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Study Comparing Two Treatments in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (RACATREX)

Primary Purpose

Squamous Cell Carcinoma of the Head and Neck

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Cabazitaxel
Methotrexate
Sponsored by
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
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 focused on measuring Head and neck, Squamous cell carcinoma, Randomized, palliative treatment

Eligibility Criteria

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

Inclusion Criteria:

  1. Recurrent and/or metastatic head and neck squamous cell carcinoma not amenable to curative treatment with surgery and/or chemotherapy and/or radiation.
  2. At least one measurable lesion by MRI or CT-scan according to RECIST 1.1.
  3. Progressive disease within 1 year after first line platinum-based chemotherapy given either as a part of the multimodal curative treatment or in the palliative setting.
  4. ECOG performance status 0 -2, in stable medical condition
  5. Patients must have an expected survival of at least 3 months
  6. Paraffin-embedded tumor tissue available for immunohistochemistry but not mandatory
  7. Patients must be over 18 years old and must be able to give written informed consent.
  8. Women of child-bearing age or sexually active female patients with reproductive potential must have a negative pregnancy test (serum or urine within the 7 days prior to enrollment).
  9. Patients must have adequate organ function (Hemoglobin ≥ 9 g/100 ml, Neutrophils ≥ 1,500/mm3, Platelets ≥ 100,000/mm3, total bilirubin <1 time the upper limit of normal (ULN) for age, serum alanine aminotransferase (ALT) < 1.5 1.5 x ULN for age, aspartate aminotransferase (AST) < 1.5 ´ ULN for age , serum creatinine <1.5 x ULN for age.
  10. Signed informed consent prior to beginning protocol specific procedure.
  11. Sexually active patients must use effective contraception during the period of therapy and up to 150 days after the last treatment dose. Acceptable contraception includes, but is not limited to: oral hormone therapy, partner vasectomy, or double barrier contraception (which is defined as a male condom plus spermicide in combination with either a female condom, or diaphragm, or cervical cap or intrauterine device)

Exclusion Criteria:

  1. Non-squamous head and neck cancer
  2. Nasopharynx cancer
  3. More than two lines of chemotherapy for palliative treatment
  4. Surgery or investigational drugs or chemotherapy within 4 weeks before study inclusion. Curative radiation therapy (60-70 Gy) within 8 weeks. For palliative radiation therapy (i.e 8 Gy on a painful lesion) no delay is needed.
  5. Previous treatment with cabazitaxel
  6. Significant active cardiac disease including: uncontrolled high blood pressure according to the CTCAE 4 grading, unstable angina, congestive heart failure, myocardial infarction within the previous 6 months, or serious cardiac arrhythmias
  7. Other uncontrolled illnesses (active infections requiring antibiotics, bleeding disorders, uncontrolled diabetes …)
  8. Previous malignancy from which the patient has been disease-free for < 5years, as other than SCCHN.
  9. Previous treatments with taxanes and/or anti-EGFR therapy are not an exclusion criteria.
  10. Active grade > 2 peripheral neuropathy
  11. Active grade > 2 stomatitis
  12. Known brain or leptomeningeal involvement
  13. History of severe hypersensitivity reaction (> grade 3) to polysorbate 80 containing drugs
  14. Concurrent or planned treatment with strong inhibitors of cytochrome P450 3A/5. A one-week washout period is necessary for patients who are already on these treatments.
  15. Organic brain syndrome or significant psychiatric abnormality that would preclude participation in the full protocol and follow up.

Sites / Locations

  • Clinique Saint-Pierre
  • Cliniques universitaires Saint-Luc, Centre du Cancer, Oncologie Médicale
  • RHMS Baudour
  • Grand Hôpital de Charleroi
  • Hôpital de Jolimont
  • CHU Tivoli Centre René Goffin
  • CHU Ambroise PARE
  • CHU de Charleroi site Vésale
  • Centre Hospitalier Wallonie Picarde
  • CHU de Mont Godinne
  • Universitair Ziekenhuis Brussel (Campus Jette)
  • Universitair Ziekenhuis Gent
  • CHR Citadelle
  • CHU de Liège Sart Tilman
  • Clinique et Maternité Sainte-Elisabeth
  • Centre Hospitalier de Luxembourg

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cabazitaxel

Methotrexate

Arm Description

Cabazitaxel (XRP6258) is a new taxoid, which promotes tubulin assembly in vitro and stabilizes microtubules against cold-induced depolymerization as efficiently as docetaxel

Methotrexate is the historical control and has been widely used in SCCHN for palliation. This medication is an antimetabolite and antifolate drug. It acts by inhibiting the metabolism of folic acid.

