Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer
Head and Neck Cancer
About this trial
This is an interventional treatment trial for Head and Neck Cancer focused on measuring stage III squamous cell carcinoma of the hypopharynx, stage IV squamous cell carcinoma of the hypopharynx, stage III squamous cell carcinoma of the larynx, stage IV squamous cell carcinoma of the larynx, stage III squamous cell carcinoma of the oropharynx, stage IV squamous cell carcinoma of the oropharynx
Eligibility Criteria
Inclusion criteria: Pathologically (histologically or cytologically) proven (from primary lesion and/or lymph nodes) diagnosis of squamous cell carcinoma of the oropharynx, hypopharynx, or larynx; Selected stage III or IV disease (T2N2-3M0, T3-4 any N M0); Note: Patients with T1, any N, or T2N1 tumors are not eligible. Appropriate stage for protocol entry, including no distant metastases, based upon the following minimum diagnostic workup: History/physical examination within 4 weeks prior to registration, including assessment of weight and weight loss in past 6 months and an examination by a Medical Oncologist; Chest x-ray (or Chest CT scan or PET/CT scan) within 6 weeks prior to registration; CT scan or MRI of the head and neck (of the primary tumor and neck nodes) or PET/CT scan within 6 weeks prior to registration; see Section 6.11 for details of PET scans. Note: A PET/CT can only be used instead of a CT scan or MRI if the CT is a high quality scan with contrast. Left ejection fraction determined by echocardiogram and/or multiple gated acquisition (MUGA) technique within 12 weeks of registration; Zubrod Performance Status 0-1; Age > 18; Adequate bone marrow function, defined as follows: Absolute neutrophil count (ANC) > 1,800 cells/mm3 based upon CBC/differential obtained within 2 weeks prior to registration on study; Platelets > 100,000 cells/mm3 based upon complete blood count (CBC)/differential obtained within 2 weeks prior to registration on study; Hemoglobin > 8.0 g/dl based upon CBC/differential obtained within 2 weeks prior to registration on study (Note: The use of transfusion or other intervention to achieve Hgb > 8.0 g/dl is acceptable.) Adequate hepatic function, defined as follows: Bilirubin < 1.5 mg/dl within 2 weeks prior to registration on study; For patients with Gilbert's disease as the sole cause of elevated bilirubin, please contact the PI, Dr. Ang. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 2x the upper limit of normal within 2 weeks prior to registration on study; Adequate renal function, defined as follows: Serum creatinine < 1.5 mg/dl within 2 weeks prior to registration Creatinine clearance (CCr) ≥ 50 ml/min within 2 weeks prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula: CCr male = [(140 - age) x (wt in kg)]/[(Serum Cr mg/dl) x (72)] CCr female = 0.85 x (CrCl male) Pregnancy test within 2 weeks prior to registration for women of childbearing potential; Women of childbearing potential and male participants must agree to use a medically effective means of birth control throughout their participation in the treatment phase of the study (until at least 60 days following the last study treatment); Patient must sign study specific informed consent prior to study entry. Exclusion criteria: Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years; Patients with simultaneous primaries or bilateral tumors are excluded. Gross total excision (e.g., by tonsillectomy) of the primary tumor; however, partial removal of the tumor to alleviate an impending airway obstruction does not make the patient ineligible. Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable; Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields; Primary site of tumor of oral cavity, nasopharynx, sinuses, or salivary glands; Initial surgical treatment, excluding diagnostic biopsy of the primary site or nodal sampling of neck disease; radical or modified neck dissection is not permitted. Severe, active co-morbidity, defined as follows: Current uncontrolled cardiac disease; i.e., uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, and cardiomyopathy with decreased ejection fraction; Left Ventricular Ejection Fraction < 45%; Transmural myocardial infarction within the last 6 months; Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration; Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration; Acquired Immune Deficiency Syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive. Protocol-specific requirements may also exclude immuno-compromised patients. Any uncontrolled condition, which in the opinion of the investigator, would interfere in the safe and timely completion of study procedures; CTCAE, v. 3.0 grade 3-4 electrolyte abnormalities: Calcium < 7 mg/dl or > 12.5 mg/dl; Glucose < 40 mg/dl or > 250 mg/dl; Magnesium < 0.9 mg/dl or > 3 mg/dl; Potassium < 3 mmol/L or > 6 mmol/L; Sodium < 130 mmol/L or > 155 mmol/L Pregnant or lactating women or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic. Prior allergic reaction to the study drug(s) involved in this protocol; Prior therapy that specifically and directly targets the EGFR pathway; Prior severe infusion reaction to a monoclonal antibody.
Sites / Locations
- Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
- Providence Cancer Center
- Mayo Clinic Scottsdale
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- Auburn Radiation Oncology
- Alta Bates Summit Comprehensive Cancer Center
- Peninsula Medical Center
- Radiation Oncology Centers - Cameron Park
- Mercy Cancer Center at Mercy San Juan Medical Center
- East Bay Radiation Oncology Center
- Valley Medical Oncology Consultants - Castro Valley
- Cancer Care Center at John Muir Health - Concord Campus
- City of Hope Comprehensive Cancer Center
- Valley Medical Oncology
- Virginia K. Crosson Cancer Center at St. Jude Medical Center
- Marin Cancer Institute at Marin General Hospital
- Sutter Health - Western Division Cancer Research Group
- Rebecca and John Moores UCSD Cancer Center
- USC/Norris Comprehensive Cancer Center and Hospital
- Memorial Medical Center
- Alta Bates Summit Medical Center - Summit Campus
- Bay Area Breast Surgeons, Incorporated
- CCOP - Bay Area Tumor Institute
- Larry G Strieff MD Medical Corporation
- Tom K Lee, Incorporated
- Valley Medical Oncology Consultants - Pleasanton
- Radiation Oncology Center - Roseville
- Radiological Associates of Sacramento Medical Group, Incorporated
- University of California Davis Cancer Center
- Mercy General Hospital
- San Francisco General Hospital Medical Center
- UCSF Helen Diller Family Comprehensive Cancer Center
- California Pacific Medical Center - California Campus
- Doctors Medical Center - San Pablo Campus
- Stanford Cancer Center
- General Robert Huyser Cancer Center at David Grant Medical Center
- Solano Radiation Oncology Center
- Sutter Solano Medical Center
- John Muir/Mt. Diablo Comprehensive Cancer Center
- Aurora Presbyterian Hospital
- University of Colorado Cancer Center at UC Health Sciences Center
- Boulder Community Hospital
- Penrose Cancer Center at Penrose Hospital
- Porter Adventist Hospital
- Presbyterian - St. Luke's Medical Center
- St. Joseph Hospital
- Veterans Affairs Medical Center - Denver
- Swedish Medical Center
- Poudre Valley Radiation Oncology
- St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
- North Colorado Medical Center
- Sky Ridge Medical Center
- Hope Cancer Care Center at Longmont United Hospital
- McKee Medical Center
- St. Mary - Corwin Regional Medical Center
- North Suburban Medical Center
- Exempla Lutheran Medical Center
- CCOP - Christiana Care Health Services
- Lombardi Comprehensive Cancer Center at Georgetown University Medical Center
- Washington Cancer Institute at Washington Hospital Center
- Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
- Memorial Cancer Institute at Memorial Regional Hospital
- Integrated Community Oncology Network
- Baptist Cancer Institute - Jacksonville
- Integrated Community Oncology Network at Southside Cancer Center
- Mayo Clinic - Jacksonville
- Baptist Medical Center South
- Ella Milbank Foshay Cancer Center at Jupiter Medical Center
- CCOP - Mount Sinai Medical Center
- University of Miami Sylvester Comprehensive Cancer Center - Miami
- Integrated Community Oncology Network - Orange Park
- M.D. Anderson Cancer Center at Orlando
- Florida Cancer Center - Palatka
- Bay Medical
- Flagler Cancer Center
- H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
- Georgia Cancer Center for Excellence at Grady Memorial Hospital
- Emory Crawford Long Hospital
- Piedmont Hospital
- Winship Cancer Institute of Emory University
- Northside Hospital Cancer Center
- Saint Joseph's Hospital of Atlanta
- CCOP - Atlanta Regional
- Charles B. Eberhart Cancer Center at DeKalb Medical Center
- Veterans Affairs Medical Center - Atlanta (Decatur)
- Northeast Georgia Medical Center
- Medical Center of Central Georgia
- Kennestone Cancer Center at Wellstar Kennestone Hospital
- Southern Regional Medical Center
- Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
- Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler
- Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
- Mountain States Tumor Institute at St. Luke's Regional Medical Center
- Saint Anthony's Hospital at Saint Anthony's Health Center
- Rush-Copley Cancer Care Center
- Good Shepherd Hospital
- St. Joseph Medical Center
- John H. Stroger, Jr. Hospital of Cook County
- University of Illinois Cancer Center
- Rush University Medical Center
- Creticos Cancer Center at Advocate Illinois Masonic Medical Center
- Decatur Memorial Hospital Cancer Care Institute
- Good Samaritan Cancer Care Center at Advocate Good Samaritan Hospital
- InterCommunity Cancer Center of Western Illinois
- Ingalls Cancer Care Center at Ingalls Memorial Hospital
- Joliet Oncology-Hematology Associates, Limited - West
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- BroMenn Regional Medical Center
- Community Cancer Center
- Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields
- Advocate Lutheran General Cancer Care Center
- Cancer Treatment Center at Pekin Hospital
- OSF St. Francis Medical Center
- CCOP - Illinois Oncology Research Association
- Oncology Hematology Associates of Central Illinois, PC - Peoria
- Methodist Medical Center of Illinois
- Swedish-American Regional Cancer Center
- Center for Cancer Care at OSF Saint Anthony Medical Center
- Valley Cancer Center
- Cancer Institute at St. John's Hospital
- Carle Cancer Center at Carle Foundation Hospital
- CCOP - Carle Cancer Center
- Saint John's Cancer Center at Saint John's Medical Center
- St. Francis Hospital and Health Centers - Beech Grove Campus
- Elkhart General Hospital
- Radiation Oncology Associates Southwest
- Parkview Regional Cancer Center at Parkview Health
- Center for Cancer Care at Goshen General Hospital
- Methodist Cancer Center at Methodist Hospital
- Howard Community Hospital
- Center for Cancer Therapy at LaPorte Hospital and Health Services
- Saint Anthony Memorial Health Centers
- Reid Hospital & Health Care Services
- CCOP - Northern Indiana CR Consortium
- Memorial Hospital of South Bend
- McFarland Clinic, PC
- Siouxland Hematology-Oncology Associates, LLP
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- Menorah Medical Center
- Shawnee Mission Medical Center
- Cotton-O'Neil Cancer Center
- Lucille P. Markey Cancer Center at University of Kentucky
- James Graham Brown Cancer Center at University of Louisville
- Tulane Cancer Center Office of Clinical Research
- Pennington Cancer Center at Baton Rouge General
- Mary Bird Perkins Cancer Center - Baton Rouge
- MBCCOP - LSU Health Sciences Center
- Medical Center of Louisiana - New Orleans
- Feist-Weiller Cancer Center at Louisiana State University Health Sciences
- St. Agnes Hospital Cancer Center
- Tufts-NEMC Cancer Center
- Boston University Cancer Research Center
- Lahey Clinic Medical Center - Burlington
- NSMC Cancer Center - Peabody
- Saint Joseph Mercy Cancer Center
- CCOP - Michigan Cancer Research Consortium
- Oakwood Cancer Center at Oakwood Hospital and Medical Center
- Barbara Ann Karmanos Cancer Institute
- Josephine Ford Cancer Center at Henry Ford Hospital
- Green Bay Oncology, Limited - Escanaba
- Genesys Hurley Cancer Institute
- Hurley Medical Center
- Great Lakes Cancer Institute at McLaren Regional Medical Center
- CCOP - Grand Rapids
- Lacks Cancer Center at Saint Mary's Health Care
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- Dickinson County Healthcare System
- Foote Memorial Hospital
- Borgess Medical Center
- West Michigan Cancer Center
- Bronson Methodist Hospital
- Sparrow Regional Cancer Center
- St. Mary Mercy Hospital
- Mercy Regional Cancer Center at Mercy Hospital
- William Beaumont Hospital - Royal Oak Campus
- Seton Cancer Institute at Saint Mary's - Saginaw
- Lakeland Regional Cancer Care Center - St. Joseph
- Providence Cancer Institute at Providence Hospital - Southfield Campus
- Munson Medical Center
- St. John Macomb Hospital
- MeritCare Bemidji
- Fairview Ridges Hospital
- Mercy and Unity Cancer Center at Mercy Hospital
- Duluth Clinic Cancer Center - Duluth
- CCOP - Duluth
- Miller - Dwan Medical Center
- St. Luke's Hospital Cancer Care Center
