Comparing weekly vs. every three weeks cisplatin with radiation for advanced head and neck cancer
Official title: Randomized Phase II/III Trial of Radiation With Cisplatin at 100 mg/m2 Every Three Weeks Versus Radiation With Weekly Cisplatin at 40 mg/m2 for Patients With Locoregionally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN)
Run by NRG Oncology · NCT05050162 · Data updated 2026-05-14
This study is no longer in our active list. It may have stopped recruiting or finished. The details below are as of 2026-05-14 and are kept for reference. Check ClinicalTrials.gov for its current status, or see similar studies below.
This study is testing whether giving cisplatin weekly instead of every three weeks along with radiation can help people with advanced head and neck cancer feel better and live longer.
Quick facts
| Phase | Phase2; Phase3 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 1714 (estimated) |
| Sponsor | NRG Oncology Academic / other |
| Drugs / interventions | chemotherapy, radiation |
| Locations | 363 sites (Mobile, Alabama and 362 other locations) |
| Trial ID | NCT05050162 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates include patients with pathologically confirmed advanced squamous cell carcinoma of the head and neck, particularly those with p16-positive oropharyngeal cancer.
✕Probably not a fit
Patients with early-stage head and neck cancer or those not meeting the specific histological criteria may not benefit from this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This clinical trial evaluates the effectiveness and tolerability of administering cisplatin weekly compared to every three weeks in conjunction with radiation therapy for patients with advanced head and neck cancer. The study aims to determine if the weekly regimen results in less acute toxicity and if it is non-inferior in terms of overall survival compared to the less frequent dosing. Additionally, the trial will assess progression-free survival, locoregional failure, and patient-reported quality of life outcomes. The research involves multiple medical centers and utilizes advanced imaging techniques to monitor patient responses.
Why it matters
Potential benefit: If successful, this approach could lead to improved treatment tolerability and potentially better survival outcomes for patients with advanced head and neck cancer.
How similar studies have gone: Previous studies have shown promise in using different dosing schedules of cisplatin, but this specific comparison is novel.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria:
* Pathologically (histologically or cytologically) proven diagnosis of SCCHN of the oropharynx, larynx, hypopharynx, or p16-positive unknown primary prior to registration; specimen from cervical lymph nodes with a well-defined primary site documented clinically or radiologically is acceptable; in patients with carcinoma of unknown primary this will be sufficient for pathologic confirmation without a clinically or radiographically defined primary site
* For patients with oropharyngeal cancer (OPC)/cancer of unknown primary (CUP):
P16 status based on local site immunohistochemical tissue staining is required. A cell block obtained from a fine needle aspiration (FNA) biopsy specimen may be used as the sole diagnostic tissue. Centers are encouraged to contact the pathology chair for clarification.
* Note: Institutions must screen patients for p16 status by immunohistochemistry (IHC) in order to be eligible for the trial using a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory. A rigorous laboratory accreditation process similar to the United States (U.S.) CLIA certification, such as the provincial accreditation status offered by the Ontario Laboratory Accreditation (OLA) Program in Canada, the College of American Pathologists (CAP), or an equivalent accreditation in other countries, is acceptable.
* The p16 results must be reported on the pathology report being submitted. The p16 positivity is defined as \> 70% of tumor cells showing strong nuclear and/or cytoplasmic immunostaining with p16 antibody.
* For patients with laryngeal and hypopharyngeal primaries: Analysis of p16 status is NOT required.
* Patients must have clinically or radiographically evident measurable disease at the primary site or at nodal stations. Simple tonsillectomy or local excision of the primary without removal of nodal disease is permitted, as is excision removing gross nodal disease but with intact primary site. Limited neck dissections retrieving =\< 4 nodes are permitted and considered as non-therapeutic nodal excisions
* Clinical stage (American Joint Committee on Cancer \[AJCC\], 8th ed.), including no distant metastases based on the following diagnostic workup:
* History/physical examination within 60 days prior to registration
* One of the following imaging studies is required within 60 days prior to registration:
* Computed tomography (CT) scan of neck (diagnostic quality with contrast, unless contraindicated) OR
* Magnetic resonance imaging (MRI) of the neck (diagnostic quality with contrast, unless contraindicated) OR
* Fludeoxyglucose F-18 (FDG)-positron emission tomography (PET)/CT of the neck; the CT component must be of diagnostic quality with contrast, unless contraindicated.
