Surgery and Radiation Therapy With or Without Interleukin-2 in Treating Patients With Cancer of the Mouth or Oropharynx
Conditions
Head and Neck Cancer
Conditions: official terms
Carcinoma, Squamous Cell - Head and Neck Neoplasms
Conditions: Keywords
stage II squamous cell carcinoma of the lip and oral cavity, stage III squamous cell carcinoma of the lip and oral cavity, stage IV squamous cell carcinoma of the lip and oral cavity, stage II squamous cell carcinoma of the oropharynx, stage III squamous cell carcinoma of the oropharynx, stage IV squamous cell carcinoma of the oropharynx, tongue cancer
Study Type
Interventional
Study Phase
Phase 3
Study Design
Allocation: Randomized, Primary Purpose: Treatment
Intervention
Name: aldesleukin Type: Biological
Name: adjuvant therapy Type: Procedure
Name: conventional surgery Type: Procedure
Name: neoadjuvant therapy Type: Procedure
Name: radiation therapy Type: Radiation
Overall Status
Recruiting
Summary
RATIONALE: Interleukin-2 may stimulate a person's white blood cells to kill cancer cells of the mouth or oropharynx. Radiation therapy uses high-energy x-rays to damage tumor cells. It is not known whether giving interleukin-2 with surgery and radiation therapy is more effective than surgery and radiation therapy alone.

PURPOSE: This randomized phase III trial is studying surgery and radiation therapy alone to see how well they work compared to surgery, radiation therapy, and interleukin-2 in treating patients with cancer of the mouth or oropharynx.
Detailed Description
OBJECTIVES:

- Compare the disease-free and overall survival in patients with previously untreated squamous cell carcinoma of the oral cavity or oropharynx treated with resection with or without and neoadjuvant and adjuvant perilymphatic interleukin-2 (IL-2) and radiotherapy.

- Compare the response rate in patients treated with these regimens.

- Determine the local and systemic effects of locoregional IL-2 on host-tumor interaction and immune properties in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to center and tumor stage (T2, N0-2 vs T2, N3 or T3-4, N0-3). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients undergo induction comprising interleukin-2 (IL-2) via perilymphatic injections to the ipsilateral myelohyoid muscle and insertion of the sternocleidomastoid muscle on days 1-5 and 8-12. Within 10 days after the last IL-2 injection, patients undergo en bloc resection of the primary tumor and corresponding lymphatic drainage area and pre-study margins. Beginning within 4 weeks after surgery, patients with T2, N0-3 disease but with pathohistological evidence of node invasion or capsular rupture of node metastasis or T3-4, N0-3 disease undergo adjuvant radiotherapy 5 days a week for 4.5-6.5 weeks. Beginning within 4 weeks after surgery or radiotherapy (if applicable), patients receive adjuvant IL-2 via perilymphatic injections to the contralateral myelohyoid muscle and insertion of the sternocleidomastoid muscle on days 1-5. Adjuvant IL-2 continues monthly for at least 1 year in the absence of disease progression.

- Arm II: Patients undergo resection and radiotherapy (if eligible) as in arm I. Patients are followed monthly for 1 year and then every 2 months for 2 years.

PROJECTED ACCRUAL: A total of 260 patients (130 per treatment arm) will be accrued for this study.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: 75 Years
Minimum Age: N/A
Gender: Both
Criteria: DISEASE CHARACTERISTICS:

- Histologically proven squamous cell carcinoma of the oral cavity or oropharynx

- Operable, primary, unilateral, stage T2-4, N0-3, M0 disease

- No high probability of bilateral lymphatic spread (requirement for bilateral neck dissection)

- No tumor involvement of the following sites:

- Pterygopalatine fossa

- Carotid artery

- Maxillary sinus

- Facial skin

- Anterior floor of the mouth

- Base of the tongue infiltrating more than 1 cm

- Measurable or evaluable disease by physical exam and/or noninvasive imaging

PATIENT CHARACTERISTICS:

Age:

- 75 and under

Performance status:

- ECOG 0-2 OR

- Karnofsky 70-100%

Life expectancy:

- More than 3 months

Hematopoietic:

- WBC at least 4,000/mm3

- Platelet count at least 60,000/mm3

- Hematocrit at least 30%

Hepatic:

- Bilirubin normal

- Hepatitis B surface antigen negative

Renal:

- Creatinine normal

Cardiovascular:

- No congestive heart failure

- No uncontrolled hypertension

- No coronary artery disease

- No serious arrhythmia

- No evidence of prior myocardial infarction on ECG (stress test required if in doubt)

Other:

- HIV negative

- No autoimmune disease

- No contraindications to pressor agents

- No serious infection requiring antibiotics

- No other concurrent primary malignancy

- Not pregnant or nursing

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- No prior or other concurrent immunotherapy

Chemotherapy:

- No prior or concurrent chemotherapy

Endocrine therapy:

- No prior or concurrent hormonal therapy

- No concurrent corticosteroids

Radiotherapy:

- No prior radiotherapy

Surgery:

- See Disease Characteristics

- No prior major organ allografts

Other:

- No other prior therapy

- No other concurrent investigational drugs, agents, or devices

- No concurrent nonsteroidal antiinflammatory drugs, ranitidine, cimetidine, or coumarin
Locations
Universita Degli Studi di Bari
Bari, Italy
Status: Recruiting
Contact: G. Cervellera, MD - 39-080-5478-660
Cattedra di Oncologia Medica - Universita degli Studi di Cagliari
Cagliari, Italy
Status: Recruiting
Contact: P. Puxeddu, MD - 39-070-5109-6253
Universita di Ferrara
Ferrara, Italy
Status: Recruiting
Contact: C. Calearo, MD - 39-0532-209-296 - ccv@dns.unife.it
Universita Degli Studi di Florence - Policlinico di Careggi
Florence, Italy
Status: Recruiting
Contact: O. Fini-Storchi, MD - 39-55-411739
Azienda Sanitaria Ospedaliera Ordine Mauriziano
Turin, Italy
Status: Recruiting
Contact: G. Forni, MD - 39-11-508-1111
Universita di Torino
Turin, Italy
Status: Recruiting
Contact: G. Valente, MD - 39-011-670-5955
Ospedale San Bortolo
Vicenza, Italy
Status: Recruiting
Contact: C. Curioni, MD - 39-444-993-906
Start Date
September 1992
Sponsors
European Institute of Oncology
Source
National Cancer Institute (NCI)
Record processing date
ClinicalTrials.gov processed this data on July 28, 2015
ClinicalTrials.gov page