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Safety and Efficacy Study of P276-00 in Combination With Radiation in Subjects With Advanced Head and Neck Cancer (SPARK)

Primary Purpose

Squamous Cell Carcinoma of Head and Neck

Status
Completed
Phase
Phase 1
Locations
India
Study Type
Interventional
Intervention
P276-00
External beam radiotherapy (EBRT)
Sponsored by
Piramal Enterprises Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Squamous Cell Carcinoma of Head and Neck

Eligibility Criteria

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

Inclusion Criteria:

  1. Disease specifications:

    • Phase I component: Radiation naïve subjects with histologically and/ or cytologically confirmed squamous cell carcinoma of head and neck that is non-metastatic, unresectable and recurrent. Radiation naïve subjects with non-recurrent, non-metastatic, unresectable, disease can also be enrolled if he/she is intolerant to and/or unwilling for chemoradiotherapy involving standard cytotoxic agents (e.g. cisplatin, carboplatin, oxaliplatin, 5-FU, taxanes, methotrexate, etc)
    • Phase II component: Radiation naïve subjects with non-recurrent, non-metastatic, unresectable, locally advanced squamous cell carcinoma of head and neck who are intolerant to and/or unwilling for chemoradiotherapy involving standard cytotoxic agents (e.g. cisplatin, carboplatin, oxaliplatin, 5-FU, taxanes, methotrexate, etc).
  2. Treatment specifications:

    • Phase I Component: subjects must not have received any treatment (chemotherapy, targeted or biologic agents, radiotherapy, surgery etc) for the recurrent disease.
    • Phase II Component: The subjects must not have been curatively operated for the disease.
  3. Subjects must have completed any prior chemotherapy, biologic/targeted anti-cancer therapy or surgery at least 4 weeks (at least 6 weeks for nitrosureas and mitomycin C) before initiation of protocol treatment and subjects must have recovered (to < or = grade 1) from the toxic effects from any prior therapy
  4. Measurable disease as per RECIST criteria.
  5. Age > or = 18 years
  6. ECOG (Eastern Cooperative Oncology Group) performance status < or = 2
  7. Life expectancy of at least 12 weeks
  8. Normal organ and marrow function:

    • Hemoglobin > or = 100 g/L
    • Leukocytes > or = 3 x 109/L
    • Absolute Neutrophil Count (ANC)> or = 1.5 x 109/L
    • Platelets > or = 75 x 109/L
    • Total bilirubin < or = 1.5 X institutional Upper Limit of Normal (ULN)
    • AST(SGOT)< or = 2.5 X institutional ULN
    • ALT(SGPT)< or = 2.5 X institutional ULN
    • Creatinine < or = 1.5 X institutional ULN
  9. Ability to understand and willingness to sign a written informed consent document.

Exclusion Criteria:

  1. Nasopharyngeal carcinoma
  2. Subjects who had received any other investigational drug within 1 month prior to day 1 of study drug administration or who have not recovered (to < or = grade 1) from adverse effects of the investigational agent received prior to this period.
  3. History of unstable angina or myocardial infarction or stroke within 6 months prior to initiation of protocol treatment.
  4. QTcF > 450 msec
  5. Subjects with uncontrolled inter-current illness including, but not limited to active infection, symptomatic congestive heart failure, cardiac arrhythmia, psychiatric illness or any condition that would limit compliance with study requirements.
  6. Subjects known to be suffering from infection with HIV, Tuberculosis, Hepatitis C or Hepatitis B.
  7. Women who are pregnant or lactating.
  8. Women of childbearing potential [defined as a sexually mature woman who has not undergone hysterectomy or who has not been naturally postmenopausal for at least 24 consecutive months (i.e. who has had menses any time in the preceding 24 consecutive months)] and men, not agreeing to use at least two approved methods of contraception, including at least one barrier method prior to study entry (after signing the informed consent document), during the duration of study participation and for at least 4 weeks after withdrawal from the study drug, unless they are surgically sterilised.
  9. Any condition, including laboratory abnormalities, that in the opinion of the investigator places the subject at an unacceptable risk or deems the subject not suitable for participation in the study.

