Now Available for Public Comment: Notice of Proposed Rulemaking (NPRM) for FDAAA 801 and NIH Draft Reporting Policy for NIH-Funded Trials

Cisplatin and Radiation Therapy With or Without Erlotinib Hydrochloride in Treating Patients With Stage III or Stage IV Head and Neck Cancer

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Renato Martins, Fred Hutchinson Cancer Research Center
ClinicalTrials.gov Identifier:
NCT00410826
First received: December 11, 2006
Last updated: May 8, 2013
Last verified: May 2013

December 11, 2006
May 8, 2013
June 2006
May 2012   (final data collection date for primary outcome measure)
Comparison of the Percentage of Participants With a Complete Response in Each Treatment Arm [ Time Frame: 12 weeks after the completion of therapy ] [ Designated as safety issue: No ]
Complete response requires both a pathological complete response (independent of observer) and a complete response radiologically (RECIST 1.0).
Complete response rate as measured by pathological and radiological methods
Complete list of historical versions of study NCT00410826 on ClinicalTrials.gov Archive Site
  • Safety as Assessed Through Summaries of Adverse Events and Laboratory Test Results by Treatment Arm [ Time Frame: 30 days after the completion of therapy ] [ Designated as safety issue: Yes ]
  • Progression Free Survival of Patients With Locally Advanced Head and Neck Cancer Treated With Cisplatin and Radiotherapy, With and Without Erlotinib Hydrochloride [ Time Frame: Every 3 months for up to 5 years ] [ Designated as safety issue: No ]
    Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions
Safety as measured by The NCI Common Toxicity Criteria v 3.0
Not Provided
Not Provided
 
Cisplatin and Radiation Therapy With or Without Erlotinib Hydrochloride in Treating Patients With Stage III or Stage IV Head and Neck Cancer
Multicenter Randomized Phase II Study of Erlotinib, Cisplatin and Radiotherapy Versus Cisplatin and Radiotherapy in Patients With Stage III and IV Squamous Cell Carcinoma of the Head and Neck

This randomized phase II trial is studying cisplatin and radiation therapy together with or without erlotinib hydrochloride to compare how well they work in treating patients with stage III or stage IV head and neck cancer. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It may also make tumor cells more sensitive to radiation therapy. Giving cisplatin and radiation therapy together with erlotinib hydrochloride may kill more tumor cells. It is not yet known whether cisplatin and radiation therapy are more effective with or without erlotinib hydrochloride in treating head and neck cancer

PRIMARY OBJECTIVES:

I. Compare the complete response rate in patients with locally advanced head and neck cancer, treated with cisplatin, radiotherapy and erlotinib (erlotinib hydrochloride) versus cisplatin and radiotherapy alone.

SECONDARY OBJECTIVES:

I. Evaluate whether the addition of erlotinib increases the acute and long term toxicities of cisplatin and radiotherapy, in patients with locally advanced head and neck cancer.

II. Compare the disease-free and overall survivals of patients with locally advanced head and neck cancer treated with cisplatin and radiotherapy, with and without erlotinib.

III. Evaluate whether the symptomatic improvement observed in the first week of erlotinib alone predicts for complete response and long term disease control.

IV. Correlate epidermal growth factor receptor (EGFR), p16 and excision repair cross-complementing 1 (ERCC-1) expression with response outcome to therapy with cisplatin and radiation with and without erlotinib.

V. Identify other molecular correlates that may be relevant in the pathogenesis of squamous cell carcinoma of head and neck (SCCHN) or response to therapy.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive cisplatin intravenously (IV) on days 1, 22, and 43 and undergo 3-dimensional conformal or intensity modulated radiotherapy once daily, 5 days per week, on days 1-47. Patients also receive erlotinib hydrochloride orally (PO) once daily (QD) on days -7 to 47.

ARM II: Patients receive cisplatin and undergo radiotherapy as in Arm I.

Within 10-14 weeks after completion of study treatment, patients with N2 or N3 disease at the time of screening undergo a neck dissection.

After completion of study treatment, patients are followed up periodically for 5 years.

