Dose-escalating AZD1775 + Concurrent Radiation + Cisplatin for Intermediate/High Risk HNSCC

Who cannot join

• 4.2.1 Major surgical procedures ≤28 days prior to D1 of AZD1775 or minor surgical procedures ≤7 days; no waiting required following port-a-cath placement 4.2.2 Patients who have received prior radiation therapy for HNSCC 4.2.3 4.2.3 Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure (see section 12.3, Appendix C), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at Screening has to be documented by the investigator as not medically relevant.
• ECG ≤450 msec for males and ≤470 msec for females required on screening ECG 4.2.4 AST or ALT ≥3 x ULN (upper limit of normal) and total bilirubin ≥2 x ULN please refer to Appendix 12.5 'Actions required in cases of combined increase of Aminotransferase and Total Bilirubin - Hy's Law', for further instructions 4.2.5 Not deemed a candidate for concurrent CRT for medical reasons, such as uncontrolled infection (including HIV), or uncontrolled diabetes mellitus which in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient.
• 4.2.6 Not willing to avoid grapefruit, grapefruit juices, grapefruit hybrids, Seville oranges, pummelos, and exotic citrus fruits from 14 days prior to the dose of study medication, throughout the study, and until 2 weeks after the last dose of AZD1775 due to potential CYP3A4 interaction with the study medication. Orange juice is allowed.
• 4.2.7 Patient has had prescription or non-prescription drugs or other products (ie, grapefruit juice) known to be moderate to strong inhibitors or inducers of CYP3A4, which cannot be discontinued 14 days before Day 1 of dosing and withheld throughout the study until 14 days after the last dose of AZD1775 (see section 12.5 Appendix E). Co-administration of aprepitant and fosaprepitant during this study is prohibited. Co-treatment with weak inhibitors of CYP3A4 is allowed.
• 4.2.8 AZD1775 is an inhibitor of breast cancer resistance protein (BCRP). The use of statins including atorvastatin which are substrates for BCRP are therefore prohibited and patients should be moved on to non-BCRP alternatives.
• 4.2.9 Unable or unwilling to discontinue use of any sensitive CYP3A4 substrates and CYP3A4 substrates with a narrow therapeutic window (see section 12.5, Appendix E) 4.2.10 Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of AZD1775 (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection) 4.2.11 Receiving or less than 21 days since receiving any other concurrent cytotoxic, biologic agent(s) or investigational agent 4.2.12 Patients with a "currently active" second malignancy other than non-melanoma skin cancers, non-invasive bladder cancer, "low risk" adenocarcinoma of the prostate and carcinoma in situ of the cervix. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥ 2 years.
• 4.2.13 Pregnant or nursing