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Cetuximab + Taxotere With Low Dose Fractionated Radiation for Head and Neck Carcinoma

Primary Purpose

Squamous Cell Carcinoma, Head and Neck Cancer, Recurrent Disease

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Erbitux
Taxotere
Low Dose Fractionated Radiation Therapy
Sponsored by
University of Miami
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Squamous Cell Carcinoma focused on measuring SCCHN, Head and Neck Cancer, Squamous Cell Carcinoma, Recurrent

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must have pathologically confirmed recurrence (reappearance of previously cleared) squamous cell cancer primary in the upper aerodigestive tract .Patients may have experienced more than one recurrence as long as the first recurrence occurred ≥ 6 months following the end of the prior RT.
  2. The recurrence must have defined bi- or uni-dimensional measurements.
  3. Recurrence must be confined to the head and neck above the clavicles (loco-regional recurrence).
  4. The patient must not be a candidate for surgical resection.
  5. Patients must be at least 6 months from completion of prior chemotherapy and radiation therapy.
  6. Patients may have received prior chemotherapy as a component of their primary treatment, but not for recurrent disease.
  7. Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  8. Granulocytes ≥ 1500/mm3, platelets ≥ 100,000/mm3, serum bilirubin ≤ 1.5 mg/dl, creatinine < 1.5 mg/dl within 3 weeks prior to registration.
  9. Liver Function Tests (LFTs) ≤ 2 x normal (serum glutamic oxaloacetic transaminase (SGOT)/serum glutamic-pyruvic transaminase (SGPT)/Alkaline Phosphatase). If > 2 x normal, liver ultrasound or CT is required to exclude metastases. If negative for metastases, patients are eligible.
  10. Patients must sign a study-specific informed consent form prior to study entry.

Exclusion Criteria:

  1. Distant metastases outside of the head and neck.
  2. Primary disease in the nasopharynx or the salivary gland.
  3. Other concurrent invasive malignancies.
  4. Prior invasive malignancy unless disease free for at least two years (except prior in situ malignancies, e.g. cervix, breast, non-melanomatous skin cancer, etc. are permissible).
  5. Intercurrent medical illnesses which would impair patient tolerance to therapy or limit survival.
  6. Pre-existing grade ≥ 2 peripheral sensory neuropathy
  7. Pregnant and nursing women are excluded because of the potential teratogenic effects and potential unknown effects on nursing newborns.
  8. Prior history of sever hypersensitivity reaction to Docetaxol, Cetuximab or a drug with formulated with Polysorbate 80.

Sites / Locations

  • University of Miami

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Erbitux, Taxotere, LD Fractionated RT

Arm Description

Erbitux, Taxotere and Low Dose Fractionated Radiation Therapy (LDFRT)

Outcomes

Primary Outcome Measures

Overall Response Rate (ORR) of Participants
ORR is defined as the rate of study participants achieving complete response (CR) or partial response (PR) to protocol therapy according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) criteria.

Secondary Outcome Measures

Number of Study Participants Experiencing Treatment-Related Toxicity
Assess the safety profile (acute and late toxicities) of the proposed treatment. Number of study participants experiencing treatment-related acute and late toxicity: Acute toxicity is defined as toxicity occurring within 90 days of start of therapy. Late/Long-term toxicity defined as toxicity occurring more than 90 days after start of therapy.
Estimated Progression-Free Survival (PFS)
Progression-free survival (PFS) is defined of the length of time from the start date of treatment to the earliest documented occurrence of disease progression according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) criteria. In the absence of an event constituting failure, follow up time will be censored at the date of last disease assessment.
Estimated Overall Survival (OS)
Overall survival (OS) is defined as the length of time from the start of treatment that study participants diagnosed with the disease are still alive. OS will be measured from the start date of treatment to the date of death or last contact (censored observations).

Full Information

First Posted
February 14, 2013
Last Updated
March 31, 2017
Sponsor
University of Miami
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1. Study Identification

Unique Protocol Identification Number
NCT01794845
Brief Title
Cetuximab + Taxotere With Low Dose Fractionated Radiation for Head and Neck Carcinoma
Official Title
Phase II Trial Using Erbitux+ Taxotere With Low Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Terminated
Why Stopped
Early termination due to lack of efficacy (overall response)
Study Start Date
June 3, 2013 (Actual)
Primary Completion Date
June 7, 2016 (Actual)
Study Completion Date
June 7, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Miami

