This phase II trial investigates how well sodium thiosulfate works in preventing ototoxicity (hearing loss/damage) in patients with squamous cell cancer of the head and neck that has spread to nearby tissue or lymph nodes (locally advanced) who are undergoing a chemoradiation. Sodium thiosulfate is a type of medication used to treat cyanide poisoning and to help lessen the side effects from cisplatin. Chemotherapy drugs, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving chemotherapy with radiation therapy may kill more tumor cells. The purpose of this trial is to find out whether it is feasible to give sodium thiosulfate 4 hours after each cisplatin infusion along with standard of care radiation therapy in patients with head and neck cancer. Giving sodium thiosulfate after cisplatin may help decrease the risk of hearing loss.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT04541355.
PRIMARY OBJECTIVE:
I. To establish feasibility of intravenous sodium thiosulfate (STS) after each dose of concurrent cisplatin in patients with locally advanced head and neck squamous cell carcinoma undergoing definitive radiotherapy.
SECONDARY OBJECTIVES:
I. To determine the rate of grade >= 2 hearing impairment based on Common Terminology Criteria for Adverse Events (CTCAE) version 5 with use of STS after concurrent chemoradiation with cisplatin 3 months post-treatment.
II. To determine the rate of tinnitus measured by Patient Reported Outcomes (PRO)-CTCAE with use of STS 3 months post-treatment.
III. To describe patient reported outcomes with STS measured with PRO-CTCAE for selected oral, gastrointestinal (GI), neurologic and perceptual symptoms.
IV. To describe patient reported outcomes measured with Hearing Handicap Inventory for Adults – Screening (HHIA-S) compared to results from standard NRG Oncology head and neck trials (such as RTOG 1016).
OUTLINE:
Patients undergo standard of care radiation therapy. Patients receive cisplatin intravenously (IV) and sodium thiosulfate IV throughout the study.
After completion of study treatment, patients are followed up every 3 months for up to 3 years.
Trial PhasePhase II
Trial Typesupportive care
Lead OrganizationUniversity of California San Francisco
Principal InvestigatorHyunseok Kang