Cetuximab and Dasatinib in Recurrent Squamous Cell Carcinoma

This study is currently recruiting participants. (see Contacts and Locations)
Verified January 2015 by University of Pittsburgh
Sponsor:
Collaborator:
Bristol-Myers Squibb
Information provided by (Responsible Party):
University of Pittsburgh
ClinicalTrials.gov Identifier:
NCT01488318
First received: November 30, 2011
Last updated: January 13, 2015
Last verified: January 2015
  Purpose

This is a single-arm, non-masked, open-label, Phase II study of cetuximab + dasatinib in recurrent Squamous Cell Carcinoma of The Head and Neck (SCCHN) that has recurred after cetuximab-containing therapy (please see attached schema).

The primary endpoint 12-week PFS.


Condition Intervention Phase
Squamous Cell Carcinoma Of The Head And Neck
Drug: Cetuximab
Drug: Dasatinib
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Trial of Cetuximab and Dasatinib in Patients With Cetuximab-resistant, Metastatic and/or Recurrent Squamous Cell Carcinoma of the Head and Neck and Low Serum IL-6

Resource links provided by NLM:


Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • Overall Response Rate [ Time Frame: 3 years ] [ Designated as safety issue: No ]
    To evaluate the efficacy of the combination of cetuximab and dasatinib in patients with cetuximab-resistant, recurrent/metastatic SCCHN and low serum IL-6, as measured by 12-week PFS.


Secondary Outcome Measures:
  • Time to progression [ Time Frame: 3 years ] [ Designated as safety issue: No ]
    To estimate time to progression and overall survival.

  • The maximum toxicity for each category of interest in each subject [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
    To evaluate the safety of the combination of dasatinib (D) and cetuximab (C) in this patient population. The maximum toxicity for each category of interest will be recorded for each patient and the summary results will be presented in tabular form.


Estimated Enrollment: 37
Study Start Date: October 2013
Estimated Study Completion Date: May 2017
Estimated Primary Completion Date: October 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CETUXIMAB AND DASATINIB

Cetuximab on a standard weekly schedule (see Section 6.2). Group 1 (subjects more than 2 weeks post last dose of Cetuximab): Loading dose of 400 mg/m2 on cycle 1, day 1 then 250 mg/m2 IV weekly.

Group 2 (subjects last Cetuximab treatment within 2 weeks): Cycle 1 will start at a dose of 250 mg/m2 Dasatinib 150 mg once daily without interruption. On the FIRST cycle (1 cycle is 3 weeks) dasatinib will start 3 days after the cetuximab loading dose (i.e. cycle 1, day 4) to avoid headache as shown on the previous phase I trial.

Treatment will continue until progression.

Drug: Cetuximab
Cetuximab 250 mg/m2 IV weekly after loading dose 400 mg/m2 on cycle 1, day 1
Other Name: Erbitux
Drug: Dasatinib
Dasatinib 150 mg po

Detailed Description:

Patients must have recurrent SCCHN and may have received any number of prior palliative systemic therapies for recurrent disease (without cetuximab or othr EGFR inhibitor). One prior curative regimen (induction, primary or postoperative chemoradiotherapy) should have been given AND all patients should have been exposed to cetuximab as part of prior potentially curative treatment.Those who have received a prior Src kinase inhibitor or EGFR inhibitor other than cetuximab are not eligible.

Patients will be tested for serum IL-6. If IL-6 is detectable, the patient will be ineligible. If IL-6 is not detected, the patient will be eligible for the study. Subjects more than 2 weeks post last dose of Cetuximab will receive an initial loading dose 400 mg/m2 on cycle 1, day 1. Subjects who have received Cetuximab within 2 weeks of starting study will start Cycle 1 with dose of 250 mg/m2. Dasatinib will start 3 days after initial cetuximab study dose on cycle 1 (i.e cycle 1, day 4), and continue without interruption.