* Note: A diagnostic quality CT or MRI with contrast or FDG-PET/CT scan of neck performed for the purposes of radiation planning may serve as both staging and planning tools
* One of the following imaging studies is required within 60 days prior to registration:
* FDG-PET/CT of the chest; FDG-PET/CT scan is strongly preferred and highly recommended to be used for eligibility OR
* Chest CT
* Exam with laryngopharyngoscopy (mirror or in office direct procedure acceptable) within 70 days prior to registration;
* Eligibility by patient cohort;
* Non-OPC/p16-negative OPC Cohort; Tumor Site: Larynx/Hypopharynx; Clinical Staging (AJCC, 8th ed.): T3-4 N0 or T1-4 N1-3 T2 N0 (hypopharynx only)
* Tumor Site: p16-negative OPC; Clinical Staging (AJCC, 8th ed.): T2N1, T1-4 N2-3, or T3-4 N0-1
* p16-positive OPC/CUP Cohort;
* Tumor Site: OPC; Smoking Status: =\< 10 pack-years; Clinical Staging (AJCC, 8th ed.): T1-3 N2-3 or T4 N0-3
* Tumor Site: OPC; Smoking Status: \> 10 pack-years; Clinical Staging (AJCC, 8th ed.): T1N2-3, T2N1-3, or T3-4 N0-3
* Tumor Site: CUP; Smoking Status: Any; Clinical Staging (AJCC, 8th ed.): T0 N2-3 Note: Cigar and pipe tobacco consumption is not included in calculating the lifetime pack-years. Marijuana consumption is likewise not considered in this calculation. There is also no clear scientific evidence regarding the role of chewing tobacco-containing products in oropharyngeal cancer, although this is possibly more concerning given the proximity of the oral cavity and oropharynx. In any case, investigators should not count use of non-cigarette tobacco products in the pack-years calculation.
* Age \>= 18
* Zubrod (Eastern Cooperative Oncology Group \[ECOG\]) performance status of 0-1 within 14 days prior to registration
* Absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3 (within 30 days prior to registration)
* Platelets \>= 75,000 cells/mm\^3 (within 30 days prior to registration)
* Hemoglobin \>= 8.0 g/dL (within 30 days prior to registration)
* Note: The use of transfusion or other intervention to achieve hemoglobin \[Hgb\] \>= 8.0 g/dL is acceptable)
* Calculated creatinine clearance (CrCl) \>= 50 mL/min by the Cockcroft-Gault formula (within 30 days prior to registration)
* Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) (within 30 days prior to registration) (not applicable to patients with known Gilbert's syndrome)
* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 1.5 x institutional ULN (within 30 days prior to registration)
* Known human immunodeficiency virus (HIV) infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months and CD4 T Cell count \> 200 cells/mm\^3 are eligible for this trial. Testing is not required for entry into protocol
* Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
* Negative urine or serum pregnancy test (in persons of childbearing potential) within 14 days prior to registration. Childbearing potential is defined as any person who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal. Menopause is defined clinically as 12 months of amenorrhea in a woman over 45 in the absence of other biological or physiological causes
* Willing to use highly effective contraceptives for participants of childbearing potential (participants who may become pregnant or who may impregnate a partner) during therapy and for 14 months (females); for 11 months (males) following last dose of cisplatin; this inclusion is necessary because the treatment in this study may be significantly teratogenic.
* The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information
Exclusion Criteria:
* Patients with oral cavity cancer, nasopharynx cancer, or p16-negative cancer of unknown primary (CUP)
* Recurrence of the study cancer
* Definitive clinical or radiologic evidence of distant metastatic disease
* Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable, however, any prior exposure to cisplatin is excluded
* Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
* Severe, active co-morbidity defined as follows:
* Unstable angina requiring hospitalization in the last 6 months
* Myocardial infarction within the last 6 months
* New York Heart Association Functional Classification III/IV (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification.)
