search
Back to results

EMD 1201081 in Combination With Cetuximab in Second-Line Cetuximab-Naïve Subjects With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

Primary Purpose

Squamous Cell Carcinoma of the Head and Neck Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Cetuximab
EMD 1201081
Sponsored by
EMD Serono
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Squamous Cell Carcinoma of the Head and Neck Cancer focused on measuring Head and Neck Cancer, Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck Cancer, Cetuximab, EMD 1201081

Eligibility Criteria

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

Inclusion Criteria:

  • Signed and dated written informed consent prior to any trial-specific procedure
  • Male or female subjects age greater than or equal to (>=) 18 years with R/M SCCHN
  • Histologically confirmed R/M SCCHN, documented in the medical record
  • History of progressing disease on a first-line cytotoxic chemotherapy regimen for R/M SCCHN, such as 5-fluorouracil (FU) plus cisplatin, or taxanes. (A history of chemotherapy or radiotherapy for localized disease was not considered a first-line regimen)
  • The subject is suited for systemic therapy in the opinion of the Investigator
  • At least one radiographically documented lesion measurable according to response evaluation criteria in solid tumors (RECIST) 1.0. All target lesions are to be measurable (that is, the lesion must be adequately measurable in at least one dimension; longest diameter to be recorded as >= 2 centimeter (cm) by conventional techniques or >= 1 centimeter (cm) by spiral computed tomography [CT] scan). Target lesions are to be selected from the required protocol imaging. If the sole site of measurable disease is in a prior radiation field, there has to be unequivocal evidence of progression at >= 8 weeks since the completion of radiation or a positive biopsy
  • Eastern cooperative oncology group performance status (ECOG PS) of 0 or 1
  • If female, either post-menopausal, surgically sterile, or having a negative urine or serum pregnancy test (beta-human chorionic gonadotropin [beta-HCG]) at screening and practicing medically accepted contraception. If male, practicing contraception if the risk of conception exists. For relevant subjects, the duration of contraception should be 1 week prior to the start of therapy through 4 weeks after receipt of trial therapy
  • Recovered from previous toxicities of prior cytotoxic regimen to common terminology criteria of adverse events (CTCAE) Grade 1 (with the exception of alopecia)
  • Hemoglobin >= 9 gram per deciliter (g/dL) without transfusion support; no transfusion within 7 days prior to screening)
  • Neutrophils >= 1.5 * 10^9 per liter
  • Platelets >= 100 * 10^9 per liter
  • Prothrombin time/partial thromboplastin time (PT/PTT) less than or equal to (=<) 1.5 times the upper limit of normal (ULN) for the site, unless there is therapeutic anti-coagulation
  • Serum creatinine =< 1.5 times the ULN for the site
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 3 times the ULN for the site
  • Be willing and able to comply with the protocol procedures for the duration of the trial

Exclusion Criteria:

  • History of prior exposure to cetuximab or panitumumab or any other approved or investigational anti-epidermal growth factor receptor (EGFR) agents
  • Undifferentiated nasopharyngeal carcinoma
  • Chemotherapy, radiotherapy or any investigational agents within 4 weeks prior to first dose of study drug
  • Major surgical or planned procedure within 30 days prior to first dose of trial medication (isolated biopsies are not considered major surgical procedures)
  • Active malignancy other than SCCHN, non-metastatic basal cell or squamous cell carcinoma of the skin, or second primary SCCHN
  • Impaired cardiac function (for example, left ventricular ejection fraction less than [<] 45 percent defined by echocardiograph or other study), history of uncontrolled serious arrhythmia, unstable angina pectoris, congestive heart failure (new york heart association [NYHA] Grade III and IV), myocardial infarction within the last 12 months prior to trial entry, or signs of pericardial effusion
  • Hypertension uncontrolled by standard pharmacologic therapies
  • History of diagnosed interstitial lung disease
  • Subject requires systemic anti-coagulation (example, warfarin greater than [>] 10 milligram per day [mg/day])
  • Pregnancy or breastfeeding
  • Legal incapacity or limited legal capacity
  • Significant medical or psychiatric disease which makes the trial inappropriate in the Investigator's opinion
  • Any brain metastasis and/or leptomeningeal disease (known or suspected)
  • Significant pre-existing immune deficiency, such as infection of human immuno-deficiency virus (HIV) (documented or known)
  • Clinically significant ongoing infection
  • Known hypersensitivity to the trial treatments
  • Signs and symptoms suggestive of transmissible spongiform encephalopathy, or family members who suffer from such disease
  • Other significant disease that in the Investigator's opinion would exclude the subject from the trial