Sites / Locations

  • Government Medical College
  • Curie Manavata Cancer Center
  • Bhagwan Mahawir Cancer Hospital & Research Centre
  • V. N. Cancer Centre, GKNM Hospital
  • Meenakshi Mission Hospital & Research Centre
  • Christian Medical College

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

P276-00 plus Radiation

Arm Description

P276-00: Level 1:100 mg/m2/day x 5 q 3 weeks, level 2:140 mg/m2/day x 5 q 3 weeks, level 3: 185 mg/m2/day x 5 q 3 weeks. External beam radiotherapy (EBRT): 2 Gy per day for 5 days a week for a total radiation dose of 60 Gy over 2 cycles (6 weeks)followed by upto 10 additional Gy if required

Outcomes

Primary Outcome Measures

To determine the maximum tolerated dose (MTD) and dose limiting toxicity (ies) (DLT/s) of P276-00 in combination with radiation in subjects with recurrent and/or locally advanced squamous cell carcinoma of head and neck (SCCHN)

Secondary Outcome Measures

To evaluate safety and tolerability of the combination regimen of P276-00 and radiation in the study population
To analyze pharmacokinetics (PK) of P276-00 in the study population
To evaluate efficacy of the combination regimen of P276-00 and radiation in the study population
To perform exploratory analysis of biomarkers associated with use of P276-00 and radiation in the study population

Full Information

First Posted
May 6, 2009
Last Updated
November 21, 2012
Sponsor
Piramal Enterprises Limited
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1. Study Identification

Unique Protocol Identification Number
NCT00899054
Brief Title
Safety and Efficacy Study of P276-00 in Combination With Radiation in Subjects With Advanced Head and Neck Cancer
Acronym
SPARK
Official Title
An Open Label, Multicenter Phase I/II Study Of Selective Cyclin Dependent Kinase Inhibitor P276-00 In Combination With Radiation In Subjects With Recurrent And/Or Locally Advanced Squamous Cell Carcinoma Of Head And Neck
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
August 2009 (undefined)
Primary Completion Date
January 2011 (Actual)
Study Completion Date
November 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Piramal Enterprises Limited