* Persistent grade 3-4 (CTCAE version 5.0) electrolyte abnormalities that cannot be reversed despite replacement as indicated by repeat testing
* Patient must not have an active infection requiring IV antibiotics prior to registration;
* Other chronic renal disease like nephrotic syndrome, that could be worsened by cisplatin therapy
* History of allogenic organ transplantation
* Any symptomatic peripheral sensory neuropathy grade \>= 2 (CTCAE version 5.0);
* Pregnancy and individuals unwilling to discontinue nursing
* History of hypersensitivity to cisplatin or platinum-containing compounds
Where it's running
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Mobile Infirmary Medical Center
Mobile, Alabama, United States Recruiting -
NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
Jonesboro, Arkansas, United States Recruiting -
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States Recruiting -
Kaiser Permanente-Anaheim
Anaheim, California, United States Recruiting -
Kaiser Permanente-Deer Valley Medical Center
Antioch, California, United States Recruiting -
Sutter Auburn Faith Hospital
Auburn, California, United States Recruiting
Show 44 more locations
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Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California, United States Recruiting -
Kaiser Permanente-Bellflower
Bellflower, California, United States Recruiting -
Alta Bates Summit Medical Center-Herrick Campus
Berkeley, California, United States Recruiting -
Tower Cancer Research Foundation
Beverly Hills, California, United States Recruiting -
Mercy Cancer Center - Carmichael
Carmichael, California, United States Recruiting -
Mercy San Juan Medical Center
Carmichael, California, United States Recruiting -
UC Irvine Health Cancer Center-Newport
Costa Mesa, California, United States Recruiting -
Kaiser Permanente Dublin
Dublin, California, United States Recruiting -
Mercy Cancer Center - Elk Grove
Elk Grove, California, United States Recruiting -
UC San Diego Health System - Encinitas
Encinitas, California, United States Recruiting -
Kaiser Permanente-Fremont
Fremont, California, United States Recruiting -
Palo Alto Medical Foundation-Fremont
Fremont, California, United States Recruiting -
Fresno Cancer Center
Fresno, California, United States Recruiting -
Kaiser Permanente-Fresno
Fresno, California, United States Recruiting -
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
Irvine, California, United States Recruiting -
Kaiser Permanente-Irvine
Irvine, California, United States Recruiting -
UC San Diego Moores Cancer Center
La Jolla, California, United States Recruiting -
The Angeles Clinic and Research Institute - West Los Angeles Office
Los Angeles, California, United States Recruiting -
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, United States Recruiting -
Cedars Sinai Medical Center
Los Angeles, California, United States Recruiting -
Fremont - Rideout Cancer Center
Marysville, California, United States Recruiting -
Memorial Medical Center
Modesto, California, United States Recruiting -
Kaiser Permanente-Modesto
Modesto, California, United States Recruiting -
Palo Alto Medical Foundation-Camino Division
Mountain View, California, United States Recruiting -
Kaiser Permanente Oakland-Broadway
Oakland, California, United States Recruiting -
Kaiser Permanente-Oakland
Oakland, California, United States Recruiting -
Kaiser Permanente-Ontario
Ontario, California, United States Recruiting -
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California, United States Recruiting -
Palo Alto Medical Foundation Health Care
Palo Alto, California, United States Recruiting -
Stanford Cancer Institute Palo Alto
Palo Alto, California, United States Recruiting -
VA Palo Alto Health Care System
Palo Alto, California, United States Recruiting -
Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, California, United States Recruiting -
Kaiser Permanente- Marshall Medical Offices
Redwood City, California, United States Recruiting -
Kaiser Permanente-Richmond
Richmond, California, United States Recruiting -
Mercy Cancer Center - Rocklin
Rocklin, California, United States Recruiting -
Rohnert Park Cancer Center
Rohnert Park, California, United States Recruiting -
Kaiser Permanente-Roseville
Roseville, California, United States Recruiting -
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California, United States Recruiting -
Sutter Roseville Medical Center
Roseville, California, United States Recruiting -
The Permanente Medical Group-Roseville Radiation Oncology
Roseville, California, United States Recruiting -
Kaiser Permanente Downtown Commons
Sacramento, California, United States Recruiting -
Mercy Cancer Center - Sacramento
Sacramento, California, United States Recruiting -
Sutter Medical Center Sacramento
Sacramento, California, United States Recruiting -
University of California Davis Comprehensive Cancer Center
Sacramento, California, United States Recruiting
+313 more sites. See ClinicalTrials.gov for the full list.
Study contacts
- Principal investigator: Paul M Harari — NRG Oncology
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
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Camonsertib added to precise radiation therapy for recurrent head and neck cancer
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.