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A Trial of Erlotinib + Radiotherapy for Cutaneous Squamous Cell Carcinoma (RAD0503)

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ClinicalTrials.gov Identifier: NCT00369512
Recruitment Status : Completed
First Posted : August 29, 2006
Results First Posted : August 8, 2013
Last Update Posted : May 30, 2017
Information provided by (Responsible Party):

Study Description
Brief Summary:
This is a phase II study designed to study the effectiveness of combined radiotherapy and erlotinib in the postoperative setting for patients with cutaneous SCC that are at high risk for recurrence. Participants enrolled in the study will be evaluated by a head and neck surgeon, and a radiation oncologist. Whenever possible, a preoperative biopsy will be performed after participant enrollment in the study for histological confirmation and for molecular correlates. Participants enrolled prior to surgical resection will begin erlotinib at 150 mg by mouth (PO) every day (QD) (14 tablets) to be taken 14 days prior to surgical resection. Following planned surgical resection, the participant will begin Erlotinib therapy and radiotherapy at the same time and within 4-8 weeks of the surgical resection.

Condition or disease Intervention/treatment Phase
Cancer Drug: Erlotinib Phase 2

Detailed Description:

This is a single-institution, open-label, non-randomized phase II trial of erlotinib administered concomitantly with radiation therapy following surgical resection of gross disease. A total of 45 patients with previously unirradiated, high-risk cutaneous SCC requiring post-operative radiotherapy will be enrolled to assess the primary endpoints of time to recurrence and disease free survival. Pretreatment biopsies will be required to confirm the histological diagnosis of SCC. Four to six weeks after surgical resection, patients will begin erlotinib (150 mg po qd) beginning the first day of radiotherapy. Patients will receive 5040 cGy beginning on day 1 of therapy in standard fractionations. Patients will be followed to evaluate for toxicity based on NCI common toxicity criteria (v3.0). Patients will be followed on protocol for a minimum of 2 years with regularly scheduled CT scans, clinical evaluations, and laboratory work. Patients with residual or recurrent cancer will be taken off protocol for salvage therapy.

As a secondary objective, molecular response of tumors to erlotinib monotherapy will be determined. When possible, participants will be enrolled and treated for 14 days with erlotinib prior to surgical resection. The pretreatment biopsy specimen (control) will then be compared to tissue acquired during the surgical resection after 14 days of erlotinib (experimental group).

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 15 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Trial of Erlotinib and Radiotherapy in Patients With Stage III Cutaneous Squamous Cell Carcinomas
Study Start Date : August 2006
Primary Completion Date : January 2012
Study Completion Date : September 2012

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: Erlotinib
Erlotinib therapy for 2 weeks (150 mg po qd)(for those who are enrolled before surgery is done), surgery/biopsy up to 8 weeks recovery, radiation/Erlotinib therapy for 6 weeks (150mg po qd).
Drug: Erlotinib
Erlotinib therapy for 2 weeks (150 mg po qd)(for those who are enrolled before surgery is done), surgery/biopsy up to 8 weeks recovery, radiation/Erlotinib therapy for 6 weeks (150mg po qd).
Other Name: Tarceva

Outcome Measures

Primary Outcome Measures :
  1. Toxicities Associated With Combined Radiotherapy and Erlotinib Treatments. [ Time Frame: 2 years ]
    Number of gradeable toxicities (via CTCAE manual) experienced by patients on this protocol--number of events

  2. Median Time to Cancer Recurrence [ Time Frame: 2 years ]
    Per protocol, patients were followed every 3 months for recurrent disease by physical exam and imaging (MRI/CT). Recurrence, in most cases, is detected during routine history/physical exam. If disease was detected during follow-up, every attempt was made to obtain pathological confirmation of recurrence.

  3. Number of Patients With Recurrence at 2 Years [ Time Frame: 2 years ]
    Rate of recurrence at 2 years.

Eligibility Criteria

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Ages Eligible for Study:   19 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically proven primary or recurrent squamous cell carcinoma arising from the lip or skin of the face, ear, scalp or neck.
  • Participants must meet one of the four criteria:
  • 1. T4 cutaneous SCC as determined by physical exam, imaging studies, prior resections or biopsy. T4 disease is defined as tumor that invades deep extradermal structures such as cartilage, skeletal muscle (e.g., muscles of facial expression), parotid gland or bone.Patients with a T2 or greater squamous cell carcinoma of the lower lip who will require post operative radiation will be allowed.
  • 2. Histologically proven regional lymph node involvement (N1 disease). Fine needle aspiration or biopsy can be used to demonstrate the presence of lymphatic spread.
  • 3. Histologically proven parotid gland metastasis. Fine needle aspiration or biopsy can be used to demonstrate the presence of regional spread. Includes delayed regional metastasis; primary scalp or other skin lesion treated within 36 months that would drain into the involved parotid.
  • 4. Patients who following surgical resection of the primary are found to have histologically positive lymph nodes (N1). Includes delayed regional metastasis; primary lip or cutaneous lesion treated within 36 months that would drain into the involved nodal basin.
  • Age > 19 years
  • Tumors must be considered surgically resectable.(Patients may be enrolled after surgery is completed as long as Erlotinib therapy and concurrent radiation is started within 8 weeks of surgical resection.)
  • Required laboratory data obtained prior to beginning treatment: WBC > 1,500/ml; Platelets > 90,000; serum creatinine ≤ 2.0 mg/dl
  • The patient may have had a prior non-cutaneous malignancy, but must be two years from treatment.
  • Performance status of ≤ 2 (ECOG scale) and life expectancy ≥ 12 months.
  • The patients must agree to use effective contraception if there is the potential for procreativity. Contraception must be conducted for at least 3 months following the study.
  • Patients must sign informed consent

Exclusion Criteria:

  • The patient has received prior radiation therapy to the head and neck.
  • The patient is pregnant or lactating
  • Patients with a prior history of head and neck mucosal cancers.
  • Psychological condition that renders the patient unable to understand the informed consent.
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00369512

United States, Alabama
University of Alabama at Birmingham Medical Center
Birmingham, Alabama, United States, 35233
Sponsors and Collaborators
University of Alabama at Birmingham
Genentech, Inc.
OSI Pharmaceuticals
Principal Investigator: Eben Rosenthal, M.D. University of Alabama at Birmingham
More Information

Responsible Party: Eben Rosenthal, Professor of Surgery - Otolaryngology, University of Alabama at Birmingham
ClinicalTrials.gov Identifier: NCT00369512     History of Changes
Other Study ID Numbers: F060106002
First Posted: August 29, 2006    Key Record Dates
Results First Posted: August 8, 2013
Last Update Posted: May 30, 2017
Last Verified: May 2017

Keywords provided by Eben Rosenthal, University of Alabama at Birmingham:
Phase II
Squamous Cell Carcinomas
Stage III

Additional relevant MeSH terms:
Carcinoma, Squamous Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Squamous Cell
Erlotinib Hydrochloride
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action