403 Participants Needed

Chemotherapy + Bevacizumab for Head and Neck Cancers

Recruiting at 878 trial locations
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This randomized phase III trial studies chemotherapy to see how well it works with or without bevacizumab in treating patients with head and neck squamous cell carcinoma that has come back (recurrent) or that has spread to other parts of the body (metastatic). Drugs used in chemotherapy, such as docetaxel, cisplatin, carboplatin, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Monoclonal antibodies, such as bevacizumab, may interfere with the ability of tumor cells to grow and spread. Bevacizumab may also make tumor cells more sensitive to chemotherapy and stop the growth of head and neck cancer by blocking blood flow to the tumor. It is not yet known whether combination chemotherapy is more effective when given with or without bevacizumab in treating patients with head and neck squamous cell carcinoma.

Do I have to stop taking my current medications for the trial?

The trial does not specify if you need to stop taking your current medications. However, you cannot be on any other investigational agents, and certain medications like high-dose aspirin or NSAIDs that affect platelet function are restricted. It's best to discuss your current medications with the trial team to ensure they don't interfere with the study.

Is the combination of chemotherapy drugs including docetaxel, cisplatin, and 5-fluorouracil safe for head and neck cancer patients?

Studies have shown that the combination of docetaxel, cisplatin, and 5-fluorouracil is generally safe for patients with head and neck cancer, although it can cause side effects. These side effects may include nausea, fatigue, and low blood cell counts, which are common with chemotherapy treatments.12345

What makes the chemotherapy and bevacizumab drug combination unique for head and neck cancers?

This treatment combines chemotherapy drugs with bevacizumab, which targets blood vessel growth in tumors, potentially enhancing the effectiveness of chemotherapy. The combination of docetaxel, cisplatin, and 5-fluorouracil is known for high response rates, and adding bevacizumab may improve outcomes by inhibiting tumor blood supply.26789

What data supports the effectiveness of the drug combination used in the clinical trial for head and neck cancers?

Research shows that the combination of docetaxel, cisplatin, and 5-fluorouracil (TPF) has been effective in treating head and neck cancers, with response rates ranging from 52% to 100% in some studies. Additionally, docetaxel combined with cisplatin has shown response rates of 33% to 44% in recurrent disease, with promising survival outcomes.210111213

Who Is on the Research Team?

A(

Athanassios (Ethan) Argiris

Principal Investigator

ECOG-ACRIN Cancer Research Group

Are You a Good Fit for This Trial?

This trial is for adults with recurrent or metastatic head and neck squamous cell carcinoma who haven't had chemotherapy or targeted therapy for the recurrence. They must have adequate blood counts, organ function, no severe bleeding history, controlled blood pressure without major surgery recently, and no brain metastases. Pregnant women are excluded.

Inclusion Criteria

Patients must not be receiving any other investigational agent while on the study
My cancer can be measured by scans.
Patients must meet specified laboratory values for ANC, Hgb, platelet count, creatinine clearance, total bilirubin, AST or ALT, alkaline phosphatase, and urine dipstick
See 11 more

Exclusion Criteria

My cancer has not caused major bleeding or required blood-thinning medication.
I have no severe allergies to docetaxel or polysorbate 80.
Women must not be pregnant or breastfeeding; agreement to use adequate birth control is required for women of child-bearing potential and men
See 7 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive chemotherapy with or without bevacizumab. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Varies, typically 21-day cycles
Visits every 21 days for treatment administration

Follow-up

Participants are monitored for safety and effectiveness after treatment. Follow-up occurs every 3 months for 2 years, then every 6 months for 3 years.

5 years
Every 3 months for 2 years, then every 6 months for 3 years

What Are the Treatments Tested in This Trial?

Interventions

  • Bevacizumab
  • Carboplatin
  • Cisplatin
  • Docetaxel
  • Fluorouracil
Trial Overview The study compares the effectiveness of standard chemotherapy drugs (docetaxel, cisplatin, carboplatin, fluorouracil) alone versus combined with bevacizumab (a drug that may block tumor blood supply). It's a phase III trial to see if adding bevacizumab improves treatment outcomes.
How Is the Trial Designed?
8Treatment groups
Experimental Treatment
Active Control
Group I: Arm IVB (carboplatin, fluorouracil, bevacizumab)Experimental Treatment4 Interventions
Group II: Arm IIIB (cisplatin, fluorouracil, bevacizumab)Experimental Treatment4 Interventions
Group III: Arm IIB (docetaxel, carboplatin, bevacizumab)Experimental Treatment4 Interventions
Group IV: Arm IB (docetaxel, cisplatin, bevacizumab)Experimental Treatment4 Interventions
Group V: Arm IIIA (cisplatin, fluorouracil)Active Control3 Interventions
Group VI: Arm IVA (carboplatin, fluorouracil)Active Control3 Interventions
Group VII: Arm IIA (docetaxel, carboplatin)Active Control3 Interventions
Group VIII: Arm IA (docetaxel, cisplatin)Active Control3 Interventions

