A Pilot Prospective Clinical Trial to Use Pharmacogenetics (PGx) to Select Erbitux or Cisplatin to Treat Head and Neck Cancer
Overview
- Phase
- Not Applicable
- Intervention
- Cisplatin
- Conditions
- Head and Neck Squamous Cell Cancer
- Sponsor
- Georgetown University
- Enrollment
- 2
- Locations
- 1
- Primary Endpoint
- Feasibility of Returning Genetic Testing Results in a Timely Manner to the Treating Physician
- Status
- Terminated
- Last Updated
- 11 years ago
Overview
Brief Summary
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.
Detailed Description
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.
Investigators
Eligibility Criteria
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
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
Arms & Interventions
Cisplatin
Cisplatin
Intervention: Cisplatin
Cisplatin
Cisplatin
Intervention: Radiation
Cetuximab
cetuximab
Intervention: cetuximab
Cetuximab
cetuximab
Intervention: Radiation
Outcomes
Primary Outcomes
Feasibility of Returning Genetic Testing Results in a Timely Manner to the Treating Physician
Time Frame: 20 months
Feasibility is defined as follows: - Patients' genetic test results are returned to the treating physician within 3 days