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CetuGEX™ in Comparison to Cetuximab for the Treatment of Patients With Head and Neck Cancer (RESGEX)

Primary Purpose

Carcinoma, Squamous Cell of Head and Neck

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
CetuGEX™
Cetuximab
Chemotherapy
Sponsored by
Glycotope GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Squamous Cell of Head and Neck focused on measuring tomuzotuximab, cetuximab, SCCHN

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients with histologically confirmed recurrent and/or metastatic SCCHN not eligible for local treatment.
  2. Patients with measurable disease according to RECIST 1.1.
  3. Patients aged at least 18 years at screening.
  4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  5. Minimum life expectancy of 3 months.
  6. Tissue samples available for specific and therapy-related biological assessments.
  7. If female and of childbearing potential, was non-lactating and had negative pregnancy test results at screening and prior to randomization.
  8. If female, was either not of childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or willing to use highly effective contraceptives during study participation until 6 months after last administration of any study medication, particularly cisplatin or carboplatin, with a failure rate <1% according to the Note for Guidance on non-clinical safety studies for the conduct of human clinical trials and marketing authorization for pharmaceuticals (CPMP/ICH/286/95) of the European Medicines Agency. Male patients who had partners of childbearing potential had to confirm adequate use of highly effective contraceptives during study participation until 6 months after last administration of any study medication, particularly cisplatin or carboplatin, as well.
  9. Willing and able to comply with the protocol.
  10. Willing and able to provide written informed consent.

Exclusion Criteria:

  1. Prior systemic chemotherapy, except if given as part of a multimodal treatment for locally advanced disease which was completed more than 6 months prior to randomization.
  2. Cetuximab or other epidermal growth factor receptor (EGFR)-targeting agent treatment, except if given as part of a multimodal treatment for locally advanced disease which was completed more than 6 months prior to randomization.
  3. Surgery (other than minor interventions like diagnostic biopsy or intravenous port implantation) or irradiation within 30 days before randomization.
  4. Concomitant antitumor therapy or concomitant immunotherapy, live vaccines including yellow fever vaccination (as per cisplatinum Summary of Product Characteristics [SmPC]).
  5. Concomitant corticosteroid treatment unless specified within the protocol.
  6. Clinical evidence of brain metastasis or leptomeningeal involvement.
  7. Patients with nasopharyngeal tumors.
  8. Concomitant malignant disease, except for adequately treated tumors with high likelihood of being cured (e.g., basal cell cancer of the skin, cervical cancer or breast cancer in situ). Patients with previous malignancies but without evidence of disease for at least 5 years were allowed to enter the study.
  9. Patients with renal or hepatic impairment (serum creatinine and bilirubin >1.5 fold above the upper limit of normal ranges, creatinine clearance <60 mL/min, and transaminase >5-fold above the upper limit of normal ranges) and patients with hematology parameters outside the normal ranges (hemoglobin <9 g/dL, absolute neutrophil count <1500/mm3 and platelet count <105/mm3) at screening as well as patients with impaired auditory function or platinum-related neuropathy.
  10. Clinically active infections ≥Grade 2 using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4 and/or requiring intravenous antibiotics.
  11. Known active hepatitis B or C.
  12. Known human immunodeficiency virus (HIV) infection.
  13. Myocardial infarction within 6 months prior to screening.
  14. Symptomatic congestive heart failure (New York Heart Association Grade 3 or 4), unstable angina pectoris within 6 months prior to screening, significant cardiac arrhythmia, history of stroke, or transient ischemic attack within 1 year prior to screening.
  15. History of keratitis requiring medical interventions within the last 5 years or interstitial lung disease.
  16. Patients with any other disorder that, in the opinion of the investigator, might have interfered with the conduct of the study.
  17. Patients with an unstable condition (e.g., psychiatric disorder, a recent history of drug or alcohol abuse, interfering with study compliance, within 6 months prior to screening) or otherwise thought to be unreliable or incapable of complying with the requirements of the protocol.
  18. Patients institutionalized by official means or court order.
  19. Receipt of any other IMP within the last 30 days before randomization or any previous CetuGEX™ administration.
  20. Prior allergic reaction to a monoclonal antibody, grade 3 infusion related reaction (IRR) or any grade 4 reaction to a monoclonal antibody.
  21. Known sensitivity to any component of the IMP and medication used in this study.
  22. Known dihydropyrimidine dehydrogenase deficiency (France only).

