Chemoprevention Study of Oral Cavity Squamous Cell Carcinoma

This study has been completed.
Sponsor:
Collaborators:
National Taiwan University Hospital
Changhua Christian Hospital
China Medical University Hospital
Buddhist Tzu Chi General Hospital
Taichung Veterans General Hospital
Mackay Memorial Hospital
Chang Gung Memorial Hospital
Sun Yat-sen University
Chi Mei Medical Hospital
National Cheng-Kung University Hospital
Information provided by:
National Health Research Institutes, Taiwan
ClinicalTrials.gov Identifier:
NCT00201279
First received: September 13, 2005
Last updated: NA
Last verified: January 2005
History: No changes posted

September 13, 2005
September 13, 2005
April 1999
Not Provided
Primary tumor recurrence
Same as current
No Changes Posted
The development of a second primary tumor
Same as current
Not Provided
Not Provided
 
Chemoprevention Study of Oral Cavity Squamous Cell Carcinoma
Phase III Placebo-Controlled Chemoprevention Study of Oral Cavity Squamous Cell Carcinoma Patients

The purpose of this study is to study the effect of 13-cis retinoic acid in preventing second primary malignancy in the oral cavity cancer patients after curative local treatment and to study the toxicity and compliance of 13-cis retinoic acid.

There are more than one thousand deaths annually from head and neck cancer in Taiwan (excluding nasopharyngeal carcinoma) and the majority of treatment failures are related to recurrence of primary disease. Only patients with early-stage disease have high cure rates, but they remain at risk for the development of second primary tumors.

Second primary malignancies occur at a constant annual rate of 5% to 7% in all head and neck cancer patients1. Furthermore, because the mortality from primary disease recurrence plateaus after 2 to 3 years in patients with locally advanced disease, second primary tumors become the major cause of late cancer mortality.

Sporn et al defined chemoprevention as an effort to arrest or reverse premalignant cells during their progression to invasive malignancy2,3. The concept of chemoprevention has evolved to include the use of specific compounds, rather than general dietary changes, to prevent the development of cancer.

Hong et al studied the effects of 13-cis retinoic acid on patients with history of head and neck cancers 4. After treatment of head and neck primary cancers with either radiotherapy or surgery or both, 103 patients were randomized to receive either adjuvant 13-cis retinoic acid or placebo. In an update of this trial with 55 months of follow-up, 16 patients (31%) in the placebo group had developed second primary tumors, whereas 7 patients (14%) in the treatment group had developed second primary tumors (p=0.04) 5. Betel quid chewing becomes increasingly popular in Taiwan. Exposure to both smoking and betel quid significantly increases the risk of oral cavity cancer6. The hazard of developing second primary tumors is high in this population, therefore, chemoprevention is worthy of trial.

Use of 13-cis RA for chemoprevention of head and neck cancer only has been published by Hong et al. Their cases included a variety of head and neck cancers that are known to be not a homogenous group. The risk of second primary is different for different primary sites. Therefore, the value of 13-cis RA in chemoprevention is not conclusively addressed. In our proposal, only oral cavity cancer is included and the result will be more convincing. The result could be the basis of further chemoprevention clinical trial or guideline for clinical practice.

Interventional
Phase 3
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind
Primary Purpose: Prevention
  • Oral Cavity
  • Squamous Cell Carcinoma
Drug: 13-cis Retino Acid
Not Provided
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
342
September 2012
Not Provided

Inclusion Criteria:

  • Clinically free of disease after having undergone surgery for histologically confirmed primary SCC of the oral cavity(Buccal mucosa +Oral tongue )
  • Without any risk factor of recurrence listed below:
  • Nodal extracapsular spread of disease (ECS)
  • Number of positive node > 2
  • Perineural involvement
  • Lymphovascular emboli/permeation in resected surgical specimen
  • Histologically positive surgical margins, but no gross residual disease

Exclusion Criteria:

  • A KPS of less than 50 percent
  • Serum creatinine and/or GOT/GPT greater than 2 times upper normal limit
  • Distant metastasis
  • Has previously received chemotherapy
  • Has received within the two years diagnosis of any cancer
  • Women of reproductive capacity
  • Cases beyond the age range of 20-65 years.
Both
20 Years to 65 Years
No
Contact information is only displayed when the study is recruiting subjects
Taiwan
 
NCT00201279
T1399
Not Provided
Not Provided
National Health Research Institutes, Taiwan
  • National Taiwan University Hospital
  • Changhua Christian Hospital
  • China Medical University Hospital
  • Buddhist Tzu Chi General Hospital
  • Taichung Veterans General Hospital
  • Mackay Memorial Hospital
  • Chang Gung Memorial Hospital
  • Sun Yat-sen University
  • Chi Mei Medical Hospital
  • National Cheng-Kung University Hospital
Study Chair: Mow-Ming Hsu, MD National Taiwan University Hospital
National Health Research Institutes, Taiwan
January 2005

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP