Chemotherapy With Cetuximab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer
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Purpose
PURPOSE: Cetuximab with platinum and 5FU is now the standard combination as first-line treatment in patients with metastatic or recurrent Head and Neck squamous cell carcinomas. Cetuximab and taxane combinations have demonstrated promising activity in Head and Neck cancer. This phase II trial is studying new cetuximab, docetaxel and cisplatin combination named TPEx as first-line treatment in this setting.
| Condition | Intervention | Phase |
|---|---|---|
|
Squamous Cell Head and Neck Carcinoma Recurrent or Metastatic Disease |
Biological: cetuximab IV Other: Biopsies |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Study of Cetuximab, Docetaxel and Cisplatin as First-line Treatment in Patients With Metastatic or Recurrent Head and Neck Squamous Cell Carcinomas - GORTEC2008-03 TPEx |
- objective tumor response rate [ Time Frame: 12 weeks (after completion of the fourth cycle of chemotherapy) ] [ Designated as safety issue: No ]The objective tumor response rate is evaluated every 6 weeks according to RECIST criteria
- Grade 1 to 5 toxicity [ Time Frame: 24 weeks (average) ] [ Designated as safety issue: Yes ]All grade 1 to 5 toxicity are registered during treatment. Patients have weekly clinical and biological examination.
- best overall response [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]Tumor response is evaluated every 6 weeks according to RECIST criteria
- progression-free survival [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- overall survival [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- biomarkers [ Time Frame: two years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 54 |
| Study Start Date: | September 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: cetuximab
Patients receive four cycles of chemotherapy comprising cetuximab IV plus docetaxel IV over 1 hour and cisplatin IV over 2 hours on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. After completion of the fourth cycle of chemotherapy, patients receive a maintenance therapy with cetuximab every 2 weeks. Treatment will be continued until disease progression or unacceptable toxicities according
|
Biological: cetuximab IV
Drug: Cisplatin IV : 75 mg/m2 intravenous every 3 weeks for 4 cycles Drug: Docetaxel IV : 75 mg/m2 intravenous every 3 weeks for 4 cycles G-CSF support with lenograstim 150 microg./m2/day is delivered after each cycle of chemotherapy. No intervention, only biopsy for translational project.
|
Detailed Description:
OBJECTIVES:
Primary
- To determine the efficacy of TPEx combination in patients with head and neck cancer in term of objective response rate (RECIST, see statistical consideration) Secondary
- To assess toxicities of TPEx combination
- Determine the efficacy of TPEx combination in patients with head and neck cancer: Best Overall Response , progression-free survival and survival.
- Translational research objective:To better understand the mechanisms of chemoresistance and to identify biomarkers by the analysis of the tumor biopsies (RNA, gene expression profile) and protein profile (plasma samples). Exploratory analyses.
OUTLINE: This is an open-label phase II, multicenter study. Patients receive four cycles of chemotherapy comprising cetuximab IV plus docetaxel IV over 1 hour and cisplatin IV over 2 hours on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. After completion of the fourth cycle of chemotherapy, patients receive a maintenance therapy with cetuximab every 2 weeks. Treatment will be continued until disease progression or unacceptable toxicities according to the patient or the investigator. Tumor check-up will be performed every 6 weeks. This study will allow translational research with blood sample and biopsies at baseline before any treatment, during the treatment with TPEx combination (week 6).,After completion of study treatment, patients are followed every 2 months.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically proven squamous cell carcinoma of the oral cavity, larynx, oropharynx or hypopharynx
- Recurrent disease, incurable disease as determined by surgery or radiation, or metastatic disease
- Measurable or evaluable disease
- Age > 18 years and <= 70 years
- WHO performance status 0 or 1
- Absolute neutrophil count > 1,500/mm3
- Platelets > 150,000/mm3
- Total Bilirubin <= institutional upper limit of normal
- Aspartate aminotransferase < 1.5 X institutional upper limit of normal
- Alanine aminotransferase < 1.5 X institutional upper limit of normal
- Alkaline phosphatase < 2.5 X institutional upper limit of normal
