Ontology highlight
ABSTRACT:
Patients and methods: A total of 223 patients (from 44 institutions) with locally advanced oral cavity or oropharynx cancer planned to be treated with definitive or postoperative intensity-modulated RT (IMRT; 60 to 72 Gy [≥ 50 Gy to two or more oral sites]) plus cisplatin (weekly or every 3 weeks) were randomly assigned to receive 30 mg (n = 73) or 90 mg (n = 76) of GC4419 or to receive placebo (n = 74) by 60-minute intravenous administration before each IMRT fraction. WHO grade of OM was assessed biweekly during IMRT and then weekly for up to 8 weeks after IMRT. The primary endpoint was duration of SOM tested for each active dose level versus placebo (intent-to-treat population, two-sided α of .05). The National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03, was used for adverse event grading.
Results: Baseline patient and tumor characteristics as well as treatment delivery were balanced. With 90 mg GC4419 versus placebo, SOM duration was significantly reduced (P = .024; median, 1.5 v 19 days). SOM incidence (43% v 65%; P = .009) and severity (grade 4 incidence, 16% v 30%; P = .045) also were improved. Intermediate improvements were seen with the 30-mg dose. Safety was comparable across arms, with no significant GC4419-specific toxicity nor increase of known toxicities of IMRT plus cisplatin. The 2-year follow-up for tumor outcomes is ongoing.
Conclusion: GC4419 at a dose of 90 mg produced a significant, clinically meaningful reduction of SOM duration, incidence, and severity with acceptable safety. A phase III trial (ROMAN; ClinicalTrials.gov identifier: NCT03689712) has begun.
SUBMITTER: Anderson CM
PROVIDER: S-EPMC6881100 | biostudies-literature | 2019 Dec
REPOSITORIES: biostudies-literature
Anderson Carryn M CM Lee Christopher M CM Saunders Deborah P DP Curtis Amarinthia A Dunlap Neal N Nangia Chaitali C Lee Arielle S AS Gordon Sharon M SM Kovoor Philip P Arevalo-Araujo Roberto R Bar-Ad Voichita V Peddada Abhinand A Colvett Kyle K Miller Douglas D Jain Anshu K AK Wheeler James J Blakaj Dukagjin D Bonomi Marcelo M Agarwala Sanjiv S SS Garg Madhur M Worden Francis F Holmlund Jon J Brill Jeffrey M JM Downs Matt M Sonis Stephen T ST Katz Sanford S Buatti John M JM
Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20191016 34
<h4>Purpose</h4>Oral mucositis (OM) remains a common, debilitating toxicity of radiation therapy (RT) for head and neck cancer. The goal of this phase IIb, multi-institutional, randomized, double-blind trial was to compare the efficacy and safety of GC4419, a superoxide dismutase mimetic, with placebo to reduce the duration, incidence, and severity of severe OM (SOM).<h4>Patients and methods</h4>A total of 223 patients (from 44 institutions) with locally advanced oral cavity or oropharynx cancer ...[more]