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Bortezomib and Radiation Therapy in Treating Patients With Recurrent or Metastatic Head and Neck Cancer
This study is ongoing, but not recruiting participants.
First Received: May 6, 2001   Last Updated: August 27, 2009   History of Changes
Sponsor: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00016003
  Purpose

RATIONALE: Bortezomib may stop the growth of cancer cells by blocking the enzymes necessary for cancer cell growth. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining bortezomib with radiation therapy may kill more tumor cells

PURPOSE: Phase I trial to study the effectiveness of combining bortezomib with radiation therapy in treating patients who have recurrent or metastatic head and neck cancer.


Condition Intervention Phase
Head and Neck Cancer
Drug: bortezomib
Radiation: radiation therapy
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study of Concomitant Therapy With Proteasome Inhibitor PS-341 and Radiation in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Toxicity and maximum tolerated dose (MTD) as assessed by CTC version 2.0 during treatment and weekly for 3 months after treatment [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Response rate as assessed by RECIST criteria at end of treatment and 3 months after treatment [ Designated as safety issue: No ]

Estimated Enrollment: 51
Study Start Date: March 2001
Estimated Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of bortezomib with concurrent radiotherapy in patients with recurrent or metastatic squamous cell carcinoma of the head and neck.

OUTLINE: This is a dose-escalation study. Patients are stratified according to prior radiotherapy (yes vs no).

Patients receive bortezomib IV over 3-5 seconds twice weekly. Patients also receive radiotherapy on days 1-5 (days 2-5 only for the first course). Courses repeat every week for 3 weeks. Patients then receive radiotherapy alone on days 1-5 of weeks 4 and 5. Treatment with bortezomib and radiotherapy resumes in weeks 6 and 7 (for patients with prior radiotherapy) or weeks 6, 7, and 8 (for patients with no prior radiotherapy) in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at weeks 1-8, at week 12, and then monthly for 1 year.

PROJECTED ACCRUAL: A maximum of 51 patients (30 with prior radiotherapy and 21 with no prior radiotherapy) will be accrued for this study within 12 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed squamous cell carcinoma of the head and neck

    • Local-regional disease that is amenable to radiotherapy
    • Persistent, recurrent, or unresectable regional disease with OR without metastatic disease after standard curative therapy
  • No known brain metastases

PATIENT CHARACTERISTICS:

Age:

  • Over 18

Performance status:

  • ECOG 0-2 OR
  • Karnofsky 50-100%

Life expectancy:

  • More than 3 months

Hematopoietic:

  • Absolute neutrophil count greater than 1,500/mm^3
  • Platelet count greater than 100,000/mm^3

Hepatic:

  • Bilirubin less than 1.5 times upper limit of normal (ULN)
  • SGOT/SGPT less than 2.5 times ULN

Renal:

  • Creatinine less than 1.5 times ULN OR
  • Creatinine clearance greater than 60 mL/min

Cardiovascular:

  • No symptomatic congestive heart failure
  • No myocardial infarction within the past 6 months
  • No unstable angina pectoris
  • No unstable cardiac arrhythmia requiring assessment for clinical intervention
  • No postural hypotension due to severe baroreceptor dysfunction after prior radiotherapy and/or surgery that is not amenable to volume repletion, defined as 1 of the following:

    • Systolic blood pressure remains at 100 mm Hg or less with absence of orthostatic changes or symptoms
    • Systolic blood pressure remains at 120 mm Hg or less with orthostatic changes and absence of symptoms
  • No uncorrectable hyponatremia of 130 mEq/L or greater

Other:

  • No known HIV positivity
  • No other prior malignancy within the past 2 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No concurrent uncontrolled illness
  • No active infection
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 4 weeks since prior immunotherapy
  • No concurrent biologic therapy for treatment of malignancy
  • No concurrent colony-stimulating factors during first course of study therapy

Chemotherapy:

  • At least 4 weeks since prior chemotherapy and recovered
  • No other concurrent chemotherapy for treatment of malignancy

Endocrine therapy:

  • No concurrent endocrine therapy for treatment of malignancy

Radiotherapy:

  • More than 6 months since prior radiotherapy to the head and neck

    • At least 1 month since prior palliative radiotherapy to any other sites and recovered

Surgery:

  • At least 4 weeks since prior surgery

Other:

  • No other concurrent investigational agent or therapy for treatment of malignancy
  • No concurrent amifostine
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00016003

Locations
United States, Maryland
NCI - Center for Cancer Research
Bethesda, Maryland, United States, 20892
NIH - Warren Grant Magnuson Clinical Center
Bethesda, Maryland, United States, 20892-1182
Sponsors and Collaborators
Investigators
Study Chair: Carter Van Waes, MD, PhD National Institute on Deafness and Other Communication Disorders (NIDCD)
  More Information

Additional Information:
Publications:
Lebowitz PF, Harkins C, Conley B, et al.: Concomitant therapy with proteasome inhibitor, bortezomib, and radiation in patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) . [Abstract] Proceedings of the American Society of Clinical Oncology 22: A-2010, 499, 2003.

Study ID Numbers: CDR0000068581, NCI-01-C-0104
Study First Received: May 6, 2001
Last Updated: August 27, 2009
ClinicalTrials.gov Identifier: NCT00016003     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
stage IV squamous cell carcinoma of the lip and oral cavity
recurrent squamous cell carcinoma of the lip and oral cavity
stage IV squamous cell carcinoma of the oropharynx
recurrent squamous cell carcinoma of the oropharynx
stage IV squamous cell carcinoma of the nasopharynx
recurrent squamous cell carcinoma of the nasopharynx
stage IV squamous cell carcinoma of the hypopharynx
recurrent squamous cell carcinoma of the hypopharynx
stage IV squamous cell carcinoma of the larynx
recurrent squamous cell carcinoma of the larynx
stage IV squamous cell carcinoma of the paranasal sinus and nasal cavity
recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity
recurrent salivary gland cancer
salivary gland squamous cell carcinoma
stage IV salivary gland cancer

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Bortezomib
Enzyme Inhibitors
Pharmacologic Actions
Carcinoma
Protease Inhibitors
Neoplasms
Neoplasms by Site
Head and Neck Neoplasms
Therapeutic Uses
Neoplasms, Squamous Cell
Carcinoma, Squamous Cell
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on November 30, 2009