A Randomized Phase II Trial of Concurrent Chemoradiation With Cetuximab (ERBITUX®), 5 Fluorouracil, Hydroxyurea, and Twice-daily Radiation (CetuxFHX) Versus Cetuximab (ERBITUX®), Cisplatin, and Accelerated Radiation With Concomitant Boost (CetuxPX) After Induction Chemotherapy in Patients With Locally Advanced Head and Neck Cancer
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 110
- 试验地点
- 1
- 主要终点
- Progression Free Survival (PFS)
研究概览
简要总结
The main purpose of this study is to explore and compare the efficacy of Cetuximab (ERBITUX®) added to two concurrent chemoradiotherapy platforms of different intensity in locally advanced head and neck cancer.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 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
- •Age 18 or older
- •Stage III and IV head and neck cancer
- •Patients with squamous cell carcinoma of unknown primary and suspected origin in the head and neck area
- •No prior chemotherapy or radiotherapy
- •Prior surgical therapy of incisional or excisional biopsy and organ-sparing procedures only
- •Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2
- •Normal organ and marrow function
排除标准
- •Unequivocal demonstration of metastatic disease
- •Known severe hypersensitivity to drugs used in the study
- •Treatment with a non-approved or investigational drug within 30 days before Day 1
- •Incomplete healing from previous surgery
- •Pregnancy or breast feeding
- •Uncontrolled intercurrent illness including
- •Patients with clinically significant pulmonary dysfunction, cardiomyopathy, or any history of clinically significant CHF
- •Acute hepatitis or known HIV
- •Severe baseline neurologic deficits
- •Prior therapy which specifically and directly targets the EGFR pathway
- •Prior severe infusion reaction to a monoclonal antibody
研究组 & 干预措施
A: Cetuximab+FHX
Cetuximab [250mg/m2 (day 1, weekly x10)] + FHX (5-FU [CI: 600mg/m2/day; days 0-5 (120h total) every other week x5], Hydroxyurea [500 mg PO BID, days 0-5 (=11 doses), every other week x5] and twice-daily radiation [150 cGy per fraction - days 1-5, every other week x5 (70-72 Gy total dose)]). Total duration is 10 weeks.
干预措施: Cetuximab (Drug)
A: Cetuximab+FHX
Cetuximab [250mg/m2 (day 1, weekly x10)] + FHX (5-FU [CI: 600mg/m2/day; days 0-5 (120h total) every other week x5], Hydroxyurea [500 mg PO BID, days 0-5 (=11 doses), every other week x5] and twice-daily radiation [150 cGy per fraction - days 1-5, every other week x5 (70-72 Gy total dose)]). Total duration is 10 weeks.
干预措施: 5-FU (Drug)
A: Cetuximab+FHX
Cetuximab [250mg/m2 (day 1, weekly x10)] + FHX (5-FU [CI: 600mg/m2/day; days 0-5 (120h total) every other week x5], Hydroxyurea [500 mg PO BID, days 0-5 (=11 doses), every other week x5] and twice-daily radiation [150 cGy per fraction - days 1-5, every other week x5 (70-72 Gy total dose)]). Total duration is 10 weeks.
干预措施: Hydroxyurea (Drug)
A: Cetuximab+FHX
Cetuximab [250mg/m2 (day 1, weekly x10)] + FHX (5-FU [CI: 600mg/m2/day; days 0-5 (120h total) every other week x5], Hydroxyurea [500 mg PO BID, days 0-5 (=11 doses), every other week x5] and twice-daily radiation [150 cGy per fraction - days 1-5, every other week x5 (70-72 Gy total dose)]). Total duration is 10 weeks.
干预措施: Twice-daily radiation (Radiation)
B: Cetuximab + PX
Cetuximab [250 mg/m2 (day 1, weekly x7)] + PX (Cisplatin [100mg/m2 (week 1 & 4 on day 1 (or 2))], Accelerated fraction radiotherapy with concomitant boost [AFX-CB (72 Gy/42 F/6 W) (3-D or IMRT based)]). Total duration: 7 weeks.
干预措施: Cetuximab (Drug)
B: Cetuximab + PX
Cetuximab [250 mg/m2 (day 1, weekly x7)] + PX (Cisplatin [100mg/m2 (week 1 & 4 on day 1 (or 2))], Accelerated fraction radiotherapy with concomitant boost [AFX-CB (72 Gy/42 F/6 W) (3-D or IMRT based)]). Total duration: 7 weeks.
干预措施: Cisplatin (Drug)
B: Cetuximab + PX
Cetuximab [250 mg/m2 (day 1, weekly x7)] + PX (Cisplatin [100mg/m2 (week 1 & 4 on day 1 (or 2))], Accelerated fraction radiotherapy with concomitant boost [AFX-CB (72 Gy/42 F/6 W) (3-D or IMRT based)]). Total duration: 7 weeks.
干预措施: Accelerated fraction radiotherapy with concomitant boost (Radiation)
结局指标
主要结局
Progression Free Survival (PFS)
时间窗: 2 years
Time from randomization until disease progression or death from any cause. Kaplan-Meier estimate of PFS at 2 years. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
次要结局
- Objective Response Rate to CRT(From date of chemoradiotherapy until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 10 weeks)
- Overall Survival (OS)(2 years)
- Objective Response Rate to Induction(Post-Induction (8 weeks))
- Residual Lymph Node Disease(Up to 10 weeks)