Sites / Locations

  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facillity
  • Glycotope-contracted Research Facility
  • Gycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracteed Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility
  • Glycotope-contracted Research Facility

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CetuGEX™ plus chemotherapy

Cetuximab plus chemotherapy

Arm Description

720 mg weekly administration

250 mg/m2 weekly administration

Outcomes

Primary Outcome Measures

Progression-free Survival (PFS)
The primary efficacy endpoint was PFS as assessed by the investigator. Date of disease progression was defined as the date of imaging (based on computed tomography (CT) scans or magnetic resonance imaging (MRI)) showing disease progression, as assessed by the investigator according to adapted immune-related RECIST 1.1 (modified irRC). Disease progression was defined as a 20% increase in tumor burden, taking as reference the smallest tumor burden recorded since the treatment started; confirmation by a second scan was not required. The PFS time was censored at the time of the last tumor assessment if the patient was alive and without progression at the last time of observation.

Secondary Outcome Measures

Objective Response Rate (ORR)
Objective response rate is the percentage of patients with a tumor size reduction of a predefined amount for a minimum time period and it is defined as the sum of complete responses (CR) and partial responses (PR). CR: Disappearance of all non-nodal target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (< 10 mm short axis). PR: At least a 30% decrease in the tumor burden (sum of the longest lesion diameter (LD) of target lesions (including the short axes of any target lymph nodes plus measurable new lesions), taking as reference the baseline sum diameters.
Clinical Benefit Rate
The clinical benefit rate is the percentage of patients with an objective response or stable disease (SD). SD is defined as not meeting criteria of complete response and partial response, in absence of meeting criteria for disease progression. Follow-up measurements must have met the SD criteria at least once after randomization at a minimum interval of 8 weeks.
Time to Treatment Failure
Time to treatment failure is defined as the time from randomization to treatment discontinuation for any reason, including disease progression, treatment toxicity, patient preference, or death.
Overall Survival
The overall survival is defined as the duration of time from randomization to the time of death.
Time of Global Health Status Deterioration
Quality of Life (QoL) scores as assessed by European Oncology Research Trials Committee (EORTC) QoL questionnaires (QLQ) EORTC-QLQ-C30. Scores are on a scale of 0 to 100, where 100 represents the highest possible QoL.Time to first deterioration of at least 10 points.

Full Information

First Posted
January 27, 2014
Last Updated
October 4, 2021
Sponsor
Glycotope GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT02052960
Brief Title
CetuGEX™ in Comparison to Cetuximab for the Treatment of Patients With Head and Neck Cancer
Acronym
RESGEX
Official Title
Randomized, Controlled, Open Label, Multicenter, Phase II Study to Evaluate the Efficacy and Safety of CetuGEX™ Plus CT in Comparison to Cetuximab Plus CT in Patients With Stage III/IV Recurrent and/or Metastatic SCCHN
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
February 2014 (Actual)
Primary Completion Date
August 28, 2017 (Actual)
Study Completion Date
October 4, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Glycotope GmbH

