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Stage III Squamous Cell Carcinoma of the HypopharynxPhase 2NCT00410826

Cisplatin and Radiation Therapy With or Without Erlotinib Hydrochloride in Treating Patients With Stage III or Stage IV Head and Neck Cancer

A Phase 2 study testing erlotinib hydrochloride, cisplatin and 3-dimensional conformal radiation therapy in people with Stage III Squamous Cell Carcinoma of the Hypopharynx and Stage III Squamous Cell Carcinoma of the Larynx, run by University of Washington at 9 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized phase II trial is studying cisplatin and radiation therapy together with or without erlotinib hydrochloride to compare how well they work in treating patients with stage III or stage IV head and neck cancer. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
erlotinib hydrochloride, cisplatin and 3-dimensional conformal radiation therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
204 participants
Where
9 sitesUnited States
Study dates
Jun 2006to May 2012
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Cytological or pathological documented squamous cell carcinoma of oral cavity, oropharynx, larynx, and hypopharynx; patients with nasopharyngeal carcinoma can be included if the patients have grades I or II tumors according to the World Health Organization (WHO) classification
  • Stage III or IV according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, Sixth Edition (2002)
  • Unresectable or resection with significant morbidity
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Measurable Disease, defined according to Response Evaluation Criteria in Solid Tumors (RECIST) Criteria
  • Bilirubin =< 1.5 x upper limit of normal (ULN)
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  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3.0 x ULN
  • Calculated creatinine clearance >= 55ml/min (using the Cockcroft-Gault formula)
  • Platelet count >= 100 x 10^9 /L
  • Absolute neutrophil count (ANC) >= 1.25 x 10^9 /L
  • Signed informed consent
  • Male and female patients with reproductive potential must use an acceptable contraceptive method
  • Authorization from a dentist to begin radiation therapy

Who cannot join

  • Second primary malignancy that is clinically detectable or clinically significant at the time of consideration for study enrollment
  • Inability or unwillingness to comply with radiotherapy
  • Evidence of clinically significant congestive heart failure; patients must be able to tolerate hydration required during cisplatin chemotherapy
  • Diarrhea > grade 1 at the time of enrollment
  • Prior radiotherapy, chemotherapy, or investigational treatment for squamous cell carcinoma of head and neck
  • Prior treatment with an investigational or marketed inhibitor of the EGFR pathway
Show all 10Show fewer
  • Use of cytochrome P450 3A4 (CYP3A4) inducers
  • Presence of systemic metastases (M1)
  • Pregnant or breast-feeding women
  • Known human immunodeficiency virus (HIV) infection

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

United States9 sites
  • University of New Mexico Health Science CCOP

    Albuquerque, New Mexico, 87131

  • Alaska Oncology and Hematology LLC

    Anchorage, Alaska, 99508

  • University of North Carolina

    Chapel Hill, North Carolina, 27599

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • University of Tennessee Cancer Institute-Boston Cancer Group PLC

    Memphis, Tennessee, 38104

  • University of Miami Miller School of Medicine-Sylvester Cancer Center

    Miami, Florida, 33136

  • Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

    Seattle, Washington, 98109

  • Multicare Health System

    Tacoma, Washington, 98415

  • New Hanover Radiation Oncology Center

    Wilmington, North Carolina, 28401

Other trials in United States

About this study

Official title: Multicenter Randomized Phase II Study of Erlotinib, Cisplatin and Radiotherapy Versus Cisplatin and Radiotherapy in Patients With Stage III and IV Squamous Cell Carcinoma of the Head and Neck

This randomized phase II trial is studying cisplatin and radiation therapy together with or without erlotinib hydrochloride to compare how well they work in treating patients with stage III or stage IV head and neck cancer. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It may also make tumor cells more sensitive to radiation therapy. Giving cisplatin and radiation therapy together with erlotinib hydrochloride may kill more tumor cells. It is not yet known whether cisplatin and radiation therapy are more effective with or without erlotinib hydrochloride in treating head and neck cancer

Read the detailed description

PRIMARY OBJECTIVES:

  1. Compare the complete response rate in patients with locally advanced head and neck cancer, treated with cisplatin, radiotherapy and erlotinib (erlotinib hydrochloride) versus cisplatin and radiotherapy alone.

SECONDARY OBJECTIVES:

  1. Evaluate whether the addition of erlotinib increases the acute and long term toxicities of cisplatin and radiotherapy, in patients with locally advanced head and neck cancer.

II. Compare the disease-free and overall survivals of patients with locally advanced head and neck cancer treated with cisplatin and radiotherapy, with and without erlotinib.

III. Evaluate whether the symptomatic improvement observed in the first week of erlotinib alone predicts for complete response and long term disease control.

IV. Correlate epidermal growth factor receptor (EGFR), p16 and excision repair cross-complementing 1 (ERCC-1) expression with response outcome to therapy with cisplatin and radiation with and without erlotinib.

