Hypopharyngeal Neoplasm Malignant Primary
Conditions
Keywords
hypopharyngeal carcinoma, radiotherapy, inductive chemotherapy, PD-1 inhibitor
Brief summary
TPF is the standard regime of inductive chemotherapy for squamous carcinoma of head and neck. If the primary tumor shrinks obviously (complete remission or \>75% partial remission )after inductive chemotherapy, CCRT is suggested as the definitive therapy, for the tumor is sensitive to chemotherapy. If the primary tumor shrinks a little or progresses after inductive chemotherapy, operation is suggested as the definitive therapy to get a longer survival.
Detailed description
Inductive chemotherapy plus CCRT or operation is an option of organ preservation for patients of hypopharyngeal carcinoma. Many clinical studies have demonstrated that inductive chemotherapy plus CCRT achieved the same prognosis as total laryngectomy, and minimized the damage of normal tissue. TPF is the standard regime of inductive chemotherapy for squamous carcinoma of head and neck. If the primary tumor shrinks obviously (complete remission or \>75% partial remission )after inductive chemotherapy, CCRT is suggested as the definitive therapy, for the tumor is sensitive to chemotherapy. If the primary tumor shrinks a little or progresses after inductive chemotherapy, operation is suggested as the definitive therapy to get a longer survival. This is a prospective, phase II, cohort study. We designate TPF plus Toripalimab as the inductive regime, expecting a higher complete remission rate and longer PFS and OS. And we replace the CCRT with radiation plus Toripalimab to decrease the adverse events of CCRT.
Interventions
DRUGToripalimab
Toripalimab 240mg d1，Q3W. Given with TPF during inductive chemotherapy and definitive radiotherapy.
Sponsors
Shanghai Junshi Bioscience Co., Ltd.
Sun Yan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. 18y ≤age≤65y; 2. ECOG：0-1； 3. Histology：squamous cell carcinoma, located in hypopharynx; 4. clinical stage: cT1N1-3M0、cT2-3N0-3M0，organ-preservation-intent regime is made after multidisciplinary treatment(MDT) discussion. Efficacy evaluation will be made according to RECIST 1.1 after inductive chemotherapy, and the following treatment will be chosen according to the results of efficacy evaluation. 5. never received any previous treatment, including radiotherapy, chemotherapy, or immune therapy, et al. 6. at least one measurable lesion (RECIST 1.1 criteria). 7. expected survival ≥6 months. 8. no contraindications of radiotherapy, chemotherapy and immune therapy. 9. functions of main organs A. WBC≥3.0x109 /L，ANC≥1.5x109/L B. HB≥90g/L C. PLT≥100x109 /L D. serum albumin≥2.8g/dL E. TBil ≤1.5xULN，ALT、AST≤3.0xULN F. serum creatinine ≤1.5xULN or creatinine clearance rate\>60mL/min（Cockcroft-Gault） G. APTT and INR ≤1.5xULN 10. contraception 11. voluntary and compliance.
Exclusion criteria
1. other histology cancers located in hypopharynx. 2. synchronous or metachronous cancers located in other sites. 3. allergy to monoclonal antibody. 4. uncontrollable heart disease or symptoms. 5. uncontrollable infections. 6. fever of unknown origin\>38.5℃ during screening or before administration. 7. active autoimmune disease. 8. history of immunodeficiency disorders, including HIV. 9. active HBV or HCV. 10. history of interstitial lung disease. 11. active tuberculosis. 12. received any drugs listed below: A. received any study drug 4 weeks before first dose of Toripalimab. B. received any anti-cancer drug 4 weeks before first dose of Toripalimab. C. received any glucocorticoids （\>10mg prednison per day） 2 weeks before first dose of Toripalimab. D. received any cancer vaccine 4 weeks before first dose of Toripalimab. E. received any operation or trauma 4 weeks before first dose of Toripalimab. F. recruited in other study. 13. uncontrollable hypertension. 14. uncontrollable type 2 diabetes； 15. hemorrhagic tendency. 16. drug or alcoholic abuse. 17. woman during pregnancy or lactation period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Complete remission rate | 3 months after treatment | Complete remission rate 3 months after treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ORR | 3 months after treatment | objective response rate |
| DCR | 5 year | disease control rate |
| PFS | 5 year | progression free survival |
| OS | 5 year | overall survival |
Countries
China
Contacts
Primary ContactYan Sun, MD
Outcome results
None listed