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of the study is to evaluate the efficacy of CetuGEX™ for the treatment of patients with stage III/IV recurrent and/or metastatic SCCHN as compared to cetuximab (both in combination with platinum-based chemotherapy) in terms of progression-free survival (PFS).
Detailed Description
Indication: First line systemic treatment for stage III/IV recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) Primary Objective: To evaluate the efficacy of CetuGEX™ for the treatment of patients with stage III/IV recurrent and/or metastatic SCCHN as compared to cetuximab (both in combination with platinum-based chemotherapy) in terms of progression-free survival (PFS). Secondary Objectives: To evaluate further efficacy criteria, safety and quality of life (QoL) of patients with stage III/IV recurrent and/or metastatic SCCHN treated with CetuGEX™ as compared to cetuximab (both in combination with platinum-based chemotherapy). To assess pharmacokinetic (PK) parameters and profiles of CetuGEX™. To assess efficacy and safety based on genetic markers for immune response (Fc-gamma receptor [FcγR] allotypes) and biomarkers (exploratory only).

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CetuGEX™ plus chemotherapy
Arm Type
Experimental
Arm Description
720 mg weekly administration
Arm Title
Cetuximab plus chemotherapy
Arm Type
Active Comparator
Arm Description
250 mg/m2 weekly administration
Intervention Type
Drug
Intervention Name(s)
CetuGEX™
Other Intervention Name(s)
Tomuzotuximab
Intervention Description
60 mg/day 0, 930 mg/day 1, followed by 720 mg i.v. weekly administration
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux®
Intervention Description
400 mg/sqm body surface area (BSA) on day 1, followed by 250 mg/sqm BSA i.v. weekly administration
Intervention Type
Drug
Intervention Name(s)
Chemotherapy
Other Intervention Name(s)
Combination of Cisplatin and 5-Fluorouracil
Intervention Description
Combination of Cisplatin and 5-Fluorouracil (Carboplatin may substitute Cisplatin following the 1st cycle of therapy in case of toxicity)
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
The primary efficacy endpoint was PFS as assessed by the investigator. Date of disease progression was defined as the date of imaging (based on computed tomography (CT) scans or magnetic resonance imaging (MRI)) showing disease progression, as assessed by the investigator according to adapted immune-related RECIST 1.1 (modified irRC). Disease progression was defined as a 20% increase in tumor burden, taking as reference the smallest tumor burden recorded since the treatment started; confirmation by a second scan was not required. The PFS time was censored at the time of the last tumor assessment if the patient was alive and without progression at the last time of observation.
Time Frame
The PFS was defined as time from randomization until disease progression or death of any cause, up to 24 month
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
Objective response rate is the percentage of patients with a tumor size reduction of a predefined amount for a minimum time period and it is defined as the sum of complete responses (CR) and partial responses (PR). CR: Disappearance of all non-nodal target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (< 10 mm short axis). PR: At least a 30% decrease in the tumor burden (sum of the longest lesion diameter (LD) of target lesions (including the short axes of any target lymph nodes plus measurable new lesions), taking as reference the baseline sum diameters.
Time Frame
Time from randomization until disease progression or death, whichever occurs first, up to 24 month.
Title
Clinical Benefit Rate
Description
The clinical benefit rate is the percentage of patients with an objective response or stable disease (SD). SD is defined as not meeting criteria of complete response and partial response, in absence of meeting criteria for disease progression. Follow-up measurements must have met the SD criteria at least once after randomization at a minimum interval of 8 weeks.
Time Frame
Time from randomization until disease progression or death, whichever occurs first, up to 24 month.
Title
Time to Treatment Failure
Description
Time to treatment failure is defined as the time from randomization to treatment discontinuation for any reason, including disease progression, treatment toxicity, patient preference, or death.
Time Frame
