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    Clinical Trial Results:
    International Randomized Study to Evaluate the Addition of Docetaxel to the Combination of Cisplatin-5-fluorouracil (TCF) vs. Cisplatin-5-fluorouracil (CF) in the Induction Treatment of Nasopharyngeal Carcinoma (NPC) in Children and Adolescents

    Summary
    EudraCT number
    2007-001211-33
    Trial protocol
    ES   GR   FR   IT   DE   Outside EU/EEA  
    Global end of trial date
    24 Apr 2012

    Results information
    Results version number
    v1(current)
    This version publication date
    01 Apr 2016
    First version publication date
    23 Jul 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    EFC10339
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00565448
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Sanofi Aventis Recherche & Developpement
    Sponsor organisation address
    1 Avenue PIerre Brossolette, Chilly Mazarin, France, 91380
    Public contact
    Trial Transparency Team, Sanofi Aventis Recherche & Developpement, Contact-US@sanofi.com
    Scientific contact
    Trial Transparency Team, Sanofi Aventis Recherche & Developpement, Contact-US@sanofi.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000029-PIP01-07
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 May 2012
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Apr 2012
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To estimate the complete response rate of docetaxel to the combination of cisplatin-5-fluorouracil (TCF) compared to cisplatin-5-fluorouracil (CF) in the Induction treatment of nasopharyngeal carcinoma (NPC).
    Protection of trial subjects
    Pediatric Subjects: The study was conducted by investigators experienced in the treatment of pediatric subjects. The parent(s) or guardian(s) as well as the children were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time. In addition to the consent form for the parent(s)/guardian(s), an assent form in child-appropriate language was provided and explained to the child. Repeated invasive procedures were minimized. The number of blood samples as well as the amount of blood drawn were adjusted according to age and weight. A topical anesthesia may have been used to minimize distress and discomfort. Adult Subjects: Subjects were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time in language and terms appropriate for the subject and considering the local culture. During the course of the trial, subjects were provided with individual subject cards indicating the nature of the trial the subject is participating, contact details and any information needed in the event of a medical emergency. Collected personal data and human biological samples were processed in compliance with the Sanofi-Aventis Group Personal Data Protection Charter ensuring that the Group abides by the laws governing personal data protection in force in all countries in which it operates.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    22 Nov 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 1
    Country: Number of subjects enrolled
    Italy: 5
    Country: Number of subjects enrolled
    Algeria: 1
    Country: Number of subjects enrolled
    Brazil: 4
    Country: Number of subjects enrolled
    China: 4
    Country: Number of subjects enrolled
    India: 5
    Country: Number of subjects enrolled
    Indonesia: 2
    Country: Number of subjects enrolled
    Korea, Republic of: 4
    Country: Number of subjects enrolled
    Mexico: 1
    Country: Number of subjects enrolled
    Morocco: 16
    Country: Number of subjects enrolled
    Philippines: 4
    Country: Number of subjects enrolled
    Thailand: 3
    Country: Number of subjects enrolled
    Tunisia: 10
    Country: Number of subjects enrolled
    Turkey: 15
    Worldwide total number of subjects
    75
    EEA total number of subjects
    6
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    5
    Adolescents (12-17 years)
    56
    Adults (18-64 years)
    14
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects were enrolled from November 2007 until October 2008. The study was conducted at 26 centers in 14 countries.

    Pre-assignment
    Screening details
    Screening occurred the week prior to induction.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Docetaxel /Cisplatin/5-FU
    Arm description
    Docetaxel 75 mg/m² in combination with Cisplatin 75 mg/m² on Day 1 and 5-Fluorouracil 750 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Docetaxel
    Investigational medicinal product code
    XRP6976
    Other name
    Taxotere
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Docetaxel intravenous (IV) infusion over 1 hour.

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cisplatin IV infusion over 6 hours.

    Investigational medicinal product name
    5-Fluorouracil
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    5-Fluorouracil IV continuous infusion.

    Arm title
    Cisplatin/5-FU
    Arm description
    Cisplatin 80 mg/m² on Day 1 and 5-Fluorouracil 1000 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.
    Arm type
    Active comparator

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cisplatin IV infusion over 6 hours.

    Investigational medicinal product name
    5-Fluorouracil
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    5-Fluorouracil IV continuous infusion.

