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Chemotherapy With Cetuximab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer (TPEx)

7 de abril de 2017 atualizado por: Groupe Oncologie Radiotherapie Tete et Cou

Phase II Study of Cetuximab, Docetaxel and Cisplatin as First-line Treatment in Patients With Metastatic or Recurrent Head and Neck Squamous Cell Carcinomas - GORTEC 2008-03 TPEx

PURPOSE: Cetuximab with platinum and 5FU is now the standard combination as first-line treatment in patients with metastatic or recurrent Head and Neck squamous cell carcinomas. Cetuximab and taxane combinations have demonstrated promising activity in Head and Neck cancer. This phase II trial is studying new cetuximab, docetaxel and cisplatin combination named TPEx as first-line treatment in this setting.

Visão geral do estudo

Descrição detalhada

OBJECTIVES:

Primary

  • To determine the efficacy of TPEx combination in patients with head and neck cancer in term of objective response rate (RECIST, see statistical consideration) Secondary
  • To assess toxicities of TPEx combination
  • Determine the efficacy of TPEx combination in patients with head and neck cancer: Best Overall Response , progression-free survival and survival.
  • Translational research objective:To better understand the mechanisms of chemoresistance and to identify biomarkers by the analysis of the tumor biopsies (RNA, gene expression profile) and protein profile (plasma samples). Exploratory analyses.

OUTLINE: This is an open-label phase II, multicenter study. Patients receive four cycles of chemotherapy comprising cetuximab IV plus docetaxel IV over 1 hour and cisplatin IV over 2 hours on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. After completion of the fourth cycle of chemotherapy, patients receive a maintenance therapy with cetuximab every 2 weeks. Treatment will be continued until disease progression or unacceptable toxicities according to the patient or the investigator. Tumor check-up will be performed every 6 weeks. This study will allow translational research with blood sample and biopsies at baseline before any treatment, during the treatment with TPEx combination (week 6).,After completion of study treatment, patients are followed every 2 months.

Tipo de estudo

Intervencional

Inscrição (Real)

54

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

      • Bruxelles, Bélgica
        • Cliniques Universitaires
      • Namur, Bélgica
        • Clinique Sainte Elisabeth
      • Yvoir, Bélgica
        • Clinique universitaire de Mont Godinne UCL
      • Bordeaux, França
        • Hopital Saint André
      • Clermont-Ferrand, França
        • Centre Jean Perrin,
      • Dijon, França
        • Centre G-F Leclerc
      • Draguignan, França
        • Centre Hospitalier de la Dracénie
      • Lorient, França
        • Centre Hospitalier de Bretagne Sud
      • Lyon, França
        • Centre Léon Bérard
      • Marseille, França
        • Hôpital de la Timone
      • Rouen, França
        • Centre Henri Becquerel
      • Suresnes, França
        • Hôpital Foch
      • Tours, França
        • CHU Bretonneau
      • Villejuif, França
        • Institut Gustave Roussy

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos a 70 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  • Histologically proven squamous cell carcinoma of the oral cavity, larynx, oropharynx or hypopharynx
  • Recurrent disease, incurable disease as determined by surgery or radiation, or metastatic disease
  • Measurable or evaluable disease
  • Age > 18 years and <= 70 years
  • WHO performance status 0 or 1
  • Absolute neutrophil count > 1,500/mm3
  • Platelets > 150,000/mm3
  • Total Bilirubin <= institutional upper limit of normal
  • Aspartate aminotransferase < 1.5 X institutional upper limit of normal
  • Alanine aminotransferase < 1.5 X institutional upper limit of normal
  • Alkaline phosphatase < 2.5 X institutional upper limit of normal
  • creatinine clearance > 60 mL/min
  • Signed informed consent
  • Women of child-bearing potential and men must be willing and able practice adequate contraception prior to study entry and for the duration of study treatment

Exclusion Criteria:

