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A Phase II Clinical Trial to Study the Efficacy and Safety of a New Drug P276-00 in Treatment of Recurrent and/or Locally Advanced Head and Neck Cancer (MONARCH)

Primary Purpose

Squamous Cell Carcinoma of Head and Neck

Status
Completed
Phase
Phase 2
Locations
India
Study Type
Interventional
Intervention
P276-00
Sponsored by
Piramal Enterprises Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Squamous Cell Carcinoma of Head and Neck

Eligibility Criteria

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

Inclusion Criteria:

  1. Age more than or equal to 18 years
  2. Subjects with histologically or cytologically confirmed SCCHN that is recurrent and/or metastatic and judged incurable by surgery and/or radiation therapy and with zero to one line of chemotherapy for recurrent or metastatic disease at least 60 days prior to study entry.
  3. Measurable disease, defined as at least one unidimensionally measurable lesion ≥ 20 mm by conventional techniques or ≥10 mm by spiral computerized tomography (CT) scan or magnetic resonance imaging (MRI)
  4. Tumor that is accessible to biopsy
  5. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  6. Life expectancy of at least three months
  7. Hemoglobin ≥ 8.0 gm/dL
  8. Absolute neutrophil count (ANC) ≥ 1000/mm3
  9. Platelet count ≥ 50,000/mm3
  10. Total bilirubin ≤1.5X institutional upper limit of normal (ULN)
  11. Serum AST ≤ 3X institutional ULN
  12. Serum ALT ≤ 3X institutional ULN
  13. Serum creatinine ≤1.5X institutional ULN
  14. Ability to understand and the willingness to sign a written informed consent document (ICD)

Exclusion Criteria:

  1. Nasopharyngeal carcinoma
  2. Prior treatment with P276-00 or other Cyclin dependent kinase (CDK) targeting agents
  3. History of allergic reactions attributed to compounds of similar chemical composition to P276-00
  4. Subjects who have received radiotherapy, chemotherapy or biologic/targeted anticancer agents within 60 days prior to Day 1 of study drug administration or have not recovered from adverse effects of any prior radiotherapy, chemotherapy or biologic/targeted agents.
  5. More than one chemotherapy regimen for the recurrent or metastatic disease
  6. Subjects who had received any other investigational drug within 1 month or within five half-lives of the other investigational agent, whichever is longer prior to Day 1 of study drug administration
  7. Subjects with QTc > 450 msec on 12 lead standard electrocardiogram (ECG)
  8. History of unstable angina or myocardial infarction or stroke within previous 6 months
  9. Subjects with uncontrolled inter-current illness including, but not limited to active infection, symptomatic congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  10. Subjects known to be suffering from infection with HIV, Tuberculosis, Hepatitis C or Hepatitis B
  11. Known brain metastasis
  12. History of prior malignancy except for curatively treated basal cell or squamous cell carcinoma of skin, in situ cervical cancer, in situ breast cancer, in situ prostate cancer or any other cancer for which the subject has been disease-free for at least 3 years
  13. Women who are pregnant or lactating
  14. Women of childbearing potential [defined as sexually mature women who have not undergone hysterectomy or who have not been naturally postmenopausal for at least 24 consecutive months (i.e. who have had menses any time in the preceding 24 consecutive months)] and men, not agreeing to use adequate contraception (e.g., hormonal or barrier method of birth control or abstinence) prior to study entry (after signing the ICD), during the period of study participation and for at least 4 weeks after withdrawal from the study, unless they are surgically sterilized
  15. Any condition, including laboratory abnormalities, that in the opinion of the Investigator places the subject at an unacceptable risk or deems the subject not suitable for participation in the study

Sites / Locations

  • Bharath Hospital & Institute of Oncology, Mysore
  • Regional Cancer Centre
  • Kashyap Nursing Home
  • Jaslok Hospital, Mumbai
  • Central India Cancer Research Institute,
  • Deenanath Mangeshkar Hospital & Research Centre
  • Bhagwan Mahaveer Cancer Hospital & Research Centre, Dept. Of Medical Oncology, Jaipur
  • V. N. Cancer Centre, GKNM Hospital,
  • Dept. Of Surgical Oncology, CSM Medical University, Lucknow

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single P276-00 arm

Arm Description

This is a single experimental arm study

Outcomes

Primary Outcome Measures

Response rate

Secondary Outcome Measures

Duration of response, Progression free survival (PFS), Time to progression (TTP), PFS at one year, Overall survival (OS) at one year

Full Information

First Posted
January 15, 2009
Last Updated
July 8, 2013
Sponsor
Piramal Enterprises Limited
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1. Study Identification