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to identify a dose of P276-00 that can be safely administered along with Radiation and to examine safety and efficacy of the combination in treatment of advanced head and neck cancer.
Detailed Description
This is an open label single arm multicenter trial to evaluate safety and efficacy of P276-00 in combination with radiation in patients with recurrent and/or locally advanced squamous cell carcinoma of head and neck. The Primary objective of this study is to determine maximum tolerated dose (MTD) and dose limiting toxicity (ies) (DLT/s) of P276-00 in combination with radiation in subjects with recurrent and/or locally advanced squamous cell carcinoma of head and neck (SCCHN). The Secondary objectives are 1. To evaluate safety and tolerability of the combination regimen of P276-00 and radiation in the study population 2. To analyze pharmacokinetics (PK) of P276-00 in the study population 3. To evaluate efficacy of the combination regimen of P276-00 and radiation in the study population 4. To perform exploratory analysis of biomarkers associated with use of P276-00 and radiation in the study population. In phase 1 component,a cohort of 3 subjects will be enrolled at starting dose level of P276-00 which is 100 mg/m2/day to be given intravenously from day 1 to day 5 in 21 day cycle for 2 cycles in combination with radiation. If this dose is well tolerated then next cohort will be enrolled at higher dose level of P276-00. P276-00 dose escalation will continue until MTD of P276-00 in combination with Radiation is determined. The subsequent dose levels of P276-00 will be 140 mg/m2/day and 185 mg/m2/day. In phase 2 component 10 subjects will be enrolled at this MTD of P276-00 in combination with radiation to evaluate efficacy. Dose of radiation for both phases is 60 Gy over 6 weeks. Safety evaluations will be conducted at regular intervals during the study. Tumor measurements will be undertaken at baseline, at the end of cycle 2 and 5 to 6 weeks after end of cycle 2. Response evaluation will be performed by Response Evaluation Criteria in Solid Tumors (RECIST). Subjects showing stable disease or better response at the last assessment will be followed up for tumor measurements until progression or recurrence of disease.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
P276-00 plus Radiation
Arm Type
Experimental
Arm Description
P276-00: Level 1:100 mg/m2/day x 5 q 3 weeks, level 2:140 mg/m2/day x 5 q 3 weeks, level 3: 185 mg/m2/day x 5 q 3 weeks. External beam radiotherapy (EBRT): 2 Gy per day for 5 days a week for a total radiation dose of 60 Gy over 2 cycles (6 weeks)followed by upto 10 additional Gy if required
Intervention Type
Drug
Intervention Name(s)
P276-00
Intervention Description
P276-00 will be administered at different dose levels: level 1: 100 mg/m2/day dose level 2: 140 mg/m2/day dose level 3: 185 mg/m2/day to be given from day 1 to day 5 every 21 days for 2 cycle. P276-00 will be administered as intravenous infusion in 200 ml 5% Dextrose over 30 min from days 1 to 5 per 21 day cycle for two cycles.
Intervention Type
Radiation
Intervention Name(s)
External beam radiotherapy (EBRT)
Other Intervention Name(s)
Radiotherapy
Intervention Description
All subjects will receive external beam radiotherapy (EBRT)by using standard conventional fractionation i.e. 2 Gy per day for 5 days a week for a total radiation dose of 60 Gy over 6 weeks followed by upto 10 additional Gy if required.
Primary Outcome Measure Information:
Title
To determine the maximum tolerated dose (MTD) and dose limiting toxicity (ies) (DLT/s) of P276-00 in combination with radiation in subjects with recurrent and/or locally advanced squamous cell carcinoma of head and neck (SCCHN)
Time Frame
3 weeks
Secondary Outcome Measure Information:
Title
To evaluate safety and tolerability of the combination regimen of P276-00 and radiation in the study population
Time Frame
Every week
Title
To analyze pharmacokinetics (PK) of P276-00 in the study population
Time Frame
Day 2 and Day 5 of Cycle 1
Title
To evaluate efficacy of the combination regimen of P276-00 and radiation in the study population
Time Frame
Every 6 weeks
Title
To perform exploratory analysis of biomarkers associated with use of P276-00 and radiation in the study population
Time Frame