- creatinine clearance > 60 mL/min
- Signed informed consent
- Women of child-bearing potential and men must be willing and able practice adequate contraception prior to study entry and for the duration of study treatment
Exclusion Criteria:
- Previous chemotherapy. Chemotherapy given as part of initial curative therapy and completed more than 6 months before inclusion is allowed
- Previous treatment with total doses of cisplatin > 300 mg/ m2
- Patients must not have any co-existing disease that would preclude cisplatin administration, such as peripheral neuropathy or renal failure
- Surgery (excluding biopsy) or radiotherapy within 4 weeks prior to study entry
- Nasopharyngeal carcinoma, or cancer of sinusal cavities
- Active infection including tuberculosis or HIV positive patient
- Other malignancy within last 5 years except for non-melanoma skin cancer
- No other investigational agent within 30 days prior to study entry
- No other concurrent chemotherapy, immunotherapy, antitumor hormonal therapy (excluding contraceptives and replacement steroids), radiotherapy, or experimental medications
- No prior anti EGFR therapy
- No known brain metastases
- Uncontrolled intercurrent illness that would prevent delivery of protocol therapy
- Patients with a prior history of basal cell carcinoma of the skin or in situ carcinoma of the cervix must have been curatively treated and must have remained disease free for 5 years post diagnosis
- No history of hypersensitivity reaction to drugs on study
- No unstable angina or myocardial infarction within the past 12 months
- No symptomatic congestive heart failure or New York Heart Association (NYHA) class II-IV heart disease
- No serious uncontrolled cardiac arrhythmia
- No other prior or concomitant squamous cell carcinoma
- No other prior or concomitant cancer, except curatively treated basal carcinoma of the skin or in situ cervical cancer, for which the patient has been curatively treated and remains disease-free for the past 5 years
- Patient is pregnant or lactating
- Patients must not have any co-existing condition that would preclude full compliance with the study
Contacts and Locations| Contact: Joel GUIGAY | +33 142 11 65 36 | guigay@igr.fr |
| Contact: Alexandre CORNELY | alexandre.cornely@igr.fr |
| Belgium | |
| Cliniques Universitaires | Recruiting |
| Bruxelles, Belgium | |
| Contact: JP Machiels | |
| Clinique Sainte Elisabeth | Recruiting |
| Namur, Belgium | |
| Contact: S Henry | |
| Clinique universitaire de Mont Godinne UCL | Recruiting |
| Yvoir, Belgium | |
| Contact: J Kerger | |
| France | |
| Hôpital Saint André | Recruiting |
| Bordeaux, France | |
| Contact: L Digue | |
| Centre Jean Perrin, | Recruiting |
| Clermont-Ferrand, France | |
| Contact: A-F Dillies | |
| Centre G-F Leclerc | Recruiting |
| Dijon, France | |
| Contact: S Zanetta | |
| Centre Hospitalier de la Dracénie | Recruiting |
| Draguignan, France | |
| Contact: H Le Caer | |
| Centre Hospitalier de Bretagne Sud | Recruiting |
| Lorient, France | |
| Contact: C Sire | |
| Centre Léon Bérard | Recruiting |
| Lyon, France | |
| Contact: J Fayette | |
| Hôpital de la Timone | Recruiting |
| Marseille, France | |
| Contact: C Mercier | |
| Centre Henri Becquerel | Recruiting |
| Rouen, France | |
| Contact: I Tennevet | |
| Hôpital Foch | Recruiting |
| Suresnes, France | |
| Contact: L Bozec | |
| CHU Bretonneau | Recruiting |
| Tours, France | |
| Contact: S Chapet | |
| Institut Gustave Roussy | Recruiting |
| Villejuif, France | |
| Contact: Joel GUIGAY | |
| Study Chair: | Joel GUIGAY | GORTEC |
More Information
Additional Information:
No publications provided
| Responsible Party: | GUIGAY, Groupe Oncologie Radiotherapie Tete et Cou |
| ClinicalTrials.gov Identifier: | NCT01289522 History of Changes |
| Other Study ID Numbers: | GORTEC2008-03TPex, 2008-004869-25 |
| Study First Received: | February 1, 2011 |
| Last Updated: | February 2, 2011 |
| Health Authority: | France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) |
Keywords provided by Groupe Oncologie Radiotherapie Tete et Cou:
|
Squamous cell carcinoma of the head and neck recurrent or metastatic first line chemotherapy cetuximab |
docetaxel cisplatin antineoplastic agents First Line Palliative Treatment |
Additional relevant MeSH terms:
|
Carcinoma Carcinoma, Squamous Cell Head and Neck Neoplasms Neoplasm Metastasis Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Squamous Cell Neoplasms by Site Neoplastic Processes |
Pathologic Processes Docetaxel Cetuximab Antineoplastic Agents Cisplatin Therapeutic Uses Pharmacologic Actions Radiation-Sensitizing Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 23, 2013