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Gene Therapy in Treating Patients With Unresectable, Recurrent, or Refractory Head and Neck Cancer

Primary Purpose

Head and Neck Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
IL-12
Sponsored by
Dana-Farber Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Cancer focused on measuring recurrent metastatic squamous neck cancer with occult primary, metastatic squamous neck cancer with occult primary squamous cell carcinoma, stage III squamous cell carcinoma of the lip and oral cavity, stage IV squamous cell carcinoma of the lip and oral cavity, recurrent squamous cell carcinoma of the lip and oral cavity, stage III squamous cell carcinoma of the oropharynx, stage IV squamous cell carcinoma of the oropharynx, recurrent squamous cell carcinoma of the oropharynx, stage III squamous cell carcinoma of the nasopharynx, stage IV squamous cell carcinoma of the nasopharynx, recurrent squamous cell carcinoma of the nasopharynx, stage III squamous cell carcinoma of the hypopharynx, stage IV squamous cell carcinoma of the hypopharynx, recurrent squamous cell carcinoma of the hypopharynx, stage III squamous cell carcinoma of the larynx, stage IV squamous cell carcinoma of the larynx, recurrent squamous cell carcinoma of the larynx, stage III squamous cell carcinoma of the paranasal sinus and nasal cavity, stage IV squamous cell carcinoma of the paranasal sinus and nasal cavity, recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity

Eligibility Criteria

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

Inclusion Criteria: Females must be non-pregnant and non-lactating and either surgically sterile (via hysterectomy or bilateral tubal ligation), at least one year post-menopausal, or using acceptable methods of contraception for the duration of the study. Male subjects must be surgically sterile or using an acceptable method of contraception for the duration of the study. Disease: biopsy-proven unresectable or recurrent/refractory squamoussell_eareinoma_of_the:head-and-neck-(usualLy -Stage-Di-or-IV) - Tumor accessible to direct injection Karnofsky performance of at least 70% Life expectancy of at least three months Able to give written informed consent Exclusion Criteria: Infection (concurrent or within previous 2 weeks) Active or clinically-relevant viral illnesses. Use of corticosteroids, high-dose non-steroidal antiinflammatory, or immunosuppressive drugs Chemotherapy, radiotherapy or immunotherapy within 28 days of study entry or during the course of study Respiratory disease sufficient to influence oxygenation of arterial blood Active liver disease with transaminases >3 times the upper limit of normal Previous history of liver disease NYHA Class EU or greater heart failure Serum creatinine of greater than 1.5 times the upper limit of normal Polymorphonuclear neutrophilic leukocyte count <3,000/mm3 Platelet count <50,000/mm 3 Tumor involving major blood vessels or obstructing the airway Previous treatment with viral-based gene therapy, recombinant DNA products, or bacterial plasmids Use of an investigational drug within 30 days of screening Other malignancies requiring treatment during the study Scheduled surgical resection History of autoimmune disease, including rheumatic disease, Crohn's disease, etc. , Known allergy to polyvinylpyrrofidone (PVP) or related products History of psychiatric disabilities or seizures.

Sites / Locations

  • Dana-Farber Cancer Institute
  • Beth Israel Deaconess Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

IL-12 Injection 3mg/ml [Phase I]

IL-12 Injection 6mg/ml [Phase I]

IL-12 Injection MTD [Phase II]

Arm Description

The dosing schedule will consist of eight injections 3 mg/ml of formulated plasmid over a seven week period.

The dosing schedule will consist of eight injections 6mg/ml of formulated plasmid over a seven week period.

The dosing schedule will consist of eight injections over a seven week period of formulated plasmid at the MTD established in the phase I portion.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD) [Phase I]
The MTD of IL-12 gene medicine is determined by the number of participants who experience a dose limiting toxicity (DLT). The MTD is defined as the highest dose at which fewer than one-third of patients experience a DLT. If no DLTs are observed in the two dose levels planned then evaluation of a third escalation will be considered. If the MTD is not reached, the dose selected for use in the phase II portion will be defined as the maximum volume that can be reasonably and safely injected into the tumor.
Dose Limiting Toxicity (DLT) [Phase I]
A DLT was defined as grade 4 hematologic toxicity greater than 5 days duration or grade 3 or higher non-hematologic toxicity based on NCI common toxicity criteria (CTCAEv2).
Grade 3-4 Toxicity Rate [Phase II]
All Grade 3-4 events based on CTCAEv2 as reported on case report forms.

