- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00524017
Cetuximab in Treating Patients With Precancerous Lesions of the Upper Aerodigestive Tract
Phase II Study of Single-Agent Cetuximab for Treatment of High-Risk Pre-malignant Upper Aerodigestive Lesions
RATIONALE: Monoclonal antibodies, such as cetuximab, can block abnormal cell growth in different ways. Some block the ability of abnormal cells to grow and spread. Others find abnormal cells and help kill them or carry cell-killing substances to them.
PURPOSE: This randomized phase II trial is studying how well cetuximab works in treating patients with precancerous lesions of the upper aerodigestive tract.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
Primary
- To determine the histologic response rate in patients with high-risk, premalignant lesions of the upper aerodigestive tract treated with cetuximab.
Secondary
- To determine the clinical response rate in these patients.
- To determine if patterns of epidermal growth factor receptor (EGFR) component expression are altered in these patients.
- To determine the change in status of genetic alterations, including loss of heterozygosity, in these patients.
OUTLINE: This is a multicenter study. Patients are stratified by lesion type [diffuse dysplasia vs recurrent dysplasia vs dysplastic lesions with 3p or 9p loss of heterozygosity (LOH)]. Patients are randomized to 1 of 2 arms.
- Arm I (treatment): Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, and 50 in the absence of disease progression or unacceptable toxicity.
- Arm II (control): Patients receive regular follow-up care. Patients have the option of receiving cetuximab after completion of the study.
In both arms, patients with persistent or recurrent high-grade dysplasia or dysplastic lesions with 3p or 9p LOH undergo surgical resection, if feasible, after week 8.
Tumor biopsy samples are obtained at baseline* and after week 8 for histologic and biomarker correlative studies. Tissue samples are analyzed by histopathology to determine histologic changes in post-treatment lesions and by immuno-histochemistry (IHC) to measure expression and activation of EGFR signaling pathway components. LOH studies are also performed.
NOTE: *Paraffin-embedded tissue from the original diagnostic biopsy may be used for baseline assessment, if the diagnostic biopsy was performed within 3 months prior to study entry.
After completion of study therapy, patients are followed at approximately 1 month, every 3 months for 2 years, and then every 6 months for up to 5 years as per routine standard of care.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
British Columbia
-
Vancouver, British Columbia, Canada, V5Z 4E6
- British Columbia Cancer Agency - Vancouver Cancer Centre
-
-
-
-
California
-
San Francisco, California, United States, 94115
- UCSF Helen Diller Family Comprehensive Cancer Center
-
-
Illinois
-
Chicago, Illinois, United States, 60637-1470
- University of Chicago Cancer Research Center
-
-
Kentucky
-
Lexington, Kentucky, United States, 40536-0093
- Lucille P. Markey Cancer Center at University of Kentucky
-
-
Maryland
-
Baltimore, Maryland, United States, 21231-2410
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
-
Baltimore, Maryland, United States, 21201
- Greenebaum Cancer Center at University of Maryland Medical Center
-
-
Michigan
-
Ann Arbor, Michigan, United States, 48109-0942
- University of Michigan Comprehensive Cancer Center
-
-
New York
-
New York, New York, United States, 10010
- NYU Cancer Institute at New York University Medical Center
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15232
- UPMC Cancer Centers
-
-
South Carolina
-
Charleston, South Carolina, United States, 29425
- Hollings Cancer Center at Medical University of South Carolina
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically confirmed high-risk, premalignant lesions of the upper aerodigestive tract, meeting one of the following criteria:
- Unresectable, diffuse high-grade dysplasia, defined as moderate or severe dysplasia that is not assessable by physical examination and/or that cannot be excised by standard surgical techniques
- previously treated HNSCC with persistent or recurrent high grade dysplasia with no evidence of head and neck malignancy for three months prior to enrollment or who have successfully completed therapy for head and neck malignancy more than 3 months prior to enrollment.
- Dysplastic lesions with 3p or 9p loss of heterozygosity
Disease location amenable to endoscopic biopsy in an outpatient clinical setting or operative biopsy within the routine scheduling and practice of clinical care
- No medical contraindication to biopsy of the target lesion
- Pathology must be reviewed by the Johns Hopkins Hospital Department of Pathology
PATIENT CHARACTERISTICS:
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1
- Absolute neutrophil count (ANC) > 1,000/mm³
- Platelet count > 75,000/mm³
- Creatinine clearance > 60 mL/min
- Total serum bilirubin < 1.5 mg/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months after completion of study therapy
- No concurrent illness likely to preclude study therapy or surgical resection
- Patients with a history of a curatively treated malignancy are eligible provided they are disease-free and have a survival prognosis that exceeds 5 years
No evidence of clinically active interstitial lung disease
- Patients with chronic, stable radiographic changes who are asymptomatic are eligible
- No history or radiological evidence of pulmonary fibrosis
- No acute myocardial infarction within the past 3 months
- No uncontrolled angina, arrhythmia, or congestive heart failure
- No evidence of other severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal disease)
- No evidence of any other significant clinical disorder or laboratory finding that would preclude study participation
- No known severe hypersensitivity to cetuximab or any of its excipients
- No prior hypersensitivity reaction to chimerized or murine monoclonal antibody therapy
- No severe abnormality of the cornea
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Recovered from prior oncologic or other major surgery or biopsy
- More than 30 days since prior non-approved or investigational drugs
- No prior chemotherapy, radiotherapy, or surgery for the premalignant lesions
- No prior EGFR-targeted agents (e.g., cetuximab, gefitinib, or erlotinib)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm I (treatment)
Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, and 50 in the absence of disease progression or unacceptable toxicity.