  1. Identify other molecular correlates that may be relevant in the pathogenesis of squamous cell carcinoma of head and neck (SCCHN) or response to therapy.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive cisplatin intravenously (IV) on days 1, 22, and 43 and undergo 3-dimensional conformal or intensity modulated radiotherapy once daily, 5 days per week, on days 1-47. Patients also receive erlotinib hydrochloride orally (PO) once daily (QD) on days -7 to 47.

ARM II: Patients receive cisplatin and undergo radiotherapy as in Arm I.

Within 10-14 weeks after completion of study treatment, patients with N2 or N3 disease at the time of screening undergo a neck dissection.

After completion of study treatment, patients are followed up periodically for 5 years.

Being tested
erlotinib hydrochloride, cisplatin, 3-dimensional conformal radiation therapy, intensity-modulated radiation therapy, quality-of-life assessment
Medical subject headings
Squamous Cell Carcinoma of Head and Neck

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • erlotinib hydrochlorideDrug

    Also called CP-358,774, erlotinib, OSI-774

    Given orally

  • cisplatinDrug

    Also called CACP, CDDP, CPDD, DDP

    Given IV

  • 3-dimensional conformal radiation therapyRadiation

    Also called 3D-CRT, conformal radiation therapy

    35 fractions

  • intensity-modulated radiation therapyRadiation

    Also called IMRT

    35 fractions

  • quality-of-life assessmentProcedure or surgery

    Also called quality of life assessment

    Ancillary studies

Study groups in NCT00410826
Study groupRoleWhat they receive
Arm I (chemo, radiotherapy, enzyme inhibitor/radiosensitizer)ExperimentalPatients receive cisplatin IV on days 1, 22, and 43 and undergo 3-dimensional conformal or intensity modulated radiotherapy once daily, 5 days per week, on days 1-47. Patients also receive erlotinib hydrochloride PO once daily on days -7 to 47.
Receives: Drug: erlotinib hydrochloride; Drug: cisplatin; Radiation: 3-dimensional conformal radiation therapy; Radiation: intensity-modulated radiation therapy; Procedure: quality-of-life assessment
Arm II (chemotherapy, radiotherapy)Active comparatorPatients receive cisplatin and radiotherapy as in Arm I.
Receives: Drug: cisplatin; Radiation: 3-dimensional conformal radiation therapy; Radiation: intensity-modulated radiation therapy; Procedure: quality-of-life assessment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Comparison of the Percentage of Participants With a Complete Response in Each Treatment Arm

    Complete response requires both a pathological complete response (independent of observer) and a complete response radiologically (RECIST 1.0).

    Measured: 12 weeks after the completion of therapy

Secondary outcomes (2)
  1. Safety as Assessed Through Summaries of Adverse Events and Laboratory Test Results by Treatment Arm

    Measured: 30 days after the completion of therapy

  2. Progression Free Survival of Patients With Locally Advanced Head and Neck Cancer Treated With Cisplatin and Radiotherapy, With and Without Erlotinib Hydrochloride

    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

    Measured: Every 3 months for up to 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Dec 2006 (estimated)
  2. Study startJun 2006
  3. Primary completionMay 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
204 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00410826
Sponsor's protocol ID
6106
Other IDs
NCI-2009-01546
Status last verified
May 2013
First submitted
11 Dec 2006
Last updated
10 May 2013
Data monitoring committee
Yes

Publications

  • Psyrri A, Rampias T, Vermorken JB. The current and future impact of human papillomavirus on treatment of squamous cell carcinoma of the head and neck. Ann Oncol. 2014 Nov;25(11):2101-2115. doi: 10.1093/annonc/mdu265. Epub 2014 Jul 23.

    PubMed 25057165
  • Bauman JE, Austin MC, Schmidt R, Kurland BF, Vaezi A, Hayes DN, Mendez E, Parvathaneni U, Chai X, Sampath S, Martins RG. ERCC1 is a prognostic biomarker in locally advanced head and neck cancer: results from a randomised, phase II trial. Br J Cancer. 2013 Oct 15;109(8):2096-105. doi: 10.1038/bjc.2013.576. Epub 2013 Sep 24.

    PubMed 24064970
  • Martins RG, Parvathaneni U, Bauman JE, Sharma AK, Raez LE, Papagikos MA, Yunus F, Kurland BF, Eaton KD, Liao JJ, Mendez E, Futran N, Wang DX, Chai X, Wallace SG, Austin M, Schmidt R, Hayes DN. Cisplatin and radiotherapy with or without erlotinib in locally advanced squamous cell carcinoma of the head and neck: a randomized phase II trial. J Clin Oncol. 2013 Apr 10;31(11):1415-21. doi: 10.1200/JCO.2012.46.3299. Epub 2013 Mar 4.

    PubMed 23460709

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing erlotinib hydrochloride, cisplatin and 3-dimensional conformal radiation therapy in people with Stage III Squamous Cell Carcinoma of the Hypopharynx and Stage III Squamous Cell Carcinoma of the Larynx, run by University of Washington at 9 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 May 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Apr 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Comparison of the Percentage of Participants With a Complete Response in Each Treatment Arm (time frame: 12 weeks after the completion of therapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00410826, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2013; AzTrials last refreshed its copy on 8 Nov 2026.

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