Efficacy and Safety Study of Leukocyte Interleukin,Injection (LI) to Treat Cancer of the Oral Cavity (IT-MATTERS)

CEL-SCI

Status and phase: Completed; Phase 3

Conditions: Squamous Cell Carcinoma of the Oral Cavity; Squamous Cell Carcinoma of the Soft Palate

Treatments: Drug: Indomethacin; Drug: Cyclophosphamide; Radiation: Radiotherapy; Biological: LI; Procedure: Surgery; Drug: Cisplatin; Dietary Supplement: Zinc

Study type: Interventional

Funder types: Industry

Identifiers

NCT01265849

2010-019952-35 (EudraCT Number)

CS001P3

Details and patient eligibility

About

The purpose of this study was to determine whether LI administered in combination with cyclophosphamide, indomethacin and zinc in a multivitamin (CIZ) combination prior to standard of care therapy (surgery followed by radiotherapy or concurrent radiochemotherapy) is safe and will increase the overall survival of subjects with previously untreated locally advanced primary squamous cell carcinoma of the oral cavity or soft palate at a median of 3 to 5 years

Full description

Head and neck carcinomas constitute about 5% of all cancers annually worldwide. In the US there are about 65,000 new cases annually. Ninety percent are squamous cell carcinoma of the head and neck (SCCHN). Approximately 2/3 of SCCHN patients present on their first visit with locally advanced disease. The median 3 year overall survival (OS) for these patients with existing standard of care (SOC) therapies - surgery followed by radiotherapy or concurrent radiochemotherapy - is estimated to be between 52 and 55%; the 5 year OS is approximately 43%. There are clearly many of SCCHN patients not well served by available modalities.

Regional intra or perilymphatic and/or intratumoral or peritumoral low dose cytokine therapy may have important therapeutic effects in SCCHN patients and constitute an additional anti-tumor mechanism of action different and distinct from current SOC. Leukocyte Interleukin Injection (LI) [Multikine] contains a defined mixture of naturally derived cytokines and chemokines with demonstrated safety and immunomodulatory activity in animals and in man in Phase I and Phase II clinical trials. LI is administered prior to SOC and in combination with low non-chemotherapeutic doses of cyclophosphamide, indomethacin, and zinc (CIZ) in studies with LI. The results of these studies indicate that the local/regional injection of mixed interleukins (LI) with CIZ prior to SOC can overcome local immunosuppression, break tumor tolerance to tumor antigens and allow for a sustainable and effective anti-tumor immune response.

LI was tested in this large, global, multinational Phase III clinical trial to develop definitive proof of its efficacy and safety in treating SCCHN. The trial is an open-label randomized multi-center controlled study of LI + CIZ + SOC in subjects with advanced primary SCCHN of the oral cavity/soft palate vs. SOC [the comparator arm]. OS is the primary efficacy endpoint.

Enrollment: 928 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (main):

• Untreated SCCHN of oral cavity (anterior tongue, floor of mouth, cheek)/soft palate, categories T1N1-2M0,T2N1-2M0,T3N0-2M0,T4N0-2M0 (T4 allowed only if invasion of mandible is negligible i. e. 5mm or less) scheduled for SOC
• Primary tumor and any positive node(s) measurable in 2 dimensions
• Normal immune function
• No immunosuppressives with 1 year of entry
• KPS>70/100
• Age>18
• Male or Female (non-pregnant)
• Life expectancy >6 months
• Able to take oral medication
• Able to provide informed consent

Exclusion Criteria (main):

• Subjects to be treated with other than SOC
• Tumor invasion of bone (also see inclusion criteria)
• Tumor classifications T1N0, T2N0, T4N3, any TN classification with M1
• Tumors in locations other than those specified in inclusion criteria
• Active peptic ulcer (or on full-dose therapeutic anti-coagulants)
• Prior resection of jugular nodes ipsilateral to tumor
• Acute or chronic viral, bacterial immune or other disease associated with abnormal immune function
• Subjects on hemodialysis or peritoneal dialysis; or having a history of
• History of asthma, allergy to fluoroquinolone antibiotics, congestive heart failure, or on hemodialysis or peritoneal dialysis
• Any condition that in the opinion of the investigator would cause the subject to be unable to participate or tolerate the protocol regimen
• Failure to meet inclusion criteria

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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928 participants in 3 patient groups

LI + CIZ + SOC

Experimental group

Description:

LI plus CIZ (cyclophosphamide, indomethacin and zinc-multivitamins) was given as neoadjuvant therapy prior to standard of care (SOC).

Treatment:

Procedure: Surgery

Dietary Supplement: Zinc

Biological: LI

Radiation: Radiotherapy

Drug: Cisplatin

Drug: Indomethacin

Drug: Cyclophosphamide

Standard of Care (SOC) only

Active Comparator group

Description:

SOC for previously untreated SCCHN patients is currently surgery (with curative intent) followed by either radiotherapy or combined radiochemotherapy depending on the patient's risk status for recurrence as determined at surgery.

Treatment:

Procedure: Surgery

Radiation: Radiotherapy

Drug: Cisplatin

LI + SOC

Experimental group

Description:

LI was administered without CIZ to determine the contribution of CIZ to the effects of LI.

Treatment:

Procedure: Surgery

Biological: LI

Radiation: Radiotherapy

Drug: Cisplatin