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| ID | Type | Description | Link |
|---|---|---|---|
| SCCC-112008-019 | |||
| CDR0000634258 |
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RATIONALE: Drugs used in chemotherapy, such as paclitaxel albumin-stabilized nanoparticle formulation and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Radiation therapy uses high-energy x-rays to kill tumor cells. Paclitaxel albumin-stabilized nanoparticle formulation may make tumor cells more sensitive to radiation therapy. Giving radiation therapy and paclitaxel albumin-stabilized nanoparticle formulation together with cisplatin and cetuximab may kill more tumor cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of paclitaxel albumin-stabilized nanoparticle formulation when given together with cisplatin, cetuximab, and radiation therapy to see how well they work in treating patients with locally advanced stage III or stage IV head and neck cancer.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a multicenter, phase I dose-escalation study of paclitaxel albumin-stabilized nanoparticle formulation followed by a phase II study.
Patients receive cetuximab IV over 120 minutes in week 1. Patients then receive cetuximab IV over 60 minutes, paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes, and cisplatin IV over 60 minutes once weekly in weeks 2-8. Patients also undergo 3D conformal or intensity-modulated radiotherapy over 30 minutes on days 1-5 in weeks 2-8.
After completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 4 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| arm one | Experimental | Nab-Paclitaxel, Cisplatin, Cetuximab, intensity-modulated radiation therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cetuximab | Biological | Cetuximab is an epidermal growth factor receptor (EGFR) inhibitor |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Phase I Maximum Tolerated Dose of Nab-Paclitaxel | Seven participants were assigned nab-paclitaxel in dose of 25mg/m^2. Five participants were assigned nab-paclitaxel in dose of 20mg/m^2. | 90 days |
| Phase II 2-year Progression-free Survival | Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. The primary endpoint of 2-year progression-free survival was measured from the date of enrollment to the first occurrence of new metastatic lesion, objective tumor progression, or death. | 2 year |
| Measure | Description | Time Frame |
|---|---|---|
| Phase II 2-year Local Control | Local control is defined as the arrest cancer growth at the site of origin. Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions | 2 year |
| Phase II 2-year Overall Survival |
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DISEASE CHARACTERISTICS:
Histologically confirmed squamous cell carcinoma of the oropharynx, hypopharynx, or larynx
No primary tumor of the oral cavity, nasopharynx, sinuses, or salivary glands
No distant metastasis by chest x-ray, CT scan, or PET/CT scan within the past 6 weeks
PATIENT CHARACTERISTICS:
Zubrod performance status 0-1
ANC > 1,500/mm^3
Platelet count > 100,000/mm^3
Hemoglobin > 9.0 g/dL (transfusion or other intervention to achieve hemoglobin > 8.0 g/dL allowed)
Bilirubin ≤ 1.5 mg/dL
AST, ALT, and AP ≤ 2.5 times upper limit of normal
Serum creatinine ≤ 1.5 mg/dL
Creatinine clearance ≥ 50 mL/min
None of the following electrolyte abnormalities grade 3-4 by CTCAE v 3.0:
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No other prior invasive malignancy, except for nonmelanomatous skin cancer, unless disease-free for ≥ 3 years
No prior allergic reaction to study drugs
No active cardiac disease, defined as any of the following:
No severe chronic obstructive pulmonary disease requiring ≥ 3 hospitalizations within the past year
No AIDS
No pre-existing peripheral sensory neuropathy ≥ grade 2
No concurrent medical illnesses that would impair patient tolerance to therapy or limit survival
PRIOR CONCURRENT THERAPY:
No prior systemic chemotherapy for this cancer
No prior radiotherapy to the region of this cancer that would result in overlap of radiotherapy fields
No prior initial surgical treatment (excluding diagnostic biopsy of the primary site or nodal sampling of neck disease)
At least 48 hours since prior and no concurrent granulocytic growth factors (e.g., filgrastim [G-CSF]) during radiotherapy
No concurrent erythropoietic growth factors (e.g., darbepoetin, erythropoietin)
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| Name | Affiliation | Role |
|---|---|---|
| Hak Choy, MD | Simmons Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Baylor Research Institute | Dallas | Texas | 75204 | United States | ||
| University of Texas Southwestern Medical Center |
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| ID | Title | Description |
|---|---|---|
| FG000 | Phase I Nab-paclitaxel 25 mg/m^2 | Cetuximab 450mg/m^2 as a loading dose in week one. Cetuximab 250 mg/m^2, Cisplatin 20mg/m^2 and nab-paclitaxel 25mg/m^2 weekly, concurrent with 70 Gy in 35 fractions continuous course intensity modulated radiotherapy during weeks 2-8. |
| FG001 | Phase I Nab-paclitaxel 20mg/m^2 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Phase I-1 |
|
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| Cisplatin |