|
given IV
|
No Intervention: Arm II (control)
Patients receive regular follow-up care
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Objective Response Based on Histologic Grade
Time Frame: 8 weeks
|
Histologic downgrade by at least one grade of dysplasia (e.g Severe to Moderate).
|
8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Objective Response Based on Clinical Assessment
Time Frame: 8 weeks
|
Clinical visualization on whether lesion responded to treatment (i.e., direct visualization of the lesion combined with histologic grade)
|
8 weeks
|
Status of Epidermal Growth Factor Receptor (EGFR) Pathway Components and Molecular Alterations in Pre-treatment Biopsies
Time Frame: Baseline (pre-treatment)
|
Baseline (pre-treatment)
|
|
Status of EGFR Pathway Components and Molecular Alterations in Post-treatment Biopsies
Time Frame: At 8 weeks post-treatment
|
At 8 weeks post-treatment
|
|
Survival
Time Frame: Up to year 5 years post-treatment
|
Up to year 5 years post-treatment
|
|
Lesion Recurrence
Time Frame: Up to year 5 years post-treatment
|
Up to year 5 years post-treatment
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Joseph Califano, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- J0644 CDR0000562250
- P30CA006973 (U.S. NIH Grant/Contract)
- P50CA096784 (U.S. NIH Grant/Contract)
- JHOC-J0644
- JHOC-NA_00001757
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
-
Robert FerrisAmgenCompletedHead 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 | Cancer of the Neck | UADT Neoplasms | Cancer of Head | Head Neoplasms | Head, Neck Neoplasms | Neoplasms, Head and other conditionsUnited States
-
Assiut UniversityRecruitingHead and Neck Cancer | Head and Neck Neoplasms | Cancer of Head and Neck | Neoplasms, Head and Neck | Cancer of the Head and NeckEgypt
-
Mayo ClinicRecruitingCancer Head Neck | Cancer Neck | Cancer, HeadUnited States
-
IRCCS Policlinico S. MatteoNestlé Health Science Spain; Akern SrlCompletedHead-neck CancerItaly
-
University of California, San FranciscoCompleted
-
Chinook Therapeutics, Inc. (formerly Aduro)TerminatedRecurrent Head and Neck Cancer | Metastatic Head and Neck CancerUnited States
-
National Cancer Institute (NCI)TerminatedRecurrent Head and Neck Cancer | Metastatic Head and Neck CancerUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)TerminatedHead And Neck CancerUnited States
-
Radboud University Medical CenterUnknown
-
Centre Oscar LambretUnknownEpidermoid Head and Neck CancerFrance
Clinical Trials on cetuximab
-
University Medical Center GroningenUMC Utrecht; Erasmus Medical CenterRecruitingHead and Neck Squamous Cell Carcinoma | Margin AssessmentNetherlands
-
West China HospitalFirst Affiliated Hospital of Chongqing Medical UniversityRecruitingColo-rectal Cancer | Capecitabine | CetuximabChina
-
Amsterdam UMC, location VUmcRadboud University Medical Center; University Medical Center GroningenTerminatedMetastatic Colorectal CancerNetherlands
-
Eben RosenthalNational Cancer Institute (NCI)TerminatedPancreatic AdenocarcinomaUnited States
-
HiberCell, Inc.TerminatedColorectal CancerUnited States, Puerto Rico, Germany, France
-
Merck KGaA, Darmstadt, GermanyCompletedPreviously Untreated Metastatic Colorectal CancerFrance, Italy, Poland, Germany, Hong Kong, Austria, Brazil, Israel, Greece, Argentina, Thailand, Belgium, Australia, Mexico
-
Arbeitsgemeinschaft medikamentoese TumortherapieMerck Sharp & Dohme LLCCompleted
-
Cancer Institute and Hospital, Chinese Academy...Recruiting
-
Poitiers University HospitalCompletedMetastatic Colon CancerFrance
-
Cliniques universitaires Saint-Luc- Université...Merck Sharp & Dohme LLC; Merck Serono International SACompleted