A limited number of relatively contradictory studies have suggested that the development of
serious ototoxicity in children treated with cisplatin or, more rarely, carboplatin could be
partly related to genetic risk factors affecting detoxification enzymes and membrane
transporters of platinum derivatives. The objective of this study is therefore to identify
genetic variants associated with the development of platinum ototoxicity in patients treated
with cisplatin or carboplatin (minimum follow-up of 3 years) for one of the following
diseases: neuroblastoma, hepatoblastoma, retinoblastoma, malignant germ cell tumour,
osteosarcoma, high-risk or recurrent Wilms' tumour, non-parameningealrhabdomyosarcoma. A
total of 180 patients, corresponding to 60 cases with grade 3 or 4 ototoxicity and 120
controls with no signs of ototoxicity (separate complete audiograms for each ear) will be
included. A saliva sample will be used to obtain DNA for pharmacogenetic studies. The value
of this study will be to define a population at high risk of developing ototoxicity in order
to adapt treatment, or even develop preventive treatment of ototoxicity based on antioxidant
medications
An A/G
polymorphism situated in the substrate binding domain of the GSTP1 isoenzyme in position
+313 of exon 5 (A313G) induces substitution of a isoleucine by a valine (Ile105Val). --- A313G --- --- Ile105Val ---
Finally, the role of GSTP1 Ile105Val polymorphism has not been evaluated in
children (Barahmani et al., 2009). --- Ile105Val ---
Primary Outcomes
Measure: genetic factors (drug metabolism enzymes, membrane transporters) predisposing to cisplatin and carboplatin ototoxicity in children Time: Day 0
Secondary Outcomes
Measure: genetic factors predisposing to aminoglycoside ototoxicity; Time: Day 0
Measure: To provide a rationale for prevention of ototoxicity by the use of antioxidant medications. Time: Day 0
OPHELIA (OPHELIA (OlaParib and durvalumab in HEad and neck squamous celL carcInomA) trial is
a Greek, investigator-initiated, randomized open-label window-of-opportunity phase II study.
Patients with operable histologically documented squamous-cell carcinoma of the oral cavity,
oropharynx, hypopharynx or larynx will be randomized between combination with durvalumab and
olaparib, cisplatin and olaparib, monotherapy with olaparib or no treatment, before starting
standard treatment.
Single-nucleotide polymorphisms: GSTP1 Ile105Val (A/G). --- Ile105Val ---
Primary Outcomes
Measure: Investigation of the change in the tumour Ki-67 before and after treatment with the combination of olaparib + durvalumab or olaparib + cisplatin or olaparib monotherapy. Time: At baseline and at the day of the surgery or 2nd biopsy (at days 23-29 days)
Secondary Outcomes
Measure: Objective response rate according to RECIST 1.1 criteria Time: Imaging studies will be performed at baseline and on week 4
Measure: Pathologic complete response rate Time: On week 4 only for operable patients
Measure: Metabolic response rate assessed by FDG-PET/CT scan (optional) Time: At baseline, on week 4
Measure: Number of participants with tolerability to the treatment. Time: From the 1st day of therapy and every week for 4 weeks maximum and 90 days after last therapy administration
Measure: Surgical complication rate Time: Up to 30 days after surgery or the day of initiation of the next anticancer therapy
Measure: Mutations in genes associated with DNA repair Time: At baseline, on day of surgery or the 2nd biopsy (at days 23-29)
Measure: Expression of tissue biomarker: PARP1 Time: At baseline, on day of surgery or the 2nd biopsy (at days 23-29)
Measure: Expression of tissue biomarker: BRACA1,2 Time: At baseline, on day of surgery or the 2nd biopsy (at days 23-29)
Measure: Expression of tissue biomarker: ERCC1 Time: At baseline, on day of surgery or the 2nd biopsy (at days 23-29)
Measure: Expression of tissue biomarker: PDL-1 Time: At baseline, on day of surgery or the 2nd biopsy (at days 23-29)
Measure: Expression of tissue biomarker: TILs Time: At baseline, on day of surgery or the 2nd biopsy (at days 23-29)
Measure: Plasma methylation biomarker: PARP1 methylation in plasma cell-free DNA Time: At baseline, a day before surgery and 90 days after surgery
Measure: Plasma methylation biomarker: BRCA1,2 methylation in plasma cell-free DNA Time: At baseline, a day before surgery and 90 days after surgery
Measure: Plasma methylation biomarker: ERCC1 methylation in plasma cell-free DNA Time: At baseline, a day before surgery and 90 days after surgery
Measure: Plasma methylation biomarker: RAD51C methylation in plasma cell-free DNA Time: At baseline, a day before surgery and 90 days after surgery
Measure: Single-nucleotide polymorphisms: PARP-1 Val762Ala Time: Sample will be collected once at baseline
Measure: Single-nucleotide polymorphisms: ERCC1 Asn118Asn (C/T) Time: Sample will be collected once at baseline
Measure: Single-nucleotide polymorphisms:ERCC2 Lys751Gln (T/G) Time: Sample will be collected once at baseline
Measure: Single-nucleotide polymorphisms: GSTP1 Ile105Val (A/G) Time: Sample will be collected once at baseline
Measure: Single-nucleotide polymorphisms: XPD Lys751Gln (A/C, C/C) Time: Sample will be collected once at baseline
Measure: Single-nucleotide polymorphisms: XRCC1 Arg399Gln (G/A) Time: Sample will be collected once at baseline
Measure: Circulating tumor cells (CTCs) evaluated for DNA repair biomarkers Time: At baseline, a day before surgery and 90 days after surgery
Measure: Circulating tumor cells (CTCs) evaluated for PD-L1 Time: At baseline, a day before surgery and 90 days after surgery