Sites / Locations

  • University of Colorado Cancer Center
  • University of Kentucky, Markey Cancer Center
  • MGH Massachusetts General Hospital
  • Montefiore Medical Center Oncology
  • Research Site
  • UZ Gent
  • Research Site
  • Cliniques Universitaires Mont-Godinne
  • Research Site
  • Research Site
  • Research Site
  • Ustav radiacni onkologie Fakultni nemacnice Na Bulovce
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Szegedi Tudomayegyetem Altalanos Orvostudomanyi Kar Onkoterapias Klinika
  • Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet
  • Zala Megyei Kohaz Kulsokorhaz Onkologia Osztaly
  • SPZOZ Centrum Onkologi Liemi Lubelskiej, II Odzial Radioterapiii z pododdzialem Chemioterpii
  • Zaklad Opleki Zdrowotnej MSWIA z Warminsko-Mazurskim Centrum Onkologil, Oddziat Chemioterapli
  • Centrum Onkologi - Instytut im. Marii Sklodowskiej-Curie, Klinika Nowotworow Glowy i Szyi (NCI)
  • Onkologicky ustav Sv. Alzbety
  • Nemocnice s poliklinikou Zilina
  • Velindre Cancer Centre
  • Research Site
  • MHCW
  • St. James' University Hospital
  • Research Site
  • The Christie NHS FT
  • Research Site
  • Weston Park Hospital
  • Southampton University Hospitals NHS Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cetuximab plus EMD 1201081

Cetuximab monotherapy

Arm Description

Outcomes

Primary Outcome Measures

Progression-free Survival (PFS) Time: Independent Read Assessments
The PFS time is defined as the duration from randomization to either first observation of progressive disease (PD) or occurrence of death due to any cause within 60 days of the last tumor assessment or randomization. Participants without event were censored on the date of last tumor assessment.

Secondary Outcome Measures

Percentage of Participants With Objective Response: Independent Read Assessments
Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to Response Evaluation Criteria in Solid Tumors version 1.0 (RECIST v1.0) as assessed by Independent Read. As per RECIST v1.0 for target lesions and assessed by MRI: CR = Disappearance of all target lesions; PR = at least 30% decrease in the sum of the longest diameter of target lesions.
Percentage of Participants With Disease Control: Independent Read Assessments
Percentage of participants with disease control, defined as having achieved CR or PR or stable disease (SD) as the tumor response according to radiological assessments (based on RECIST Version 1.0 criteria), was reported. As per RECIST v1.0 for target lesions and assessed by MRI: CR = disappearance of all target lesions; PR = at least 30% decrease in the sum of the longest diameter of target lesions; SD = neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease.
Overall Survival (OS) Time
The overall survival (OS) time was defined as the time from randomization to death. Participants without event were censored at the last date known to be alive or at the clinical cut-off date, whatever was earlier.
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs
An adverse event (AE) was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or diseases that emerges or worsens relative to baseline during a clinical study with an Investigational Medicinal Product (IMP), regardless of causal relationship and even if no IMP has been administered. A Serious AE was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect.

Full Information

First Posted
December 29, 2009
Last Updated
January 12, 2017
Sponsor
EMD Serono
search

1. Study Identification

Unique Protocol Identification Number
NCT01040832
Brief Title
EMD 1201081 in Combination With Cetuximab in Second-Line Cetuximab-Naïve Subjects With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck
Official Title
A Phase II, Open-label, 1:1 Randomized, Controlled Trial Exploring the Efficacy of EMD 1201081 in Combination With Cetuximab in Second-Line Cetuximab-Naïve Subjects With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (R/M SCCHN)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2014
Overall Recruitment Status
Completed
Study Start Date
December 2009 (undefined)
Primary Completion Date
January 2012 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
EMD Serono