Secondary Outcome Measures

Time to Progressive Disease (TTP) [Phase III]
Time to progression based on the Kaplan-Meier method is defined as the duration of time from study entry to documented first observation of progressive disease (PD). Time to progression based on the Kaplan-Meier method is defined as the duration of time from study entry to documented first observation of progressive disease (PD).
Response [Phase II]
Best response on treatment classifies patients into 4 groups: complete response (CR) is complete disappearance of all signs, symptoms, biochemical and radiographic evidence of tumor for a minimum of 1 month; partial response (PR) is >/=50% decreases in tumor area for at least 4 weeks without an increase in size of other lesions of >25% or appearance of new lesions; progressive disease (PD) is >50% increase in size of any lesion present at baseline or after response, or appearance of a new lesion; and stable disease (SD) is neither PR or better nor PD.
Overall Survival (OS) [Phase II]
OS is defined as the duration of time from study entry to death or date last known alive and estimated using Kaplan-Meier (KM) methods.

Full Information

First Posted
December 10, 1999
Last Updated
April 19, 2017
Sponsor
Dana-Farber Cancer Institute
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00004070
Brief Title
Gene Therapy in Treating Patients With Unresectable, Recurrent, or Refractory Head and Neck Cancer
Official Title
A Multi-Center, Open-Label, Multiple Administration, Rising Dose Study of the Safety, Tolerability, and Efficacy of IL-12 Gene Medicine in Patients With Unresectable or Recurrent/Refractory Squamous Cell Carcinoma of the Head and Neck (SCCHN)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
July 1999 (Actual)
Primary Completion Date
November 2000 (Actual)
Study Completion Date
December 2000 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dana-Farber Cancer Institute
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Participant with squamous cell cancer of head and neck are invited to participate in this study. In this study the investigators will be Inserting the gene for interleukin-12 into a person's cancer cells with the anticipation to make the body build an immune response to kill more tumor cells.
Detailed Description
This is a Phase I/II trial to study the effectiveness of gene therapy in treating patients who have unresectable, recurrent, or refractory head and neck cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Cancer
Keywords
recurrent metastatic squamous neck cancer with occult primary, metastatic squamous neck cancer with occult primary squamous cell carcinoma, stage III squamous cell carcinoma of the lip and oral cavity, stage IV squamous cell carcinoma of the lip and oral cavity, recurrent squamous cell carcinoma of the lip and oral cavity, stage III squamous cell carcinoma of the oropharynx, stage IV squamous cell carcinoma of the oropharynx, recurrent squamous cell carcinoma of the oropharynx, stage III squamous cell carcinoma of the nasopharynx, stage IV squamous cell carcinoma of the nasopharynx, recurrent squamous cell carcinoma of the nasopharynx, stage III squamous cell carcinoma of the hypopharynx, stage IV squamous cell carcinoma of the hypopharynx, recurrent squamous cell carcinoma of the hypopharynx, stage III squamous cell carcinoma of the larynx, stage IV squamous cell carcinoma of the larynx, recurrent squamous cell carcinoma of the larynx, stage III squamous cell carcinoma of the paranasal sinus and nasal cavity, stage IV squamous cell carcinoma of the paranasal sinus and nasal cavity, recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This is a non-randomize phase I/II where patients are directly assigned treatment.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IL-12 Injection 3mg/ml [Phase I]
Arm Type
Experimental
Arm Description
The dosing schedule will consist of eight injections 3 mg/ml of formulated plasmid over a seven week period.
Arm Title
IL-12 Injection 6mg/ml [Phase I]
Arm Type
Experimental
Arm Description
The dosing schedule will consist of eight injections 6mg/ml of formulated plasmid over a seven week period.
Arm Title
IL-12 Injection MTD [Phase II]
Arm Type
Experimental
Arm Description
The dosing schedule will consist of eight injections over a seven week period of formulated plasmid at the MTD established in the phase I portion.
Intervention Type
Biological
Intervention Name(s)
IL-12
Other Intervention Name(s)
NFSK, CLMF, P35, Interleukin-12 gene
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) [Phase I]
Description
