Circulating Tumor Cells as an Early Predictive head-and -Neck Squamous-cell Carcinoma (CIRCUTEC)

December 2, 2014 updated by: University Hospital, Montpellier

Assessment of Circulating Tumor Cells as an Early Predictive Marker of Response to a First Line Treatment Based on an Anti-Human Epidermal Growth Factor Receptor (HER), Cetuximab, in Patients With Inoperable Recurrent and/or Metastatic Head-and-neck Squamous-cell Carcinoma.

In France, the incidence of head and neck squamous cell carcinomas (HNSCC) is 16 000 new cases/year. During these last years, many new chemotherapies and targeted therapies have been developed improving significantly the overall survival of patients notably anti-HER molecules. In inoperable recurrent and/or metastatic HNSCC, the best treatment is based on an anti-Human Epidermal Growth Factor Receptor (EGFR) antibody, targeting Human Epidermal Growth Factor Receptor 1 (HER1), the Cetuximab combined with platinum +/- 5 Fluoro Uracil (5FU): " Extreme protocol ". However, no clinical or biological criteria predictive of drug efficacy have been reported yet. Thus, the development of such a predictive factor is an urgent need in HNSCC at both the clinical and pharmacy-economic level, to propose the best personalized treatment. One idea would be to enumerate and characterize the circulating tumor cells (CTC) which could give us an early evaluation of the therapeutic efficiency. In this context, the investigators have developed an innovative technology, the EPISPOT assay (patent of the University Medical Center of Montpellier), that allows the detection & characterization of viable CTC in the peripheral blood. The EPISPOT technology has been already evaluated in the breast and prostate cancer.Thus, the investigators would like for the first time to perform a prospective study on a cohort of patients treated following the Extreme protocol, with this technology, to assess the predictive value of CTC count. The investigators will use the CellSearch® system as the reference test.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

This is a multi-centric prospective non randomized open labeled study performed on a cohort of patients with inoperable recurrent and/or metastatic HNSCC who will be treated, with a first line treatment based on an anti-Human Epidermal Growth Factor Receptor (HER), the Cetuximab.

Study Type

Interventional

Enrollment (Anticipated)

115

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

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:

  • Age > 18 yo.
  • Histologically or cytologically confirmed recurrent and/or metastatic Squamous Cell Carcinoma Head and Neck (SCCHN) (excluding nasopharyngeal carcinoma) not suitable for local therapy : surgery and/or radiotherapy ; or metastatic disease with or without primary evolving tumor.
  • Target definable with Response Evaluation Tumors Criteria in Solid (RECIST) 1.1 criteria.
  • WHO performance status 0,1 or 2.
  • Life expectancy > 3 month at inclusion.
  • Patient eligible for first line chemotherapy based on cisplatin (100 mg/m2 as a 1-hour intravenous (IV) infusion on day 1) or carboplatin (AUC 5 mg/ml.min by 1-hour IV infusion, day 1) and an infusion of 5-FU (1000 mg/m2/day for 4 days) every 3 weeks, with cetuximab (initial dose of 400 mg/m2 [2-hour IV infusion] followed by subsequent weekly doses of 250 mg/m2 [1-hour IV infusion], ending at least 1 hour before the start of chemotherapy).
  • Consent form for participation signed.

Exclusion Criteria:

  • Other chemotherapy protocol not involving platinum and cetuximab.
  • Other proven synchronous evolving cancer.
  • Evolving infectious disease or severe other disease preventing the patient from receiving treatment.
  • Patient refusal.
  • Patient unable to consent.
  • Pregnant or breastfeeding, or premenopausal women not taking effective contraception.
  • Current Participation to other clinical trial except experimental molecules.
  • Vulnerable persons protected by law.
  • People under guardianship

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: CTC assay, Cetuximab
Detection & characterization of viable CTC in the peripheral blood.
Other: Blood analysis by EPISPOT and CellSearch®
Other Names:
  • A counting of CTC using three technologies: EPISPOT, CellSearch®, flow cytometer sorter/analyzer.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Predictive value of the CTC on the Progression Free Survival
Time Frame: Duration study 2 years
The primary outcome aims to evaluate the predictive value of the early progression of the CTC performed with the EPISPOT assay on the progression free survival in a cohort of patients treated with protocol "Extreme". The progression disease is assessed based on imagery techniques.
Duration study 2 years

Secondary Outcome Measures

Outcome Measure
Time Frame
Prognostic value of the CTC at baseline (EPISPOT) and to compare for the first time the results with those obtained with the CellSearch system.
Time Frame: Duration study 2 years
Duration study 2 years
Prognostic value of the CTC at baseline (EPISPOT)
Time Frame: Duration study 2 years
Duration study 2 years
Predictive value of the early progression of CTC (EPISPOT) on the overall survival
Time Frame: Duration study 2 years
Duration study 2 years
Compare for the first time the results with those obtained with the CellSearch® system
Time Frame: Duration study 2 years
Duration study 2 years
Evaluate the expression of EGFR in CTCs before and after administration of cetuximab (Erbitux) with both technologies and EPISPOT CellSearch ®
Time Frame: Duration study 2 years
Duration study 2 years
Evaluate the impact of the presence of epithelial-mesenchymal transition (EMT) marker on the prognosis
Time Frame: Duration study 2 years
Duration study 2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Montpellier

Collaborators

National Cancer Institute, France

Investigators

  • Principal Investigator: RENAUD GARREL, MD, CHU Gui de Chauliac

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2012

Primary Completion (Anticipated)

October 1, 2017

Study Completion (Anticipated)

March 1, 2018

Study Registration Dates

First Submitted

March 28, 2014

First Submitted That Met QC Criteria

April 18, 2014

First Posted (Estimate)

April 21, 2014

Study Record Updates

Last Update Posted (Estimate)

December 3, 2014

Last Update Submitted That Met QC Criteria

December 2, 2014

Last Verified

September 1, 2012

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 8825
  • ID-RCB:2011-A01174-37 (Registry Identifier: ID-RCB)

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.

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