Day 1 and Day 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Disease specifications: Phase I component: Radiation naïve subjects with histologically and/ or cytologically confirmed squamous cell carcinoma of head and neck that is non-metastatic, unresectable and recurrent. Radiation naïve subjects with non-recurrent, non-metastatic, unresectable, disease can also be enrolled if he/she is intolerant to and/or unwilling for chemoradiotherapy involving standard cytotoxic agents (e.g. cisplatin, carboplatin, oxaliplatin, 5-FU, taxanes, methotrexate, etc) Phase II component: Radiation naïve subjects with non-recurrent, non-metastatic, unresectable, locally advanced squamous cell carcinoma of head and neck who are intolerant to and/or unwilling for chemoradiotherapy involving standard cytotoxic agents (e.g. cisplatin, carboplatin, oxaliplatin, 5-FU, taxanes, methotrexate, etc). Treatment specifications: Phase I Component: subjects must not have received any treatment (chemotherapy, targeted or biologic agents, radiotherapy, surgery etc) for the recurrent disease. Phase II Component: The subjects must not have been curatively operated for the disease. Subjects must have completed any prior chemotherapy, biologic/targeted anti-cancer therapy or surgery at least 4 weeks (at least 6 weeks for nitrosureas and mitomycin C) before initiation of protocol treatment and subjects must have recovered (to < or = grade 1) from the toxic effects from any prior therapy Measurable disease as per RECIST criteria. Age > or = 18 years ECOG (Eastern Cooperative Oncology Group) performance status < or = 2 Life expectancy of at least 12 weeks Normal organ and marrow function: Hemoglobin > or = 100 g/L Leukocytes > or = 3 x 109/L Absolute Neutrophil Count (ANC)> or = 1.5 x 109/L Platelets > or = 75 x 109/L Total bilirubin < or = 1.5 X institutional Upper Limit of Normal (ULN) AST(SGOT)< or = 2.5 X institutional ULN ALT(SGPT)< or = 2.5 X institutional ULN Creatinine < or = 1.5 X institutional ULN Ability to understand and willingness to sign a written informed consent document. Exclusion Criteria: Nasopharyngeal carcinoma Subjects who had received any other investigational drug within 1 month prior to day 1 of study drug administration or who have not recovered (to < or = grade 1) from adverse effects of the investigational agent received prior to this period. History of unstable angina or myocardial infarction or stroke within 6 months prior to initiation of protocol treatment. QTcF > 450 msec Subjects with uncontrolled inter-current illness including, but not limited to active infection, symptomatic congestive heart failure, cardiac arrhythmia, psychiatric illness or any condition that would limit compliance with study requirements. Subjects known to be suffering from infection with HIV, Tuberculosis, Hepatitis C or Hepatitis B. Women who are pregnant or lactating. Women of childbearing potential [defined as a sexually mature woman who has not undergone hysterectomy or who has not been naturally postmenopausal for at least 24 consecutive months (i.e. who has had menses any time in the preceding 24 consecutive months)] and men, not agreeing to use at least two approved methods of contraception, including at least one barrier method prior to study entry (after signing the informed consent document), during the duration of study participation and for at least 4 weeks after withdrawal from the study drug, unless they are surgically sterilised. Any condition, including laboratory abnormalities, that in the opinion of the investigator places the subject at an unacceptable risk or deems the subject not suitable for participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kirushna Kumar, MD, RT
Organizational Affiliation
Meenakshi Mission Hospital & Research Centre, Madurai, India
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Raj Nagarkar, MS
Organizational Affiliation
Curie Manavata Cancer Center, Nashik, India
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Subhashini John, MD, DMRT
Organizational Affiliation
Christian Medical College, Vellore, India
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Balaji Shewalkar, MD, DNB
Organizational Affiliation
Government Medical College, Aurangabad, India
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
M. Nagarajan, MD, DNB
Organizational Affiliation
V. N. Cancer Centre, GKNM Hospital, Coimbatore, India
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Naresh Somani, DM
Organizational Affiliation
Bhagwan Mahawir Cancer Hospital & Research Centre, Jaipur, India
Official's Role
Principal Investigator
Facility Information:
Facility Name
Government Medical College
City
Aurangabad
State/Province
Maharashtra
ZIP/Postal Code
431001
Country
India
Facility Name
Curie Manavata Cancer Center
City
Nashik
State/Province
Maharashtra
ZIP/Postal Code
422 004
Country
India
Facility Name
Bhagwan Mahawir Cancer Hospital & Research Centre
City
Jaipur
State/Province
Rajasthan
ZIP/Postal Code
302017
Country
India
Facility Name
V. N. Cancer Centre, GKNM Hospital
City
Coimbatore
State/Province
Tamil Nadu
ZIP/Postal Code
641037
Country
India
Facility Name
Meenakshi Mission Hospital & Research Centre
City
Madurai
State/Province
Tamil Nadu
ZIP/Postal Code
625107
Country
India
Facility Name
Christian Medical College
City
Vellore
State/Province
Tamil Nadu
ZIP/Postal Code
632 004
Country
India

12. IPD Sharing Statement

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Safety and Efficacy Study of P276-00 in Combination With Radiation in Subjects With Advanced Head and Neck Cancer

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