| Drug |
Cisplatin is an anti-cancer chemotherapy drug |
|
|
| Nab-Paclitaxel | Drug | paclitaxel albumin-stabilized nanoparticle formulation |
|
|
| intensity-modulated radiation therapy | Radiation | intensity-modulated radiation therapy |
|
median follow-up 24 months for 34 patients |
| 2 year |
| Dallas |
| Texas |
| 75239 |
| United States |
Cetuximab 450mg/m^2 as a loading dose in week one. Cetuximab 250 mg/m^2, Cisplatin 20mg/m^2 and nab-paclitaxel 20mg/m^2 weekly, concurrent with 70 Gy in 35 fractions continuous course intensity modulated radiotherapy during weeks 2-8. |
| FG002 | Phase II Nab-paclitaxel 20mg/m^2 | Cetuximab 450mg/m^2 as a loading dose in week one. Cetuximab 250 mg/m^2, Cisplatin 20mg/m^2 and nab-paclitaxel 20mg/m^2 weekly, concurrent with 70 Gy in 35 fractions continuous course intensity modulated radiotherapy during weeks 2-8. |
| COMPLETED |
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| NOT COMPLETED |
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| Phase I-2 |
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| Phase II |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Nab-Paclitaxel, Cisplatin, Cetuximab and Radiation Therapy | Phase I/II Cetuximab, Cisplatin and nab-paclitaxel concurrent with intensity-modulated radiotherapy. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants | No |
| |||||||||||||||||
| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Phase I Maximum Tolerated Dose of Nab-Paclitaxel | Seven participants were assigned nab-paclitaxel in dose of 25mg/m^2. Five participants were assigned nab-paclitaxel in dose of 20mg/m^2. | 12 patients enrolled in the phase I study. | Posted | Number | mg/m^2 | 90 days |
|
|
| ||||||||||||||||||||||||||
| Primary | Phase II 2-year Progression-free Survival | Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. The primary endpoint of 2-year progression-free survival was measured from the date of enrollment to the first occurrence of new metastatic lesion, objective tumor progression, or death. | 12 patients from Phase I also participated in Phase II of this study. 25 patients enrolled in the phase II study with 3 patients withdrew from the study prior to treatment. | Posted | Number | 95% Confidence Interval | percentage of participants | 2 year |
|
| ||||||||||||||||||||||||||
| Secondary | Phase II 2-year Local Control | Local control is defined as the arrest cancer growth at the site of origin. Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions | 12 patients from Phase I also participated in Phase II of this study. 25 patients enrolled in the phase II study with 3 patients withdrew from the study prior to treatment. | Posted | Number | 95% Confidence Interval | percentage of participants | 2 year |
|
| ||||||||||||||||||||||||||
| Secondary | Phase II 2-year Overall Survival | median follow-up 24 months for 34 patients | 12 patients from Phase I also participated in Phase II of this study. 25 patients enrolled in the phase II study with 3 patients withdrew from the study prior to treatment. | Posted | Number | 95% Confidence Interval | percentage of participants | 2 year |
|
|
Through study completion, and average of 2 years.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Nab-Paclitaxel, Cisplatin, Cetuximab and Radiation Therapy | Nab-Paclitaxel, Cisplatin, Cetuximab, intensity-modulated radiation therapy Cetuximab: Cetuximab is an epidermal growth factor receptor (EGFR) inhibitor Cisplatin: Cisplatin is an anti-cancer chemotherapy drug Nab-Paclitaxel: paclitaxel albumin-stabilized nanoparticle formulation intensity-modulated radiation therapy: intensity-modulated radiation therapy | 1 | 34 | 3 | 34 | 32 | 34 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nab-Paclitaxel toxicity | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| grade 4 larynx edema | General disorders | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| hypothyroidism | Endocrine disorders | Systematic Assessment |
| ||
| larynx edema | General disorders | Systematic Assessment |
| ||
| xerostomia | General disorders | Systematic Assessment |
| ||
| fibrosis | General disorders | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Director of Clinical Trial | UT Southwestern Medical Center | ClinicalTrials@utsouthwestern.edu |
| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| D014062 | Tongue Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D002294 | Carcinoma, Squamous Cell |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009062 | Mouth Neoplasms |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D014060 | Tongue Diseases |
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| ID | Term |
|---|---|
| D000068818 | Cetuximab |
| D002945 | Cisplatin |
| C520255 | 130-nm albumin-bound paclitaxel |
| D000068196 | Albumin-Bound Paclitaxel |
| D050397 | Radiotherapy, Intensity-Modulated |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D017239 | Paclitaxel |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D004224 | Diterpenes |
| D013729 | Terpenes |
| D000418 | Albumins |
| D020266 | Radiotherapy, Conformal |
| D011881 | Radiotherapy, Computer-Assisted |
| D011878 | Radiotherapy |
| D013812 | Therapeutics |
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