Interventional
Phase 2
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Stage III Squamous Cell Carcinoma of the Hypopharynx
  • Stage III Squamous Cell Carcinoma of the Larynx
  • Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity
  • Stage III Squamous Cell Carcinoma of the Nasopharynx
  • Stage III Squamous Cell Carcinoma of the Oropharynx
  • Stage IV Squamous Cell Carcinoma of the Hypopharynx
  • Stage IV Squamous Cell Carcinoma of the Larynx
  • Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity
  • Stage IV Squamous Cell Carcinoma of the Nasopharynx
  • Stage IV Squamous Cell Carcinoma of the Oropharynx
  • Drug: erlotinib hydrochloride
    Given orally
    Other Names:
    • CP-358,774
    • erlotinib
    • OSI-774
  • Drug: cisplatin
    Given IV
    Other Names:
    • CACP
    • CDDP
    • CPDD
    • DDP
  • Radiation: 3-dimensional conformal radiation therapy
    35 fractions
    Other Names:
    • 3D-CRT
    • conformal radiation therapy
  • Radiation: intensity-modulated radiation therapy
    35 fractions
    Other Name: IMRT
  • Procedure: quality-of-life assessment
    Ancillary studies
    Other Name: quality of life assessment
  • Experimental: Arm I (chemo, radiotherapy, enzyme inhibitor/radiosensitizer)
    Patients receive cisplatin IV on days 1, 22, and 43 and undergo 3-dimensional conformal or intensity modulated radiotherapy once daily, 5 days per week, on days 1-47. Patients also receive erlotinib hydrochloride PO once daily on days -7 to 47.
    Interventions:
    • Drug: erlotinib hydrochloride
    • Drug: cisplatin
    • Radiation: 3-dimensional conformal radiation therapy
    • Radiation: intensity-modulated radiation therapy
    • Procedure: quality-of-life assessment
  • Active Comparator: Arm II (chemotherapy, radiotherapy)
    Patients receive cisplatin and radiotherapy as in Arm I.
    Interventions:
    • Drug: cisplatin
    • Radiation: 3-dimensional conformal radiation therapy
    • Radiation: intensity-modulated radiation therapy
    • Procedure: quality-of-life assessment

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
204
Not Provided
May 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Cytological or pathological documented squamous cell carcinoma of oral cavity, oropharynx, larynx, and hypopharynx; patients with nasopharyngeal carcinoma can be included if the patients have grades I or II tumors according to the World Health Organization (WHO) classification
  • Stage III or IV according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, Sixth Edition (2002)
  • Unresectable or resection with significant morbidity
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Measurable Disease, defined according to Response Evaluation Criteria in Solid Tumors (RECIST) Criteria
  • Bilirubin =< 1.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3.0 x ULN
  • Calculated creatinine clearance >= 55ml/min (using the Cockcroft-Gault formula)
  • Platelet count >= 100 x 10^9 /L
  • Absolute neutrophil count (ANC) >= 1.25 x 10^9 /L
  • Signed informed consent
  • Male and female patients with reproductive potential must use an acceptable contraceptive method
  • Authorization from a dentist to begin radiation therapy

Exclusion Criteria:

  • Second primary malignancy that is clinically detectable or clinically significant at the time of consideration for study enrollment
  • Inability or unwillingness to comply with radiotherapy
  • Evidence of clinically significant congestive heart failure; patients must be able to tolerate hydration required during cisplatin chemotherapy
  • Diarrhea > grade 1 at the time of enrollment
  • Prior radiotherapy, chemotherapy, or investigational treatment for squamous cell carcinoma of head and neck
  • Prior treatment with an investigational or marketed inhibitor of the EGFR pathway
  • Use of cytochrome P450 3A4 (CYP3A4) inducers
  • Presence of systemic metastases (M1)
  • Pregnant or breast-feeding women
  • Known human immunodeficiency virus (HIV) infection
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00410826
6106, NCI-2009-01546
Yes
Renato Martins, Fred Hutchinson Cancer Research Center
University of Washington
National Cancer Institute (NCI)
Principal Investigator: Renato Martins Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
University of Washington
May 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP