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Use of Pharmacogenetics to Select Erbitux or Cisplatin to Treat Head and Neck Cancer

26 september 2014 uppdaterad av: Georgetown University

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.

Studieöversikt

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

2

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • District of Columbia
      • Washington, District of Columbia, Förenta staterna, 20007
        • Georgetown Lombardi Comprhensive Cancer Center

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Cisplatin
Cisplatin 100 mg/m2 during weeks 1,4, and 7 of radiation therapy
Andra namn:
  • Platina
  • Cispaltin
daily radiation for 7 weeks
Experimentell: Cetuximab
cetuximab
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.
Andra namn:
  • Erbitux

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Feasibility of Returning Genetic Testing Results in a Timely Manner to the Treating Physician
Tidsram: 20 months

Feasibility is defined as follows:

- Patients' genetic test results are returned to the treating physician within 3 days

20 months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: John F Deeken, MD, Georgetown University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 maj 2012

Primärt slutförande (Faktisk)

1 mars 2013

Avslutad studie (Faktisk)

1 juni 2013

Studieregistreringsdatum

Först inskickad

21 juni 2012

Först inskickad som uppfyllde QC-kriterierna

12 februari 2013

Första postat (Uppskatta)

13 februari 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

2 oktober 2014

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

26 september 2014

Senast verifierad

1 oktober 2013

Mer information

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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