    Number of subjects in period 1
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU
    Started
    50
    25
    Completed
    47
    23
    Not completed
    3
    2
         Disease progression
    1
    -
         Adverse event
    1
    2
         Withdrawal by Subject
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Docetaxel /Cisplatin/5-FU
    Reporting group description
    Docetaxel 75 mg/m² in combination with Cisplatin 75 mg/m² on Day 1 and 5-Fluorouracil 750 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.

    Reporting group title
    Cisplatin/5-FU
    Reporting group description
    Cisplatin 80 mg/m² on Day 1 and 5-Fluorouracil 1000 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.

    Reporting group values
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU Total
    Number of subjects
    50 25 75
    Age categorical
    Units: Subjects
        Infants from 28 days to 23 months
    0 0 0
        Children from 2 years to <12 years
    4 1 5
        Adolescents from 12 years to <16 years
    20 10 30
        Adolescents >=16
    26 14 40
    Age continuous
    Units: years
        median (full range (min-max))
    16 (9 to 21) 16 (9 to 21) -
    Gender categorical
    Units: Subjects
        Female
    15 6 21
        Male
    35 19 54

    End points

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    End points reporting groups
    Reporting group title
    Docetaxel /Cisplatin/5-FU
    Reporting group description
    Docetaxel 75 mg/m² in combination with Cisplatin 75 mg/m² on Day 1 and 5-Fluorouracil 750 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.

    Reporting group title
    Cisplatin/5-FU
    Reporting group description
    Cisplatin 80 mg/m² on Day 1 and 5-Fluorouracil 1000 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.

    Primary: Number of Subjects With Complete Response (CR)

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    End point title
    Number of Subjects With Complete Response (CR)
    End point description
    CR assessed by independent reviewers, according to the Modified Response Evaluation Criteria in Solid Tumors (RECIST) from the National Cancer Institute (NCI). Disease response evaluated after the completion of the induction treatment and prior to the radiation treatment. CR defined as the complete disappearance of the target and non-target lesion(s) identified at baseline after radiological evaluation by Magnetic Resonance Imaging (MRI) only. ITT population: all randomized subjects.
    End point type
    Primary
    End point timeframe
    after the completion of the induction treatment (up to 9 weeks)
    End point values
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU
    Number of subjects analysed
    50
    25
    Units: subjects
    1
    0
    Statistical analysis title
    Docetaxel /Cisplatin/5-FU vs Cisplatin/5-FU
    Statistical analysis description
    The Fisher’s exact test was used to compare the CR proportions.
    Comparison groups
    Docetaxel /Cisplatin/5-FU v Cisplatin/5-FU
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 1 [1]
    Method
    Fisher exact
    Confidence interval
    Notes
    [1] - There was no formal power calculation. A selection design was used to determine how many subjects would be accrued to correctly select the treatment group with the best CR rate with 80% probability.

    Secondary: Docetaxel Area Under the Plasma Concentration-time Curve (AUC) in the Docetaxel/Cisplatin/5-FU Group

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    End point title
    Docetaxel Area Under the Plasma Concentration-time Curve (AUC) in the Docetaxel/Cisplatin/5-FU Group [2]
    End point description
    AUC estimated by Bayesian method using concentration–time data for each subject and the previously defined adult population model as prior information (with validity of the estimation verified). Subjects who were randomized to docetaxel/cisplatin/5-FU and had evaluable docetaxel pharmacokinetic (PK) sample.
    End point type
    Secondary
    End point timeframe
    Three plasma samples: one just before then 45 minutes and 5 hour after the end of cycle 1 infusion
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Since the analysis was related to docetaxel AUC, only arm receiving docetaxel was selected.
    End point values
    Docetaxel /Cisplatin/5-FU
    Number of subjects analysed
    26
    Units: µg*h/mL
        arithmetic mean (standard deviation)
    3.43 ( 2.05 )
    No statistical analyses for this end point

    Secondary: Overall Response (OR)

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    End point title
    Overall Response (OR)
    End point description
    OR was classified as CR, partial response (PR), stable disease (SD), progressive disease (PD) or Unknown on completion of both induction and radiation treatment and assessed according to the Modified RECIST from the NCI. CR was defined as the disappearance of all target lesions (TLs) and non-TLs. PR was defined as ≥30% decrease in the sum of the longest diameters (LD) of TLs, taking as reference the disease measurement done at study entry. PD was defined as ≥20% increase in the sum of the LD of TLs, taking as a reference the smallest disease measurement recorded at study entry or the appearance of ≥1 new lesions or unequivocal progression of non-TLs. SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. ITT population: all randomized subjects.
    End point type
    Secondary
    End point timeframe
    after the completion of the consolidation treatment (up to 18 weeks)
    End point values
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU
    Number of subjects analysed
    50
    25
    Units: subjects
        CR
    1
    1
        PR
    43
    20
        SD
    2
    1
        PD
    2
    0
        Unknown
    0
    0
        Missing
    2
    3
    No statistical analyses for this end point

