochemotherapy (RCT) of Locally Advanced Head and Neck Cancer in the Stages III and IV A-B: Comparing Dose Reduced Radiotherapy (63,6 Gy) With Paclitaxel/Cisplatin to Standard Radiotherapy (70,2 Gy) With 5-Fluorouracil/Cisplatin
Reduced RT with Pac/Cis vs. standard RCT with 5-FU/Cis
Read the detailed description
Standard treatment for patients with advanced, unresectable head and neck cancer is a platin-based simultaneous radiochemotherapy (RCT) (Pignon JP et al., Lancet 2000;355:949-955). However, irradiation dose is still debatable regarding local tumor control and late toxicity. Moreover, it is still unclear which combination of different drugs might be more effective.
In recent years, new drugs have been introduced in the field of head and neck cancer. The Taxanes, namely Docetaxel and Paclitaxel, have been investigated in several phase I/II-studies, and showed promising results concerning locoregional control rates and survival data. The RTOG 97-03 trial (Garden et al., J Clin Oncol 2004; 22:2856-64) compared a RCT either with Cisplatin/5-FU or Cisplatin/Paclitaxel. In this phase II-study an improvement of local tumor control and disease free survival of 15-20% in favour of the Cisplatin/Paclitaxel treatment arm was seen.
Therefore, our phase III-trial compares a standard RCT (70.6 Gy) with Cisplatin/5-FU to a RCT with Cisplatin/Paclitaxel and reduced irradiation dose (63.6 Gy). Primary endpoint is to proof superiority of the experimental Cisplatin/Paclitaxel treatment arm concerning disease-free-survival. Secondary endpoints are locoregional tumor control, overall survival and quality of life.
- Conditions
- Head and Neck Cancer
- Being tested
- Paclitaxel/Cisplatin, Reduced RT, 5-FU/Cisplatin, Standard RT
- Keywords
- Radiochemotherapy, head and neck cancer, Paclitaxel, Cisplatin, 5-FU
- Medical subject headings
- Head and Neck Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Paclitaxel/CisplatinDrug
Experimental: Paclitaxel (20mg/m^2/d) on days 2, 5, 8, 11 and 25, 30, 33, 36) and Cisplatin (20mg/m^2/d) on days 1-4 and 29-32,
Reduced RTRadiation
Experimental: 63,6 Gy accelerated hyperfractionated radiotherapy
5-FU/CisplatinDrug
Active Comparator: 5-Fluorouracil(600mg/m^2/d) on days 1-5 and 29-33) and Cisplatin (20mg/m^2/d) on days 1-5 and 29-33
Standard RTRadiation
Active Comparator: 70,6 Gy accelerated hyperfractionated radiotherapy
| Study group | Role | What they receive |
|---|---|---|
| Reduced RT + Pacitaxel/Cisplatin | Experimental | 63,6 Gy accelerated hyperfractionated radiotherapy with Paclitaxel (20mg/m^2/d) on days 2, 5, 8, 11 and 25, 30, 33, 36) and Cisplatin (20mg/m^2/d) on days 1-4 and 29-32, followed by a salvage operation or neck dissection if there is persisting tumor Receives: Drug: Paclitaxel/Cisplatin; Radiation: Reduced RT |
| Standard RT + 5-Fluorouracil/Cisplatin | Active comparator | 70,6 Gy accelerated hyperfractionated radiotherapy with 5-Fluorouracil(600mg/m^2/d) on days 1-5 and 29-33) and Cisplatin (20mg/m^2/d) on days 1-5 and 29-33, followed by a salvage operation or neck dissection if there is persisting tumor Receives: Drug: 5-FU/Cisplatin; Radiation: Standard RT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Disease free survival
Measured: 3 years
Secondary outcomes (6)
Overall Survival
Measured: 3 years
Distant metastasis free survival
Measured: 3 years
Local control
Measured: 3 years
Acute and Late Toxicity
Measured: 4 years
Life Quality
Measured: 4 years
HPV/p16-Status
Measured: End of study
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 May 2010 (estimated)
- Study startJun 2010
- Primary completionJun 2015
- Study completionJun 2019
Why it stopped: After an Interims analysis the Data Safety Monitoring board recommended this because no significant difference between the two arms was seen and was not expected with an reasonable recruitment of patients. No interruptions of the trial were made.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Head and Neck CancerStudies of the same condition, open and under way.
