EVALUATION OF AMIFOSTINE FOR MUCOSAL AND HEMOPOETIC PROTECTION AND CARBOPLATIN, TAXOL, RADIOTHERAPY IN THE MANAGEMENT OF PATIENTS WITH HEAD AND NECK CANCER. - Full Text View

Sponsors and Collaborators:	University of Maryland MedImmune LLC
Information provided by:	University of Maryland
ClinicalTrials.gov Identifier:	NCT00270790

Purpose

Purpose of this study:

There is some evidence that the best treatment for head and neck cancer involves a combination of radiation therapy and chemotherapy. Radiation therapy is a form of cancer treatment using high energy x-rays. Chemotherapy is a form of cancer treatment that uses special medications. This study uses two chemotherapy drugs (Taxol and Carboplatin), which are FDA approved for treating head and neck cancers. This treatment combination has been associated with difficulty, pain, or a burning sensation upon swallowing (called esophagitis), and decrease in blood cells (cells in the blood which fight against infection). The purpose of this study is to investigate whether the addition of another drug, Amifostine, can reduce the side effects of current combination treatment (radiation and chemotherapy which is standard of care). The addition of Amifostine is the investigational part of the study. The research study is also looking at the side effects of Amifostine and cancer's growth response to this combination treatment.

Condition	Intervention	Phase
Head and Neck Cancer.	Drug: Amifostine Drug: Carboplatin Drug: Taxol Device: Radiotherapy	Phase II

MedlinePlus related topics: Cancer Head and Neck Cancer

Drug Information available for: Carboplatin Paclitaxel Amifostine

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title:	A SINGLE SITE EVALUATION OF AMIFOSTINE FOR MUCOSAL AND HEMOPOETIC PROTECTION AND CONCURRENT CARBOPLATIN, TAXOL, RADIOTHERAPY IN THE MANAGEMENT OF PATIENTS WITH ADVANCED LOCOREGIONAL SQUAMOUS CELL CARCINOMAS OF THE HEAD AND NECK.

Further study details as provided by University of Maryland:

Primary Outcome Measures:

To evaluate whether the addition of the radioprotector Amifostine can reduce the incidence and severity of mucositis and hematological toxicities caused by chemoradiation.

Secondary Outcome Measures:

1.To determine the toxicities of Amifostine given in this setting.
2. To determine the response rate of this regimen in the population.

Estimated Enrollment:	25
Study Start Date:	May 2002
Estimated Study Completion Date:	April 2007

Detailed Description:

Patients presenting with locally advanced squamous cell carcinomas of head and neck (SCCHN) continue to represent a significant therapeutic challenge. The bulk of tumor burden often proves to be overwhelming for conventional radiotherapy. Attempts to improve upon these poor outcomes have led investigators to explore several new strategies, one such being chemoradiation. One of the trials conducted at the University of Maryland with carboplatin and paclitaxel with daily radiation showed 82% CR at the primary site. But the most commonly encountered grade 3 toxicities were mucositis (70%), leukopenia (30%) and 3% grade 4 leukopenia. Amifostine: An organic thiophosphate is radioprotective and has shown to protect experimental animals from lethal doses of radiation. Clinical trials have demonstrated that amifostine can provide protection against the hematological toxicities and mucositis seen with various chemotherapeutic agents. Theoretically, drug interactions between amifostine and chemotherapeutic agents are not likely to occur, due to amifostine¿s rapid clearance from plasma (90% of the drug is cleared within 6 minutes). A promising venue would be the investigation of amifostine¿s role in reducing the toxicities associated with chemoradiation (which is standard of care of treating squamous cell carcinomas of head and neck).

Principal objectives of the study: Primary: To evaluate whether the addition of the radioprotector amifostine can reduce the incidence and severity of mucositis and hematological toxicities caused by chemoradiation. Secondary: 1.To determine the toxicities of amifostine given in this setting. 2. To determine the response rate of this regimen in the population.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Histologically proved locally advanced squamous cell carcinoma of the head and neck of all primary sites. The following TNM stages by sites will be eligible.

Oral cavity, Pharynx, Larynx, Nasopharynx, paranasal sinuses: T4 N0-3, A,B,C T3 N1-3 A,B,C any T, N3 A,B,C Unknown primary: Tx, N3 A,B,C Note: Only clearly unresectable T4 N0 lesions are eligible for study provided the reasons for unresectability are due to extensive anatomic involvement and are outlined by the surgeon.
Karnofsky performance status of 70% or better at screen and on first day of treatment.
Patients with loco-regional recurrences from any site with no prior radiation therapy and not amenable for salvage surgery are eligible for study.
No evidence of distant metastatic disease.
No previous radiation therapy
No previous chemotherapy.
Adequate renal & bone marrow function determined by the following laboratory parameters.

WBC 3500/ul or higher Platelet count 100.000/ul or higher Hemoglobin 9.0 g/dl or higher BUN 25 mg/dl or less, and Screatinine 2.0 mg/dl or less Total bilirubin less than 2.0 mg/dl, AST/ALT less than 3 times the ULN Creatinine Clearance 50 cc/min or higher
Evidence of measurable disease.
No evidence of concomitant malignancy except for non-melanomatous skin cancer (controlled or controllable) or carcinoma in situ of the cervix.
Signed informed consent.
No concomitant life threatening or uncontrolled serious medical illness such as end stage congestive heart failure cardiac arrythmia, liver disease and organic brain syndrome.
Age 18 years or older.

Exclusion Criteria:

Preexisting clinically significant neuropathy.
Patients currently taking antiarrhythmic medications are excluded.
History of poorly-controlled hypertension, angina, arrhythmias, or a history within the past 6 months of myocardial infarction or acute congestive heart failure.
Requirement for concurrent use of pilocarpine.
Treatment with any investigational drugs within 4 weeks of study entry.
Pregnant or lactating females or females of child bearing potential not employing adequate contraception.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00270790

Locations

United States, Maryland
University of Maryland
Baltimore, Maryland, United States, 21201

Sponsors and Collaborators

University of Maryland

MedImmune LLC

Investigators

Principal Investigator:

Mohan Suntharalingam, MD

University of Maryland

More Information

Study ID Numbers:	GCC 0202
Study First Received:	December 23, 2005
Last Updated:	December 23, 2005
ClinicalTrials.gov Identifier:	NCT00270790
Health Authority:	United States: Food and Drug Administration

Keywords provided by University of Maryland:

Head and Neck cancer

Study placed in the following topic categories:

Epidermoid carcinoma
Amifostine
Paclitaxel
Squamous cell carcinoma
Head and Neck Neoplasms

Carcinoma, squamous cell
Carboplatin
Carcinoma, Squamous Cell
Carcinoma, squamous cell of head and neck
Carcinoma

Additional relevant MeSH terms:

Radiation-Protective Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Mitosis Modulators
Antimitotic Agents
Protective Agents

Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses
Tubulin Modulators
Antineoplastic Agents, Phytogenic

ClinicalTrials.gov processed this record on January 16, 2009