    Secondary: Overall Survival (OS) Rate

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    End point title
    Overall Survival (OS) Rate
    End point description
    OS rate was the percentage of subjects who survived 3 years after completion of consolidation treatment period. The Kaplan-Meier method was used to estimate OS rate. ITT population: all randomized subjects.
    End point type
    Secondary
    End point timeframe
    3 years after the end of the consolidation treatment period (up to 40 months from randomization)
    End point values
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU
    Number of subjects analysed
    50
    25
    Units: percentage of subjects
        number (confidence interval 95%)
    85.7 (75.9 to 95.5)
    78 (60.8 to 95.1)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All Adverse Events (AE) were collected from signature of the informed consent form up to the final visit regardless of seriousness or relationship to investigational product.
    Adverse event reporting additional description
    Reported AEs and deaths are treatment-emergent that is AEs that developed/worsened and death that occurred during the ‘on treatment period’ (from first dose up 30 days after administration of the last cycle [maximum cycle 3]). Safety population: all subjects who received at least one cycle of any component of the study drug combination.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11.1
    Reporting groups
    Reporting group title
    Docetaxel /Cisplatin/5-FU
    Reporting group description
    Docetaxel 75 mg/m² in combination with Cisplatin 75 mg/m² on Day 1 and 5-Fluorouracil 750 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.

    Reporting group title
    Cisplatin/5-FU
    Reporting group description
    Cisplatin 80 mg/m² on Day 1 and 5-Fluorouracil 1000 mg/m²/day on Days 1 to 4 every 3 weeks as induction therapy. Consolidation treatment: radiation therapy for 7-8 weeks and 3 cycles of cisplatin 100 mg/m² every 3 weeks.

