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Tadalafil in Treating Patients Undergoing Surgery for Cancer of the Oral Cavity or Oropharynx

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Donald T. Weed, University of Miami
ClinicalTrials.gov Identifier:
NCT00843635
First received: February 12, 2009
Last updated: October 27, 2014
Last verified: October 2014

February 12, 2009
October 27, 2014
September 2008
September 2015   (final data collection date for primary outcome measure)
Immune response as assessed by number of CD4+ and CD8+ cells in tumor tissue by IHC and proliferation of CD8+ lymphocytes in peripheral blood mononuclear cells by FACS [ Time Frame: The primary endpoint, patient immune response, will be assessed by several parameters quantifying the presence and function of MDSC and T cell populations at the time of surgery as compared to pre-treatment. ] [ Designated as safety issue: No ]
Immune response as assessed by number of CD4+ and CD8+ cells in tumor tissue by IHC and proliferation of CD8+ lymphocytes in peripheral blood mononuclear cells by FACS [ Designated as safety issue: No ]
Complete list of historical versions of study NCT00843635 on ClinicalTrials.gov Archive Site
  • Optimal dosing schedule for tadalafil [ Time Frame: Analysis will be performed on patient tumor specimens obtained at the time of surgery ] [ Designated as safety issue: No ]
  • Treatment-related side effects [ Time Frame: Side effects will be assessed via questionnaire at Day 5 and Day 20 of treatment ] [ Designated as safety issue: Yes ]
  • Progression-free survival [ Time Frame: From the date of initiation of study treatment to the date of documented disease progression or death from any cause, whichever is earlier. ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: From the date of initiation of study treatment to date of death from any cause. ] [ Designated as safety issue: No ]
  • Optimal dosing schedule for tadalafil [ Designated as safety issue: No ]
  • Treatment-related side effects [ Designated as safety issue: Yes ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
Not Provided
Not Provided
 
Tadalafil in Treating Patients Undergoing Surgery for Cancer of the Oral Cavity or Oropharynx
Pilot Study of Phosphodioesterase-5 Inhibitor Tadalafil (Cialis) as an Immunomodulator in Patients With Oral Cavity and Oropharyngeal Squamous Cell Carcinoma.

RATIONALE: Biological therapies, such as tadalafil, may stimulate the immune system in different ways and stop tumor cells from growing.

PURPOSE: This randomized clinical trial is studying how well tadalafil works in treating patients who are undergoing surgery for cancer of the oral cavity or oropharynx.

OBJECTIVES:

  • To analyze the phenotype and the function of the tumor-induced suppressive network associated with squamous cell carcinoma (SCC) of the head and neck in patients with SCC of the oral cavity or oropharynx treated with tadalafil followed by definitive surgical resection.
  • To analyze the immune response before and after treatment with tadalafil to determine whether or not tadalafil treatment modulates in these patients.
  • To compare two doses of tadalafil to determine whether there are measurable differences in immune response in these patients.
  • To analyze treatment-related side effects of tadalafil at each of the two doses tested in these patients.

OUTLINE: Patients are randomized to 1 of 3 treatment arms.

  • Arm I: Patients receive oral tadalafil once daily on days 1-20 in the absence of unacceptable toxicity.
  • Arm II: Patients receive oral tadalafil (at a higher dose than in arm I) once daily on days 1-20 in the absence of unacceptable toxicity.
  • Arm III: Patients receive oral placebo once daily on days 1-20 in the absence of unacceptable toxicity.

All patients undergo scheduled definitive surgical resection on day 23.

Patients undergo blood sample collection at baseline, on day 20, and at 6 weeks after surgical resection for correlative laboratory studies. Patients also undergo tumor tissue sample collection at baseline and at the time of surgical resection. Samples are analyzed for immunological markers by FACS and IHC.

After completion of study treatment, patients are followed periodically for at least 3 years.

Interventional
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Treatment
Head and Neck Cancer
  • Drug: Tadalafil
    Given orally
  • Other: Placebo
    Given orally
  • Experimental: Arm A
    Patients will receive 10mg/day Tadalafil orally on days 1 - 20 in the absence of unacceptable toxicity.
    Intervention: Drug: Tadalafil
  • Experimental: Arm B
    Patients will receive 20mg/day Tadalafil orally on days 1 - 20 in the absence of unacceptable toxicity.
    Intervention: Drug: Tadalafil
  • Placebo Comparator: Arm C
    Patients receive oral placebo once daily on days 1-20 in the absence of unacceptable toxicity.
    Intervention: Other: Placebo
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
42
Not Provided
September 2015   (final data collection date for primary outcome measure)

INCLUSION CRITERIA:

  • Patients with surgically resectable oral cavity SCC, all subsites, T1 - T4, N0 - N3
  • Patients with surgically resectable oropharyngeal SCC, all subsites, T1 - T2, N0 - N1
  • Patients with surgically resectable T4 oropharyngeal SCC, all subsites, N0 - N3
  • Patients must be 18 years old or older

EXCLUSION CRITERIA:

  • Patients with previous surgical resection, radiation, or chemotherapy will be excluded to rule out possible effects of local tissue changes secondary to previous treatment
  • Patients with surgically unresectable disease at primary site or regional lymph nodes
  • Patients with T1 - T2 SCC oropharynx, N2 - N3
  • Patients with T3 SCC oropharynx , N0 - N3
  • Any patient for whom non-surgical therapy is recommended as treatment of choice after multidisciplinary treatment evaluation
  • Patients with an altered mental status or not capacitated for their medical decision making
  • Patients with severe or unstable cardiac or cerebrovascular disease are excluded

    • myocardial infarction within the last 90 days
    • unstable angina or angina occurring during sexual intercourse
    • New York Heart Association Class 2 or greater heart failure in the last 6 months
    • uncontrolled arrhythmias
    • hypotension (<90/50 mm Hg), or uncontrolled hypertension (>170/100 mm Hg)
    • stroke within the last 6 months
    • Left ventricle outflow obstruction.
  • Pregnant and nursing mothers will not be enrolled given unknown effects to offspring
  • Concurrent nitrate, alpha-blocker, or cytochrome P-450 inhibitor use
  • Renal Insufficiency defined as creatinine clearance less than 51.
  • Creatinine clearance will be determined by the following Cockcroft-Gault Equation: (140-age) * (Wt in kg) * (0.85 if female) / (72 * Cr)
  • Patients with hepatic insufficiency.
  • Patients currently taking a PDE-inhibitors for erectile dysfunction
  • Patients who are immunocompromised, for reasons not directly related to patients malignancy
  • Patients with significant alcohol or drug abuse
  • Patients with unilateral blindness, hereditary retinal disorders, or increased risk of blindness
  • Patients with unilateral deafness, history of hearing loss, hearing aid dependence, or clinically evident hearing loss
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00843635
20070918, SCCC-2008006
Yes
Donald T. Weed, University of Miami
Donald T. Weed
Not Provided
Principal Investigator: Donald T. Weed, MD University of Miami Sylvester Comprehensive Cancer Center
University of Miami
October 2014

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