Study of the Combination of Panitumumab With Paclitaxel as First-line Treatment of Subjects With Head and Neck Cancer (VECTITAX)

"Phase II Study of the Combination of Panitumumab With Paclitaxel as First-line Treatment of Subjects With Metastatic or Recurrent Head and Neck Cancer"

The clinical hypothesis of this study is that the first-line treatment with the combination of panitumumab and paclitaxel will provide benefit for patients with metastatic or current Squamous Cell Carcinoma of the Head and Neck (SCCHN)

Study Overview

• Status: Completed
• Conditions: Head and Neck Cancer
• Intervention / Treatment: Drug: Panitumumab + paclitaxel

Detailed Description

Panitumumab, a fully human IgG2 anti-EGFR monoclonal antibody, has shown activity in preclinical models of SCCHN, and promising activity in refractory SCCHN patients in a phase I clinical trial. Recently, the investigators also reported encouraging outcomes of anti-EGFR-paclitaxel combination in a phase II study. On the basis of this background, a phase II clinical trial (VECTITAX study) was designed with the objective of evaluating the activity and safety profile of panitumumab in combination with paclitaxel in patients with recurrent or metastatic SCCHN.

The VECTITAX study was a single arm, open label, multicenter, phase II clinical trial. To be included patients had to have histologically or cytologically confirmed SCCHN. The current situation had to be recurrent or metastatic, deemed to be untreatable by surgery or radiotherapy. No previous systemic antineoplastic therapy for the recurrent/metastatic disease may have been administered. However, previous chemotherapy was allowed as a part of a multimodality radical treatment if completed >24 weeks before study entry.

Primary endpoint was confirmed objective response rate (ORR) according to RECIST 1.1 criteria in the intention-to-treat population (ITT). Tumor assessments were planned to be performed every two months. Response confirmation was to be assessed not before 4 weeks after a partial or complete response, or before 6 weeks after a stable disease. Secondary endpoints were disease control rate, time to response, duration of response, progression-free survival (PFS), OS, safety profile and QoL through EQ-5D-3L with visual analogic scale (VAS). Quality of life scores were registered at baseline and every eight weeks thereafter.

Treatment consisted of intravenous panitumumab 6 mg/kg q2w, administered in one hour the first day and in 30 minutes thereafter (if no infusional reaction was observed) plus intravenous paclitaxel 80 mg/m2 weekly administered one hour after panitumumab in one hour infusion, until progression or unacceptable toxicity. Panitumumab does not require prophylactic premedication from the first infusion.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Phase 2

Contacts and Locations

Study Locations

• Spain
  • Barcelona, Spain
    • Hospital de la Santa Creu I Sant Pau
  • Barcelona, Spain, 08036
    • Hospital Clinic I Provincial De Barcelona
  • Burgos, Spain
    • Hospital General de Yagüe
  • Granada, Spain
    • H. Virgen de las Nieves
  • Madrid, Spain
    • Hospital Universitario 12 de Octubre
  • Madrid, Spain, 28922
    • Hospital Universitario Fundacion Alcorcon
  • Salamanca, Spain, 37007
    • Hospital Universitario de Salamanca
  • Valencia, Spain
    • Hospital General Universitario
  • Valencia, Spain
    • Hospital Universitario La Fe de Valencia
  • Zaragoza, Spain
    • Hospital Miguel Servet
  • Barcelona
    • L'Hospitalet de Llobregat, Barcelona, Spain
      • Hospital Duran i Reynals
  • Navarra
    • Pamplona, Navarra, Spain, 31008
      • Hospital De Navarra

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Signed Inform Consent
• Age > 18 years
• Histologically or cytologically confirmed SCCHN
• Diagnosis of metastatic disease by the investigator and/or recurrent disease determined to be incurable by surgery or radiotherapy
• Subjects who have received radiation as primary therapy are eligible if radiation therapy treatment was completed > 4 weeks prior to inclusion
• Subjects who have previously received chemotherapy as part of the initial multimodality treatment for locally advanced disease are eligible if the chemotherapy was completed > 24 weeks prior to inclusion
• At least 1 unidimensionally measurable lesion of ≥ 20 mm using conventional techniques or ≥10 mm with spiral CT scan. Target lesions must not be chosen from a previously irradiated field unless there had been documented tumour progression in that lesion prior to inclusion
• Eastern Cooperative Oncology Group (ECOG) performance status score 0 or 1 at screening