The MTD of IL-12 gene medicine is determined by the number of participants who experience a dose limiting toxicity (DLT). The MTD is defined as the highest dose at which fewer than one-third of patients experience a DLT. If no DLTs are observed in the two dose levels planned then evaluation of a third escalation will be considered. If the MTD is not reached, the dose selected for use in the phase II portion will be defined as the maximum volume that can be reasonably and safely injected into the tumor.
Time Frame
Assessed during therapy up to 7 weeks.
Title
Dose Limiting Toxicity (DLT) [Phase I]
Description
A DLT was defined as grade 4 hematologic toxicity greater than 5 days duration or grade 3 or higher non-hematologic toxicity based on NCI common toxicity criteria (CTCAEv2).
Time Frame
Assessed during therapy up to 7 weeks.
Title
Grade 3-4 Toxicity Rate [Phase II]
Description
All Grade 3-4 events based on CTCAEv2 as reported on case report forms.
Time Frame
Assessed until last scheduled on-study visit up to visit 12/day 112.
Secondary Outcome Measure Information:
Title
Time to Progressive Disease (TTP) [Phase III]
Description
Time to progression based on the Kaplan-Meier method is defined as the duration of time from study entry to documented first observation of progressive disease (PD). Time to progression based on the Kaplan-Meier method is defined as the duration of time from study entry to documented first observation of progressive disease (PD).
Time Frame
Measurement by CT occurs up to the earliest of progression, death or 4 months after enrollment of last patient.
Title
Response [Phase II]
Description
Best response on treatment classifies patients into 4 groups: complete response (CR) is complete disappearance of all signs, symptoms, biochemical and radiographic evidence of tumor for a minimum of 1 month; partial response (PR) is >/=50% decreases in tumor area for at least 4 weeks without an increase in size of other lesions of >25% or appearance of new lesions; progressive disease (PD) is >50% increase in size of any lesion present at baseline or after response, or appearance of a new lesion; and stable disease (SD) is neither PR or better nor PD.
Time Frame
Measurement by CT occurs up to visit 12/day 112.
Title
Overall Survival (OS) [Phase II]
Description
OS is defined as the duration of time from study entry to death or date last known alive and estimated using Kaplan-Meier (KM) methods.
Time Frame
Measurement by CT occurs up to the earliest of progression, death or 4 months after enrollment of last patient.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Females must be non-pregnant and non-lactating and either surgically sterile (via hysterectomy or bilateral tubal ligation), at least one year post-menopausal, or using acceptable methods of contraception for the duration of the study. Male subjects must be surgically sterile or using an acceptable method of contraception for the duration of the study. Disease: biopsy-proven unresectable or recurrent/refractory squamoussell_eareinoma_of_the:head-and-neck-(usualLy -Stage-Di-or-IV) - Tumor accessible to direct injection Karnofsky performance of at least 70% Life expectancy of at least three months Able to give written informed consent Exclusion Criteria: Infection (concurrent or within previous 2 weeks) Active or clinically-relevant viral illnesses. Use of corticosteroids, high-dose non-steroidal antiinflammatory, or immunosuppressive drugs Chemotherapy, radiotherapy or immunotherapy within 28 days of study entry or during the course of study Respiratory disease sufficient to influence oxygenation of arterial blood Active liver disease with transaminases >3 times the upper limit of normal Previous history of liver disease NYHA Class EU or greater heart failure Serum creatinine of greater than 1.5 times the upper limit of normal Polymorphonuclear neutrophilic leukocyte count <3,000/mm3 Platelet count <50,000/mm 3 Tumor involving major blood vessels or obstructing the airway Previous treatment with viral-based gene therapy, recombinant DNA products, or bacterial plasmids Use of an investigational drug within 30 days of screening Other malignancies requiring treatment during the study Scheduled surgical resection History of autoimmune disease, including rheumatic disease, Crohn's disease, etc. , Known allergy to polyvinylpyrrofidone (PVP) or related products History of psychiatric disabilities or seizures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
A. Dimitrios Colevas, MD
Organizational Affiliation
NCI-Investigational Drug Branch
Official's Role
Study Chair
Facility Information:
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Gene Therapy in Treating Patients With Unresectable, Recurrent, or Refractory Head and Neck Cancer

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