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Phase III Randomized Study of Radiotherapy With or Without Concurrent Cetuximab in Patients With Advanced Squamous Cell Carcinoma of the Oropharynx, Hypopharynx, or Larynx
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Published Results Trial Contact Information Registry Information
Alternate Title
Radiation Therapy With or Without Cetuximab in Treating Patients With Stage III or Stage IV Cancer of the Oropharynx, Hypopharynx, or Larynx
Basic Trial Information
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Protocol IDs
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Phase III
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Treatment
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Closed
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18 and over
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NCI, Pharmaceutical / Industry
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UAB-9901 IMCL-CP02-9815, NCI-G99-1657, NCT00004227
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Objectives - Compare the rate of locoregional disease control maintained for 1 year in patients with advanced squamous cell carcinoma of the oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concurrent cetuximab.
- Compare the response rates, progression-free survival and overall survival rates, and quality of life in patients treated with these regimens.
- Compare acute and late toxicity of these regimens in these patients.
- Determine tumor epidermal growth factor receptor levels in patients treated with these regimens.
Entry Criteria Disease Characteristics:
- Histologically proven advanced squamous cell carcinoma of the oropharynx,
hypopharynx, or larynx
- Stage III
OR
- Stage IV without distant metastases
- Measurable disease
- Tumor tissue available for immunohistochemical assay of epidermal growth
factor receptor expression
Prior/Concurrent Therapy:
Biologic therapy: - No prior cetuximab or other murine monoclonal
antibody
Chemotherapy: - At least 3 years since prior systemic chemotherapy
- No concurrent chemotherapy
Endocrine therapy: Radiotherapy: - No prior radiotherapy to head and neck
- No other concurrent radiotherapy
Surgery: - No prior surgery for indicator lesion except biopsy
- Study radiotherapy must not be a part of a postoperative
regimen after primary surgical resection
Patient Characteristics:
Age: Performance status: Life expectancy: Hematopoietic: - Absolute neutrophil count at least 1,500/mm3
- Platelet count at least 100,000/mm3
Hepatic: - Bilirubin no greater than 1.5 mg/dL
- SGOT and SGPT no greater than 2 times upper limit of
normal
Renal: - Creatinine no greater than 1.5 mg/dL
OR - Creatinine clearance at least 50 mL/min
- Calcium normal
Other: - Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Medically able to withstand a course of definitive
radiotherapy
- No medical or psychologic condition that would preclude
informed consent or compliance
- No other malignancy within the past 3 years except basal cell
skin cancer or preinvasive carcinoma of the cervix
Expected Enrollment Approximately 416 patients (208 per arm) will be accrued for this study within
approximately 5 years. Outline This is a randomized, multicenter study. Patients are stratified by
Karnofsky performance status (60-80% vs 90-100%), nodal stage (N0 vs N+),
tumor stage (T1-3 vs T4), and radiotherapy schedule (concurrent boost vs once
daily vs twice daily). Patients are randomized to 1 of 2 treatment arms: - Arm I: Patients undergo radiotherapy beginning on day 1. Patients are
assigned to 1 of 3 radiotherapy groups:
- Group 1: Patients undergo concurrent boost radiotherapy comprised of
radiotherapy once daily 5 days a week for 3.5 weeks followed by radiotherapy
twice daily 5 days a week for 2.5 weeks.
- Group 2: Patients undergo radiotherapy once daily 5 days a week for 7
weeks.
- Group 3: Patients undergo radiotherapy twice daily 5 days a week for
6-6.5 weeks.
- Arm II: Patients receive a test dose of cetuximab IV over 10 minutes on
day 1. Patients who do not experience grade 4 anaphylactic reaction receive a
loading dose of cetuximab IV over 2 hours beginning 30 minutes after
completion of test dose. Patients receive maintenance cetuximab IV over 1
hour on day 8. Maintenance cetuximab repeats every week for 7 courses.
Beginning on day 8, patients undergo radiotherapy as in arm I concurrently
with maintenance cetuximab. There must be an hour interval between the
completion of cetuximab infusion and the start of any radiotherapy.
Patients with more than N1 neck disease at initial presentation undergo
neck dissection 4-8 weeks after the completion of radiotherapy. Quality of life is assessed before initiation of study therapy, at 8
weeks, and then every 4 months for 1 year. Patients are followed at 8 weeks, every 4 months for 2 years, and then
every 6 months for 3 years. Published ResultsBonner JA, Harari PM, Giralt J, et al.: Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354 (6): 567-78, 2006.[PUBMED Abstract] Bonner JA, Harari PM, Giralt J, et al.: The relationship of cetuximab-induced rash and survival in patients with head and neck cancer treated with radiotherapy and cetuximab. [Abstract] Int J Radiat Oncol Biol Phys 63 (2 Suppl 1): A-120, S73, 2005. Bonner JA, Girald J, Harari PM, et al.: Phase III evaluation of radiation with and without cetuximab for locoregionally advanced head and neck cancer. [Abstract] Int J Radiat Oncol Biol Phys 60 (1 Suppl 1): A-31, S147-8, 2004. Available online. Last accessed February 3, 2005.
Trial Contact Information
Trial Lead Organizations Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham | | | James Bonner, MD, Protocol chair | | | |
Registry Information | | Official Title | | Randomized Phase III Trial to Compare Radiation Therapy Alone with Radiation Therapy and Concomitant Anti-EGFr Antibody (C225) for Locally Advanced Squamous Cell Carcinomas of the Head and Neck | | Trial Start Date | | 2000-05-16 | | Registered in ClinicalTrials.gov | | NCT00004227 | | Date Submitted to PDQ | | 1999-12-09 | | Information Last Verified | | 2001-11-01 | | NCI Grant/Contract Number | | P30-CA13148 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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