Treatment of locally advanced HNSCC with NBTXR3

RSNA, Chicago, 2019, Le Tourneau C. et al.


Christophe Le Tourneau1, Valentin Calugaru1, Victor Moreno Garcia2, Xavier Mirabel3, Bernard Doger2, Emiliano Calvo2, Jacek Fijuth4, Tomasz Rutkowski5, Nicolas Magné6, Miren Sanz Taberna7, Jorge Contreras8, Irene Brana9, Zsuzsanna Papai10, Zoltán Takacsi-Nagy11, Xavier Liem3, Sébastien Salas12, Stéphanie Wong12, Carmen Florescu13, Juliette Thariat13, Caroline Hoffmann1

1 – Institut Curie, Paris, France
2 – START Madrid, Madrid, Spain
3 – Centre Oscar Lambret, Lille, France
4 – Provita Prolife, Tomaszów Mazowiecki, Poland
5 – Maria Skłodowska-Curie Institute of Oncology, Gliwice, Poland
6 – Institut de Cancérologie Lucien Neuwirt, Saint-Priest-en-Jarez, France
7 – Institut Catala d’Oncologia, Barcelona, Spain
8 – University Regional Hospital of Malaga, Malaga, Spain
9 – Vall d’Hebron University Hospital, Bacelona, Spain
10 – Hungarian Defense Forces Military Hospital, Budapest, Hungary
11 – National Institute of Oncology, Budapest, Hungary
12 – Hôpital Timone, APHM, Marseille
13 – Unicancer – François Baclesse Center, Caen, France


Purpose: Elderly head and neck squamous cell carcinoma (HSNCC) patients (pts) ineligible for standard of care treatment require new therapeutic approaches. NBTXR3, hafnium oxide nanoparticles, may represent such an option. NBTXR3 is activated by radiotherapy, enhancing its effects, leading to physical destruction of cancer cells. A Phase I/II trial [NCT01946867] is underway to evaluate NBTXR3 in elderly (≥70 years) or frail pts with HNSCC of the oral cavity and oropharynx ineligible for cisplatin or intolerant to cetuximab.

Method & Materials: Pts received a single intratumoral injection of NBTXR3 and intensity modulated radiation therapy (IMRT; 70 Gy/35 fractions/7 weeks). The study was a 3 + 3 dose escalation to test the NBTXR3 dose equivalent to 5, 10, 15, and 22% of baseline tumor volume, followed by a dose expansion. Primary endpoints include Recommended Phase 2 Dose (RP2D) determination and early dose limiting toxicities (DLT). Presence of NBTXR3 in surrounding healthy tissues and efficacy (RECIST 1.1 principles) were also evaluated.

Results: Enrollment for the dose escalation phase was completed at all dose levels: 5% (3 pts), 10% (3 pts), 15% (5 pts), and 22% (8 pts). No early DLT or SAE related to NBTXR3 or injection were observed. One G1 AE (asthenia; 22%) related to NBTXR3 and four AEs (G2 oral pain, G1 tumor hemorrhage, G1 asthenia, and G1 injection site hemorrhage) related to injection were reported. RT-related toxicity was as expected. The RP2D has been determined to be 22%. CT-scan assessment demonstrated absence of NBTXR3 in surrounding tissues. Among 13 evaluable pts treated at doses ≥10%, 9 achieved complete response of the injected lesion. The final dose escalation safety results will be presented herein.

Conclusion: NBTXR3 was well tolerated at all tested doses and demonstrated a good safety profile. A dose expansion phase has started with the identified RP2D. NBTXR3 is currently being evaluated in a phase II/III trial in soft tissue sarcoma [NCT02379845] and phase I/II trials in prostate [NCT02805894], liver [NCT02721056] and rectal [NCT02465593] cancers.

Clinical Relevance & Application: The results of this study highlight the potential of NBTXR3 as a novel treatment option for elderly and/or frail pts with locally advanced HNSCC and address an unmet medical need.

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