  Eligibility

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

Inclusion:

  • Patients must have metastatic and/or recurrent SCCHN that has been previously treated with cetuximab.
  • Undetectable baseline serum IL-6 NOTE : This eligibility criterion applies only to patients enrolling to the second, biomarker-enrichment stage of the trial.
  • Measurable disease per RECIST 1.1.
  • Unlimited prior treatment with radiation or chemoradiotherapy
  • Any number of prior regimens for recurrent or metastatic SCCHN (i.e. palliative treatment) including cetuximab or other EGFR inhibitor
  • Age >18 years
  • ECOG performance status <2 (Karnofsky >60%, see Appendix A).
  • Life expectancy of greater than 12 weeks.
  • Patients must have normal organ and marrow function as defined below:

    1. absolute neutrophil count >1,200/µL
    2. platelets >100,000/µL
    3. total bilirubin within normal institutional limits
    4. AST(SGOT)/ALT(SGPT) < 2.5 X institutional upper limit of normal
    5. Creatinine up to 1.5 X normal institutional limits
  • Ability to understand and the willingness to sign a written informed Consent document.
  • Patients should not be taking concomitant medication that are CYP3A4 inducers or potent inhibitors and should try to avoid taking proton pump inhibitors and H2 antagonists during rest of treatment period. The above medications will be continued only if medically necessary and their use will be noted.
  • Sexually active women of childbearing potential must use an effective method of birth control during the course of the study, in a manner such that risk of failure is minimized. Prior to study enrollment, women of childbearing potential (WOCBP) must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. In addition, men enrolled on this study should understand the risks to any sexual partner of childbearing potential and should practice an effective method of birth control. All WOCBP MUST have a negative pregnancy test prior to first receiving investigational product. If the pregnancy test is positive, the patient must not receive investigational product and must not be enrolled in the study. In addition, all WOCBP should be instructed to contact the Investigator immediately if they suspect they might be pregnant (e.g., missed or late menstrual period) at any time during study participation.

Exclusion:

  • Patients who have not recovered from adverse events due to prior agents. A minimum interval of 3 weeks should have elapsed from prior chemotherapy other than cetuximab. A minimum of 12 weeks should have elapsed from prior definitive radiotherapy, and a minimum of 1 week should have elapsed from prior palliative radiotherapy.
  • Patients may not have received an investigational agent within 4 weeks of starting this trial.
  • Patients with untreated brain metastases should be excluded from this clinical trial.
  • History of allergic reactions to monoclonal antibodies.
  • Inability to swallow oral medications (unless patients use a feeding tube in which case they are eligible).
  • Uncontrolled angina or uncontrolled hypertension or any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de pointes).
  • Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec) on the Bazett's correction.
  • Diagnosed or suspected congenital long QT syndrome.
  • Patients currently taking drugs that are generally accepted to have a risk of causing Torsades de Pointes including: quinidine, procainamide, disopyramide, amiodarone, sotalol, ibutilide, dofetilide, erythromycins, clarithromycin, chlorpromazine, haloperidol, mesoridazine, thioridazine, pimozide, cisapride, bepridil, droperidol, methadone, arsenic, chloroquine, domperidone, halofantrine, levomethadyl, pentamidine, sparfloxacin, lidoflazine.
  • Any other uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, or psychiatric illness/social situations that would limit compliance with study requirements.
  • History of significant bleeding disorder unrelated to cancer, including: diagnosed congenital bleeding disorders (e.g., von Willebrand's disease), diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies).
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01488318

Contacts
Contact: Rita Johnson, RN 412-647-8571 johnsonr1@upmc.edu
Contact: Wieping DeBlasio, RN 412-623-7957 deblasiowx@upmc.edu

Locations
United States, Pennsylvania
University of Pittsburgh Cancer Institute Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: RIta Johnson, RN    412-647-8571    johnsonr1@upmc.edu   
Principal Investigator: Julie Bauman, MD         
Sponsors and Collaborators
University of Pittsburgh
Bristol-Myers Squibb
Investigators
Principal Investigator: Julie Bauman University of Pittsburgh
  More Information

No publications provided by University of Pittsburgh

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: University of Pittsburgh
ClinicalTrials.gov Identifier: NCT01488318     History of Changes
Other Study ID Numbers: 08-034, CA180264
Study First Received: November 30, 2011
Last Updated: January 13, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by University of Pittsburgh:
Cetuximab
Dasatinib
Squamous Cell
Head and Neck
After Cetuximab Containing Chemoradiotherapy
Recurrent
Metastatic

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

ClinicalTrials.gov processed this record on March 31, 2015