  • Previous chemotherapy. Chemotherapy given as part of initial curative therapy and completed more than 6 months before inclusion is allowed
  • Previous treatment with total doses of cisplatin > 300 mg/ m2
  • Patients must not have any co-existing disease that would preclude cisplatin administration, such as peripheral neuropathy or renal failure
  • Surgery (excluding biopsy) or radiotherapy within 4 weeks prior to study entry
  • Nasopharyngeal carcinoma, or cancer of sinusal cavities
  • Active infection including tuberculosis or HIV positive patient
  • Other malignancy within last 5 years except for non-melanoma skin cancer
  • No other investigational agent within 30 days prior to study entry
  • No other concurrent chemotherapy, immunotherapy, antitumor hormonal therapy (excluding contraceptives and replacement steroids), radiotherapy, or experimental medications
  • No prior anti EGFR therapy
  • No known brain metastases
  • Uncontrolled intercurrent illness that would prevent delivery of protocol therapy
  • Patients with a prior history of basal cell carcinoma of the skin or in situ carcinoma of the cervix must have been curatively treated and must have remained disease free for 5 years post diagnosis
  • No history of hypersensitivity reaction to drugs on study
  • No unstable angina or myocardial infarction within the past 12 months
  • No symptomatic congestive heart failure or New York Heart Association (NYHA) class II-IV heart disease
  • No serious uncontrolled cardiac arrhythmia
  • No other prior or concomitant squamous cell carcinoma
  • No other prior or concomitant cancer, except curatively treated basal carcinoma of the skin or in situ cervical cancer, for which the patient has been curatively treated and remains disease-free for the past 5 years
  • Patient is pregnant or lactating
  • Patients must not have any co-existing condition that would preclude full compliance with the study

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: cetuximab
Patients receive four cycles of chemotherapy comprising cetuximab IV plus docetaxel IV over 1 hour and cisplatin IV over 2 hours on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. After completion of the fourth cycle of chemotherapy, patients receive a maintenance therapy with cetuximab every 2 weeks. Treatment will be continued until disease progression or unacceptable toxicities according
  • Cetuximab 400 mg/m² over 120 minutes on day 1 of cycle 1 only.
  • Cetuximab dose will be 250 mg/m² IV over 60 minutes weekly on subsequent administrations during the four cycles of chemotherapy.
  • Cetuximab dose will be 500mg/m2 IV every 2 weeks during the maintenance therapy.

Drug: Cisplatin IV : 75 mg/m2 intravenous every 3 weeks for 4 cycles

Drug: Docetaxel IV : 75 mg/m2 intravenous every 3 weeks for 4 cycles

G-CSF support with lenograstim 150 microg./m2/day is delivered after each cycle of chemotherapy.

No intervention, only biopsy for translational project.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Objective Tumor Response Rate
Prazo: 12 weeks (after completion of the 4th cycle of chemotherapy)

The objective tumor response rate is evaluated every 6 weeks according to RECIST criteria.

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT-scan or MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Objective Response (OR) = CR + PR.

12 weeks (after completion of the 4th cycle of chemotherapy)

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Sobrevivência geral
Prazo: 1 ano
1 ano
Sobrevivência livre de progressão
Prazo: 1 ano
1 ano
Grade 1 to 5 Toxicity
Prazo: 24 weeks (average)
All grade 1 to 5 toxicity are registered during treatment. Patients have weekly clinical and biological examination.
24 weeks (average)
Best Overall Response
Prazo: 12 weeks
Tumor response is evaluated every 6 weeks according to RECIST criteria. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions, Stable Disease (SD); Best overall Response = CR + PR + SD.
12 weeks
Biomarkers
Prazo: two years
two years

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

  • Cadeira de estudo: Joel GUIGAY, GORTEC

Publicações e links úteis

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de setembro de 2009

Conclusão Primária (Real)

1 de janeiro de 2014

Conclusão do estudo (Real)

1 de janeiro de 2014

Datas de inscrição no estudo

Enviado pela primeira vez

1 de fevereiro de 2011

Enviado pela primeira vez que atendeu aos critérios de CQ

2 de fevereiro de 2011

Primeira postagem (Estimativa)

3 de fevereiro de 2011

Atualizações de registro de estudo

Última Atualização Postada (Real)

15 de maio de 2017

Última atualização enviada que atendeu aos critérios de controle de qualidade

7 de abril de 2017

Última verificação

1 de outubro de 2016

Mais Informações

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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