Time to treatment failure, defined as the interval between the date of randomization and the date of treatment discontinuation for any reason, up to 24 month.
Title
Overall Survival
Description
The overall survival is defined as the duration of time from randomization to the time of death.
Time Frame
Time from randomization to the time of death, up to 24 month.
Title
Time of Global Health Status Deterioration
Description
Quality of Life (QoL) scores as assessed by European Oncology Research Trials Committee (EORTC) QoL questionnaires (QLQ) EORTC-QLQ-C30. Scores are on a scale of 0 to 100, where 100 represents the highest possible QoL.Time to first deterioration of at least 10 points.
Time Frame
From randomization up to end-of study visit, up to 24 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with histologically confirmed recurrent and/or metastatic SCCHN not eligible for local treatment. Patients with measurable disease according to RECIST 1.1. Patients aged at least 18 years at screening. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Minimum life expectancy of 3 months. Tissue samples available for specific and therapy-related biological assessments. If female and of childbearing potential, was non-lactating and had negative pregnancy test results at screening and prior to randomization. If female, was either not of childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or willing to use highly effective contraceptives during study participation until 6 months after last administration of any study medication, particularly cisplatin or carboplatin, with a failure rate <1% according to the Note for Guidance on non-clinical safety studies for the conduct of human clinical trials and marketing authorization for pharmaceuticals (CPMP/ICH/286/95) of the European Medicines Agency. Male patients who had partners of childbearing potential had to confirm adequate use of highly effective contraceptives during study participation until 6 months after last administration of any study medication, particularly cisplatin or carboplatin, as well. Willing and able to comply with the protocol. Willing and able to provide written informed consent. Exclusion Criteria: Prior systemic chemotherapy, except if given as part of a multimodal treatment for locally advanced disease which was completed more than 6 months prior to randomization. Cetuximab or other epidermal growth factor receptor (EGFR)-targeting agent treatment, except if given as part of a multimodal treatment for locally advanced disease which was completed more than 6 months prior to randomization. Surgery (other than minor interventions like diagnostic biopsy or intravenous port implantation) or irradiation within 30 days before randomization. Concomitant antitumor therapy or concomitant immunotherapy, live vaccines including yellow fever vaccination (as per cisplatinum Summary of Product Characteristics [SmPC]). Concomitant corticosteroid treatment unless specified within the protocol. Clinical evidence of brain metastasis or leptomeningeal involvement. Patients with nasopharyngeal tumors. Concomitant malignant disease, except for adequately treated tumors with high likelihood of being cured (e.g., basal cell cancer of the skin, cervical cancer or breast cancer in situ). Patients with previous malignancies but without evidence of disease for at least 5 years were allowed to enter the study. Patients with renal or hepatic impairment (serum creatinine and bilirubin >1.5 fold above the upper limit of normal ranges, creatinine clearance <60 mL/min, and transaminase >5-fold above the upper limit of normal ranges) and patients with hematology parameters outside the normal ranges (hemoglobin <9 g/dL, absolute neutrophil count <1500/mm3 and platelet count <105/mm3) at screening as well as patients with impaired auditory function or platinum-related neuropathy. Clinically active infections ≥Grade 2 using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4 and/or requiring intravenous antibiotics. Known active hepatitis B or C. Known human immunodeficiency virus (HIV) infection. Myocardial infarction within 6 months prior to screening. Symptomatic congestive heart failure (New York Heart Association Grade 3 or 4), unstable angina pectoris within 6 months prior to screening, significant cardiac arrhythmia, history of stroke, or transient ischemic attack within 1 year prior to screening. History of keratitis requiring medical interventions within the last 5 years or interstitial lung disease. Patients with any other disorder that, in the opinion of the investigator, might have interfered