    Serious adverse events
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU
    Total subjects affected by serious adverse events
         subjects affected / exposed
    20 / 50 (40.00%)
    11 / 25 (44.00%)
         number of deaths (all causes)
    0
    1
         number of deaths resulting from adverse events
    Investigations
    Alanine Aminotransferase Increased
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspartate Aminotransferase Increased
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood Creatinine Increased
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoglobin Decreased
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Tumour Haemorrhage
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Ataxia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Convulsion
         subjects affected / exposed
    1 / 50 (2.00%)
    2 / 25 (8.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Bone Marrow Failure
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile Bone Marrow Aplasia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Febrile Neutropenia
         subjects affected / exposed
    5 / 50 (10.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    7 / 7
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia/Neutrophil Count
         subjects affected / exposed
    4 / 50 (8.00%)
    2 / 25 (8.00%)
         occurrences causally related to treatment / all
    4 / 4
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    2 / 50 (4.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    2 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mallory-Weiss Syndrome
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Proctalgia
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    2 / 50 (4.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    3 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    2 / 50 (4.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute Prerenal Failure
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Central Line Infection
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic Infection
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngitis Bacterial
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Postoperative Wound Infection
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic Shock
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences causally related to treatment / all
    3 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypomagnesaemia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 25 (4.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Docetaxel /Cisplatin/5-FU Cisplatin/5-FU
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    49 / 50 (98.00%)
    23 / 25 (92.00%)
    Vascular disorders
    Phlebitis
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences all number
    12
    0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    5 / 50 (10.00%)
    0 / 25 (0.00%)
         occurrences all number
    9
    0
    Fatigue
         subjects affected / exposed
    8 / 50 (16.00%)
    1 / 25 (4.00%)
         occurrences all number
    17
    1
    Mucosal Inflammation
         subjects affected / exposed
    5 / 50 (10.00%)
    3 / 25 (12.00%)
         occurrences all number
    8
    7
    Pyrexia
         subjects affected / exposed
    11 / 50 (22.00%)
    5 / 25 (20.00%)
         occurrences all number
    15
    8
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    4 / 50 (8.00%)
    0 / 25 (0.00%)
         occurrences all number
    5
    0
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    5 / 50 (10.00%)
    0 / 25 (0.00%)
         occurrences all number
    10
    0
    Epistaxis
         subjects affected / exposed
    8 / 50 (16.00%)
    0 / 25 (0.00%)
         occurrences all number
    12
    0
    Oropharyngeal Pain
         subjects affected / exposed
    4 / 50 (8.00%)
    0 / 25 (0.00%)
         occurrences all number
    11
    0
    Pharyngeal Inflammation
         subjects affected / exposed
    3 / 50 (6.00%)
    4 / 25 (16.00%)
         occurrences all number
    8
    5
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    4 / 50 (8.00%)
    0 / 25 (0.00%)
         occurrences all number
    10
    0
    Depression
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences all number
    7
    0
    Investigations
    Alanine Aminotransferase Increased
         subjects affected / exposed
    3 / 50 (6.00%)
    1 / 25 (4.00%)
         occurrences all number
    12
    1
    Aspartate Aminotransferase Increased
         subjects affected / exposed
    4 / 50 (8.00%)
    1 / 25 (4.00%)
         occurrences all number
    9
    1
    Platelet Count Decreased
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences all number
    3
    0
    Weight Decreased
         subjects affected / exposed
    20 / 50 (40.00%)
    8 / 25 (32.00%)
         occurrences all number
    57
    27
    Weight Increased
         subjects affected / exposed
    4 / 50 (8.00%)
    1 / 25 (4.00%)
         occurrences all number
    18
    2
    White Blood Cell Count Decreased
         subjects affected / exposed
    7 / 50 (14.00%)
    2 / 25 (8.00%)
         occurrences all number
    25
    3
    Injury, poisoning and procedural complications
    Overdose
         subjects affected / exposed
    2 / 50 (4.00%)
    2 / 25 (8.00%)
         occurrences all number
    3
    4
    Radiation Skin Injury
         subjects affected / exposed
    11 / 50 (22.00%)
    1 / 25 (4.00%)
         occurrences all number
    22
    3
    Thermal Burn
         subjects affected / exposed
    5 / 50 (10.00%)
    2 / 25 (8.00%)
         occurrences all number
    12
    3
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    4 / 50 (8.00%)
    0 / 25 (0.00%)
         occurrences all number
    13
    0
    Headache
         subjects affected / exposed
    8 / 50 (16.00%)
    1 / 25 (4.00%)
         occurrences all number
    9
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    14 / 50 (28.00%)
    3 / 25 (12.00%)
         occurrences all number
    58
    4
    Bone Marrow Failure
         subjects affected / exposed
    3 / 50 (6.00%)
    1 / 25 (4.00%)
         occurrences all number
    10
    2
    Leukopenia
         subjects affected / exposed
    6 / 50 (12.00%)
    1 / 25 (4.00%)
         occurrences all number
    18
    3
    Lymphopenia
         subjects affected / exposed
