Phase Ib Study of BKM120 With Cisplatin and XRT in High Risk Locally Advanced Squamous Cell Cancer of Head and Neck
Carcinoma, Squamous Cell of Head and Neck, HPV Positive Oropharyngeal Squamous Cell Carcinoma, Hypopharyngeal Cancer
About this trial
This is an interventional treatment trial for Carcinoma, Squamous Cell of Head and Neck focused on measuring Carcinoma, Squamous Cell of Head and Neck, Human Papillomavirus Positive Oropharyngeal Carcinoma, Hypopharyngeal Cancer, Early Invasive Cervical Squamous Cell Carcinoma, Carcinoma of Larynx, Cancer of Nasopharynx
Eligibility Criteria
Inclusion Criteria:
- Stage III/IV, locally advanced, biopsy proven squamous cell cancer of the head and neck that undergo chemoradiation as their primary treatment with curative intent.
- Oropharynx (HPV positive and HPV negative), hypopharynx, larynx primaries, nasopharynx as well as those with documented SCC of the cervical lymph nodes, with unknown primaries.
- >10 pack years of tobacco use
- Age ≥ 18 years
- ECOG performance status ≤ 2
- At least one site of measurable disease
- Adequate bone marrow function as shown by: ANC > 1.5 x 109/L, Platelets >100 x 109/L, Hb >9 g/dL
- Total calcium (corrected for serum albumin) within normal limits
- Magnesium ≥ the lower limit of normal
- Potassium within normal limits for the institution.
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) within normal range
- Serum bilirubin within normal range (or ≤ 1.5 x ULN if liver metastases are present; or total bilirubin ≤ 3.0 x ULN with direct bilirubin within normal range in patients with well documented Gilbert Syndrome)
- Serum creatinine ≤ 1.5 x ULN or 24-hour clearance ≥ 50 mL/min
- Serum amylase ≤ ULN
- Serum lipase ≤ ULN
- Fasting plasma glucose ≤ 120 mg/dL (6.7 mmol/L)
- Signed informed consent
- INR ≤ 2
Exclusion Criteria:
- Distant metastatic disease
- Less than or equal to 10 pack years of tobacco history
- Received prior chemotherapy
- Received prior radiation to the head and neck or adjacent anatomical site
- Received prior treatment with a P13K inhibitor.
- Known hypersensitivity to BKM120 or to its excipients
- Acute or chronic liver, renal disease or pancreatitis
- Mood disorders ≥ CTCAE grade 3
- Diarrhea ≥ CTCAE grade 2
- Active cardiac disease
- History of cardiac dysfunction including any of the following:
- Patient has poorly
- Impairment of gastrointestinal (GI) function
- Currently receiving treatment with medication with a known risk to prolong the QT interval or inducing Torsades de Pointes and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug.
- Chronic treatment with steroids or another immunosuppressive agent.
- Herbal medications and certain fruits within 7 days prior to starting study drug.
- Currently treated with drugs known to be moderate and strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug. Please refer to Appendix B for a list of prohibited inhibitors and inducers of CYP3A (Please note that co-treatment with weak inhibitors of CYP3A is allowed).
- Undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy.
- Currently taking therapeutic doses of warfarin sodium or any other coumadin-derivative anticoagulant.
- Women who are pregnant or breast feeding or adults of reproductive potential not employing an effective method of birth control.
- Known diagnosis of human immunodeficiency virus (HIV) infection
- History of another malignancy within 3 years, except cured basal cell carcinoma of the skin or excised carcinoma in situ of the cervix
Sites / Locations
- Dana-Farber Cancer Institute
Arms of the Study
Arm 1
Experimental
BKM120
Participants will be enrolled in cohorts of 3- 6 per dose level. Once the MTD is reached, an additional 10 patients will be treated at that dose level and an amendment will be submitted to declare the dose. BKM120 will start 2 weeks prior to first dose of cisplatin and radiation start. During the study, BKM120 will be administered orally daily for 45 days. Starting dose 40 mg. Cisplatin: Starting Dose 30 mg/m2, given IV, weekly on days: (1, 8, 15, 22, 29, 36 and 43). Radiotherapy: All participants will receive daily radiotherapy with intensity-modulated radiotherapy (IMRT) for 7 weeks.