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Cetuximab, Cisplatin, and Radiotherapy in Women With Locally Advanced Cervical Carcinoma

Primary Purpose

Cancer of the Cervix

Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Cetuximab
Sponsored by
University of Virginia
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer of the Cervix focused on measuring Cervical Cancer, Cetuximab, Phase II Clinical Trials, Stage IB2-IVB Carcinoma of the Cervix

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Patients must have signed a Washington University, Human Studies Committee (HSC) approved, informed consent. Patients must have primary, histologically documented FIGO Clinical Stage IB2-IVB invasive carcinoma of the uterine cervix with measurable disease amendable to repeated biopsy. Patients must have an ECOG performance status of 0, 1, or 2 at study entry. Patients, 18 years and older, must either be not of child bearing potential or have a negative pregnancy test within 7 days of treatment. Patients are considered not of child bearing potential if they are surgically sterile (they have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are postmenopausal. Women should not breast feed while on this study. Women must have a primary diagnosis of invasive carcinoma of the uterine cervix. Men are excluded from this study as a consequence of the diagnosis being investigated. Patients must have had no previous treatment for invasive carcinoma of the uterine cervix. Patients must be newly diagnosed with locally advanced or metastatic cervical carcinoma. Bone marrow function: absolute neutrophil count (ANC) ≥ 1,500/mcl; platelets > 100,000/mcl. Renal function: creatinine ≤ 2.0 mg/dl. Hepatic function: bilirubin ≤ 1.5 times upper limit normal (ULN); SGOT ≤ 2.5 times upper limit normal (ULN). Patients with ureteral obstruction must be treated with stent or nephrostomy tube placement. Patients with neuropathy (sensory and motor) must be ≤ grade 1 defined by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 (June 10, 2003). Exclusion Criteria: Acute hepatitis or known HIV. Active or uncontrolled infection. Significant history of uncontrolled cardiac disease i.e., uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, and cardiomyopathy with decreased ejection fraction. Prior therapy which specifically and directly targets the EGFR pathway. Prior severe infusion reaction to a monoclonal antibody. Any concurrent chemotherapy not indicated in the study protocol or any other investigational agent(s). A serious uncontrolled medical disorder that in the opinion of the Investigator would impair the ability of the subject to receive protocol therapy. Unresolved ureteral obstruction. Renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal transplant, that would require modification of radiation fields. Known or documented brain metastases. Any concurrent malignancy other than non-melanoma skin cancer. (Patients with a previous malignancy but without evidence of disease for ≥ 5 years will be allowed to enter the trial). Prior radiation therapy to the abdomen and/or pelvis Incarceration

Sites / Locations

  • Washinton University School of Medicine
  • University of Virginia Cancer CenterRecruiting

Outcomes

Primary Outcome Measures

To identify genes that may be identified as predictive of response to cetuximab
To sequence the epidermal growth factor receptor (EGFR) to describe mutations in the receptor that may predict tumor response to cetuximab
To evaluate the validity of fluorodeoxyglucose (FDG) uptake, as determined by positron emission tomography (PET) imaging, as a surrogate marker for response to cetuximab

Secondary Outcome Measures

To determine the safety and tolerability of cetuximab with concurrent chemoradiation in women with locally advanced cervical carcinoma
To determine the progression-free and overall survival in women with locally advanced or metastatic cervical carcinoma treated with concurrent chemoradiation and cetuximab

Full Information

First Posted
February 14, 2006
Last Updated
May 26, 2011
Sponsor
University of Virginia
Collaborators
Bristol-Myers Squibb, Eli Lilly and Company, Washington University School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT00292955
Brief Title
Cetuximab, Cisplatin, and Radiotherapy in Women With Locally Advanced Cervical Carcinoma
Official Title
An Exploratory Pharmacogenomic Study of Neoadjuvant Cetuximab Followed by Cisplatin, Radiotherapy, and Cetuximab in Women With Newly Diagnosed Locally Advanced or Metastatic Cervical Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2011
Overall Recruitment Status
Unknown status
Study Start Date
February 2006 (undefined)
Primary Completion Date
February 2012 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
University of Virginia
Collaborators
Bristol-Myers Squibb, Eli Lilly and Company, Washington University School of Medicine

4. Oversight

5. Study Description

Brief Summary
The anti-tumor activity of cetuximab prior to chemoradiotherapy and the safety and tolerability of cetuximab with concurrent chemoradiation will be determined in women with locally advanced or metastatic cervical carcinoma.
Detailed Description
Women with Federation of Gynecology and Obstetrics (FIGO) Clinical Stage IB2-IVB carcinoma of the cervix Baseline cervical biopsy, blood samples, and FDG-PET/computed tomography (CT) scan Cetuximab 400 mg/m2 on day 1 followed by cetuximab 250 mg/m2 on days 8 and 15 Repeat cervical biopsy and FDG-PET/CT scan following cetuximab monotherapy Radiation and weekly cisplatin 40 mg/m2 and cetuximab 250 mg/2 for 6 weeks Cetuximab 250 mg/m2 weekly for 12 weeks Repeat cervical biopsy (if tumor present) and FDG-PET/CT scan after completion of therapy Follow for tumor recurrence and survival

