Weekly Oxaliplatin and Gemcitabine for Recurrent or Metastatic Head and Neck Cancer
The combination of oxaliplatin and gemcitabine is highly active in a wide variety of tumors including pancreatic, germ cell, breast, biliary, mesothelioma (Mitchell et al, 2002), and lung. In the last study which utilized days 1 and 8 gemcitabine 1000 mg/m2 and days 1 and 8 oxaliplatin 65 mg/m2 in poor prognosis lung cancer patients (PS 1-3) the response rate was 16% with no incidence of febrile neutropenia.
Toxicity is a crucial consideration when designing regimens intended for palliation. Toxicities associated with cisplatin can make it difficult to use in patients with Head and Neck Cancer (HNC), many of whom are elderly and have comorbidities. In addition, many patients with metastatic HNC have previously received cisplatin during neoadjuvant/adjuvant therapy, or as part of their primary chemoradiation treatment. When these patients recur, it is possible their tumors have innate or acquired cisplatin resistance. Oxaliplatin is likely to be better tolerated than cisplatin containing regimens, especially with regards to neurotoxicity. Gemcitabine has shown promising activity as a single agent and in combination chemotherapy in the first line treatment of patients with HNC. A combination chemotherapy regimen using oxaliplatin and gemcitabine administered once every week is logical and worth exploring in patients with metastatic and recurrent head and neck cancer to improve the toxicity profile and patient monitoring while maintaining efficacy of the chemotherapy regimen.
Cancer of the Head and Neck
|Study Design:||Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase II Study of Weekly Oxaliplatin and Gemcitabine Combination Chemotherapy for Recurrent or Metastatic Head and Neck Cancer|
- Overall Response Rate (Complete and Partial Response) [ Time Frame: 5 years ] [ Designated as safety issue: No ]
Complete Response (CR): Complete disappearance of all measurable and non-measurable disease. No new lesions. No disease related symptoms. Normalization of markers and other abnormal lab values. All disease must be assessed using the same techniques as baseline.
Partial Response (PR): Applies only to patients with at least one measurable lesion. Greater than or equal to 30% decrease under baseline of longest diameters of all target measurable lesions. No unequivocal progression of non-measurable disease. No new lesions. All target measurable lesions must be assessed using the same techniques as baseline.
- Frequency and Severity of Toxicities [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
- Overall Survival and Time to Treatment Failure [ Time Frame: 5 years ] [ Designated as safety issue: No ]
|Study Start Date:||April 2005|
|Study Completion Date:||October 2011|
|Primary Completion Date:||February 2008 (Final data collection date for primary outcome measure)|
Experimental: Gemcitabine plus Oxaliplatin
Gemcitabine given 1000 mg/m2 IV over 100 minutes Every 21 days. Oxaliplatin given 65 mg/m2 IV over 120 minutes immediately following gemcitabine Every 21 days.
1000 mg/m2 IV over 100 minutes Every 21 days
Other Names:Drug: Oxaliplatin
65 mg/m2 IV over 120 minutes immediately following gemcitabine Every 21 days
Other Name: NSC-266046
Please refer to this study by its ClinicalTrials.gov identifier: NCT00256295
|United States, California|
|Chao Family Comprehensive Cancer Center|
|Orange, California, United States, 92868|
|Principal Investigator:||Ignatius Ou, MD||Chao Family Comprehensive Cancer Center|