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if EMD 1201081 in combination with cetuximab is more efficient than cetuximab alone to control the cancer. EMD 1201081 is an immune modulatory oligonucleotide (IMO) containing phosphorothioate oligodeoxynucleotide and acts as an agonist of Toll-like receptor 9 (TLR9). EMD 1201081 has been studied in six clinical trials in over 170 subjects either as a monotherapy or in combination with chemotherapeutic agents or targeted therapies. Two studies have been conducted in healthy volunteers. In the other five studies, subjects with advanced solid tumors, renal cell carcinoma, non-small cell lung cancer and colorectal cancer have been treated with EMD 1201081. Two studies are still ongoing. Future clinical development of EMD 1201081 will focus on colorectal cancer (CRC) and squamous cell cancer of the head and neck (SCCHN). In this Phase 2 study, subjects with recurrent or metastatic squamous cell cancer of the head and neck (R/M SCCHN), will be treated with cetuximab plus EMD 1201081 or cetuximab alone. The study will be conducted as a multicenter study in several European Union (EU) member states and the Unites States. EMD 1201081 in combination with cetuximab will be evaluated for antitumor activity in subjects by examining its effects on accepted clinical endpoints. Progression-free survival (PFS) will be evaluated in subjects treated with EMD 1201081 plus cetuximab compared to cetuximab alone in cetuximab-naïve subjects with R/M SCCHN who have progressed on a cytotoxic therapy. Cetuximab, approved in colorectal cancer and SCCHN in combination with platinum-based chemotherapy and SCCHN in combination with radiotherapy in the EU, will be provided as investigational medicinal product (IMP) in this study. Commercially available Cetuximab will be provided in the United States.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Squamous Cell Carcinoma of the Head and Neck Cancer
Keywords
Head and Neck Cancer, Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck Cancer, Cetuximab, EMD 1201081