• Haematological function:

  • ANC ≥ 1.5 x 109 cells/L
  • Hemoglobin ≥ 9.0 g/dL
  • Platelet count ≥ 100 x 109/L

• Kidney function:

  o Adequate renal function with creatinine clearance ≥ 60 mL/min)

• Liver function:

  • AST ≤ 3 x ULN (if liver metastases, ≤ 5 x ULN)
  • ALT ≤ 3 x ULN (if liver metastases, ≤ 5 x ULN)
  • Bilirubin ≤ 2 x ULN

• Metabolic function:

  • Magnesium ≥ lower limit of normal,
  • Calcium ≥ lower limit of normal

Exclusion Criteria:

• Documented or symptomatic central nervous system metastases
• Nasopharyngeal carcinoma
• History of interstitial lung disease (eg, pneumonitis or pulmonary fibrosis) or evidence of interstitial lung disease on baseline chest scan

• History of another primary cancer, except:

  • Curatively treated in situ cervical cancer, or
  • Curatively resected non-melanoma skin cancer or
  • Other primary solid tumour curatively treated with no known active disease present and no treatment administered for ≥ 3 years prior to starting the study treatment. In that case confirmation of inclusion by the sponsor is required.
• Clinically significant cardiovascular disease ≤ 1 year prior to starting the study treatment
• Pulmonary embolism, deep vein thrombosis, or other significant thromboembolic event ≤ 8 weeks prior to starting the study treatment
• Symptomatic peripheral neuropathy of Grade ≥ 2 based on the CTCAE v3.0
• Subjects not recovered from all previous acute radiotherapy-related toxicities to ≤ grade 1
• History of severe skin disorder that in the opinion of the investigator may interfere with study conduct
• Known positive test for human immunodeficiency virus (HIV) infection, hepatitis C virus, acute or chronic hepatitis B infection
• Active infection requiring systemic treatment or any uncontrolled infection ≤ 14 days prior to starting the study treatment
• History of interstitial pneumonia or pulmonary fibrosis or signs of interstitial pneumonia or pulmonary fibrosis on the baseline chest X-ray.
• Known allergy or hypersensitivity to panitumumab, or other study medications.
• Prior anti epidermal growth factor receptor (EGFr) antibody therapy or treatment with small molecule EGFr inhibitors unless received as part of prior multimodality treatment and completed > 24 weeks prior to starting the study treatment. In this case, the investigator should confirm that the subject had not presented any previous cetuximab-related infusion reaction > grade 2.
• Subject is currently enrolled in or ≤ 30 days since ending other investigational device, investigational procedure, or drug study(s), or subject is receiving other investigational agent(s)
• Subjects requiring use of immunosuppressive agents, however, corticosteroids are allowed
• Man or woman of child-bearing potential who do not consent to use adequate contraceptive precautions during the course of the study, and for 6 months after the last study drug administration for women, and 3 months for men.
• Female subject who is pregnant or breast-feeding, or planning to become pregnant within 6 months after the end of treatment.
• Major surgery requiring general anesthesia/ spinal anesthesia and a significant incision ≤ 28 days or minor surgery ≤ 14 days prior to starting the study treatment. Subjects must have recovered from surgery-related toxicities.
• Subjects who do not wish to meet the study requirements or are unable to do so.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

EXPERIMENTAL: Panitumumab + Paclitaxel; Treatment consisted of intravenous panitumumab 6 mg/kg q2w, administered in one hour the first day and in 30 minutes thereafter (if no infusional reaction was observed) plus intravenous paclitaxel 80 mg/m2 weekly administered one hour after panitumumab in one hour infusion, until progression or unacceptable toxicity. Panitumumab does not require prophylactic premedication from the first infusion. Paclitaxel was administered with: dexamethasone 10 mg, diphenhydramine 30 mg and antiH2 (cimetidine 300 mg or ranitidine 50 mg). Dose modifications of paclitaxel included 4.8 mg/kg (80% of the initial dose) and 3.6 mg/kg (60%) when recovered from a grade 3-4 skin toxicity to grade ≤2. Continuing paclitaxel on the day of the planned infusion required no grade ≥2 mucositis and hematologic recovery with an absolute neutrophil count ≥1,500/ml and a platelet count ≥75,000.