- More trials run by University of Erlangen-Nürnberg Medical SchoolThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 221 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Erlangen-Nürnberg Medical School
- Sponsor type
- University, hospital or other
- Collaborators
- Deutsche Krebshilfe e.V., Bonn (Germany)
- Responsible party
- Sponsor
- Investigators
- Rainer Fietkau, MD, Study director, Strahlenklinik, Universitätsklinikum Erlangen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01126216
- Sponsor's protocol ID
- Paccis-RCT_2005
- Other IDs
- 2005-003484-23, 107028, 2005
- Acronym
- Paccis-RCT
- Status last verified
- Aug 2017
- First submitted
- 17 May 2010
- Last updated
- 4 May 2021
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Fietkau R, Hecht M, Hofner B, Lubgan D, Iro H, Gefeller O, Rodel C, Hautmann MG, Kolbl O, Salay A, Rube C, Melchior P, Breinl P, Krings W, Gripp S, Wollenberg B, Keerl R, Schreck U, Siekmeyer B, Grabenbauer GG, Balermpas P; PacCis-Study Group. Randomized phase-III-trial of concurrent chemoradiation for locally advanced head and neck cancer comparing dose reduced radiotherapy with paclitaxel/cisplatin to standard radiotherapy with fluorouracil/cisplatin: The PacCis-trial. Radiother Oncol. 2020 Mar;144:209-217. doi: 10.1016/j.radonc.2020.01.016. Epub 2020 Feb 7.
PubMed 32044419
Study at a glance
From the registry record, last updated by the sponsor on 4 May 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomised Phase-III-trial of Simultaneous Radiochemotherapy (RCT) of Locally Advanced Head and Neck Cancer in the Stages III and IV A-B: Comparing Dose Reduced Radiotherapy (63,6 Gy) With Paclitaxel/Cisplatin to Standard Radiotherapy (70,2 Gy) With 5-Fluorouracil/Cisplatin
- ClinicalTrials.gov ID
- NCT01126216
- Acronym / sponsor ID
- Paccis-RCT / Paccis-RCT_2005
- Conditions
- Head and Neck Cancer
- Keywords
- Radiochemotherapy, head and neck cancer, Paclitaxel, Cisplatin, 5-FU
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: After an Interims analysis the Data Safety Monitoring board recommended this because no significant difference between the two arms was seen and was not expected with an reasonable recruitment of patients. No interruptions of the trial were made.
- Enrolment
- 221 participants (actual)
- Lead sponsor
- University of Erlangen-Nürnberg Medical SchoolUniversity, hospital or other
- Collaborators
- Deutsche Krebshilfe e.V., Bonn (Germany)
- Study start
- Jun 2010 (actual)
- Primary completion
- Jun 2015 (actual)
- Study completion
- Jun 2019 (actual)
- First posted
- 19 May 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Reduced RT with Pac/Cis vs. standard RCT with 5-FU/Cis
Detailed description
Standard treatment for patients with advanced, unresectable head and neck cancer is a platin-based simultaneous radiochemotherapy (RCT) (Pignon JP et al., Lancet 2000;355:949-955). However, irradiation dose is still debatable regarding local tumor control and late toxicity. Moreover, it is still unclear which combination of different drugs might be more effective.
In recent years, new drugs have been introduced in the field of head and neck cancer. The Taxanes, namely Docetaxel and Paclitaxel, have been investigated in several phase I/II-studies, and showed promising results concerning locoregional control rates and survival data. The RTOG 97-03 trial (Garden et al., J Clin Oncol 2004; 22:2856-64) compared a RCT either with Cisplatin/5-FU or Cisplatin/Paclitaxel. In this phase II-study an improvement of local tumor control and disease free survival of 15-20% in favour of the Cisplatin/Paclitaxel treatment arm was seen.