Unique Protocol Identification Number
NCT00824343
Brief Title
A Phase II Clinical Trial to Study the Efficacy and Safety of a New Drug P276-00 in Treatment of Recurrent and/or Locally Advanced Head and Neck Cancer
Acronym
MONARCH
Official Title
An Open Label, Multicenter Phase II Study to Evaluate Efficacy and Safety of P276-00 in Indian Subjects With Recurrent, Metastatic or Unresectable Locally Advanced Squamous Cell Carcinoma of Head and Neck
Study Type
Interventional

2. Study Status

Record Verification Date
July 2013
Overall Recruitment Status
Completed
Study Start Date
September 2008 (undefined)
Primary Completion Date
April 2011 (Actual)
Study Completion Date
June 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Piramal Enterprises Limited

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a single arm phase II trial to study the efficacy and safety of a Cdk inhibitor P276-00 in the treatment of squamous cell carcinoma of head and neck. Patients with recurrent or metastatic disease that is unresectable and incurable by radiation will be enrolled. Thirty eight evaluable patients need to be enrolled in the study. All patients will receive protocol treatment i.e. P276-00 as an intravenous infusion from day 1 to day 5 and from day 8 to day 12 in each 21 day cycle till progression of disease or unacceptable toxicity. Safety evaluations by means of recording vitals, physical examination and lab investigations like hematology and clinical chemistry will be undertaken at regular intervals in each cycle. Tumor measurements by spiral CT scan will be undertaken at baseline and at the end of every 2 cycles for response evaluation by RECIST criteria. All patients will be followed up for survival status till one year of cycle 1 day 1.
Detailed Description
P276-00 was administered at a dose of 185mg/m2/day from day 1 to day 5 in each 21 day cycle. The protocol was amended in July 2009. As per the amendment P276-00 will be administered at a dose of 144 mg/m2/day from day 1 to day 5 and from day 8 to day 12 in each 21 day cycle till progression of disease or unacceptable toxicity.33 patients have been recruited in version 1 protocol, 38 more evaluable patients need to be recruited in version 2 protocol. Allowing for approximately 30% drop-outs, it is estimated that, for enrolling 38 evaluable subjects in the study, approximately 54 subjects would be enrolled. As the study has already enrolled 33 subjects, the sample size for the study to accommodate for same number of subjects (38 evaluable) in the revised protocol is estimated as approximately 87 (33 + 54) subjects. Hence the total sample size (accounting for drop-outs) is 87 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Squamous Cell Carcinoma of Head and Neck

