EBV Positive Nasopharyngeal Carcinoma Treated With Concurrent Chemo-radiotherapy With or Without Anti-Viral Drug

Kuwait Cancer Control Center

Status and phase: Unknown; Phase 3

Conditions: Drug Use for Unapproved Schedule

Treatments: Combination Product: Radiotherapy and chemotherapy; Drug: Acyclovir 800 MG

Study type: Interventional

Funder types: Other

Identifiers

NCT03656965

RODKCCC

Details and patient eligibility

About

PCR-DNA of EBV test is a good prognostic indicator for survival after treatment (report: Prognostic Impact of Plasma, Epstein-Barr Virus DNA in Patients with Nasopharyngeal Carcinoma Treated using Intensity-Modulated Radiation Therapy.

The chances of the local recurrence or metastasis are higher in the patients at same stage with positive PCR-DNA of EBV in Nasopharyngeal carcinoma after same treatment.(ref.) Antiviral drugs have been used to inhibit EBV replication and target viral DNA polymerase are Foscarnet and phosphonoacetic acid both interact directly with the pyrophosphate-binding site of the enzyme, where Acyclovir as antiviral drug act at two levels: as competitive alternative substrates, competing with GTP on the substrate-binding site, and as DNA chain terminators, by incorporating into the growing DNA chain and blocking its elongation due to their acyclic structure.

Enrollment: 50 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Confirmed histopathologic diagnosis of nasopharyngeal squamous cell carcinoma, types WHO II-III.
• Stage II-IVB
• Requiring primary concomitant Radiotherapy and Chemotherapy.
• No head and neck surgery of the primary tumor or lymph nodes except for incisional or excisional biopsies.
• Positive PCR-DNA EBV
• ≥ 18 years of age
• ECOG performance status 0-1
• WBC ≥ 4,000/µl, platelets ≥ 100,000/µl; serum creatinine ≤ 1.6 mg/dl or 24 hr. calculated creatinine clearance ≥ 60 ml/min (see Section 3.1.6).
• Pre-treatment evaluation of tumor extent and tumor measurement.
• Nutritional and general physical condition must be considered compatible with the proposed radio-therapeutic treatment.
• Signed study-specific consent form prior to study entry Assessment.

Exclusion criteria

• Prior radiotherapy to the head and neck or any prior chemotherapy ≤ 6 months prior to study entry.
• Other malignancy except non-melanoma skin cancer or a carcinoma not of head and neck origin ≤ 5 years
• Evidence of distant metastasis.
• on any experimental therapeutic cancer treatment.
• major medical or psychiatric illness.
• pregnant females.
• Age ≤ 18 years old

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups

Antiviral Drug with Chemoradiotherapy

Experimental group

Description:

Antiviral therapy Acyclovir 800 mg per day during the whole course of treatment.

Treatment:

Combination Product: Radiotherapy and chemotherapy

Drug: Acyclovir 800 MG

Chemoradiotherapy

Other group

Description:

Patients will receive concurrent chemoradiotherapy which consisted of Cisplatin 40 mg/m2 weekly or 100mg/m2 every 3 weeks with IMRT 70Gy/35 fractions.

Treatment:

Combination Product: Radiotherapy and chemotherapy