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Whether low-dose radiation in addition to Taxotere and Erbitux improves the response rate of patients with recurrent unresectable head and neck squamous cell carcinoma.
Detailed Description
The investigator's approach is based on the following reasons: Low dose hyper-radiation sensitivity response will be significantly enhanced in Taxotere- induced G2/M cell cycle arrest. LDFRT will render enhanced bax activation mediated mode of cell death. Erbitux will arrest the cells in G1/G0 phase leading to p21-mediated mode of cell death. The toxicity profile is expected to be minimal. Based on the above mentioned reasons, we propose this novel schema of treatment in recurrent SCCHN.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Erbitux, Taxotere, LD Fractionated RT
Arm Type
Experimental
Arm Description
Erbitux, Taxotere and Low Dose Fractionated Radiation Therapy (LDFRT)
Intervention Type
Drug
Intervention Name(s)
Erbitux
Other Intervention Name(s)
Cetuximab
Intervention Description
Erbitux: 400 mg/m2 as a loading dose one week prior to radiation and taxotere, and then at 250 mg/m2 given weekly on Day 1 of treatment week following Taxotere.
Intervention Type
Drug
Intervention Name(s)
Taxotere
Other Intervention Name(s)
Docetaxel
Intervention Description
Taxotere : 20 mg/m2 IV once a week on Day 1 during treatment weeks 2 to 7.
Intervention Type
Radiation
Intervention Name(s)
Low Dose Fractionated Radiation Therapy
Other Intervention Name(s)
LDFRT
Intervention Description
Low-dose fractionated Radiation (LDFRT): 0.5 Gy per fraction twice-a-day (BID) at least 6 to 8 hours apart on Days 2 and 3 of treatment weeks 2 to 7 for a total dose of 12 Gy.
Primary Outcome Measure Information:
Title
Overall Response Rate (ORR) of Participants
Description
ORR is defined as the rate of study participants achieving complete response (CR) or partial response (PR) to protocol therapy according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) criteria.
Time Frame
Up to 6 months from End of Treatment, about 9 months
Secondary Outcome Measure Information:
Title
Number of Study Participants Experiencing Treatment-Related Toxicity
Description
Assess the safety profile (acute and late toxicities) of the proposed treatment. Number of study participants experiencing treatment-related acute and late toxicity: Acute toxicity is defined as toxicity occurring within 90 days of start of therapy. Late/Long-term toxicity defined as toxicity occurring more than 90 days after start of therapy.
Time Frame
Up to 6 years
Title
Estimated Progression-Free Survival (PFS)
Description
Progression-free survival (PFS) is defined of the length of time from the start date of treatment to the earliest documented occurrence of disease progression according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) criteria. In the absence of an event constituting failure, follow up time will be censored at the date of last disease assessment.
Time Frame
Up to 6 years
Title
Estimated Overall Survival (OS)
Description
Overall survival (OS) is defined as the length of time from the start of treatment that study participants diagnosed with the disease are still alive. OS will be measured from the start date of treatment to the date of death or last contact (censored observations).
Time Frame
Up to 6 years

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have pathologically confirmed recurrence (reappearance of previously cleared) squamous cell cancer primary in the upper aerodigestive tract .Patients may have experienced more than one recurrence as long as the first recurrence occurred ≥ 6 months following the end of the prior RT. The recurrence must have defined bi- or uni-dimensional measurements. Recurrence must be confined to the head and neck above the clavicles (loco-regional recurrence). The patient must not be a candidate for surgical resection. Patients must be at least 6 months from completion of prior chemotherapy and radiation therapy. Patients may have received prior chemotherapy as a component of their primary treatment, but not for recurrent disease. Eastern Cooperative Oncology Group (ECOG) performance status 0-2. Granulocytes ≥ 1500/mm3, platelets ≥ 100,000/mm3, serum bilirubin ≤ 1.5 mg/dl, creatinine < 1.5 mg/dl within 3 weeks prior to registration. Liver Function Tests (LFTs) ≤ 2 x normal (serum glutamic oxaloacetic transaminase (SGOT)/serum glutamic-pyruvic transaminase (SGPT)/Alkaline Phosphatase). If > 2 x normal, liver ultrasound or CT is required to exclude metastases. If negative for metastases, patients are eligible. Patients must sign a study-specific informed consent form prior to study entry. Exclusion Criteria: Distant metastases outside of the head and neck. Primary disease in the nasopharynx or the salivary gland. Other concurrent invasive malignancies. Prior invasive malignancy unless disease free for at least two years (except prior in situ malignancies, e.g. cervix, breast, non-melanomatous skin cancer, etc. are permissible). Intercurrent medical illnesses which would impair patient tolerance to therapy or limit survival. Pre-existing grade ≥ 2 peripheral sensory neuropathy Pregnant and nursing women are excluded because of the potential teratogenic effects and potential unknown effects on nursing newborns. Prior history of sever hypersensitivity reaction to Docetaxol, Cetuximab or a drug with formulated with Polysorbate 80.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matthew C Abramowitz, MD
Organizational Affiliation
University of Miami
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Cetuximab + Taxotere With Low Dose Fractionated Radiation for Head and Neck Carcinoma

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