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Pilot Study of Imatinib Cetuximab Combo for H & N Cancer

Primary Purpose

Head and Neck Cancer, Squamous Cell Carcinoma of Head and Neck

Status
Recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cetuximab
Imatinib
Sponsored by
University of Wisconsin, Madison
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Cancer

Eligibility Criteria

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

Inclusion Criteria: Age > 18 years at the time of consent. Histological confirmation of squamous cell carcinoma of the head and neck. For those patients with oropharyngeal cancer, subjects must have either HPV-negative status by p16 expression or HPV-DNA Expression. HPV-positive status by p16 expression AND a >10 pack year smoking history. Subjects must be appropriate candidates for definitive curative intent treatment, either via surgical resection, definitive radiation therapy alone, or definitive concurrent chemoradiation therapy. For the screening research biopsy, subjects must have sufficient tumor volume (approximately 10 cc) to accommodate at minimum 2-3 core samples for the research biopsy. For the post-treatment (CTX/Imatinib) research biopsy, subjects who are scheduled to receive definitive radiation therapy (+/- concurrent chemotherapy) are required to have sufficient tumor volume to accommodate at minimum 2-3 core samples for the research biopsy. Demonstrate adequate organ function; all screening labs to be obtained within 28 days prior to registration. Exclusion Criteria: Subjects with a diagnosis of nasopharyngeal carcinoma, advanced cutaneous squamous cell carcinoma of the head and neck, or salivary gland tumors are excluded from this study. Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g. active or uncontrolled infection, uncontrolled diabetes) that could cause unacceptable safety risks or compromise compliance with the protocol. Prior chemotherapy, radiotherapy, or major surgery within 8 weeks of study enrollment or those who have not recovered (to grade ≤ 1 or baseline) from clinically significant adverse events due to agents administered more than 8 weeks earlier (alopecia and fatigue excluded). Clinical significance to be determined by the study investigator. Subjects who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study. Subjects who are receiving any other investigational agents. History of allergic reactions attributed to compounds of similar chemical or biologic composition to imatinib or CTX.

Sites / Locations

  • University of Wisconsin Carbone Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Imatinib Cetuximab Combination

Arm Description

Participants will receive two doses of CTX and a minimum of an 8 day (maximum 14 day) course of imatinib prior to definitive surgery or definitive radiation/chemoradiation.

Outcomes

Primary Outcome Measures

Change in Ki67 from pre- versus post-imatinib/cetuximab treated tumors
The change in Ki67 is calculated as the ratio of pre- to post- treatment Ki67 index

Secondary Outcome Measures

Adverse Events that are probably related to CTX and imatinib prior to the start of definitive concurrent chemoradiation therapy or surgical resection
Count of adverse events that are probably related to the regimen
Rate of hospital re-admissions
For subjects undergoing definitive surgical resection, rate of hospital re-admissions for wound care or surgical complications attributed to imatinib plus cetuximab (such as fistula or deep cellulitis) within 28 days after surgery
Objective response rate (ORR)
Measured by clinical examination
Objective response rate (ORR)
Measured by clinical measurements

Full Information

First Posted
March 22, 2023
Last Updated
April 26, 2023
Sponsor
University of Wisconsin, Madison
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT05816785
Brief Title
Pilot Study of Imatinib Cetuximab Combo for H & N Cancer
Official Title
A Pilot Window of Opportunity Study of Imatinib in Combination With Cetuximab in Patients With Squamous Cell Carcinomas of the Head and Neck
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 18, 2023 (Actual)
Primary Completion Date
September 2025 (Anticipated)
Study Completion Date
September 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Wisconsin, Madison
Collaborators
National Cancer Institute (NCI)