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
107 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cetuximab plus EMD 1201081
Arm Type
Experimental
Arm Title
Cetuximab monotherapy
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux®
Intervention Description
Cetuximab weekly (initial dose 400 milligram per square meter [mg/m^2] over 120 minutes followed by 250 mg/m^2 intravenous infusion over 60 minutes) will be administered in 3-week treatment cycle until disease progression. The total treatment period will be approximately 18 months.
Intervention Type
Drug
Intervention Name(s)
EMD 1201081
Other Intervention Name(s)
IMO-2055
Intervention Description
EMD 1201081 weekly (0.32 milligram per kilogram [mg/kg] by subcutaneous injection) will be administered in 3-week treatment cycle until disease progression. Subjects who will discontinue cetuximab due to toxicity in cetuximab monotherapy, could continue to receive EMD 1201081 monotherapy until disease progression. The total treatment period will be approximately 18 months.
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS) Time: Independent Read Assessments
Description
The PFS time is defined as the duration from randomization to either first observation of progressive disease (PD) or occurrence of death due to any cause within 60 days of the last tumor assessment or randomization. Participants without event were censored on the date of last tumor assessment.
Time Frame
Every 6 weeks until disease progression, death or last tumor assessment, reported between day of first participant randomized, that is, 17 Dec 2009 until cut-off date (11 Jan 2012)
Secondary Outcome Measure Information:
Title
Percentage of Participants With Objective Response: Independent Read Assessments
Description
Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to Response Evaluation Criteria in Solid Tumors version 1.0 (RECIST v1.0) as assessed by Independent Read. As per RECIST v1.0 for target lesions and assessed by MRI: CR = Disappearance of all target lesions; PR = at least 30% decrease in the sum of the longest diameter of target lesions.
Time Frame
Every 6 weeks until disease progression, reported between day of first participant randomized, that is, 17 Dec 2009 until cut-off date (11 Jan 2012)
Title
Percentage of Participants With Disease Control: Independent Read Assessments
Description
Percentage of participants with disease control, defined as having achieved CR or PR or stable disease (SD) as the tumor response according to radiological assessments (based on RECIST Version 1.0 criteria), was reported. As per RECIST v1.0 for target lesions and assessed by MRI: CR = disappearance of all target lesions; PR = at least 30% decrease in the sum of the longest diameter of target lesions; SD = neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease.
Time Frame
Every 6 weeks until disease progression, reported between day of first participant randomized, that is, 17 Dec 2009 until cut-off date (11 Jan 2012)
Title
Overall Survival (OS) Time
Description
The overall survival (OS) time was defined as the time from randomization to death. Participants without event were censored at the last date known to be alive or at the clinical cut-off date, whatever was earlier.
Time Frame
Time from randomization to death or last day known to be alive, reported between day of first participant randomized, that is, 17 Dec 2009 until cut-off date, (11 Jan 2012)
Title
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs
Description
An adverse event (AE) was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or diseases that emerges or worsens relative to baseline during a clinical study with an Investigational Medicinal Product (IMP), regardless of causal relationship and even if no IMP has been administered. A Serious AE was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect.
Time Frame
Time from first dose up to Day 42 to 49 after last dose of trial treatment, reported between day of first participant randomized, that is, 17 Dec 2009 until cut-off date, (11 Jan 2012)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated written informed consent prior to any trial-specific procedure Male or female subjects age greater than or equal to (>=) 18 years with R/M SCCHN Histologically confirmed R/M SCCHN, documented in the medical record History of progressing disease on a first-line cytotoxic chemotherapy regimen for R/M SCCHN, such as 5-fluorouracil (FU) plus cisplatin, or taxanes. (A history of chemotherapy or radiotherapy for localized disease was not considered a first-line regimen) The subject is suited for systemic therapy in the opinion of the Investigator At least one radiographically documented lesion measurable according to response evaluation criteria in solid tumors (RECIST) 1.0. All target lesions are to be measurable (that is, the lesion must be adequately measurable in at least one dimension; longest diameter to be recorded as >= 2 centimeter (cm) by conventional techniques or >= 1 centimeter (cm) by spiral computed tomography [CT] scan). Target lesions are to be selected from the required protocol imaging. If the sole site of measurable disease is in a prior radiation field, there has to be unequivocal evidence of progression at >= 8 weeks since the completion of radiation or a positive biopsy Eastern cooperative oncology group performance status (ECOG PS) of 0 or 1 If female, either post-menopausal, surgically sterile, or having a negative urine or serum pregnancy test (beta-human chorionic gonadotropin [beta-HCG]) at screening and practicing medically accepted contraception. If male, practicing contraception if the risk of conception exists. For relevant subjects, the duration of contraception should be 1 week prior to the start of therapy through 4 weeks after receipt of trial therapy Recovered from previous toxicities of prior cytotoxic regimen to common terminology criteria of adverse events (CTCAE) Grade 1 (with the exception of alopecia) Hemoglobin >= 9 gram per deciliter (g/dL) without transfusion support; no transfusion within 7 days prior to screening) Neutrophils >= 1.5 * 10^9 per liter Platelets >= 100 * 10^9 per liter Prothrombin time/partial thromboplastin time (PT/PTT) less than or equal to (=<) 1.5 times the upper limit of normal (ULN) for the site, unless there is therapeutic anti-coagulation Serum creatinine =< 1.5 times the ULN for the site Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 3 times the ULN for the site Be willing and able to comply with the protocol procedures for the duration of the trial Exclusion Criteria: History of prior exposure to cetuximab or panitumumab or any other approved or investigational anti-epidermal growth factor receptor (EGFR) agents Undifferentiated nasopharyngeal carcinoma Chemotherapy, radiotherapy or any investigational agents within 4 weeks prior to first dose of study drug Major surgical or planned procedure within 30 days prior to first dose of trial medication (isolated biopsies are not considered major surgical procedures) Active malignancy other than SCCHN, non-metastatic basal cell or squamous cell carcinoma of the skin, or second primary SCCHN Impaired cardiac function (for example, left ventricular ejection fraction less than [<] 45 percent defined by echocardiograph or other study), history of uncontrolled serious arrhythmia, unstable angina pectoris, congestive heart failure (new york heart association [NYHA] Grade III and IV), myocardial infarction within the last 12 months prior to trial entry, or signs of pericardial effusion Hypertension uncontrolled by standard pharmacologic therapies History of diagnosed interstitial lung disease Subject requires systemic anti-coagulation (example, warfarin greater than [>] 10 milligram per day [mg/day]) Pregnancy or breastfeeding Legal incapacity or limited legal capacity Significant medical or psychiatric disease which makes the trial inappropriate in the Investigator's opinion Any brain metastasis and/or leptomeningeal disease (known or suspected) Significant pre-existing immune deficiency, such as infection of human immuno-deficiency virus (HIV) (documented or known) Clinically significant ongoing infection Known hypersensitivity to the trial treatments Signs and symptoms suggestive of transmissible spongiform encephalopathy, or family members who suffer from such disease Other significant disease that in the Investigator's opinion would exclude the subject from the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philip Breitfeld, MD
Organizational Affiliation
EMD Serono, Inc., Rockland MA, a subsidiary of Merck KGaA, Darmstadt, Germany
Official's Role
Study Director
Facility Information:
Facility Name
University of Colorado Cancer Center
City
Aurora
State/Province
Colorado
Country
United States
Facility Name
University of Kentucky, Markey Cancer Center
City
Lexington
State/Province
Kentucky
Country
United States
Facility Name
MGH Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
Montefiore Medical Center Oncology
City
Bronx
State/Province
New York
Country
United States
Facility Name
Research Site
City
Brussels
Country
Belgium
Facility Name
UZ Gent
City
Gent
Country
Belgium
Facility Name
Research Site
City
Wilrijk
Country
Belgium
Facility Name
Cliniques Universitaires Mont-Godinne
City
Yvoir
Country
Belgium
Facility Name
Research Site
City
Brno
Country
Czech Republic
Facility Name
Research Site
City
Kladno
Country
Czech Republic
Facility Name
Research Site
City
Pardubice
Country
Czech Republic
Facility Name
Ustav radiacni onkologie Fakultni nemacnice Na Bulovce
City
Praha
Country
Czech Republic
Facility Name
Research Site
City
Montpellier
Country
France
Facility Name
Research Site
City
Villejuif
Country
France
Facility Name
Research Site
City
Győr
Country
Hungary
Facility Name
Research Site
City
Kecskemét
Country
Hungary
Facility Name
Research Site
City
Miskolc
Country
Hungary
Facility Name
Research Site
City
Nyiregyahaza
Country
Hungary
Facility Name
Szegedi Tudomayegyetem Altalanos Orvostudomanyi Kar Onkoterapias Klinika
City
Szeged
Country
Hungary
Facility Name
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet
City
Szolnok
Country
Hungary
Facility Name
Zala Megyei Kohaz Kulsokorhaz Onkologia Osztaly
City
Zalaegerszeg
Country
Hungary
Facility Name
SPZOZ Centrum Onkologi Liemi Lubelskiej, II Odzial Radioterapiii z pododdzialem Chemioterpii
City
Lublin
Country
Poland
Facility Name
Zaklad Opleki Zdrowotnej MSWIA z Warminsko-Mazurskim Centrum Onkologil, Oddziat Chemioterapli
City
Olsztyn
Country
Poland
Facility Name
Centrum Onkologi - Instytut im. Marii Sklodowskiej-Curie, Klinika Nowotworow Glowy i Szyi (NCI)
City
Warszawa
Country
Poland
Facility Name
Onkologicky ustav Sv. Alzbety
City
Bratislava
Country
Slovakia
Facility Name
Nemocnice s poliklinikou Zilina
City
Zilina
Country
Slovakia
Facility Name
Velindre Cancer Centre
City
Cardiff
Country
United Kingdom
Facility Name
Research Site
City
Conventry
Country
United Kingdom
Facility Name
MHCW
City
Coventry
Country
United Kingdom
Facility Name
St. James' University Hospital
City
Leeds
Country
United Kingdom
Facility Name
Research Site
City
London
Country
United Kingdom
Facility Name
The Christie NHS FT
City
Manchester
Country
United Kingdom
Facility Name
Research Site
City
Newcastle upon Tyne
Country
United Kingdom
Facility Name
Weston Park Hospital
City
Sheffield
Country
United Kingdom
Facility Name
Southampton University Hospitals NHS Trust
City
Southampton
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
24894651
Citation
Ruzsa A, Sen M, Evans M, Lee LW, Hideghety K, Rottey S, Klimak P, Holeckova P, Fayette J, Csoszi T, Erfan J, Forssmann U, Goddemeier T, Bexon A, Nutting C; NA EMD 1201081 Study Group. Phase 2, open-label, 1:1 randomized controlled trial exploring the efficacy of EMD 1201081 in combination with cetuximab in second-line cetuximab-naive patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Invest New Drugs. 2014 Dec;32(6):1278-84. doi: 10.1007/s10637-014-0117-2. Epub 2014 Jun 4.
Results Reference
result
Links:
URL
http://www.cancer.gov/
Description
Related Info

Learn more about this trial

EMD 1201081 in Combination With Cetuximab in Second-Line Cetuximab-Naïve Subjects With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

We'll reach out to this number within 24 hrs