Use of Pharmacogenetics to Select Erbitux or Cisplatin to Treat Head and Neck Cancer
A Pilot Prospective Clinical Trial to Use Pharmacogenetics (PGx) to Select Erbitux or Cisplatin to Treat Head and Neck Cancer
This study is for patients with newly diagnosed head and neck cancer that cannot be removed by surgery.
The purpose of this study is to determine the feasibility of using genetic variations in patients to select the right drug to treat head and neck cancer. Cisplatin and cetuximab (Erbitux)are both approved by the FDA to treat head and neck cancer in combination with radiation therapy. In this study the investigators will test whether genetic differences between patients can be used to pick which of these two drugs a patient should receive. All patients will have a blood sample drawn that will be tested for genetic differences. If patients have genetic differences that correlate with a better outcome from cisplatin they will receive cisplatin with radiation. If patients have genetic differences that do not correlate with a better outcome from cisplatin they will receive cetuximab with their radiation therapy.
調査の概要
詳細な説明
Treatment-naive patients with locally advanced, non-metastatic (Stage III to IVB) squamous cell carcinoma of the head and neck who are candidates for concurrent chemoradiotherapy as primary therapy with curative intent will be enrolled. Patients will be genotyped for germline variations at four SNP loci in three genes involved in DNA nucleotide excision repair (ERCC1, ERCC2, and XRCC1). Patients with 3 to 8 variants will receive cisplatin (Arm A). Patients with 2 or fewer variants will receive cetuximab (Arm B).
The hypothesis of the study is that prospectively testing patients for variations in DNA repair enzymes to determine whether to use cisplatin or cetuximab in locally advanced head and neck squamous cell cancer is feasible.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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District of Columbia
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Washington、District of Columbia、アメリカ、20007
- Georgetown Lombardi Comprhensive Cancer Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Biopsy proven squamous cell carcinoma of the head and neck, including the oral cavity, oropharynx, hypopharynx, or larynx, but not including primary tumors of the nasopharynx, sinuses, or salivary glands.
- Locally advanced, Stage III to IVB disease, and a candidate for primary therapy using chemotherapy and radiation therapy with curative intent.
- Patients with a diagnosis of 'unknown primary' will be eligible if chemoradiotherapy is the primary modality of treatment
- No previous chemotherapy, radiation, or surgery for their diagnosis of head and neck cancer
- Eastern Cooperative Oncology Group performance status </= 1
- Women of child-bearing potential must have a negative pregnancy test within 30 hours before initiation of study drug dosing. Female subjects of reproductive potential must agree to avoid pregnancy throughout the study and for up to 3 months following discontinuation of study drug. Male subjects must agree to avoid conceiving a child throughout the study and for up to 3 months following discontinuation of study drug;
- Hemoglobin >/= 8.0 gm/dL
- Absolute neutrophil count >/= 1500
- Platelet count >/= 100,000
- Glomerular Filtration Rate > 50 mL/min calculated by the Cockcroft-Gault equation
- Total bilirubin </= 2.0 times the upper limit of normal unless the patient has Gilbert's syndrome
- Aspartate aminotransferase and Alanine Aminotransferase </= 2.5 times the upper limit of normal
- No other current malignancy, other than basal cell skin cancer, squamous cell skin cancer, in situ cervical cancer, ductal or lobular in situ of the breast. Patients with other malignancies are eligible if they have been continuously disease-free for >/= 3 years prior to screening for this protocol.
- Age of 18 or older
- Ability and willingness to give informed consent
- Subjects must in the opinion of the Investigator be capable of complying with this protocol.
Exclusion Criteria:
- Acute treatment for an infection or other serious medical illness within 14 days prior to study entry
- Major surgery within 3 weeks prior to study entry
- Known hypersensitivity to cisplatin or cetuximab
- Patients who have any severe or uncontrolled medical conditions or other conditions that could affect their participation in this study, including: unstable angina, serious uncontrolled cardiac arrhythmia, active acute or uncontrolled infectious disorder, or myocardial infarction </= 6 months prior to study entry.
- Female patients who are pregnant or breast feeding, or adults who are of reproductive potential and are unwilling to refrain from conceiving a child during study treatment.
- Patients unwilling to comply with the protocol, or provide informed consent
- Psychiatric illness that would limit compliance with study requirements
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：非ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Cisplatin
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Cisplatin 100 mg/m2 during weeks 1,4, and 7 of radiation therapy
他の名前：
daily radiation for 7 weeks
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実験的：Cetuximab
cetuximab
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daily radiation for 7 weeks
Cetuximab beginning at a dose of 400 mg/m2 the week before radiation commences and then 250 mg/m2 weekly during weeks 1 and 7 of radiation.
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Feasibility of Returning Genetic Testing Results in a Timely Manner to the Treating Physician
時間枠：20 months
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Feasibility is defined as follows: - Patients' genetic test results are returned to the treating physician within 3 days |
20 months
|
協力者と研究者
スポンサー
捜査官
- 主任研究者：John F Deeken, MD、Georgetown University
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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