Carboplatin is already approved in United States, European Union, Canada for the following indications:

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Approved in United States as Paraplatin for:
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Approved in European Union as Carboplatin for:
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Approved in Canada as Carboplatin for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

National Cancer Institute (NCI)

Lead Sponsor

Trials
14,080
Recruited
41,180,000+

Published Research Related to This Trial

The combination of docetaxel and cisplatin demonstrated a significant overall response rate of 53.7% in patients with locally advanced, recurrent, or metastatic squamous cell carcinoma of the head and neck, indicating its efficacy as a treatment option.
Despite common hematologic and non-hematologic toxicities, the treatment was generally well-tolerated, with serious adverse effects being infrequent due to the use of corticosteroid prophylaxis.
Docetaxel and cisplatin: an active regimen in patients with locally advanced, recurrent or metastatic squamous cell carcinoma of the head and neck. Results of a phase II study of the EORTC Early Clinical Studies Group.Schöffski, P., Catimel, G., Planting, AS., et al.[2020]
Docetaxel shows promising efficacy as a treatment for recurrent squamous cell cancer of the head and neck, with response rates between 33% to 44% when combined with cisplatin, and median survival times of 9.6 to 11 months.
In the neoadjuvant setting, docetaxel has demonstrated response rates greater than 90%, indicating its potential for improving disease-free and overall survival, with ongoing trials comparing its effectiveness to standard treatments.
The role of docetaxel in the management of squamous cell cancer of the head and neck.Glisson, BS.[2018]
The combination of docetaxel, cisplatin, and 5-fluorouracil (5-FU) showed a response rate of 64% in patients at dose level I and 78.3% at dose level II, indicating significant efficacy in treating squamous cell carcinoma of the head and neck (SCCHN).
The treatment was associated with manageable safety concerns, with dose-limiting toxicities including renal toxicity and nausea, and the maximum tolerated dose was reached at level II, suggesting that dose level I is safer and recommended for further testing.
Docetaxel, cisplatin and 5-fluorouracil in patients with locally advanced unresectable head and neck cancer: a phase I-II feasibility study.Schrijvers, D., Van Herpen, C., Kerger, J., et al.[2020]

Citations

A phase II trial of docetaxel, cisplatin and 5-fluorouracil in patients with recurrent squamous cell carcinoma of the head and neck (SCCHN). [2013]
Docetaxel and cisplatin: an active regimen in patients with locally advanced, recurrent or metastatic squamous cell carcinoma of the head and neck. Results of a phase II study of the EORTC Early Clinical Studies Group. [2020]
The role of docetaxel in the management of squamous cell cancer of the head and neck. [2018]
Adjuvant docetaxel, cisplatin and 5-fluorouracil (TPF) in locally advanced squamous cell carcinoma of the head and neck. [2013]
The chemotherapy of head and neck cancer. [2018]
Docetaxel, cisplatin and 5-fluorouracil in patients with locally advanced unresectable head and neck cancer: a phase I-II feasibility study. [2020]
Comparison of carboplatin-paclitaxel to docetaxel-cisplatin-5-flurouracil induction chemotherapy followed by concurrent chemoradiation for locally advanced head and neck cancer. [2021]
A phase II study of docetaxel and carboplatin with concurrent radiation therapy for locally advanced head and neck cancer. [2018]
Docetaxel: an active drug for squamous cell carcinoma of the head and neck. [2018]
10.United Statespubmed.ncbi.nlm.nih.gov
Phase I Trial Using Induction Ciplatin, Docetaxel, 5-FU and Erlotinib Followed by Cisplatin, Bevacizumab and Erlotinib With Concurrent Radiotherapy for Advanced Head and Neck Cancer. [2019]
[Docetaxel and squamous cell carcinoma of the head and neck]. [2018]
12.United Statespubmed.ncbi.nlm.nih.gov
Intravenous 5-Fluorouracil in Patients With Advanced Squamous Cell Carcinoma: A Retrospective Study. [2019]
Oral chemotherapy in head and neck cancer. [2018]
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