Ruxolitinib in Operable Head and Neck Cancer
Pharmacodynamic Effects and Predictive Biomarkers of Janus Kinases (JAK)/Signal Transducer and Activator of Transcription (STAT) Inhibition With Ruxolitinib in Operable Head and Neck Cancer: a Window Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To identify baseline and/or pharmacodynamic biomarkers of response to ruxolitinib, based upon association with quantitative change in tumor size following 14-21 days of neoadjuvant ruxolitinib in patients with operable HNSCC as determined by quantitative change in Tumor size.
SECONDARY OBJECTIVES:
I. To describe the tolerability of brief neoadjuvant exposure to ruxolitinib II. To assess the effect of ruxolitinib on the tumoral Ki-67 proliferation index III. To evaluate additional candidate biomarkers of ruxolitinib response or resistance in HNSCC patients as determined by quantitative change in Tumor size,
OUTLINE:
Participants will be assigned neoadjuvant ruxolitinib based on participant platelet counts at baseline. Participants with a platelet count of 200,000 or greater will take 20 mg twice daily and participants with a platelet count between 150,000 and 200,000 will take 15 mg twice daily. Participants may continue treatment for up to 4 weeks from the time of study entry to time of planned standard of care surgery for cancer. Participants will be followed up for 12-weeks post-operation.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Angelica Valadez
- Phone Number: (415) 502-1879
- Email: Angelica.Valadez@ucsf.edu
Study Locations
-
-
Arizona
-
Tucson, Arizona, United States, 85724
- University of Arizona Cancer Center
-
-
California
-
San Francisco, California, United States, 94143
- University of California, San Francisco
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically or cytologically confirmed, primary or recurrent, head and neck squamous cell carcinoma, including variants. Patients must have at least one measureable lesion in accordance with RECIST 1.1 (tumor diameter ≥ 1 cm; short-axis lymph node diameter ≥ 1.5 cm) OR by caliper measurement (tumor diameter ≥ 1 cm). Any diagnostic pretreatment biopsy sample is acceptable including fine needle aspiration (FNA).
- Primary tumors of any head and neck (oral cavity, oropharynx, hypopharynx, or larynx) site will be included.
- Surgical resection of head and neck must be planned, either as primary treatment or salvage. Patients must have submitted adequate pretreatment archival or fresh tissue.
- Age ≥ 18 years.
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2 (See Appendix 1).
- Women of childbearing potential (WOCBP) must have a negative serum pregnancy test (sensitivity ≤ 25 human chorionic gonadotropin (HCG) IU/L) within 4 weeks prior to registration and will be repeated within 72 hours prior to the start of study drug administration.
- Persons of reproductive potential must agree to use and utilize an adequate method of contraception throughout treatment and for at least 12 weeks after study drug is stopped. Prior to study enrollment, women of childbearing potential must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy.
Adequate hematologic, renal and hepatic function, as defined by:
- Absolute neutrophil count (ANC) ≥ 1,500/ul, platelets ≥ 150,000/ul.
- Creatinine ≤ 1.5 x institutional upper limit of normal (ULN).
- Bilirubin ≤ 1.5 x ULN, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 2.5 x ULN.
- Have signed written informed consent
Exclusion Criteria:
- Subjects who fail to meet the above criteria.
- Prior therapy for head and neck cancer is allowed, and the number of treatments is not limited. However, any systemic therapy should have been completed at least 30 days prior to study enrollment. Any radiation to the head and neck should have been completed at least 30 days prior to study enrollment. Palliative radiation outside of the head and neck does not require a washout.
- Pregnancy or breastfeeding. Women (patients or partners of male patients) of childbearing potential (WOCBP) must practice acceptable methods of birth control to prevent pregnancy. All WOCBP must have a negative pregnancy test within 4 weeks prior to registration, and this must be repeated within 72 hours prior to first receiving ruxolitinib. If the pregnancy test is positive, the patient must not receive ruxolitinib and must not be enrolled in the study.
- Any unresolved chronic toxicity ≥ grade 2 from previous anticancer therapy (except alopecia and anemia), according to Common Terminology Criteria for Adverse Events v4.0 (CTCAE).
- Current active infection requiring systemic antibiotic or antifungal therapy.
- Acute hepatitis or known HIV.
- Treatment with a non-approved or investigational drug within 30 days prior to Day 1 of study treatment.
- New York Heart Association (NYHA) Class III or IV heart disease.
- History of thromboembolic event or other condition currently requiring anticoagulation with warfarin (coumadin). Patients who are treated with low molecular weight heparin or fondaparinux are eligible.
- History of significant bleeding disorder unrelated to cancer, including: diagnosed congenital bleeding disorders (e.g., von Willebrand's disease, diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies, or ongoing or recent (≤ 3 months) significant gastrointestinal bleeding
- Concomitant Medications, any of the following should be considered for exclusion: Strong CYP3A4 inhibitors: (Patients must discontinue drug 7 days prior to starting ruxolitinib), including but not limited to boceprevir, clarithromycin, conivaptan, indinavir, itraconazole, ketoconazole, lopinavir, mibefradil, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, or voriconazole. In addition, patients will be instructed to avoid grapefruit or grapefruit juice, starfruit, or seville oranges.
- Prisoners or subjects who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious) illness.
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: Neoadjuvant Ruxolitinib
Participants will take 15 mg or 20 mg of ruxolitinib by mouth twice daily for up to 4 weeks during the pre-operative window for 14-21 days, or up to 28 days for delays in planned surgery.
Dose will be assigned based on participant platelet count at baseline.
The last dose will be taken the morning of planned surgery.