Outcomes

Primary Outcome Measures

Efficacy
Determine the efficacy of cabazitaxel in patients with head and neck cancer in terms of progression-free survival rate at 18 weeks.

Secondary Outcome Measures

Safety profile
Determine the safety profile of cabazitaxel in patients with head and neck cancer: adverse event

Full Information

First Posted
February 3, 2012
Last Updated
June 12, 2017
Sponsor
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
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1. Study Identification

Unique Protocol Identification Number
NCT01528163
Brief Title
Study Comparing Two Treatments in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck
Acronym
RACATREX
Official Title
Randomized Phase II Study of Cabazitaxel Versus Methotrexate in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck Previously Treated With Platinum-based Therapy.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
February 2012 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cliniques universitaires Saint-Luc- Université Catholique de Louvain

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In this clinical trial, the investigators want to know if cabazitaxel is more effective than methotrexate for patients with recurrent or metastatic squamous cell carcinoma of the head and neck in palliative treatment.
Detailed Description
The principal aim is to evaluate the efficacy of cabazitaxel in patients with palliative head and neck previously treated with platinum-based therapy. The study design is a non comparative randomized phase II trial: ARM 1: cabazitaxel (20 mg/m2, every 3 weeks) versus ARM 2 methotrexate (40 mg/m2, weekly). Cabazitaxel dose will be increased to 25mg/m2 for the second and subsequent cycles, in the absence of non-hematological AE > grade 2 and hematological AE > grade 3 during the first cycle. (maximum 10 cycles). The aim of the randomization is to offer a valid internal control group by avoiding possible selection bias. However, results obtained in the two treatment group will not be formally compared as this is not the objective of a phase II study. Tumor check-up will be performed every 9 weeks. Treatment will be continued until disease progression or unacceptable toxicities according to the patient or the investigator. A maximum of 10 cycles of cabazitaxel will be given.

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
Keywords
Head and neck, Squamous cell carcinoma, Randomized, palliative treatment

