Everolimus, Carboplatin, and Paclitaxel in Locally Advanced Head and Neck Cancer That Cannot Be Removed by Surgery (CAPRA)
Phase I/II Study of Induction Chemotherapy With Weekly RAD001, Carboplatin and Paclitaxel in Unresectable or Inoperable Locally Advanced Head and Neck Squamous Cell Carcinoma (HNSCC)
RATIONALE: Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
PURPOSE: This phase I/II trial is studying the side effects and best dose of giving everolimus together with carboplatin and paclitaxel in treating patients with locally advanced head and neck cancer that cannot be removed by surgery.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
OBJECTIVES:
Primary
- To determine the maximum-tolerated dose of everolimus when combined with carboplatin and paclitaxel in chemonaïve patients with unresectable or inoperable locally advanced head and neck squamous cell carcinoma. (Phase I)
- To determine the safety profile of weekly everolimus in combination with carboplatin and paclitaxel in chemonaïve patients with unresectable or inoperable locally advanced head and neck squamous cell carcinoma. (Phase I)
- To determine the anti-tumor activity of this regimen, in terms of objective response rate of the combination, according to the RECIST criteria in these patients. (Phase II)
Secondary
- To identify molecular markers of resistance to this regimen in these patients.
- To assess objective response rate before and after completion of radiation therapy in these patients. (Phase II)
OUTLINE: This is a multicenter, phase I dose-escalation study of everolimus followed by a phase II study.
- Phase I: Patients receive paclitaxel IV over 1 hour, carboplatin IV over 1 hour, and escalating doses of oral everolimus on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses in the absence of disease progression or unacceptable toxicity.
- Phase II: Patients receive paclitaxel and carboplatin as in phase I and oral everolimus (at a dose determined in the phase I portion of the study) on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses in the absence of disease progression or unacceptable toxicity.
After the completion of combination therapy, patients may receive radiotherapy or surgery, at the investigator's discretion.
Blood samples are collected for translational research and molecular markers analysis at baseline and weeks 1, 4, and 9. Tissue samples are collected at baseline and periodically during the study for biomarker and other laboratory analysis.
After completion of study treatment, patients are followed up at 14 days and periodically thereafter.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
-
Clichy, France, 92110
- Hopital Beaujon
-
Lyon, France, 69000
- Centre Léon Bérard
-
Paris, France, 75005
- Institut Curie
-
Paris, France, 75014
- Hôpital Privé Saint Joseph
-
Toulouse, France, 31052
- Institut Claudius Regaud
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically confirmed squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx
- Locally advanced disease (T4 N0-N3 disease)
- Unresectable disease OR resectable disease with surgery contra-indication
- No stage I, II, III, or IVc disease
- Measurable lesions defined as those accurately measured in ≥ 1 dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan
- No known brain metastases (cerebral CT scan is not required if no symptom is present)
PATIENT CHARACTERISTICS:
- WHO performance status 0-2
- Life expectancy > 3 months
- Absolute neutrophil count ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- Hemoglobin ≥ 9 g/dL
- Total bilirubin ≤ 1.25 times upper limit of normal (ULN)
- Transaminases ≤ 2.5 times ULN
- Alkaline phosphatase ≤ 5 times ULN
- Creatinine clearance ≥ 60 mL/min
- Glycemia ≤ 1.5 times ULN
- Cholesterol level ≤ 7.30 mmol/L
- Serum total protein normal
- Oxygen saturation > 88%
- Able to swallow pills
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months after completion of study treatment
- No preexisting neuropathy ≥ grade 2
