MedPath

Irinotecan and Cisplatin in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

Phase 2
Completed
Conditions
Head and Neck Cancer
Interventions
Registration Number
NCT00639769
Lead Sponsor
Vanderbilt-Ingram Cancer Center
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as irinotecan and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.

PURPOSE: To determine if CPT-11 given together with cisplatin is effective in treating recurrent or metastatic head and neck cancer.

Detailed Description

OBJECTIVES:

* Evaluate the efficacy of irinotecan hydrochloride and cisplatin in patients with local-regionally recurrent or metastatic squamous cell carcinoma of the head and neck.

* Evaluate the toxicity of irinotecan hydrochloride and cisplatin in these patients.

* Determine the palliative effect of irinotecan hydrochloride and cisplatin on head and neck cancer symptoms using the Vanderbilt Cancer Center (VICC) Head and Neck Cancer Symptom Survey.

OUTLINE: Patients receive irinotecan hydrochloride IV over 60 minutes and cisplatin IV on days 1, 8, 22, and 29. Treatment repeats every 6 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Patients complete the Vanderbilt Cancer Center (VICC) Head and Neck Cancer Symptom Survey at baseline, before each course, at the completion of study therapy, and then at each follow-up visit.

After completion of study therapy, patients are followed every 6 weeks for 1 year and then every 3 months thereafter.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
41
Inclusion Criteria
  • Histologically confirmed squamous cell carcinoma of the head and neck that is considered incurable with surgery or radiotherapy

  • Meets one of the following criteria:

    • Previously untreated disease

      • Newly diagnosed disease with distant metastases
    • Recurrent or persistent disease

      • Local-regional recurrence/persistence or distant metastases after initial treatment with surgery or radiotherapy

        • No locally advanced unresectable disease that was not previously treated with radiotherapy
  • Bidimensionally measurable disease

    • If the only measurable disease is within the radiotherapy port, there must be biopsy-proven recurrence ≥ 8 weeks after the completion of radiotherapy

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy ≥ 12 weeks
  • Creatinine clearance ≥ 50 mL/min
  • SGOT ≤ 3 times upper limit of normal
  • Serum bilirubin < 1.5 mg/dL
  • Granulocytes ≥ 1,500/mm ^3
  • Platelet count > 100,000/mm^3
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No significant detectable infection
  • No co-morbid disease unless under adequate control
  • No other cancer within the past 3 years except basal cell or squamous cell skin cancer or early-stage prostate cancer
Exclusion Criteria

-Pregnant or lactating women

Not specified

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics

  • Recovered from any prior major surgery

  • No prior chemotherapy for recurrent or metastatic disease

    • Patients who completed neoadjuvant, concurrent, or adjuvant chemotherapy ≥ 3 months prior to recurrence will be considered chemotherapy-naive
    • Patients who completed neoadjuvant, concurrent, or adjuvant chemotherapy < 3 months prior to recurrence will be considered chemotherapy failures
  • No prior therapy with topotecan or irinotecan hydrochloride

  • At least 4 weeks since prior biologic therapy (e.g., interleukin-2, interferon, megestrol acetate)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Therapeutic Interventioncisplatin-
Therapeutic Interventionirinotecan hydrochloride-
Primary Outcome Measures
NameTimeMethod
Patient Response6 weeks after last chemotherapy treatment

Number of patients in each response category according to RECIST criteria: Progressive disease (PD): \>=20% increase in sum of longest diameter (LD) of target lesion(s), taking as reference smallest sum LD recorded since treatment started. Complete response (CR): disappearance of all target lesions. Partial response (PR): \>=30% decrease in sum of LD of target lesion(s), taking as reference baseline sum LD. Stable disease (SD): neither sufficient shrinkage to qualify as PR nor sufficient increase to qualify as PD.

Secondary Outcome Measures
NameTimeMethod
Number of Patients With Each Worst-grade Toxicity6 weeks after last chemotherapy

Number of patients with worst-grade toxicity response of each grade (grade 1 to 5) following NCI Common Toxicity Criteria, with grade 1=mild adverse event; 2=moderate adverse event; 3=severe and undesirable adverse event; 4=life-threatening or disabling adverse event; 5=death

Trial Locations

Locations (8)

Meharry Medical College

🇺🇸

Nashville, Tennessee, United States

VA Tennessee Valley Healthcare Center

🇺🇸

Nashville, Tennessee, United States

Vanderbilt-Ingram Cancer Center

🇺🇸

Nashville, Tennessee, United States

Center for Biomedical Research

🇺🇸

Knoxville, Tennessee, United States

Central Georgia Hematology Oncology Associates, P.C.

🇺🇸

Macon, Georgia, United States

East Tennessee State University

🇺🇸

Johnson City, Tennessee, United States

Erlanger Health System

🇺🇸

Chattanooga, Tennessee, United States

Jackson-Madison County Hospital

🇺🇸

Jackson, Tennessee, United States

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