A Phase I Study of the Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor, OSI-774, in Combination With Docetaxel and Radiation in Locally Advanced Squamous Cell Cancer of the Head and Neck
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- MTD defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity assessed using Common Toxicity Criteria (CTC) version 3.0 (Phase I)
研究概览
简要总结
Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining erlotinib with docetaxel may make the tumor cells more sensitive to radiation therapy and may kill more tumor cells. Phase I trial to study the maximum tolerated dose (MTD) of combining erlotinib with docetaxel and radiation therapy in treating patients who have locally advanced head and neck cancer
详细描述
PRIMARY OBJECTIVES:
I. Determine MTD and toxicity of combination of EGFR inhibitor (OSI-774), docetaxel, and radiation.
II. Pharmacokinetic profile of OSI-774 alone and in combination with docetaxel.
SECONDARY OBJECTIVES:
I. Determine the overall and complete response rate of this combination.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients must have histologically or cytologically confirmed locally advanced (stage III or IV) squamous cell carcinoma of the head and neck without distant metastatic disease
- •No prior chemotherapy, radiation therapy, or investigational anti-tumor drug
- •Measurable disease within 4 weeks prior to registration according to the recommended RECIST response criteria
- •ECOG performance status =< 2 (Karnofsky >= 60%)
- •Life expectancy of greater than 12 weeks
- •Absolute neutrophil count >= 1,500/ul
- •Platelets >= 100,000/ul
- •Hemoglobin >= 10 mg/dL
- •Total bilirubin within normal institutional limits
- •AST(SGOT)/ALT(SGPT) =< 5 x ULN when alkaline phosphatase is =< ULN
- •Alkaline phosphatase =< 5 x ULN when AST or ALT =< ULN
- •Prothrombin time within normal institutional limits
- •Creatinine within normal institutional limits or creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
- •No clinically significant heart disease (including NYHA class III or IV heart disease, significant arrhythmias requiring medication, symptomatic coronary artery disease, myocardial infarction within the previous six months, second or third degree heart block or bundle branch block)
- •Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control) prior to study entry and for the duration of study participation; men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter; women of childbearing potential must have a negative pregnancy test; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
- •Ability to understand and willingness to sign a written informed consent document
排除标准
- •All histologies other than squamous cell carcinoma
- •Salivary gland and paranasal sinus squamous cell carcinoma
- •Patients who have had prior chemotherapy or radiotherapy
- •Patients may not be receiving any other investigational agents
- •Patients with known brain metastases or direct cerebral invasion by tumor should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events; patients with intracranial extension (but without cerebral involvement) may still be eligible to participate
- •History of allergic reactions attributed to compounds of similar chemical or biologic composition to OSI-774 or docetaxel, including other drugs formulated with polysorbate 80
- •No pre-existing peripheral neuropathy >= grade 2
- •Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- •Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated on this protocol
- •HIV positive patients are excluded from participation
- •Patients with history of any other malignancy (except squamous cell or basal cell cancer of the skin or CIS of cervix) are ineligible unless a period of 5 years has elapsed since treatment of the previous cancer and the patient has remained continuously disease free
- •Patients who are felt to be poorly compliant
研究组 & 干预措施
Treatment (erlotinib hydrochloride, docetaxel, and radiation)
Patients receive oral erlotinib alone daily on weeks 1 and 2. Patients then receive oral erlotinib daily beginning on day 1 and docetaxel IV over 1 hour on day 3 of weeks 3-9. Patients also undergo radiotherapy once daily 5 days a week on weeks 3-9. Patients continue erlotinib for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who had N2 or greater cervical lymph node involvement at baseline or have residual neck adenopathy after chemoradiotherapy undergo neck dissection 6-8 weeks after completion of chemoradiotherapy. Erlotinib is held for 1 week before planned surgery and until healing is complete.
干预措施: erlotinib hydrochloride (Drug)
Treatment (erlotinib hydrochloride, docetaxel, and radiation)
Patients receive oral erlotinib alone daily on weeks 1 and 2. Patients then receive oral erlotinib daily beginning on day 1 and docetaxel IV over 1 hour on day 3 of weeks 3-9. Patients also undergo radiotherapy once daily 5 days a week on weeks 3-9. Patients continue erlotinib for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who had N2 or greater cervical lymph node involvement at baseline or have residual neck adenopathy after chemoradiotherapy undergo neck dissection 6-8 weeks after completion of chemoradiotherapy. Erlotinib is held for 1 week before planned surgery and until healing is complete.
干预措施: docetaxel (Drug)
Treatment (erlotinib hydrochloride, docetaxel, and radiation)
Patients receive oral erlotinib alone daily on weeks 1 and 2. Patients then receive oral erlotinib daily beginning on day 1 and docetaxel IV over 1 hour on day 3 of weeks 3-9. Patients also undergo radiotherapy once daily 5 days a week on weeks 3-9. Patients continue erlotinib for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who had N2 or greater cervical lymph node involvement at baseline or have residual neck adenopathy after chemoradiotherapy undergo neck dissection 6-8 weeks after completion of chemoradiotherapy. Erlotinib is held for 1 week before planned surgery and until healing is complete.
干预措施: radiation therapy (Radiation)
Treatment (erlotinib hydrochloride, docetaxel, and radiation)
Patients receive oral erlotinib alone daily on weeks 1 and 2. Patients then receive oral erlotinib daily beginning on day 1 and docetaxel IV over 1 hour on day 3 of weeks 3-9. Patients also undergo radiotherapy once daily 5 days a week on weeks 3-9. Patients continue erlotinib for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who had N2 or greater cervical lymph node involvement at baseline or have residual neck adenopathy after chemoradiotherapy undergo neck dissection 6-8 weeks after completion of chemoradiotherapy. Erlotinib is held for 1 week before planned surgery and until healing is complete.
干预措施: therapeutic conventional surgery (Procedure)
Treatment (erlotinib hydrochloride, docetaxel, and radiation)
Patients receive oral erlotinib alone daily on weeks 1 and 2. Patients then receive oral erlotinib daily beginning on day 1 and docetaxel IV over 1 hour on day 3 of weeks 3-9. Patients also undergo radiotherapy once daily 5 days a week on weeks 3-9. Patients continue erlotinib for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who had N2 or greater cervical lymph node involvement at baseline or have residual neck adenopathy after chemoradiotherapy undergo neck dissection 6-8 weeks after completion of chemoradiotherapy. Erlotinib is held for 1 week before planned surgery and until healing is complete.
干预措施: laboratory biomarker analysis (Other)
Treatment (erlotinib hydrochloride, docetaxel, and radiation)
Patients receive oral erlotinib alone daily on weeks 1 and 2. Patients then receive oral erlotinib daily beginning on day 1 and docetaxel IV over 1 hour on day 3 of weeks 3-9. Patients also undergo radiotherapy once daily 5 days a week on weeks 3-9. Patients continue erlotinib for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who had N2 or greater cervical lymph node involvement at baseline or have residual neck adenopathy after chemoradiotherapy undergo neck dissection 6-8 weeks after completion of chemoradiotherapy. Erlotinib is held for 1 week before planned surgery and until healing is complete.
干预措施: pharmacological study (Other)
结局指标
主要结局
MTD defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity assessed using Common Toxicity Criteria (CTC) version 3.0 (Phase I)
时间窗: 9 weeks
Pharmacokinetic profile (Phase I)
时间窗: Pre-dose, 0.5, 1, 2, 4, 8, 12, 24 48, and 72 hours
Time to disease progression (TTP) (Phase II)
时间窗: Up to 5.5 years
次要结局
- Progression-free survival (PFS) (Phase II)(From the date of treatment to date of death or date of disease progression, and to date of last follow-up for those still alive and progression free, assessed up to 5.5 years)
- Overall survival (OS) (Phase II)(From the date of treatment to date of death, and to date of last follow-up for those still alive, assessed up to 5.5 years)
- True objective response rate (Phase II)(Up to 5.5 years)
- Changes of EGFR expression and serum markers over time (Phase II)(Baseline and up to 5.5 years)
- Patterns of gene expression data (Phase II)(Up to 5.5 years)