with the conduct of the study. Patients with an unstable condition (e.g., psychiatric disorder, a recent history of drug or alcohol abuse, interfering with study compliance, within 6 months prior to screening) or otherwise thought to be unreliable or incapable of complying with the requirements of the protocol. Patients institutionalized by official means or court order. Receipt of any other IMP within the last 30 days before randomization or any previous CetuGEX™ administration. Prior allergic reaction to a monoclonal antibody, grade 3 infusion related reaction (IRR) or any grade 4 reaction to a monoclonal antibody. Known sensitivity to any component of the IMP and medication used in this study. Known dihydropyrimidine dehydrogenase deficiency (France only).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ulrich Keilholz, Prof
Organizational Affiliation
Charite University, Berlin, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Glycotope-contracted Research Facility
City
Antwerp
ZIP/Postal Code
2650
Country
Belgium
Facility Name
Glycotope-contracted Research Facility
City
Brussels
ZIP/Postal Code
1000
Country
Belgium
Facility Name
Glycotope-contracted Research Facility
City
Brussels
ZIP/Postal Code
1200
Country
Belgium
Facility Name
Glycotope-contracted Research Facility
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
Glycotope-contracted Research Facility
City
Avignon
ZIP/Postal Code
84918
Country
France
Facility Name
Glycotope-contracted Research Facility
City
Lille
ZIP/Postal Code
59020
Country
France
Facility Name
Glycotope-contracted Research Facility
City
Lyon
ZIP/Postal Code
69008
Country
France
Facility Name
Glycotope-contracted Research Facility
City
Nice
ZIP/Postal Code
06189
Country
France
Facility Name
Glycotope-contracted Research Facility
City
St Herblain
ZIP/Postal Code
44805
Country
France
Facility Name
Glycotope-contracted Research Facility
City
Aachen
ZIP/Postal Code
52074
Country
Germany
Facility Name
Glycotope-contracted Research Facility
City
Berlin
ZIP/Postal Code
12203
Country
Germany
Facility Name
Glycotope-contracted Research Facility
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Glycotope-contracted Research Facility
City
Essen
ZIP/Postal Code
45122
Country
Germany
Facility Name
Glycotope-contracted Research Facility
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Glycotope-contracted Research Facillity
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Glycotope-contracted Research Facility
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Gycotope-contracted Research Facility
City
Milan
ZIP/Postal Code
20142
Country
Italy
Facility Name
Glycotope-contracted Research Facility
City
Pavia
ZIP/Postal Code
27100
Country
Italy
Facility Name
Glycotope-contracted Research Facility
City
Bydgoszcz
ZIP/Postal Code
85-796
Country
Poland
Facility Name
Glycotope-contracted Research Facility
City
Krakow
Country
Poland
Facility Name
Glycotope-contracted Research Facility
City
Lodz
ZIP/Postal Code
93-513
Country
Poland
Facility Name
Glycotope-contracted Research Facility
City
Lublin
ZIP/Postal Code
20-090
Country
Poland
Facility Name
Glycotope-contracted Research Facility
City
Warsaw
ZIP/Postal Code
2781
Country
Poland
Facility Name
Glycotope-contracted Research Facility
City
Brasov
ZIP/Postal Code
500091
Country
Romania
Facility Name
Glycotope-contracted Research Facility
City
Clui-Napoca
ZIP/Postal Code
400015
Country
Romania
Facility Name
Glycotope-contracted Research Facility
City
Craiova
ZIP/Postal Code
200385
Country
Romania
Facility Name
Glycotope-contracted Research Facility
City
Oradea
ZIP/Postal Code
410469
Country
Romania
Facility Name
Glycotope-contracted Research Facility
City
Ploiesti
ZIP/Postal Code
100011
Country
Romania
Facility Name
Glycotope-contracted Research Facility
City
Timisoara
ZIP/Postal Code
300167
Country
Romania
Facility Name
Glycotope-contracteed Research Facility
City
Timisoara
ZIP/Postal Code
300239
Country
Romania
Facility Name
Glycotope-contracted Research Facility
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Glycotope-contracted Research Facility
City
Madrid
ZIP/Postal Code
28050
Country
Spain
Facility Name
Glycotope-contracted Research Facility
City
Madrid
ZIP/Postal Code
28911
Country
Spain
Facility Name
Glycotope-contracted Research Facility
City
Valencia
ZIP/Postal Code
46009
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

CetuGEX™ in Comparison to Cetuximab for the Treatment of Patients With Head and Neck Cancer

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