Head and Neck Cancer Study Project in the Geriatric Population
Brown University
Summary
This is a study conducted in patients with a diagnosis of stage IB-IVA squamous cell carcinoma of the head and neck. Patients will have a comprehensive geriatric assessment (CGA) as part of standard assessments. The patients classified as frail, with a CGA score of 3-5, will then be treated with a novel reduced intensity regimen. The regimen will be tailored based on the programmed cell death ligand 1 combined positive score (PD-L1 CPS) and will involve 4 cycles of systemic chemotherapy and/or immunotherapy followed by radiation treatment.
Description
See above summary.
Eligibility
- Age range
- 65+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Patients must have the following * Pathology confirmed squamous cell carcinoma of the head and neck (unknown primary is excluded). * Confirmed stage of disease between IB and IVA, based on imaging studies. * CGA score of 3-5 * Evaluation by medical oncology and radiation oncology. * Patients in the experimental group must be eligible for systemic treatment with chemoimmunotherapy followed by radiation treatment as determined by the geriatric oncology team. * Age ≥ 65 years. * ECOG performance status ≤ 2 * Adequate organ and marrow function as defined below: Absolute neu…
Interventions
- DrugArm I Carboplatin, Paclitaxel, Pembrolizumab
Carboplatin, AUC 5, day 1 of each cycle, each cycle every 21 days for 4 cycles Paclitaxel, 175 mg/m2, day 1 of each cycle, each cycle every 21 days for 4 cycles Pembrolizumab, 200 mg, day 1 of each cycle, each cycle every 21 days for 4 cycles Radiation Therapy 30Gy 1 week
- DrugArm II Carboplatin, Paclitaxel, Cetuximab
Carboplatin, AUC 5, day 1 of each cycle, each cycle every 21 days for 4 cycles Paclitaxel, 175 mg/m2, day 1 of each cycle, each cycle every 21 days for 4 cycles Cetuximab 400 mg/m2, day 1 of the first cycle and then 250 mg/m2 days 1, 8, 15 every 21 days for 4 cycles Radiation Therapy 30Gy 1 week
- DrugArm III Pembrolizumab
Pembrolizumab, 200 mg, day 1 of each cycle, each cycle every 21 days for 4 cycles Radiation Therapy 30Gy 1 week
Location
- Rhode Island and The Miriam HospitalsProvidence, Rhode Island