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Rosiglitazone in Preventing Oral Cancer in Patients With Oral Leukoplakia
This study is ongoing, but not recruiting participants.
First Received: August 24, 2006   Last Updated: January 25, 2010   History of Changes
Sponsor: M.D. Anderson Cancer Center
Collaborators: National Cancer Institute (NCI)
Memorial Sloan-Kettering Cancer Center
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00369174
  Purpose

RATIONALE: Chemoprevention is the use of certain drugs to keep cancer from forming, growing, or coming back. The use of rosiglitazone may keep cancer from forming in patients with oral leukoplakia.

PURPOSE: This phase II trial is studying how well rosiglitazone works in preventing oral cancer in patients with oral leukoplakia.


Condition Intervention Phase
Head and Neck Cancer
Drug: Rosiglitazone
Phase II

Study Type: Interventional
Study Design: Prevention, Non-Randomized, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: Phase IIa Trial of Rosiglitazone (Avandia) for Oral Leukoplakia

Resource links provided by NLM:


Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Clinical and/or histological response rate at week 12 [ Time Frame: Baseline to Week 12 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Tissue expressions of cyclooxygenase-2, cyclin D1, Ki-67, p21/waf1, PPAR γ, K1 cytokeratin, involucrin, and transglutaminase and tissue levels of apoptosis as assessed by TUNEL assay [ Time Frame: At baseline and Week 12 ] [ Designated as safety issue: No ]

Estimated Enrollment: 25
Study Start Date: June 2006
Estimated Primary Completion Date: September 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Rosiglitazone (Avandia): Experimental
8 mg daily oral therapy x 3 months
Drug: Rosiglitazone
8 mg daily oral therapy for 3 months on oral premalignant lesions (OPL)

Detailed Description:

OBJECTIVES:

Primary

  • Determine the rate of clinical response in patients with oral leukoplakia treated with rosiglitazone.

Secondary

  • Determine the rate and degree of change in putative biomarkers of rosiglitazone efficacy, as measured by cyclooxygenase-2, cyclin D1, Ki-67, p21/waf1, PPAR γ, K1 cytokeratin, involucrin, transglutaminase expressions, and TUNEL assay.
  • Correlate DNA-ploidy measurements or oral leukoplakia with clinical response and/or response of biomarkers to rosiglitazone.
  • Estimate the efficacy of rosiglitazone to normalize aberrant DNA-ploidy in these patients.
  • Assess smoking patterns among these patients and examine the relationship of smoking to treatment response.
  • Assess the safety of short-term use of rosiglitazone in these patients.

OUTLINE: This is a multicenter, open-label, nonrandomized study.

Patients receive oral rosiglitazone once daily. Treatment continues for 12 weeks in the absence of unacceptable toxicity.

Tissue samples are collected at baseline and then periodically throughout the study for correlative studies. Immunohistochemistry is used to analyze biologic markers, including cyclin D1, Ki-67, p21/waf1, PPAR γ, K1 cytokeratin, transglutaminase, involucrin, and TUNEL assay. Cyclooxygenase-2 expression is measured by reverse transcriptase-polymerase chain reaction. DNA-ploidy is also measured.

After completion of study treatment, patients are followed at 1 week.

PROJECTED ACCRUAL: A total of 25 patients will be accrued for this study.

  Eligibility

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

Inclusion Criteria:

