Boronophenylalanine (BPA)-Based Boron Neutron Capture Therapy (BNCT) in the Treatment Head and Neck Tumors - Full Text View

Sponsor:	Boneca Corporation
Information provided by:	Boneca Corporation
ClinicalTrials.gov Identifier:	NCT00114790

Purpose

Boron Neutron Capture Therapy (BNCT) is an experimental radiation therapy technique which is based on the principle of irradiating boron atoms with neutrons. When neutrons have relatively low energy, boron atoms that have been targeted to cancerous tissue using a suitable boron carrier (an amino acid derivative called BPA, boronophenylalanine) will capture the neutrons. As a result from the neutron capture the boron atoms will split into two, producing helium and lithium ions. The helium and lithium ions, in turn, have only a short pathlength in tissue (about 5 micrometers) and will deposit their cell damaging effect mainly within the tumor provided that the boron carrier (BPA) has accumulated in the tumor. In practice, the study participants will receive BPA as an approximately 2-hour intravenous infusion, following which the tumor is irradiated with low energy (epithermal) neutrons obtained from a nuclear reactor at the BNCT facility. BNCT requires careful radiation dose planning, but neutron irradiation will last approximately only for one hour. In this study BNCT will be repeated, and the 2 treatments will be given 3 to 5 weeks apart. The study hypothesis is that head and neck cancers that have recurred following conventional radiotherapy might accumulate the boron carrier compound, and might respond to BNCT.

Condition	Intervention	Phase
Head and Neck Cancer	Radiation: boronophenylalanine-based BNCT	Phase I Phase II

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Boronophenylalanine (BPA)-Based Boron Neutron Capture Therapy (BNCT) in the Treatment of Inoperable and Irradiated Head and Neck Tumors: A Feasibility Study

Resource links provided by NLM:

MedlinePlus related topics: Cancer Head and Neck Cancer

U.S. FDA Resources

Further study details as provided by Boneca Corporation:

Primary Outcome Measures:

treatment response [ Time Frame: 1 year ] [ Designated as safety issue: No ]
safety [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
adverse effects [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
tumor-related symptoms [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
effect on tumor 18F-labeled BPA uptake [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

time to progression [ Time Frame: 2 years ] [ Designated as safety issue: No ]
survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Estimated Enrollment:	24
Study Start Date:	December 2003
Estimated Study Completion Date:	May 2009
Primary Completion Date:	October 2008 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: A Active treatment arm.	Radiation: boronophenylalanine-based BNCT Boronophenylalanine is infused into a peripheral vein prior to neutron irradiation.

Detailed Description:

This is a single BNCT-facility, non-randomized, non-comparative, open-label, phase I to II trial to determine the value of BNCT in the treatment of inoperable, irradiated, locally advanced cancers of the head and neck region. An attempt to perform 18F-labeled boronophenylalanine (18F-BPA) SPECT or PET imaging will be made before BNCT. Patients whose tumor uptake is >2.5 times that of the corresponding normal head and neck tissue will be enrolled, and treated with a single fraction BPA-based BNCT twice, 3 to 5 weeks apart. Another 18F-BPA SPECT or PET study may be performed 1 to 3 months after BNCT to determine the SPECT/PET response.

The neutron irradiation site is the FiR 1 reactor site, located at Otaniemi, Espoo, Finland, about 6 kilometers from the Helsinki University Central Hospital, Helsinki, where patient evaluation and post-irradiation care will take place.

Prior to BNCT, BPA is infused as a fructose complex (l-BPA-F) into a peripheral vein over 2 hours. Blood samples will be taken for monitoring whole blood boron concentration before starting the BPA infusion, and thereafter at 20 to 40 minute intervals during the infusion, following infusion, and after delivering neutron irradiation. The blood samples will be analyzed for blood boron concentration to estimate the average blood boron concentration during neutron irradiation.

All patients will be evaluated for response using CT or magnetic resonance imaging (MRI).

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Histologically confirmed, malignant head and neck cancer.
Inoperable tumor, prior surgery may or may not have been done.
Prior radiotherapy or chemoradiotherapy has been given.
If prior SPECT or PET with 18F-BFA has been done, BPA needs to accumulate at least 2.5 times more in the tumor than in the corresponding contralateral normal tissue.
WHO performance status <3.
WBC >2,500/mm3, platelets >75,000/mm3, serum creatinine <180 umol/L.
A written informed consent.

Exclusion Criteria:

Lymphoma or other tumor type that is expected to respond to cancer chemotherapy or to a dose of conventional radiation therapy that can be safely given.
A non-experimental, effective treatment option is available.
Expected survival less than 3 months.
Concomitant systemic chemotherapy (prior cancer chemotherapy is allowed).
Other concurrent experimental therapy, or such therapy is being planned to be given.
Less than 3 months since prior radiation therapy.
Untreated or severe, treated congestive heart failure or renal failure.
A cardiac pace-maker or an unremovable metal implant present in the head and neck region that will interfere with MRI-based dose-planning.
Restlessness or inability to lie in a cast for 30 to 60 minutes.
Clinical follow-up after therapy cannot be arranged or the patient is not willing to participate in follow-up.
Pregnancy.
Age less than 18.
The patient is not able to understand the treatment options.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00114790

Locations

Finland
Department of Oncology, Helsinki University Central Hospital
Helsinki, Finland, FIN-00029

Sponsors and Collaborators

Boneca Corporation

Investigators

Principal Investigator:

Heikki T Joensuu, M.D., prof.

Helsinki University Central Hospital

More Information

Additional Information:

Boneca Corporation is a Finnish company that provides BNCT. This link exits the ClinicalTrials.gov site

Publications:

Kouri M, Kankaanranta L, Seppala T, Tervo L, Rasilainen M, Minn H, Eskola O, Vahatalo J, Paetau A, Savolainen S, Auterinen I, Jaaskelainen J, Joensuu H. Undifferentiated sinonasal carcinoma may respond to single-fraction boron neutron capture therapy. Radiother Oncol. 2004 Jul;72(1):83-5.

Joensuu H, Kankaanranta L, Seppala T, Auterinen I, Kallio M, Kulvik M, Laakso J, Vahatalo J, Kortesniemi M, Kotiluoto P, Seren T, Karila J, Brander A, Jarviluoma E, Ryynanen P, Paetau A, Ruokonen I, Minn H, Tenhunen M, Jaaskelainen J, Farkkila M, Savolainen S. Boron neutron capture therapy of brain tumors: clinical trials at the finnish facility using boronophenylalanine. J Neurooncol. 2003 Mar-Apr;62(1-2):123-34.

Responsible Party:	Markku Pohjola, Boneca Corporation
ClinicalTrials.gov Identifier:	NCT00114790 History of Changes
Other Study ID Numbers:	HN-BPA-01-2003
Study First Received:	June 17, 2005
Last Updated:	January 27, 2009
Health Authority:	Finland: Finnish Medicines Agency

Keywords provided by Boneca Corporation:

head and neck cancer
boron neutron capture therapy
radiation therapy
boronophenylalanine

Additional relevant MeSH terms:

Head and Neck Neoplasms
Neoplasms by Site
Neoplasms

ClinicalTrials.gov processed this record on February 12, 2012