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Erlotinib and Radiation Therapy With or Without Cisplatin in Treating Patients With Mouth or Throat Cancer
This study is ongoing, but not recruiting participants.
First Received: November 12, 2002   Last Updated: February 6, 2009   History of Changes
Sponsor: Sidney Kimmel Comprehensive Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00049166
  Purpose

RATIONALE: Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining erlotinib with radiation therapy with or without cisplatin may kill more tumor cells.

PURPOSE: Phase I trial to study the effectiveness of combining erlotinib with radiation therapy with or without cisplatin in treating patients who have advanced mouth or throat cancer.


Condition Intervention Phase
Head and Neck Cancer
Drug: cisplatin
Drug: erlotinib hydrochloride
Radiation: radiation therapy
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study Of OSI-774 In Combination With Intensity-Modulated Radiation (IMRT) Therapy In Patients With Oral Cavity Or Oropharyngeal Cancer Stage II Or III And In Combination With Standard Fractionation Radiation Therapy And Low Dose Daily Cisplatin In Patients With Oral Cavity Or Oropharyngeal Cancer Stage III And IV

Resource links provided by NLM:


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

Estimated Enrollment: 48
Study Start Date: November 2002
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of erlotinib administered with intensity-modulated radiotherapy (IMRT) with or without cisplatin in patients with stage II, III, or IV squamous cell carcinoma of the oral cavity or oropharynx.
  • Determine the safety of these regimens in these patients.
  • Determine biological markers of activity of erlotinib in tumor biopsy specimens from these patients before and after treatment with these regimens.
  • Determine the ability of fludeoxyglucose F 18 positron-emission tomography scan to demonstrate biological activity of erlotinib and predict clinical response in patients treated with these regimens.

OUTLINE: This is a multicenter, dose-escalation study of erlotinib. Patients are assigned to 1 of 2 regimens according to disease stage.

  • Regimen A (patients with stage II [T2, N0] or III [T1-2, N1] disease): Patients receive oral erlotinib once daily. Beginning on day 15, patients also undergo intensity-modulated radiotherapy (IMRT) once daily 5 days a week for 7 weeks.
  • Regimen B (patients with stage III [T3, N0-1] or IV [T1-4, N2-3, M0 or T4, N0-1, M0] disease): Patients receive oral erlotinib and undergo IMRT as in regimen A. Patients also receive cisplatin IV over 20 minutes on each day of radiotherapy.

Patients in both regimens continue to receive erlotinib until the last day of IMRT (patients already in the maintenance phase of this study as of 5/11/04 continue to receive erlotinib once daily for up to 2 years) in the absence of disease progression or unacceptable toxicity.

In both regimens, cohorts of 3-6 patients receive escalating doses of erlotinib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at 30 days and then every 3 months for up to 2 years.

PROJECTED ACCRUAL: A total of 24-48 patients (12-24 per regimen) will be accrued for this study within 6-24 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 oral cavity (OC) or oropharynx (OP)

    • OC sites include: oral tongue, buccal mucosa, floor of mouth, retromolar trigone, alveolar ridge, hard palate, and mucosal lip
    • OP sites include: base of tongue, tonsil, soft palate, and oropharyngeal wall
    • Stage II (T2, N0) or III (T1-2, N1) (eligible for regimen A only)
    • Stage III (T3, N0-1) or IV (T1-4, N2-3, M0 or T4, N0-1, M0) (eligible for regimen B only)
  • Documentation of evaluable tumor within the past 4 weeks
  • Operable or inoperable tumors allowed
  • No known brain involvement
  • No prior head and neck malignancies

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2 OR
  • Karnofsky 60-100%

Life expectancy

  • At least 6 months

Hematopoietic

  • WBC at least 3,000/mm^3
  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3

Hepatic

  • Bilirubin normal (unless due to hemolysis or Gilbert's syndrome)
  • AST/ALT no greater than 2.5 times upper limit of normal
  • aPTT/INR normal (correctable with vitamin K)

Renal

  • Creatinine normal OR
  • Creatinine clearance at least 60 mL/min

Cardiovascular

  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No untreated or new cardiac arrhythmia

Ophthalmic

  • No abnormalities of the cornea (e.g., dry eye syndrome or Sjögren's syndrome)
  • No congenital abnormalities (e.g., Fuch's dystrophy)
  • No abnormal slit-lamp examination using a vital dye (e.g., fluorescein or Bengal-Rose)
  • No abnormal corneal sensitivity test (e.g., Schirmer test or similar tear production test)

Gastrointestinal

  • G-tube dependency allowed
  • No gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation
  • No active peptic ulcer disease
  • No known malabsorption syndrome

Other

  • No other concurrent uncontrolled illness that would preclude study participation
  • No ongoing or active infection
  • No uncontrolled diabetes mellitus
  • No psychiatric illness or social situation that would preclude study participation
  • No prior allergic reactions attributed to compounds of similar chemical or biological composition to erlotinib or other study agents
  • No significant traumatic injury within the past 28 days
  • No other malignancy within the past 3 years except completely resected basal cell skin cancer or carcinoma in situ of the cervix
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior immunotherapy for this malignancy

Chemotherapy

  • No prior chemotherapy for this malignancy

Endocrine therapy

  • Not specified

Radiotherapy

  • No prior radiotherapy for this malignancy

Surgery

  • No prior surgical procedures affecting absorption
  • At least 28 days since prior major surgery

Other

  • No prior epidermal growth factor receptor-targeting therapies for this malignancy
  • No prior investigational agents for this malignancy
  • No other prior therapy for this malignancy
  • No concurrent commercial or other investigational anticancer agents or therapies
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent warfarin
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00049166

Locations
United States, Louisiana
MBCCOP - LSU Health Sciences Center
New Orleans, Louisiana, United States, 70118
New Orleans Cancer Institute at Memorial Medical Center
New Orleans, Louisiana, United States, 70115
Stanley S. Scott Cancer Center at Louisiana State University Medical Center - New Orleans
New Orleans, Louisiana, United States, 70112
Tulane Cancer Center at Tulane University Hospital and Clinic
New Orleans, Louisiana, United States, 70112-2699
United States, Maryland
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, Maryland, United States, 21231-2410
United States, Pennsylvania
Hillman Cancer Center at University of Pittsburgh Cancer Institute
Pittsburgh, Pennsylvania, United States, 15232
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
Investigators
Study Chair: Maura Gillison, MD, PhD Sidney Kimmel Comprehensive Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000257942, JHOC-20020723, JHOC-J0174, NCI-5375
Study First Received: November 12, 2002
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00049166     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
stage II squamous cell carcinoma of the lip and oral cavity
stage II squamous cell carcinoma of the oropharynx
stage III squamous cell carcinoma of the lip and oral cavity
stage III squamous cell carcinoma of the oropharynx
stage IV squamous cell carcinoma of the lip and oral cavity
stage IV squamous cell carcinoma of the oropharynx

Additional relevant MeSH terms:
Erlotinib
Otorhinolaryngologic Neoplasms
Otorhinolaryngologic Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Pharyngeal Neoplasms
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharyngeal Diseases
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Radiation-Sensitizing Agents
Cisplatin
Head and Neck Neoplasms
Therapeutic Uses
Stomatognathic Diseases
Oropharyngeal Neoplasms

ClinicalTrials.gov processed this record on November 09, 2009