Evaluate Efficacy of the Association Nimotuzumab(HR3) /Cisplatin-Vinorelbine on Patients With Cervical Carcinom (CIMAHOPE)
Cervical Cancer
About this trial
This is an interventional treatment trial for Cervical Cancer focused on measuring Cervix, Oncology,, hR3,, Nimotuzumab,, Chemotherapy,, Survival, Monoclonal antibody, RECIST, Cisplatin, Vinorelbine, Paclitaxel, Carboplatine, Randomisation, Placebo, cancer, cimahope
Eligibility Criteria
Inclusion Criteria:
- Patients aged between 18 to 75, including both limits.
- Patients who give their written consent to participate to the study.
- Chemonaive patients with local cervical cancer and / or persistent or recurrent metastatic disease with measurable disease (RECIST criteria) by a physical examination (scanner or MRI).
A confirmation by biopsy is necessary in case there is a single lesion less than 2 cm.
- Patients who had pelvic CT + radiotherapy may also be included in the study (concomitant chemotherapy as a radiotherapy stabilizer).
- Patients having a histopathological report: epidermoid carcinoma, adenocarcinoma, adenosquamous carcinoma and / or clear cells carcinoma.
- Patients with an ECOG score between 0-2
- Patients with a life expectancy greater than six months.
- Patients with Left Ventricular Ejection Fraction (LVEF) ≥50%, through Echocardiography.
Patients with normal function of organs and bone marrow, defined by the following parameters:
- Haemoglobin ≥ 9 g / dL
- White Blood cell ≥ 4000 /mm3
- Absolute neutrophil count≥ 1500 /mm3
- Platelet count≥ 100000 /mm3
- Total bilirubin up to 1.5 the upper limit of normal (ULN)
- Albumin ≥ 2 g/dL (3,5 - 5,0 g /dl)
- Serum Glutamopyruvate Transférase (SGPT) and SErum Glutamooxaloacetate Transferase (SGTO) < or = 2.5 ULN
- Serum creatinine within the normal limits and the calculation of glomerular filtration according to Cockcroft formula ≥ 60ml and according to MDRD formula for patients whose age is 70 years ≥ 60ml . Glomerular filtration will be performed only on clinical discretion for patients suspected to have a kidney problem. (The normal laboratory values will be appropriate to the techniques and equipment used in the place where they are done).
- The determination or expression of EGF-R (epidermal growth factor receptor), p53, Ki67 and Bcl-2 by immuno-histochemistry in the primary tumor before treatment integrated in a paraffin block.
The results are not an inclusion criterion, but will be evaluated as an indicator of prognostic response in the final assessment.
Exclusion Criteria:
- Pregnant or breastfeeding patients
- Patients with small cells and / or neuroendocrine cervical cancer.
- Patients receiving another onco-specific drug, for other clinical trial,
- Patients with a history of allergy attributed to chemical or biological compounds similar to the monoclonal antibody being evaluated or to chemotherapeutic agents.
- Patients having uncontrolled intercurrent diseases, including active infections, symptomatic congestive heart failure , unstable angina, cardiac arrhythmia, decompensated diabetes, uncontrolled hypertension and psychiatric disorders.
- Patients having a second tumor . Excepting for those receiving appropriate therapy for skin cancer (basal or squamous)
- Previous or concomitant malignancy with exception for non-melanoma skin carcinomas
- Patients having special conditions or circumstances that could significantly limit the complete follow up of the study
Sites / Locations
- Centre Pierre et Marie Curie (CPMC)
- CAC Annaba
- CAC Batna
- CHU Frantz Fanon
- CHU Sidi Belloua
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Nimotuzumab
Placebo
Injection of 200 mg of Nimotuzumab (weekly during 18 weeks), in combination with chemotherapy (6 cycles, every 21 days: 70 mg / m2 Cisplatin and Vinorelbine 60 mg / m2 (Per Os) at day 1 and day 8. The objective of the present study is to assess the overall survival of patients after administration of Nimotuzumab hR3 monoclonal antibodies (combined with a chemotherapy) in the treatment of patients with cervix epithelial tumors as first-line treatment. After the first line , a 200mg dose of hR3 monoclonal antibodies will be given every 14 days until progress. A second -line chemotherapy is proposed, this is based on Carboplatin (CBP) at AUC of 6, and Paclitaxel (Txl) 175 mg / m2 / SC as 3 hour infusion, every 3 weeks, concomitant with the administration of hR3, every 14 days, until a toxicity limit or an ECOG status greater than 3 appears.
Injection of the Placebo in the same procedures (weekly during 18 weeks), in combination with chemotherapy (6 cycles, every 21 days: 70 mg / m2 Cisplatin and Vinorelbine 60 mg / m2 (Per Os) at day 1 and day 8. After the first line , a 200mg dose of hR3 monoclonal antibodies will be given every 14 days until progress. A second -line chemotherapy is proposed, this is based on Carboplatin (CBP) at AUC of 6, and Paclitaxel (Txl) 175 mg / m2 / SC as 3 hour infusion, every 3 weeks, concomitant with the administration of hR3, every 14 days, until a toxicity limit or an ECOG status greater than 3 appears.