Adjuvant Erlotinib After Completing Chemoradiotherapy in Treating Patients With Locally Advanced Squamous Cell Carcinoma of
the Head and Neck
This study is currently recruiting patients.
Sponsored by: |
National Cancer Institute of Canada |
Information provided by: |
National Cancer Institute (NCI) |
Purpose
RATIONALE: Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Giving erlotinib
after chemoradiotherapy may kill more tumor cells.
PURPOSE: Phase I trial to study the effectiveness of adjuvant erlotinib after completing chemoradiotherapy in treating patients
who have locally advanced squamous cell carcinoma (cancer) of the head and neck.
Condition
|
Treatment or Intervention |
Phase |
Head and Neck Cancer
|
Drug: erlotinib Procedure: adjuvant therapy Procedure: enzyme inhibitor therapy Procedure: protein tyrosine kinase inhibitor therapy
|
Phase I
|
MedlinePlus related topics: Head and Neck Cancer
Study Type: Interventional
Study Design: Treatment
Official Title: Phase I Study of Adjuvant Erlotinib After Completion of Chemoradiotherapy in Patients With Locally Advanced Squamous Cell
Carcinoma of the Head and Neck
Further Study Details:
OBJECTIVES: Primary
- Determine the recommended dose of adjuvant erlotinib after the completion of chemoradiotherapy in patients with stage III,
IVA, or IVB squamous cell carcinoma of the head and neck.
- Determine the toxicity of this drug in these patients.
- Determine the effects of this drug on plasma and urinary angiogenic factors (specifically vascular endothelial growth factor
receptor [VEGFR], VEGFR1, VEGFR2, and basic fibroblast growth factor levels) in these patients.
- Compare the disease-free survival of patients treated with this drug after chemoradiotherapy vs historical control patients
treated with chemoradiotherapy alone.
- Correlate levels of angiogenic factors with initial blood vessel concentration in the tumor and the presence or absence of
EGFRvIII mutation in patients treated with this drug.
OUTLINE: This is an open-label, dose-escalation, multicenter study.
Patients receive oral erlotinib once daily on days 1-28. Treatment repeats every 28 days for up to 6 courses in the absence
of disease progression or unacceptable toxicity.
Cohorts of 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 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined,
an additional 8 patients are treated at that dose level.
Patients are followed at 4 weeks, every 12 weeks for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 6-20 patients will be accrued for this study.
Eligibility
Ages Eligible for Study:
18 Years and above,
Genders Eligible for Study:
Both
DISEASE CHARACTERISTICS:
- Histologically confirmed squamous cell carcinoma of the head and neck
- Stage III, IVA, or IVB
- Must have completed cisplatin- or carboplatin-based chemoradiotherapy within the past 4-12 weeks
- Prior radiotherapy must have been given with a radical intent with receipt of at least 90% of planned dose
- No evidence of disease or presence of inoperable minimal residual disease, defined by 1 of the following:
- Complete response at primary tumor site and nodes (with or without nodal surgery after chemoradiotherapy)
- Negative lymph node status (by physical or radiological exam) AND persistent tumefaction less than 25% of original tumor size
or residual mass due to scarring
- Tumor tissue samples available for EGFRvIII mutation analysis
- No known brain metastasis
PATIENT CHARACTERISTICS: Age
Performance status
Life expectancy
Hematopoietic
- Absolute granulocyte count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
Hepatic
- ALT/AST < 2 times upper limit of normal (ULN)
- Bilirubin < ULN (unless due to Gilbert’s syndrome)
Renal
- Creatinine < 1.5 times ULN
Cardiovascular
- No myocardial infarction within the past year
- No cardiac ventricular arrhythmias requiring medication
- No history of cardiac disease
- No uncontrolled high blood pressure
- No unstable angina
- No congestive heart failure
Ophthalmic
- No history of severe dry eye syndrome, Sjögren’s syndrome, or keratoconjunctivitis sicca
- No severe exposure keratopathy
- No abnormal slit-lamp examination using a vital dye (e.g., fluorescein or Bengal-Rose)
- No abnormal corneal sensitivity test (Schirmer test or similar tear production test)
- No disorder that might increase the risk for epithelium-related complication (e.g., bullous keratopathy, aniridia, severe
chemical burns, or neutrophilic keratitis)
- No congenital abnormality (e.g., Fuch’s dystrophy)
- No ocular inflammation or infection
Gastrointestinal
- Able to take oral medication
- No gastrointestinal (GI) tract disease requiring IV alimentation
- No uncontrolled inflammatory GI disease (e.g., Crohn's disease or ulcerative colitis)
- No active peptic ulcer disease
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No serious active infection
- No other serious underlying medical condition that would preclude study participation
- No prior allergic reaction to compounds of similar chemical or biological composition to erlotinib
- No other malignancy with the past 5 years except adequately treated non-melanoma skin cancer (unless in the same area treated
with radical radiotherapy) or carcinoma in situ of the cervix
PRIOR CONCURRENT THERAPY: Biologic therapy
Chemotherapy
- See Disease Characteristics
- Recovered from prior chemotherapy
Endocrine therapy
Radiotherapy
- See Disease Characteristics
- Recovered from prior radiotherapy
Surgery
- See Disease Characteristics
- No prior surgical procedure affecting absorption
- No concurrent ophthalmic surgery
Other
- More than 4 weeks since other prior investigational drugs
- No other concurrent investigational agents
- No other concurrent anticancer therapy
- Concurrent oral anticoagulants (e.g., warfarin) allowed provided there is increased vigilance with respect to INR
- Concurrent nasogastric or gastrostomy tube feeding for dysphagia allowed provided there is no evidence of significant residual
mucositis (i.e., > grade 1)
Location
and Contact
Information
Canada, Ontario Margaret and Charles Juravinski Cancer Centre, Hamilton,
Ontario,
L8V 5C2,
Canada; Recruiting
James Wright, MD
905-387-9495 ext. 64705
Canada, Quebec Centre Hospitalier de l'Universite de Montreal, Montreal,
Quebec,
H2L-4M1,
Canada; Recruiting
Study chairs or principal investigators
Denis Soulieres, MD, Study Chair, Centre Hospitalier de l'Universite de Montreal
More Information
Clinical trial summary from the National Cancer Institute's PDQ® database
Study ID Numbers:
CDR0000353485; CAN-NCIC-HN5; ROCHE-CAN-NCIC-HN5
Record last reviewed:
May 2004
Record first received:
March 8, 2004
ClinicalTrials.gov Identifier:
NCT00079053Health Authority: Unspecified
ClinicalTrials.gov processed this record on 2004-11-18