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Cabazitaxel
Arm Type
Experimental
Arm Description
Cabazitaxel (XRP6258) is a new taxoid, which promotes tubulin assembly in vitro and stabilizes microtubules against cold-induced depolymerization as efficiently as docetaxel
Arm Title
Methotrexate
Arm Type
Active Comparator
Arm Description
Methotrexate is the historical control and has been widely used in SCCHN for palliation. This medication is an antimetabolite and antifolate drug. It acts by inhibiting the metabolism of folic acid.
Intervention Type
Drug
Intervention Name(s)
Cabazitaxel
Other Intervention Name(s)
Jevtana
Intervention Description
from 20 mg/m2 to 25 mg/m2. Intravenous injection every three weeks.
Intervention Type
Drug
Intervention Name(s)
Methotrexate
Other Intervention Name(s)
Emthexate
Intervention Description
From 40 mg/m2 (first cycle) to 50 mg/m2. Intravenous injections every three weeks.
Primary Outcome Measure Information:
Title
Efficacy
Description
Determine the efficacy of cabazitaxel in patients with head and neck cancer in terms of progression-free survival rate at 18 weeks.
Time Frame
18 weeks
Secondary Outcome Measure Information:
Title
Safety profile
Description
Determine the safety profile of cabazitaxel in patients with head and neck cancer: adverse event
Time Frame
18 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Recurrent and/or metastatic head and neck squamous cell carcinoma not amenable to curative treatment with surgery and/or chemotherapy and/or radiation. At least one measurable lesion by MRI or CT-scan according to RECIST 1.1. Progressive disease within 1 year after first line platinum-based chemotherapy given either as a part of the multimodal curative treatment or in the palliative setting. ECOG performance status 0 -2, in stable medical condition Patients must have an expected survival of at least 3 months Paraffin-embedded tumor tissue available for immunohistochemistry but not mandatory Patients must be over 18 years old and must be able to give written informed consent. Women of child-bearing age or sexually active female patients with reproductive potential must have a negative pregnancy test (serum or urine within the 7 days prior to enrollment). Patients must have adequate organ function (Hemoglobin ≥ 9 g/100 ml, Neutrophils ≥ 1,500/mm3, Platelets ≥ 100,000/mm3, total bilirubin <1 time the upper limit of normal (ULN) for age, serum alanine aminotransferase (ALT) < 1.5 1.5 x ULN for age, aspartate aminotransferase (AST) < 1.5 ´ ULN for age , serum creatinine <1.5 x ULN for age. Signed informed consent prior to beginning protocol specific procedure. Sexually active patients must use effective contraception during the period of therapy and up to 150 days after the last treatment dose. Acceptable contraception includes, but is not limited to: oral hormone therapy, partner vasectomy, or double barrier contraception (which is defined as a male condom plus spermicide in combination with either a female condom, or diaphragm, or cervical cap or intrauterine device) Exclusion Criteria: Non-squamous head and neck cancer Nasopharynx cancer More than two lines of chemotherapy for palliative treatment Surgery or investigational drugs or chemotherapy within 4 weeks before study inclusion. Curative radiation therapy (60-70 Gy) within 8 weeks. For palliative radiation therapy (i.e 8 Gy on a painful lesion) no delay is needed. Previous treatment with cabazitaxel Significant active cardiac disease including: uncontrolled high blood pressure according to the CTCAE 4 grading, unstable angina, congestive heart failure, myocardial infarction within the previous 6 months, or serious cardiac arrhythmias Other uncontrolled illnesses (active infections requiring antibiotics, bleeding disorders, uncontrolled diabetes …) Previous malignancy from which the patient has been disease-free for < 5years, as other than SCCHN. Previous treatments with taxanes and/or anti-EGFR therapy are not an exclusion criteria. Active grade > 2 peripheral neuropathy Active grade > 2 stomatitis Known brain or leptomeningeal involvement History of severe hypersensitivity reaction (> grade 3) to polysorbate 80 containing drugs Concurrent or planned treatment with strong inhibitors of cytochrome P450 3A/5. A one-week washout period is necessary for patients who are already on these treatments. Organic brain syndrome or significant psychiatric abnormality that would preclude participation in the full protocol and follow up.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Pascal Machiels, MD, PhD
Organizational Affiliation
Centre du Cancer, Cliniques universitaires Saint-Luc
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinique Saint-Pierre
City
Ottignies
State/Province
Brabant Wallon
ZIP/Postal Code
1340
Country
Belgium
Facility Name
Cliniques universitaires Saint-Luc, Centre du Cancer, Oncologie Médicale
City
Brussels
State/Province
Bruxelles Capitale
ZIP/Postal Code
1200
Country
Belgium
Facility Name
RHMS Baudour
City
Baudour
State/Province
Hainaut
ZIP/Postal Code
7331
Country
Belgium
Facility Name
Grand Hôpital de Charleroi
City
Charleroi
State/Province
Hainaut
ZIP/Postal Code
6000
Country
Belgium
Facility Name
Hôpital de Jolimont
City
Haine-Saint-Paul
State/Province
Hainaut
ZIP/Postal Code
7100
Country
Belgium
Facility Name
CHU Tivoli Centre René Goffin
City
La Louvière
State/Province
Hainaut
ZIP/Postal Code
7100
Country
Belgium
Facility Name
CHU Ambroise PARE
City
Mons
State/Province
Hainaut
ZIP/Postal Code
7000
Country
Belgium
Facility Name
CHU de Charleroi site Vésale
City
Montigny-Le-Tilleul
State/Province
Hainaut
ZIP/Postal Code
6110
Country
Belgium
Facility Name
Centre Hospitalier Wallonie Picarde
City
Tournai
State/Province
Hainaut
ZIP/Postal Code
7500
Country
Belgium
Facility Name
CHU de Mont Godinne
City
Yvoir
State/Province
Namur
ZIP/Postal Code
5530
Country
Belgium
Facility Name
Universitair Ziekenhuis Brussel (Campus Jette)
City
Brussel
ZIP/Postal Code
1090
Country
Belgium
Facility Name
Universitair Ziekenhuis Gent
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
CHR Citadelle
City
Liège
ZIP/Postal Code
4000
Country
Belgium
Facility Name
CHU de Liège Sart Tilman
City
Liège
ZIP/Postal Code
4000
Country
Belgium
Facility Name
Clinique et Maternité Sainte-Elisabeth
City
Namur
ZIP/Postal Code
5000
Country
Belgium
Facility Name
Centre Hospitalier de Luxembourg
City
Luxembourg
ZIP/Postal Code
L-1210
Country
Luxembourg

12. IPD Sharing Statement

Citations:
PubMed Identifier
27903924
Citation
Machiels JP, Van Maanen A, Vandenbulcke JM, Filleul B, Seront E, Henry S, D'Hondt L, Lonchay C, Holbrechts S, Boegner P, Brohee D, Dequanter D, Louviaux I, Sautois B, Whenham N, Berchem G, Vanderschueren B, Fontaine C, Schmitz S, Gillain A, Schoonjans J, Rottey S. Randomized Phase II Study of Cabazitaxel Versus Methotrexate in Patients With Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck Previously Treated With Platinum-Based Therapy. Oncologist. 2016 Dec;21(12):1416-e17. doi: 10.1634/theoncologist.2016-0296. Epub 2016 Nov 30.
Results Reference
derived

Learn more about this trial

Study Comparing Two Treatments in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

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