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer of the Cervix
Keywords
Cervical Cancer, Cetuximab, Phase II Clinical Trials, Stage IB2-IVB Carcinoma of the Cervix

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Cetuximab
Intervention Description
monotherapy (day 1), then weekly thereafter along with radiation. dose is at 200mg/m2.
Primary Outcome Measure Information:
Title
To identify genes that may be identified as predictive of response to cetuximab
Time Frame
completion
Title
To sequence the epidermal growth factor receptor (EGFR) to describe mutations in the receptor that may predict tumor response to cetuximab
Time Frame
completion
Title
To evaluate the validity of fluorodeoxyglucose (FDG) uptake, as determined by positron emission tomography (PET) imaging, as a surrogate marker for response to cetuximab
Time Frame
completion
Secondary Outcome Measure Information:
Title
To determine the safety and tolerability of cetuximab with concurrent chemoradiation in women with locally advanced cervical carcinoma
Time Frame
weekly
Title
To determine the progression-free and overall survival in women with locally advanced or metastatic cervical carcinoma treated with concurrent chemoradiation and cetuximab
Time Frame
every three months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have signed a Washington University, Human Studies Committee (HSC) approved, informed consent. Patients must have primary, histologically documented FIGO Clinical Stage IB2-IVB invasive carcinoma of the uterine cervix with measurable disease amendable to repeated biopsy. Patients must have an ECOG performance status of 0, 1, or 2 at study entry. Patients, 18 years and older, must either be not of child bearing potential or have a negative pregnancy test within 7 days of treatment. Patients are considered not of child bearing potential if they are surgically sterile (they have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are postmenopausal. Women should not breast feed while on this study. Women must have a primary diagnosis of invasive carcinoma of the uterine cervix. Men are excluded from this study as a consequence of the diagnosis being investigated. Patients must have had no previous treatment for invasive carcinoma of the uterine cervix. Patients must be newly diagnosed with locally advanced or metastatic cervical carcinoma. Bone marrow function: absolute neutrophil count (ANC) ≥ 1,500/mcl; platelets > 100,000/mcl. Renal function: creatinine ≤ 2.0 mg/dl. Hepatic function: bilirubin ≤ 1.5 times upper limit normal (ULN); SGOT ≤ 2.5 times upper limit normal (ULN). Patients with ureteral obstruction must be treated with stent or nephrostomy tube placement. Patients with neuropathy (sensory and motor) must be ≤ grade 1 defined by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 (June 10, 2003). Exclusion Criteria: Acute hepatitis or known HIV. Active or uncontrolled infection. Significant history of uncontrolled cardiac disease i.e., uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, and cardiomyopathy with decreased ejection fraction. Prior therapy which specifically and directly targets the EGFR pathway. Prior severe infusion reaction to a monoclonal antibody. Any concurrent chemotherapy not indicated in the study protocol or any other investigational agent(s). A serious uncontrolled medical disorder that in the opinion of the Investigator would impair the ability of the subject to receive protocol therapy. Unresolved ureteral obstruction. Renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal transplant, that would require modification of radiation fields. Known or documented brain metastases. Any concurrent malignancy other than non-melanoma skin cancer. (Patients with a previous malignancy but without evidence of disease for ≥ 5 years will be allowed to enter the trial). Prior radiation therapy to the abdomen and/or pelvis Incarceration
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Meredith Gross, M.S.
Phone
434-924-0436
Email
mpg8b@virginia.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Linda R. Duska, M.D.
Organizational Affiliation
University of Virginia
Official's Role
Principal Investigator
Facility Information:
Facility Name
Washinton University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Suspended
Facility Name
University of Virginia Cancer Center
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Citations:
PubMed Identifier
35696702
Citation
Fracasso PM, Duska LR, Thaker PH, Gao F, Zoberi I, Dehdashti F, Siegel BA, Uliel L, Menias CO, Rehm PK, Goodner SA, Creekmore AN, Lothamer HL, Rader JS. An Exploratory Study of Neoadjuvant Cetuximab Followed by Cetuximab and Chemoradiotherapy in Women With Newly Diagnosed Locally Advanced Cervical Cancer. Am J Clin Oncol. 2022 Jul 1;45(7):286-293. doi: 10.1097/COC.0000000000000926. Epub 2022 Jun 7.
Results Reference
derived

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Cetuximab, Cisplatin, and Radiotherapy in Women With Locally Advanced Cervical Carcinoma

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