No uncontrolled disease including any of the following:
- Diabetes
- Hypertension
- Symptomatic congestive heart or pulmonary failure
- Renal or hepatic chronic disease
- Severe infectious disease
- No active hemorrhagic syndrome
- No prior history of cancer within the past 5 years, except in situ cervical cancer and basal cell skin carcinoma
- No psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
- Registration in a national health care system (CMU included)
- Not eligible for organ preservation program
PRIOR CONCURRENT THERAPY:
- No prior therapy for this cancer
- No prior chemotherapy unless received for treatment of another primary tumor considered in remission
- No prior investigational drug
- More than 30 days since prior participation in another therapeutic trial
- No prior or concurrent radiotherapy (except anterior radiotherapy) unless received for treatment of another primary tumor considered in remission
- No concurrent CYP3A4 strong inhibitors (e.g., azole antimycotics [itraconazole, ketoconazole], HIV protease inhibitor [ritonavir], erythromycin, anti-epileptic drugs [phenytoin, carbamazepine])
- No concurrent anti-coagulant therapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: RAD001-paclitaxel-carboplatin
RAD001: 20,30 or 50 mg PO 9 weekly cycles Paclitaxel: 60 mg/m²IV, in 1 hour, 9 weekly cycles Carboplatin AUC2 IV in 1 hour,9 weekly cycles
|
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Maximum tolerated dose
Time Frame: weekly
|
to determine the maximum tolerated dose (MTD) and recommended dose of weekly RAD001 in combination with carboplatin and paclitaxel (phase I)
|
weekly
|
|
objective response rate
Time Frame: 9 weeks
|
To access the objective response rate of the combination RAD001-carboplatin-Paclitaxel according the the RECIST criteria, after 9 weekly cycles (phase II)
|
9 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Sandrine Faivre, Hopital Beaujon
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- stage IV squamous cell carcinoma of the lip and oral cavity
- stage IV verrucous carcinoma of the oral cavity
- stage IV squamous cell carcinoma of the oropharynx
- stage IV squamous cell carcinoma of the hypopharynx
- stage IV squamous cell carcinoma of the larynx
- stage IV verrucous carcinoma of the larynx
- tongue cancer
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Site
- Head and Neck Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Carboplatin
- Paclitaxel
- Everolimus
Other Study ID Numbers
Other Study ID Numbers
- CDR0000698330
- FRE-GERCOR-CAPRA
- FRE-GERCOR-O08-1
- EU-21109
- EUDRACT-2008-005702-39
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Head and Neck Cancer
-
NCT00798655CompletedHead and Neck Cancer | Cancer of Head and Neck | Head Cancer | Neck Cancer | Neoplasms, Head and Neck | Cancer of the Head and Neck | Cancer of Neck | Upper Aerodigestive Tract Neoplasms | Neck Neoplasms | Cancer of the Head
-
NCT02557048RecruitingHead and Neck Cancer | Head and Neck Neoplasms | Cancer of Head and Neck | Neoplasms, Head and Neck | Cancer of the Head and Neck
-
NCT05979883CompletedCancer Head Neck | Cancer Neck | Cancer, Head
-
NCT07072325Not yet recruitingHead and Neck Cancer | Malignant Neoplasm | Advanced Head and Neck Carcinoma | Head &Amp; Neck Cancer
-
NCT02055833Completed
-
NCT00088907TerminatedRecurrent Head and Neck Cancer | Metastatic Head and Neck Cancer
-
NCT06641791Recruiting
-
NCT01647555CompletedEpidermoid Head and Neck Cancer
Clinical Trials on carboplatin
-
NCT00268905Completed
-
NCT00877253Completed
-
NCT07493980Not yet recruiting
-
NCT07285941Recruiting
-
NCT00098878CompletedOvarian Cancer | Fallopian Tube Cancer | Primary Peritoneal Cavity Cancer
-
NCT00002749CompletedBrain and Central Nervous System Tumors
-
NCT06574763Not yet recruiting
-
NCT01445418CompletedBreast Cancer | Ovarian Cancer
-
NCT07353723Recruiting
-
NCT00382811CompletedPeritoneal Neoplasms | Ovarian Cancer | Fallopian Tube Cancer