    6 / 50 (12.00%)
    0 / 25 (0.00%)
         occurrences all number
    26
    0
    Neutropenia/Neutrophil Count
         subjects affected / exposed
    20 / 50 (40.00%)
    7 / 25 (28.00%)
         occurrences all number
    49
    16
    Thrombocytopenia
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences all number
    3
    0
    Ear and labyrinth disorders
    Ototoxicity
         subjects affected / exposed
    7 / 50 (14.00%)
    6 / 25 (24.00%)
         occurrences all number
    27
    20
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    10 / 50 (20.00%)
    3 / 25 (12.00%)
         occurrences all number
    13
    5
    Abdominal Pain Upper
         subjects affected / exposed
    11 / 50 (22.00%)
    2 / 25 (8.00%)
         occurrences all number
    14
    2
    Constipation
         subjects affected / exposed
    7 / 50 (14.00%)
    0 / 25 (0.00%)
         occurrences all number
    13
    0
    Diarrhoea
         subjects affected / exposed
    15 / 50 (30.00%)
    3 / 25 (12.00%)
         occurrences all number
    21
    4
    Dry Mouth
         subjects affected / exposed
    9 / 50 (18.00%)
    5 / 25 (20.00%)
         occurrences all number
    26
    13
    Dyspepsia
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences all number
    5
    0
    Dysphagia
         subjects affected / exposed
    12 / 50 (24.00%)
    7 / 25 (28.00%)
         occurrences all number
    31
    19
    Nausea
         subjects affected / exposed
    33 / 50 (66.00%)
    10 / 25 (40.00%)
         occurrences all number
    126
    28
    Odynophagia
         subjects affected / exposed
    3 / 50 (6.00%)
    1 / 25 (4.00%)
         occurrences all number
    4
    1
    Salivary Hypersecretion
         subjects affected / exposed
    3 / 50 (6.00%)
    0 / 25 (0.00%)
         occurrences all number
    7
    0
    Stomatitis
         subjects affected / exposed
    30 / 50 (60.00%)
    5 / 25 (20.00%)
         occurrences all number
    65
    12
    Vomiting
         subjects affected / exposed
    47 / 50 (94.00%)
    21 / 25 (84.00%)
         occurrences all number
    189
    78
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    29 / 50 (58.00%)
    1 / 25 (4.00%)
         occurrences all number
    169
    4
    Dermatitis
         subjects affected / exposed
    7 / 50 (14.00%)
    4 / 25 (16.00%)
         occurrences all number
    12
    11
    Rash
         subjects affected / exposed
    4 / 50 (8.00%)
    0 / 25 (0.00%)
         occurrences all number
    5
    0
    Skin Hyperpigmentation
         subjects affected / exposed
    5 / 50 (10.00%)
    3 / 25 (12.00%)
         occurrences all number
    10
    6
    Renal and urinary disorders
    Nephropathy Toxic
         subjects affected / exposed
    4 / 50 (8.00%)
    0 / 25 (0.00%)
         occurrences all number
    7
    0
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    0 / 50 (0.00%)
    2 / 25 (8.00%)
         occurrences all number
    0
    2
    Infections and infestations
    Folliculitis
         subjects affected / exposed
    5 / 50 (10.00%)
    0 / 25 (0.00%)
         occurrences all number
    17
    0
    Oral Candidiasis
         subjects affected / exposed
    8 / 50 (16.00%)
    0 / 25 (0.00%)
         occurrences all number
    15
    0
    Sinusitis
         subjects affected / exposed
    2 / 50 (4.00%)
    3 / 25 (12.00%)
         occurrences all number
    2
    3
    Upper Respiratory Tract Infection
         subjects affected / exposed
    3 / 50 (6.00%)
    2 / 25 (8.00%)
         occurrences all number
    8
    9
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    21 / 50 (42.00%)
    5 / 25 (20.00%)
         occurrences all number
    49
    13
    Hypocalcaemia
         subjects affected / exposed
    4 / 50 (8.00%)
    1 / 25 (4.00%)
         occurrences all number
    5
    1
    Hypokalaemia
         subjects affected / exposed
    6 / 50 (12.00%)
    1 / 25 (4.00%)
         occurrences all number
    8
    1
    Hypomagnesaemia
         subjects affected / exposed
    6 / 50 (12.00%)
    0 / 25 (0.00%)
         occurrences all number
    11
    0
    Hyponatraemia
         subjects affected / exposed
    6 / 50 (12.00%)
    0 / 25 (0.00%)
         occurrences all number
    7
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Jul 2007
    - Changed the total number of subjects to be randomized from 51 to 72. - Modified inclusion criteria to include subjects ≤21 years of age. - Revised Sections 7, 9, and 12 to clarify study procedures.
    14 Nov 2007
    - Added regular cardiac surveillance during each visit for administration of chemotherapies that included vital signs as: heart rate, blood pressure and electrocardiogram (ECG) as medically indicated to now mandatory clinical examinations at induction phase and reflected in Study Flowchart. - Added the following exclusion criterion: “Hypersensitivity to one of the drugs or their excipients”. - Made administrative changes to reflect changes in study personnel.
    03 Dec 2007
    - Revised the radiation rules for consolidation therapy. - Clarified inclusion criterion on age required for study entry to >1 month to ≤21 years of age at the time of diagnosis. - Added a description of how to calculate glomerular filtration rate (GFR). - Revised hydration regimen by allowing magnesium sulfate (MgSO4). - Clarified that the RECIST criteria used for CR evaluation were modified by employing volumetric assessment of the primary NPC tumor and associated adenopathy. - Clarified that the MRI scan required at screening was to the head and neck area. - Added computed tomography (CT)/MRI scan of chest, abdomen and/or pelvis as well as a bone scan if the presence of distant metastases was suspected. - Added hematology and biochemistry analyses at the screening visit to serve as baseline and removed the requirement for these tests prior to Cycle 1. - Added recommendations regarding audiology, oral, and dental examinations. - Clarified times of disease assessment. - Increased the number of PK samples from 20 to 25. - Introduced the potential analysis of response based on disease staging. - Revised study flow chart.
    28 Oct 2010
    The reason for this amendment was to clarify study procedures as it relates to safety reporting and study treatment.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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