Therefore, our phase III-trial compares a standard RCT (70.6 Gy) with Cisplatin/5-FU to a RCT with Cisplatin/Paclitaxel and reduced irradiation dose (63.6 Gy). Primary endpoint is to proof superiority of the experimental Cisplatin/Paclitaxel treatment arm concerning disease-free-survival. Secondary endpoints are locoregional tumor control, overall survival and quality of life.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Reduced RT + Pacitaxel/Cisplatin | Experimental | Drug: Paclitaxel/Cisplatin, Radiation: Reduced RT63,6 Gy accelerated hyperfractionated radiotherapy with Paclitaxel (20mg/m^2/d) on days 2, 5, 8, 11 and 25, 30, 33, 36) and Cisplatin (20mg/m^2/d) on days 1-4 and 29-32, followed by a salvage operation or neck dissection if there is persisting tumor |
| Standard RT + 5-Fluorouracil/Cisplatin | Active comparator | Drug: 5-FU/Cisplatin, Radiation: Standard RT70,6 Gy accelerated hyperfractionated radiotherapy with 5-Fluorouracil(600mg/m^2/d) on days 1-5 and 29-33) and Cisplatin (20mg/m^2/d) on days 1-5 and 29-33, followed by a salvage operation or neck dissection if there is persisting tumor |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Histologically proven, locally advanced stage III-IV A-B (UICC 2002) primary squamous cell carcinoma of the oral cavity, the oropharynx, the hypopharynx, the supraglottic larynx
- Age ≥ 18
- Written informed consent for the participation in the clinical trial
Key exclusion criteria (22 listed)
- Inadequate hepatic function: Bilirubin > 2,0 mg/dl, SGOT, SGPT, AP, Gamma-GT > 3 x ULN
- Inadequate bone marrow function: leukocytes < 3,5 x 10^9/l, platelets < 100 x 10^9/l or neutrophils < 1,5 x 10^9/l
- Serum creatinine > 1,5 mg/dl, creatinine clearance < 60ml/min
- Uncontrolled severe somatic or psychological disease: e.g. unstable angina pectoris; myocardial infarction during the last 6 months; significant cardial rhythm disorders; apoplexy; high grade stenosis of the carotis; neurological or psychiatric disorders including convulsive disorders; dementia; psychosis; active uncontrolled infection or sepsis; liver cirrhosis; Child stage B,C; severe liver function disorders; marginal changes in the blood count; severe kidney damage; HIV-infection
- Acute infections
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Paclitaxel/CisplatinExperimental: Paclitaxel (20mg/m^2/d) on days 2, 5, 8, 11 and 25, 30, 33, 36) and Cisplatin (20mg/m^2/d) on days 1-4 and 29-32, | Drug | Reduced RT + Pacitaxel/Cisplatin |
| Reduced RTExperimental: 63,6 Gy accelerated hyperfractionated radiotherapy | Radiation | Reduced RT + Pacitaxel/Cisplatin |
| 5-FU/CisplatinActive Comparator: 5-Fluorouracil(600mg/m^2/d) on days 1-5 and 29-33) and Cisplatin (20mg/m^2/d) on days 1-5 and 29-33 | Drug | Standard RT + 5-Fluorouracil/Cisplatin |
| Standard RTActive Comparator: 70,6 Gy accelerated hyperfractionated radiotherapy | Radiation | Standard RT + 5-Fluorouracil/Cisplatin |
Primary outcome
Disease free survival
Time frame: 3 years
6 secondary outcomes
Overall Survival
Time frame: 3 years
Distant metastasis free survival
Time frame: 3 years
Local control
Time frame: 3 years
Acute and Late Toxicity
Time frame: 4 years
Life Quality
Time frame: 4 years
HPV/p16-Status
Time frame: End of study
Results and safety
The study was stopped early (reason given: After an Interims analysis the Data Safety Monitoring board recommended this because no significant difference between the two arms was seen and was not expected with an reasonable recruitment of patients. No interruptions of the trial were made.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 May 2021.
- Derived from this study: PubMed 32044419Fietkau R, Hecht M, Hofner B, Lubgan D, Iro H, Gefeller O, Rodel C, Hautmann MG, Kolbl O, Salay A, Rube C, Melchior P, Breinl P, Krings W, Gripp S, Wollenberg B, Keerl R, Schreck U, Siekmeyer B, Grabenbauer GG, Balermpas P; PacCis-Study Group. Randomized phase-III-trial of concurrent chemoradiation for locally advanced head and neck cancer comparing dose reduced radiotherapy with paclitaxel/cisplatin to standard radiotherapy with fluorouracil/cisplatin: The PacCis-trial. Radiother Oncol. 2020 Mar;144:209-217. doi: 10.1016/j.radonc.2020.01.016. Epub 2020 Feb 7.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Rainer Fietkau, MD study director
Strahlenklinik, Universitätsklinikum Erlangen
13 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Paclitaxel/Cisplatin, Reduced RT and 5-FU/Cisplatin in people with Head and Neck Cancer, run by University of Erlangen-Nürnberg Medical School at 13 sites in Germany.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 4 May 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 13 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: After an Interims analysis the Data Safety Monitoring board recommended this because no significant difference between the two arms was seen and was not expected with an reasonable recruitment of patients. No interruptions of the trial were made.). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Disease free survival (time frame: 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01126216, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 May 2021.