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Phase II Trial of Nab-Paclitaxel, Cisplatin, and 5-FU (ACF) as Induction Therapy Followed by Definitive Concurrent Chemoradiation for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (HNSCC)

Phase 2
18 Years
Open (Enrolling)
Head and Neck Neoplasms

Thank you

Trial Information

Phase II Trial of Nab-Paclitaxel, Cisplatin, and 5-FU (ACF) as Induction Therapy Followed by Definitive Concurrent Chemoradiation for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (HNSCC)

Inclusion Criteria:

- Patient must have selected stage III or IVa/b head and neck squamous cell carcinoma
(HNSCC); all patients must have T2-T4 primary tumors; (patients with T1 tumors will
be excluded); although most of these patients will have regional nodal disease,
patients with no nodal disease will also be eligible

- Patient must have disease at the oropharynx, hypopharynx, larynx, or oral cavity

- Patient must have measurable disease defined as lesions that can be accurately
measured in at least one dimension (longest diameter to be recorded) as >= 10 mm with
CT scan

- Patient must be >= 18 years of age.

- Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status =<

- Patient must have adequate bone marrow and organ function as defined below:

- Absolute neutrophil count (ANC) >= 1500/mcL

- Platelets > 100,000/mcL

- Hemoglobin > 9.0 g/dL

- Total bilirubin =< 1.5 mg/dL

- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x upper limit
of normal (ULN)

- Alkaline phosphatase =< 2.5 x ULN

- Serum creatinine < 1.8 mg/dL

- Women of childbearing potential and men must agree to use adequate contraception
(hormonal or barrier method of birth control, abstinence) prior to study entry, for
the duration of study participation, and for 3 months after completing treatment.
Should a woman become pregnant or suspect she is pregnant while participating in this
study, she must inform her treating physician immediately

- Patient must be able to understand and willing to sign an Institutional Review Board
(IRB)-approved written informed consent document

- Patient with uncontrolled diabetes or fasting blood glucose level of greater than 200
mg/dL will not be evaluable for PET imaging

Exclusion Criteria:

- Patient must not have had prior chemotherapy, prior epidermal growth factor receptor
(EGFR) targeted therapy, or prior radiation therapy for HNSCC

- Patient must not have disease at the nasopharyngeal, sinus, or other sub-site not
specified in the inclusion criteria; patient must not have unknown primary squamous
cell carcinoma of the head and neck

- Patient must not have a history of prior invasive malignancy diagnosed within 3 years
prior to study enrollment other than local stage non-melanoma skin cancer

- Patient must not be receiving any other investigational agents

- Patient must not have a history of allergic reactions attributed to compounds of
similar chemical or biologic composition to any of the agents used in this study

- Patient must not be taking cimetidine or allopurinol. If currently taking either of
these medications, patient must discontinue for one week before receiving treatment
with nab-paclitaxel

- Patient must not have an uncontrolled intercurrent illness including, but not limited
to, ongoing or active serious infection, symptomatic congestive heart failure,
unstable angina pectoris, cardiac arrhythmia, or serious psychiatric illness/social
situations that would limit compliance with study requirements

- Patient must not be pregnant and/or breastfeeding; a negative serum or urine
pregnancy test is required at screening for all female patients of childbearing

- Patient must not be known to be human immunodeficiency virus (HIV)-positive on
combination antiretroviral therapy because of the potential for pharmacokinetic
interactions with the study agents; in addition, these patients are at increased risk
of lethal infections when treated with marrow suppressive therapy; appropriate
studies will be undertaken in patients receiving combination antiretroviral therapy
when indicated

- Patient must not have peripheral neuropathy > grade 1

Type of Study:


Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

CR by clinical exam at primary tumor site

Outcome Description:

Response will be assessed by laryngoscopy.

Outcome Time Frame:

6 weeks (2 cycles of therapy)

Safety Issue:


Principal Investigator

Douglas Adkins, M.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

Washington University School of Medicine


United States: Institutional Review Board

Study ID:




Start Date:

August 2012

Completion Date:

October 2023

Related Keywords:

  • Head and Neck Neoplasms
  • Neoplasms
  • Carcinoma, Squamous Cell
  • Head and Neck Neoplasms



Washington University School of MedicineSaint Louis, Missouri  63110
Yale Cancer CenterNew Haven, Connecticut  06520-8028
University of ArkansasLittle Rock, Arkansas  72202
University of Tennessee, KnoxvilleKnoxville, Tennessee  37916