- Fairview Southdale Hospital
- Mercy and Unity Cancer Center at Unity Hospital
- Minnesota Oncology Hematology, PA - Maplewood
- Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
- Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center
- Mayo Clinic Cancer Center
- CCOP - Metro-Minnesota
- Park Nicollet Cancer Center
- United Hospital
- St. Francis Cancer Center at St. Francis Medical Center
- Ridgeview Medical Center
- University of Mississippi Cancer Clinic
- Regional Cancer Center at Singing River Hospital
- Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital
- Cancer Institute of Cape Girardeau, LLC
- Saint Francis Medical Center
- Independence Regional Health Center
- Truman Medical Center - Hospital Hill
- Saint Luke's Cancer Institute at Saint Luke's Hospital
- St. Joseph Medical Center
- North Kansas City Hospital
- Parvin Radiation Oncology
- CCOP - Kansas City
- Research Medical Center
- Liberty Hospital
- Heartland Regional Medical Center
- Saint Louis University Cancer Center
- CCOP - St. Louis-Cape Girardeau
- David C. Pratt Cancer Center at St. John's Mercy
- CCOP - Cancer Research for the Ozarks
- St. John's Regional Health Center
- Hulston Cancer Center at Cox Medical Center South
- CCOP - Montana Cancer Consortium
- Northern Rockies Radiation Oncology Center
- Billings Clinic - Downtown
- Great Falls Clinic - Main Facility
- Good Samaritan Cancer Center at Good Samaritan Hospital
- CCOP - Missouri Valley Cancer Consortium
- Methodist Estabrook Cancer Center
- Immanuel Medical Center
- Alegant Health Cancer Center at Bergan Mercy Medical Center
- Creighton University Medical Center
- CCOP - Nevada Cancer Research Foundation
- Dartmouth - Hitchcock Concord
- Kingsbury Center for Cancer Care at Cheshire Medical Center
- Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
- Elliot Regional Cancer Center at Elliot Hospital
- Ocean Medical Center at Meridian Health
- Princeton Radiation Oncology Center
- Saint Peter's University Hospital
- Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
- University Medical Center at Princeton
- Frederick R. and Betty M. Smith Cancer Treatment Center
- J. Phillip Citta Regional Cancer Center at Community Medical Center
- Cancer Institute of New Jersey at Cooper - Voorhees
- New Mexico Cancer Center
- Maimonides Cancer Center at Maimonides Medical Center
- Roswell Park Cancer Institute
- CCOP - Hematology-Oncology Associates of Central New York
- Charles R. Wood Cancer Center at Glens Falls Hospital
- St. Vincent's Comprehensive Cancer Center - Manhattan
- Highland Hospital of Rochester
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- Mission Hospitals - Memorial Campus
- Presbyterian Cancer Center at Presbyterian Hospital
- Wayne Memorial Hospital, Incorporated
- Wayne Radiation Oncology
- Leo W. Jenkins Cancer Center at ECU Medical School
- Pardee Memorial Hospital
- Cancer Centers of North Carolina - Raleigh
- Rex Cancer Center at Rex Hospital
- Wilmed Radiation Oncology Services
- Forsyth Regional Cancer Center at Forsyth Medical Center
- CCOP - MeritCare Hospital
- MeritCare Broadway
- McDowell Cancer Center at Akron General Medical Center
- Summa Center for Cancer Care at Akron City Hospital
- Adena Regional Medical Center
- Charles M. Barrett Cancer Center at University Hospital
- Riverside Methodist Hospital Cancer Care
- CCOP - Columbus
- Grant Medical Center Cancer Care
- Mount Carmel Health - West Hospital
- Doctors Hospital at Ohio Health
- Grandview Hospital
- Good Samaritan Hospital
- David L. Rike Cancer Center at Miami Valley Hospital
- Samaritan North Cancer Care Center
- Veterans Affairs Medical Center - Dayton
- CCOP - Dayton
- Grady Memorial Hospital
- Blanchard Valley Medical Associates
- Middletown Regional Hospital
- Charles F. Kettering Memorial Hospital
- St. Rita's Medical Center
- Strecker Cancer Center at Marietta Memorial Hospital
- Licking Memorial Cancer Care Program at Licking Memorial Hospital
- Mercy Medical Center
- UVMC Cancer Care Center at Upper Valley Medical Center
