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| ID | Type | Description | Link |
|---|---|---|---|
| UCSD-HRPP-050275 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
RATIONALE: Drugs used in chemotherapy, such as AP5346 and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
PURPOSE: This randomized clinical trial is studying the dose of AP5346 to see how well it works compared with the dose of oxaliplatin in treating patients with metastatic and/or unresectable recurrent head and neck cancer.
OBJECTIVES:
OUTLINE: This is a randomized, pilot study. Patients are randomized to 1 of 2 treatment arms.
Beginning on day 29, all patients may receive AP5346 as in arm I. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Patients undergo tumor biopsy before and 24 hours after the first course of treatment for correlative pharmacological, immunohistochemical (IHC), and molecular studies. Tumor specimens are assessed for platinum content, GADD153 gene expression (by molecular analysis), and copper transporter (CTR1, ATP7A, ATP7B) expression by IHC.
PROJECTED ACCRUAL: A total of 12 patients will be accrued for this study.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DACH polymer platinate AP5346 | Drug | |||
| oxaliplatin | Drug | |||
| gene expression analysis | Genetic | |||
| immunohistochemistry staining method | Other | |||
| pharmacological study | Other | |||
| biopsy | Procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Delivered-dose of platinum 24 hours after IV injection of a single dose of AP5346 vs a single dose of oxaliplatin | ||
| Correlation of platinum accumulation in the tumor and tumor DNA with clinical response | ||
| Correlation of platinum accumulation in the tumor and tumor DNA with molecular response as determined by GADD153 expression | ||
| Quantification of expression of CTR1, ATP7A, and ATP7B in squamous cell carcinoma of the head and neck (SCCHN) tumors by immunohistochemistry | ||
| Correlation of expression of CTR1, ATP7A, and ATP7B in SCCHN tumors with tumor platinum levels | ||
| Toxicity of AP5346 |
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DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed primary squamous cell carcinoma of the head and neck, including the oral cavity, oropharynx, hypopharynx, larynx, or nasopharynx
Metastatic and/or unresectable locally recurrent disease for which no curative treatment is available
Tumor(s) must be amenable to minimally invasive biopsy during the first course of treatment
PATIENT CHARACTERISTICS:
WHO performance status 0-2
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
Absolute neutrophil count ≥ 2,000/mm³
Platelet count ≥ 100,000/mm³
Hemoglobin ≥ 10 g/dL
Bilirubin < 1.5 times upper level of normal (ULN)
Alkaline phosphatase (AP) ≤ 5 times normal (unless elevation is due to bone disease or bone metastasis in the absence of liver disease)
AST and ALT ≤ 3 times ULN
Blood urea < 1.5 times ULN
Creatinine < 1.5 times ULN OR creatinine clearance > 60 mL/min OR creatinine clearance by 24-hour urine collection normal
Calcium normal
No history of hypersensitivity reactions of any kind to cisplatin or carboplatin
No other serious medical condition or psychiatric illness that would preclude the patient's ability to give informed consent or receive study treatment
No symptomatic peripheral neuropathy ≥ grade 2
No need for IV alimentation
No other serious illness or medical condition, including, but not limited to, the following:
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
At least 4 weeks since prior and no other concurrent anticancer treatment (i.e., chemotherapy, chemoradiotherapy, or radiotherapy)
At least 4 weeks since prior biologic therapy
No prior oxaliplatin
No concurrent anticoagulants other than cardioprotective doses of aspirin, cyclooxygenase 1-inhibitory nonspecific anti-inflammatory drugs, or prophylactic low-dose heparin
Concurrent bisphosphonates for hypercalcemia allowed provided the drug was initiated ≥ 3 months prior to study entry
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| Name | Affiliation | Role |
|---|---|---|
| William L. Read, MD | University of California, San Diego | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Moores UCSD Cancer Center | La Jolla | California | 92093-0658 | United States |
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| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D002294 | Carcinoma, Squamous Cell |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| C511763 | ProLindac |
| D000077150 | Oxaliplatin |
| D020869 | Gene Expression Profiling |
| D007150 | Immunohistochemistry |
| D001706 | Biopsy |
| ID | Term |
|---|---|
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |
| D005821 | Genetic Techniques |
| D008919 | Investigative Techniques |
| D006651 | Histocytochemistry |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D006652 | Histological Techniques |
| D007158 | Immunologic Techniques |
| D003581 | Cytodiagnosis |
| D013048 | Specimen Handling |
| D003949 | Diagnostic Techniques, Surgical |
| D013514 | Surgical Procedures, Operative |
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