Ruxolitinib will be dispensed in 5 mg tablets.
Participants will either take three tables (15 mg) in the morning and evening, or four tablets in the morning and evening (20 mg).
Participants will be asked to fill out a drug diary indicating when doses of study drug are taken and any side effects they experience.
|
Given orally
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportional Percent Change in Tumor Size by Group
Time Frame: Up to 4 weeks
|
Measured clinical ruxolitinib response of quantitative change in tumor size measured as a proportional percent (range -100% to +100%) from baseline to day 14-21 by group.
|
Up to 4 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Treatment-related Adverse Events
Time Frame: Up to 12 weeks
|
The number of participants with treatment-related adverse events, defined as definite, probable or possibly related to the study intervention and classified according to NCI CTCAE version 4 will be reported.
|
Up to 12 weeks
|
|
Number of Participants With Documented Surgical Complications
Time Frame: Up to 12 weeks.
|
The number of participants with documented surgical complications will be reported.
|
Up to 12 weeks.
|
|
Median Length of Hospital Stay
Time Frame: Up to 12 weeks
|
The median length of hospital stay following the standard of care, surgical procedure will be reported.
|
Up to 12 weeks
|
|
Median Change in Ki-67 Proliferative Index Value
Time Frame: Up to 12 weeks
|
A high Ki-67 proliferation index means many cells are dividing quickly and that the cancer is likely to grow and spread.
A Ki-67 proliferation index over 30% is typically considered high.
The Ki-67 proliferative index will be measured at baseline and post-treatment tumor tissue.
|
Up to 12 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: William Ryan, MD, University of California, San Francisco
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 16201
- NCI-2017-02304 (Registry Identifier: Clinical Trials Reporting Program (CTRP))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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 Squamous Cell Carcinoma
-
NCT07094685RecruitingAdvanced Head and Neck Squamous Cell Carcinoma | Resectable Head and Neck Squamous Cell Carcinoma | Stage II Head and Neck Cutaneous Squamous Cell Carcinoma | Stage III Head and Neck Cutaneous Squamous Cell Carcinoma | Stage IV Head and Neck Cutaneous Squamous Cell Carcinoma
-
NCT04454489CompletedRecurrent Head and Neck Squamous Cell Carcinoma | Advanced Head and Neck Squamous Cell Carcinoma | Metastatic Head-and-neck Squamous-cell Carcinoma | Locally Advanced Head and Neck Squamous Cell Carcinoma | Stage III Cutaneous Squamous Cell Carcinoma of the Head and Neck | Stage IV Cutaneous Squamous Cell Carcinoma of the Head and Neck
-
NCT03823131TerminatedRecurrent Head and Neck Squamous Cell Carcinoma | Metastatic Head and Neck Squamous Cell Carcinoma | Unresectable Head and Neck Squamous Cell Carcinoma
-
NCT01449201CompletedHead Neck Cancer Squamous Cell Recurrent | Head Neck Cancer Squamous Cell Metastatic
-
NCT06736379RecruitingHead and Neck Cancer | Squamous Cell Carcinoma of the Head and Neck | Solid Tumors | Head and Neck Squamous Cell Cancer | Head Neck Cancer | Oral Cavity Carcinoma | HNSCC | Oral Cavity | Squamous Cell Carcinoma, Head And Neck | Head and Neck Cancers- Squamous Cell
-
NCT02369458CompletedSquamous Cell Carcinoma of the Head and Neck | Squamous Cell Carcinoma, Head and Neck
-
NCT03405142CompletedHead and Neck Cancer | Head and Neck Squamous Cell Carcinoma | Squamous Cell Carcinoma of the Head and Neck (SCCHN)
-
NCT05156970CompletedRecurrent Head and Neck Squamous Cell Carcinoma | Metastatic Head and Neck Squamous Cell Carcinoma
-
NCT00903461TerminatedSquamous Cell Carcinoma of the Head and Neck | Squamous Cell Carcinoma, Head And Neck | Carcinoma, Squamous Cell of Head and Neck
-
NCT06997094RecruitingResectable Head and Neck Squamous Cell Carcinoma | HPV-Negative Squamous Cell Carcinoma | Resectable Head and Neck Squamous-cell Carcinoma | Human Papillomavirus-Negative Neck Squamous Cell Carcinoma | Resectable Human Papillomavirus-Independent Head and Neck Mucosal Squamous Cell Carcinoma
Clinical Trials on Ruxolitinib
-
NCT04908735TerminatedBronchiolitis Obliterans (BO) | Hematopoietic Stem Cell Transplant (HSCT)
-
NCT02928978CompletedDuctal Carcinoma In Situ | Atypical Ductal Hyperplasia | Atypical Lobular Hyperplasia | Lobular Carcinoma In Situ
-
NCT07588945Not yet recruitingTransplant-Related Disorder
-
NCT06695507TerminatedChronic Graft Versus Host Disease
-
NCT07424222Not yet recruitingImmune Effector Associated Hemophagocytic Lymphohistiocytosis-like Syndrome (IEC-HS)
-
NCT06824103RecruitingChronic Graft vs. Host Disease | Graft vs. Host Disease | Corticosteroid-refractory Chronic Graft vs. Host Disease
-
NCT03147742Approved for marketing
-
NCT07595939Not yet recruiting
-
NCT07566897Not yet recruitingPancreatic Adenocarcinoma | Pancreatic Adenocarcinoma Metastatic | Renal Carcinoma Metastatic | Metastatic Colorectal Carcinoma (mCRC)
-
NCT06462469RecruitingSteroid-refractory Acute Graft Versus Host Disease