4. Oversight

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

5. Study Description

Brief Summary
The goal of this clinical trial is to find if levels of a protein called AXL in tumor cells relate to how tumors respond to cetuximab (CTX) combined with imatinib in participants with head and neck cancer. This interventional study will occur in the time between diagnosis of your cancer and surgery to remove your tumor or radiation or chemoradiation treatment of your primary cancer. Participants will undergo a research blood draw and a research biopsy as part of the screening process, and will be in this research study for approximately 13 to 16 months.
Detailed Description
This is a 'window of opportunity' pilot study of oral imatinib (400 mg per day) plus cetuximab (CTX) (400mg/m2 loading dose [dose 1] and 250mg/m2 [dose 2]) for patients with head and neck squamous cell carcinoma (HNSCC) undergoing definitive surgery or radiation for treatment of their cancer. The primary objective is to determine the proportion of patients with a response to imatinib plus CTX in pre-treatment and post-treatment samples obtained as part of a window of opportunity clinical study in head and neck cancer (HNC) patients.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Imatinib Cetuximab Combination
Arm Type
Experimental
Arm Description
Participants will receive two doses of CTX and a minimum of an 8 day (maximum 14 day) course of imatinib prior to definitive surgery or definitive radiation/chemoradiation.
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Intervention Description
Week 1: loading dose of 400mg/m2; Week 2: 250mg/m2
Intervention Type
Drug
Intervention Name(s)
Imatinib
Intervention Description
400 mg orally daily
Primary Outcome Measure Information:
Title
Change in Ki67 from pre- versus post-imatinib/cetuximab treated tumors
Description
The change in Ki67 is calculated as the ratio of pre- to post- treatment Ki67 index
Time Frame
6 months after last research biopsy
Secondary Outcome Measure Information:
Title
Adverse Events that are probably related to CTX and imatinib prior to the start of definitive concurrent chemoradiation therapy or surgical resection
Description
Count of adverse events that are probably related to the regimen
Time Frame
Through study completion, an average of 2 years
Title
Rate of hospital re-admissions
Description
For subjects undergoing definitive surgical resection, rate of hospital re-admissions for wound care or surgical complications attributed to imatinib plus cetuximab (such as fistula or deep cellulitis) within 28 days after surgery
Time Frame
Up to 28 days after surgery
Title
Objective response rate (ORR)
Description
Measured by clinical examination
Time Frame
Diagnosis, 48 hours prior to surgery or radiation
Title
Objective response rate (ORR)
Description
Measured by clinical measurements
Time Frame
Diagnosis, 48 hours prior to surgery or radiation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 years at the time of consent. Histological confirmation of squamous cell carcinoma of the head and neck. For those patients with oropharyngeal cancer, subjects must have either HPV-negative status by p16 expression or HPV-DNA Expression. HPV-positive status by p16 expression AND a >10 pack year smoking history. Subjects must be appropriate candidates for definitive curative intent treatment, either via surgical resection, definitive radiation therapy alone, or definitive concurrent chemoradiation therapy. For the screening research biopsy, subjects must have sufficient tumor volume (approximately 10 cc) to accommodate at minimum 2-3 core samples for the research biopsy. For the post-treatment (CTX/Imatinib) research biopsy, subjects who are scheduled to receive definitive radiation therapy (+/- concurrent chemotherapy) are required to have sufficient tumor volume to accommodate at minimum 2-3 core samples for the research biopsy. Demonstrate adequate organ function; all screening labs to be obtained within 28 days prior to registration. Exclusion Criteria: Subjects with a diagnosis of nasopharyngeal carcinoma, advanced cutaneous squamous cell carcinoma of the head and neck, or salivary gland tumors are excluded from this study. Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g. active or uncontrolled infection, uncontrolled diabetes) that could cause unacceptable safety risks or compromise compliance with the protocol. Prior chemotherapy, radiotherapy, or major surgery within 8 weeks of study enrollment or those who have not recovered (to grade ≤ 1 or baseline) from clinically significant adverse events due to agents administered more than 8 weeks earlier (alopecia and fatigue excluded). Clinical significance to be determined by the study investigator. Subjects who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study. Subjects who are receiving any other investigational agents. History of allergic reactions attributed to compounds of similar chemical or biologic composition to imatinib or CTX.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Cancer Connect
Phone
800-622-8922
Email
cancerconnect@uwcarbone.wisc.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Justine Bruce, MD
Organizational Affiliation
University of Wisconsin, Madison
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Wisconsin Carbone Cancer Center
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diana Trask
Phone
608-236-9528
Email
trask@humonc.wisc.edu
First Name & Middle Initial & Last Name & Degree
Justine Bruce, MD

12. IPD Sharing Statement

Plan to Share IPD
Yes

Learn more about this trial

Pilot Study of Imatinib Cetuximab Combo for H & N Cancer

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