  1. Males or females with a suspected or histologically confirmed* index oral premalignant lesion (excluding carcinoma in situ), 12mm or greater in size that has not been biopsied in the past 6 wks. Each index lesion must be either a:dysplastic measurable leukoplakia or erythroplakia in the oral cavity or accessible oropharynx, or hyperplastic leukoplakia of high-risk sites, lateral and ventral tongue and floor of mouth.
  2. (Continued) * Patients will be registered using a two-stage registration process. The first stage of registration will be completed on the day of informed consent. The second stage of registration will be completed once the biopsy has been histologically confirmed to contain dysplasia.
  3. The subject is >/= 18 years of age. Because no dosing or adverse event data are currently available on the use of rosiglitazone in participants <18 years of age, children are excluded from this study but will be eligible for future pediatric trials, if applicable.
  4. The subject's life expectancy is > 12 weeks and Karnofsky performance score is 70-100%.
  5. The subject meets the following laboratory eligibility criteria during a time not to exceed 4 weeks prior to going on study: Hemoglobin and hematocrit levels above the lower limit of normal. White blood cells >/= 3,000/mL, Platelets >/= 125,000/mL, Total bilirubin </= 1.5 x ULN, AST (SGOT)/ALT (SGPT) </= 1.5 x ULN, BUN and serum creatinine </= 1.5 x ULN, LDH </= 1.5 x ULN
  6. If the subject is female and of childbearing potential (women are considered not of childbearing potential if they are at least two years postmenopausal and/or surgically sterile), she: - has been using adequate contraception (abstinence, IUD, birth control pills, or spermicidal gel with diaphragm or condom) since her last menses and will use adequate contraception during the study, AND - is not lactating, AND - has a documented negative serum pregnancy test within 14 days prior to randomization.
  7. The subject has discontinued any other oral cancer chemopreventive therapy at least 12 weeks prior to the Baseline visit and all toxicities have been fully resolved. Daily aspirin is permitted.
  8. The subject is willing and able to fully participate for the duration of the study.
  9. If applicable, the subject has been counseled on smoking cessation
  10. The effects of Avandia on the developing human fetus @ the recommended therapeutic dose are unk. For this reason,& b/c Avandia has been associated w/ fetal death & growth retardation in rats & rabbits & placental pathology in rats,women of child-bearing potential must agree to use adequate contraception(hormonal or barrier method of birth control;abstinence)prior to study entry & for the duration of study participation.Should a woman become pregnant or suspect she is pregnant while participating in this study,she should inform her study physician immediately & will be removed from the trial.
  11. Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  1. The subject has active cancer or carcinoma in situ of the head and neck
  2. The subject has a contraindication to biopsy
  3. The subject is of New York Heart Association (NYHA) Class I to IV heart failure, as well as, any patients with known heart failure.
  4. The subject has a history of myocardial infarction, angina, or coronary artery disease within the past 6 months, or active cardiac disease.
  5. The subject exhibits clinical evidence of active liver disease, history of chronic liver disease or edema.
  6. The subject is a diabetic not on treatment or hyperglycemic (has a random blood glucose level >200 mg/dl). The subject currently receives insulin, sulfonylurea or metformin (doses of rosiglitazone greater than 4 mg daily in combination with these therapies are not currently indicated. Because this protocol uses the maximum recommended dose of 8 mg daily, subjects on insulin, sulfonylurea or metformin will be ineligible for participation in this trial). The subject is currently receiving thiazolidinediones.
  7. The subject is currently receiving medical therapy for dysregulated blood sugar.
  8. The subject has experienced jaundice with Rezulin® (troglitazone)
  9. The subject has known hypersensitivity to Rosiglitazone, Avandia, or any of its components
  10. The subject has a history of colorectal cancer, familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC)
  11. The subject has a history of invasive cancer within the past 18 months (excluding non-invasive bladder cancer, non-melanoma skin cancer and in situ cervical cancer). Subjects (excluding those with a history of colorectal cancer, FAP or HNPCC) who received curative treatment and have shown no evidence of recurrence for 18 months will be eligible.
  12. The subject has had chemotherapy, immunotherapy, hormonal therapy (other than HRT for menopause), or radiation therapy within 18 months of the Baseline visit.
  13. The subject will need concurrent chemotherapy, radiotherapy, hormonal (other than HRT for menopause), or immunotherapy during the time of study.
  14. The subject has received any investigational medication within 30 days of the Baseline visit or is scheduled to receive an investigational drug during the course of the study.
  15. The subject participated in the study previously and was withdrawn.
  16. The subject is pregnant or nursing
  17. Subjects who have had the study drug prior to this study
  18. The subject has uncontrolled intercurrent illness including: ongoing or active infection, HIV, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00369174

Locations
United States, Louisiana
Louisiana State University Health Services Center
New Orleans, Louisiana, United States, 70112
United States, New York
Herbert Irving Comprehensive Cancer Center at Columbia University
New York, New York, United States, 10032
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, Texas
M.D. Anderson Cancer Center at University of Texas
Houston, Texas, United States, 77030-4009
Norway
Norwegian Radium Hospital, University of Oslo
Oslo, Norway
Sponsors and Collaborators
M.D. Anderson Cancer Center
Memorial Sloan-Kettering Cancer Center
Investigators
Study Chair: Jay O. Boyle, MD Memorial Sloan-Kettering Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: M. D. Anderson Cancer Center at University of Texas ( Scott Michael Lippman )
Study ID Numbers: 2005-0485, MSKCC-05062, MDA-2005-0485, CDR0000491154
Study First Received: August 24, 2006
Last Updated: January 25, 2010
ClinicalTrials.gov Identifier: NCT00369174     History of Changes
Health Authority: United States: Federal Government

Keywords provided by M.D. Anderson Cancer Center:
precancerous/nonmalignant condition
lip and oral cavity cancer
oropharyngeal cancer
oral leukoplakia
DNA ploidy
Smoking patterns
Rosiglitazone
Avandia
Mouth
Tongue

Additional relevant MeSH terms:
Pathological Conditions, Anatomical
Mouth Diseases
Leukoplakia, Oral
Precancerous Conditions
Physiological Effects of Drugs
Mouth Neoplasms
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Hypoglycemic Agents
Head and Neck Neoplasms
Leukoplakia
Stomatognathic Diseases
Rosiglitazone

ClinicalTrials.gov processed this record on February 08, 2010