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
86 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single P276-00 arm
Arm Type
Experimental
Arm Description
This is a single experimental arm study
Intervention Type
Drug
Intervention Name(s)
P276-00
Intervention Description
For patients to be recruited in amended protocol, P276-00 will be administered to all subjects at a dose of 144 mg/m2/day as i.v infusion in 200 ml of 5% dextrose over 30 minutes from day 1 to day 5 and from day 8 to day 12 in each 21 day cycle. Subjects will receive treatment till progression of disease or till unacceptable toxicity. All subjects will be followed up for survival status till one year of initiation of protocol treatment.
Primary Outcome Measure Information:
Title
Response rate
Time Frame
Tumor measurements to be undertaken at baseline and at the end of every 2 cycles. Response evaluation to be performed on the basis of RECIST criteria
Secondary Outcome Measure Information:
Title
Duration of response, Progression free survival (PFS), Time to progression (TTP), PFS at one year, Overall survival (OS) at one year
Time Frame
Tumor measurements at the end of every 2 cycles. Follow up for survival status every 4 weeks after discontinuation of protocol treatment till one year of cycle 1 day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age more than or equal to 18 years Subjects with histologically or cytologically confirmed SCCHN that is recurrent and/or metastatic and judged incurable by surgery and/or radiation therapy and with zero to one line of chemotherapy for recurrent or metastatic disease at least 60 days prior to study entry. Measurable disease, defined as at least one unidimensionally measurable lesion ≥ 20 mm by conventional techniques or ≥10 mm by spiral computerized tomography (CT) scan or magnetic resonance imaging (MRI) Tumor that is accessible to biopsy Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 Life expectancy of at least three months Hemoglobin ≥ 8.0 gm/dL Absolute neutrophil count (ANC) ≥ 1000/mm3 Platelet count ≥ 50,000/mm3 Total bilirubin ≤1.5X institutional upper limit of normal (ULN) Serum AST ≤ 3X institutional ULN Serum ALT ≤ 3X institutional ULN Serum creatinine ≤1.5X institutional ULN Ability to understand and the willingness to sign a written informed consent document (ICD) Exclusion Criteria: Nasopharyngeal carcinoma Prior treatment with P276-00 or other Cyclin dependent kinase (CDK) targeting agents History of allergic reactions attributed to compounds of similar chemical composition to P276-00 Subjects who have received radiotherapy, chemotherapy or biologic/targeted anticancer agents within 60 days prior to Day 1 of study drug administration or have not recovered from adverse effects of any prior radiotherapy, chemotherapy or biologic/targeted agents. More than one chemotherapy regimen for the recurrent or metastatic disease Subjects who had received any other investigational drug within 1 month or within five half-lives of the other investigational agent, whichever is longer prior to Day 1 of study drug administration Subjects with QTc > 450 msec on 12 lead standard electrocardiogram (ECG) History of unstable angina or myocardial infarction or stroke within previous 6 months Subjects with uncontrolled inter-current illness including, but not limited to active infection, symptomatic congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Subjects known to be suffering from infection with HIV, Tuberculosis, Hepatitis C or Hepatitis B Known brain metastasis History of prior malignancy except for curatively treated basal cell or squamous cell carcinoma of skin, in situ cervical cancer, in situ breast cancer, in situ prostate cancer or any other cancer for which the subject has been disease-free for at least 3 years Women who are pregnant or lactating Women of childbearing potential [defined as sexually mature women who have not undergone hysterectomy or who have not been naturally postmenopausal for at least 24 consecutive months (i.e. who have had menses any time in the preceding 24 consecutive months)] and men, not agreeing to use adequate contraception (e.g., hormonal or barrier method of birth control or abstinence) prior to study entry (after signing the ICD), during the period of study participation and for at least 4 weeks after withdrawal from the study, unless they are surgically sterilized Any condition, including laboratory abnormalities, that in the opinion of the Investigator places the subject at an unacceptable risk or deems the subject not suitable for participation in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr. Ajay Mehta
Organizational Affiliation
Director and Onco-Surgeon, Central India Cancer Research Institute, Nagpur
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. M S Vishveshwara
Organizational Affiliation
Radiation Oncologist, Bharat Hospital Institute of Oncology, Mysore
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Sanjeev Misra
Organizational Affiliation
Oncosurgeon, Department of Surgical Oncology, CSM Medical University, Lucknow
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Rejnish Kumar
Organizational Affiliation
Associate Professor, Regional Cancer Centre, Trivandram
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Lalit Mohan Sharma
Organizational Affiliation
Consultant Medical Oncologist, Bhagwan Mahavir Cancer Hospital and Research Centre, Jaipur
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Maheboob Basade
Organizational Affiliation
Medical Oncologist, Jaslok Hospital, Mumbai
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Nilesh Lokeshwar, MD, DM
Organizational Affiliation
Medical Oncologist
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Chetan Deshmukh, MD, DM
Organizational Affiliation
Medical Oncologist, Deenanath Mangeshkar Hospital and Research Centre, Pune, India
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. M Nagarajan, MD
Organizational Affiliation
Radiation Oncologist, V. N. Cancer Centre, GKNM Hospital, Coimbatore, India
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bharath Hospital & Institute of Oncology, Mysore
City
Mysore
State/Province
Karnataka
ZIP/Postal Code
570017
Country
India
Facility Name
Regional Cancer Centre
City
Trivandrum
State/Province
Kerala
ZIP/Postal Code
695011
Country
India
Facility Name
Kashyap Nursing Home
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400014
Country
India
Facility Name
Jaslok Hospital, Mumbai
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400026
Country
India
Facility Name
Central India Cancer Research Institute,
City
Nagpur
State/Province
Maharashtra
ZIP/Postal Code
440010
Country
India
Facility Name
Deenanath Mangeshkar Hospital & Research Centre
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411004
Country
India
Facility Name
Bhagwan Mahaveer Cancer Hospital & Research Centre, Dept. Of Medical Oncology, Jaipur
City
Jaipur
State/Province
Rajasthan
ZIP/Postal Code
302 017
Country
India
Facility Name
V. N. Cancer Centre, GKNM Hospital,
City
Coimbatore
State/Province
Tamilnadu
ZIP/Postal Code
641037
Country
India
Facility Name
Dept. Of Surgical Oncology, CSM Medical University, Lucknow
City
Lucknow
State/Province
UttarPradesh
ZIP/Postal Code
226003
Country
India

12. IPD Sharing Statement

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A Phase II Clinical Trial to Study the Efficacy and Safety of a New Drug P276-00 in Treatment of Recurrent and/or Locally Advanced Head and Neck Cancer

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