- Precision Radiotherapy at University Pointe
- Mount Carmel St. Ann's Cancer Center
- Cancer Treatment Center
- Ruth G. McMillan Cancer Center at Greene Memorial Hospital
- Oklahoma University Cancer Institute
- Bay Area Hospital
- Three Rivers Community Hospital
- Legacy Mount Hood Medical Center
- Dubs Cancer Center at Rogue Valley Medical Center
- Providence Cancer Center at PMCC
- Providence Milwaukie Hospital
- Legacy Good Samaritan Hospital & Comprehensive Cancer Center
- Providence Cancer Center at Providence Portland Medical Center
- Adventist Medical Center
- CCOP - Columbia River Oncology Program
- Providence St. Vincent Medical Center
- Legacy Emanuel Hospital and Health Center and Children's Hospital
- Oregon Health and Science University Cancer Institute
- Legacy Meridian Park Hospital
- Geisinger Cancer Institute at Geisinger Health
- Mercy Fitzgerald Hospital
- Northeast Radiation Oncology Center
- Dale and Frances Hughes Cancer Center at Pocono Medical Center
- Upper Delaware Valley Cancer Center
- Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
- Fox Chase Cancer Center - Philadelphia
- Albert Einstein Cancer Center
- St. Joseph Medical Center
- McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center
- Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
- York Cancer Center at Apple Hill Medical Center
- Rhode Island Hospital Comprehensive Cancer Center
- Miriam Hospital
- Hollings Cancer Center at Medical University of South Carolina
- CCOP - Greenville
- Rapid City Regional Hospital
- Sanford Cancer Center at Sanford USD Medical Center
- Harrington Cancer Center
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
- Brooke Army Medical Center
- M. D. Anderson Cancer Center at University of Texas
- Wilford Hall Medical Center
- Joe Arrington Cancer Research and Treatment Center
- Sandra L. Maxwell Cancer Center
- Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
- Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
- Utah Valley Regional Medical Center - Provo
- Dixie Regional Medical Center - East Campus
- Utah Cancer Specialists at UCS Cancer Center
- Huntsman Cancer Institute at University of Utah
- LDS Hospital
- Norris Cotton Cancer Center - North
- INOVA Alexandria Hospital
- Danville Regional Medical Center
- Lynchburg Hematology-Oncology Clinic
- Sentara Cancer Institute at Sentara Norfolk General Hospital
- Naval Medical Center - Portsmouth
- Veterans Affairs Medical Center - Richmond
- Virginia Commonwealth University Massey Cancer Center
- St. Francis Hospital
- Southwest Washington Medical Center Cancer Center
- Theda Care Cancer Institute
- Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
- Green Bay Oncology, Limited at St. Mary's Hospital
- St. Mary's Hospital Medical Center - Green Bay
- St. Vincent Hospital Regional Cancer Center
- Gundersen Lutheran Center for Cancer and Blood
- University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
- Bay Area Cancer Care Center at Bay Area Medical Center
- Columbia Saint Mary's Hospital - Ozaukee
- Columbia-Saint Mary's Cancer Care Center
- Medical College of Wisconsin Cancer Center
- Veterans Affairs Medical Center - Milwaukee
- Green Bay Oncology, Limited - Oconto Falls
- Green Bay Oncology, Limited - Sturgeon Bay
- University of Wisconcin Cancer Center at Aspirus Wausau Hospital
- Tom Baker Cancer Centre - Calgary
- CancerCare Manitoba
- Nova Scotia Cancer Centre
- Ottawa Hospital Regional Cancer Centre - General Campus
- Northeastern Ontario Regional Cancer Centre
- Princess Margaret Hospital
- Hopital Notre-Dame du CHUM
- McGill Cancer Centre at McGill University
- Allan Blair Cancer Centre at Pasqua Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
RT + cisplatin
RT + cisplatin + cetuximab
Radiation therapy (RT) as accelerated fractionation by concomitant boost (AFX-CB) or intensity-modulated radiation therapy (IMRT) plus cisplatin
Radiation therapy (RT) as accelerated fractionation by concomitant boost (AFX-CB) or intensity-modulated radiation therapy (IMRT) plus cisplatin plus cetuximab