A Multicenter, Randomised 2*2 Factorial Design Comparing Standard to Reduced-target Volume Radiotherapy With or Without All-trans Retinoic Acid (ATRA) in Patients With Lateralised Oropharyngeal, Laryngeal and Hypopharyngeal Squamous Cell Carcinoma.
The aim of this study is to investigate the effect of ATRA (Vesanoid) and the effect of tailored radiotherapy in patients with squamous cell carcinoma of the oropharynx, larynx or hypopharynx.
⁃ I1. Male or female patients aged ≥ 18 years old at time of inform consent signature.
⁃ I2. Patients with primary head and neck tumour up to, but not crossing the midline, previously untreated with histologically-confirmed squamous cell carcinoma of:
• the oropharynx p16-, larynx or hypopharynx : T1/N2a-N2b, T2/N0-N2b, T3/N0-N2b (UICC 8th Ed.), or
• the oropharynx p16+ : T1/N1 (multiple nodes), T2-T3/N0-N1 (UICC 8th Ed.).
⁃ I3. Patients with lymph node staging assessed by an FDG-PET/CT with no contralateral nodal uptake.
⁃ I4. Patients amenable to treatment with RT or concomitant chemo-radiotherapy as decided by the treating physician as a function of tumor stage, tumor location, performance of the patients.
⁃ I5. Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1.
⁃ I6. Adequate hematologic and end-organ function, defined by the following laboratory test results obtained within 7 days prior to randomisation :
⁃ Hematological (without transfusion within 2 weeks) :
• Neutrophils count \> 1.5 × 109 /L
• Platelets count \> 75 × 109 /L
• WBC≥ 3.0 × 109 /L
⁃ Hepatic function :
• Total Bilirubin \< 1.5 × ULN (except for Gilbert's syndrome which will allow bilirubin ≤ 3 ULN).
• Alanine aminotransferase (ALT) ≤ 2.5 × ULN.
• Aspartate aminotransferase (AST) ≤ 2.5 × ULN.
• Albumin \>3.0g/dL
⁃ Renal function :
• Serum creatinine \< 1.5 ×ULN.
⁃ I7. QTcF ≤450ms for men and 470ms for women, from 3 electrocardiograms on screening ECG, within 7 days prior randomisation.
⁃ I8. Women patients of child-bearing potential are eligible, provided they have a negative serum or urine pregnancy test within 7 days prior randomisation, and agrees to use adequate contraception for up to 1 month after the end of study treatments.
⁃ I9. Fertile men must agree to use an effective method of contraception during the study and for up to 1 month after the end of study treatments.
⁃ I10. Patient should understand, sign, and date the written voluntary informed consent form prior to any protocol-specific procedures performed and should be able and willing to comply with study visits and procedures as per protocol.
⁃ I11. Patients must be covered by a medical insurance in country where applicable.