Drug: Panitumumab + paclitaxel; Paclitaxel 80 mg/m2 may be infused, intravenously, over one hour every week. Panitumumab will be administered every 2 weeks at a dose of 6 mg/kg, using a non pyrogenic low protein binding filter with a 0.20-0.22-μm pore size intravenously over 1 hour ± 15 minutes. Panitumumab will be administered prior to paclitaxel.; Other Names: Vectibix®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
objective response rate	To assess the effect of the combination of panitumumab and paclitaxel on objective response rate in first-line treatment of metastatic or recurrent squamous cell carcinoma of head and neck (SCCHN).	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to response, duration of response, progression free-survival, overall survival.	Secondary Objectives; To assess the disease control rate, time to response, duration of response, progression free-survival and overall survival.; To estimate changes in patient-reported outcomes (PRO).; To describe the safety profile of the combination of panitumumab and paclitaxel. 1.3 Exploratory Objectives: To investigate the effects of genetic variation in cancer genes and drug target genes on subject response to panitumumab and Paclitaxel combination chemotherapy.; To investigate the predictive potential of different biomarkers on efficacy and/or safety endpoints.	2 years

Collaborators and Investigators

• Sponsor: Grupo Español de Tratamiento de Tumores de Cabeza y Cuello
• Collaborators: Amgen; Trial Form Support S.L.
• Investigators: Study Director: Juan Jesús Cruz Hernández, Professor, University of Salamanca; Principal Investigator: Javier Martínez Trufero, MD, Hospital Miguel Servet de Zaragoza; Principal Investigator: Juan José Grau, MD, Hospital Clinic I Provincial De Barcelona; Principal Investigator: Joaquina Martínez, MD, Hospital Virgen de las Nieves (Granada); Principal Investigator: Antonio López Pousa, MD, Hospital de la Santa Creu i Sant Pau de Barcelona; Principal Investigator: Alfonso Berrocal, MD, Hospital General Universitario de Valencia; Principal Investigator: Ricardo Hitt, MD, Hospital 12 de Octubre de Madrid; Principal Investigator: Ricardo Mesia, MD, Institut Català d'Oncología. Hospital Duran i Reynals de Barcelona; Study Director: Elvira del Barco Morillo, MD, University of Salamanca; Principal Investigator: Carlos García, MD, Hospital General Yagüe de Burgos; Principal Investigator: Alicia Hurtado, MD, Fundación Hospitalaria de Alcorcón de Madrid; Principal Investigator: Miguel Pastor, MD, Hospital La Fe de Valencia; Principal Investigator: Ruth Vera García, MD, Hospital De Navarra

Publications and helpful links

General Publications

• Del Barco Morillo E, Mesia R, Adansa Klain JC, Vazquez Fernandez S, Martinez-Galan J, Pastor Borgonon M, Gonzalez-Rivas C, Caballero Daroqui J, Berrocal A, Martinez-Trufero J, Vera R, Cruz-Hernandez JJ; Spanish Head And Neck Cancer Cooperative Group (TTCC). Phase II study of panitumumab and paclitaxel as first-line treatment in recurrent or metastatic head and neck cancer. TTCC-2009-03/VECTITAX study. Oral Oncol. 2016 Nov;62:54-59. doi: 10.1016/j.oraloncology.2016.09.009. Epub 2016 Oct 8.

Helpful Links

• This site would like to expose the activities of the group and at the same time serve as an information and communication tool of this pathology for professionals and patients.

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 9, 2011
• Primary Completion (ACTUAL): October 1, 2011
• Study Completion (ACTUAL): September 29, 2014

Study Registration Dates

• First Submitted: December 2, 2010
• First Submitted That Met QC Criteria: December 20, 2010
• First Posted (ESTIMATE): December 21, 2010

Study Record Updates

• Last Update Posted (ACTUAL): April 16, 2019
• Last Update Submitted That Met QC Criteria: April 11, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Keywords: Head and neck cancer, panitumumab, TTCC-2009-03
• Additional Relevant MeSH Terms: Neoplasms; Neoplasms by Site; Head and Neck Neoplasms; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Tubulin Modulators; Antimitotic Agents; Mitosis Modulators; Antineoplastic Agents, Phytogenic; Antineoplastic Agents, Immunological; Paclitaxel; Panitumumab
• Other Study ID Numbers: TTCC-2009-03