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Erlotinib and Cetuximab in Treating Patients With Advanced Gastrointestinal Cancer, Head and Neck Cancer, Non-Small Cell Lung Cancer, or Colorectal Cancer
This study has been suspended.
Sponsors and Collaborators: Vanderbilt-Ingram Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00397384
  Purpose

RATIONALE: Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Erlotinib and cetuximab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving erlotinib together with cetuximab may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of erlotinib when given together with cetuximab and to see how well they work in treating patients with advanced gastrointestinal cancer, head and neck cancer, non-small cell lung cancer, or colorectal cancer.


Condition Intervention Phase
Cancer
Drug: cetuximab
Drug: erlotinib hydrochloride
Phase I
Phase II

MedlinePlus related topics: Cancer Colorectal Cancer Head and Neck Cancer Lung Cancer Tonsils and Adenoids
Drug Information available for: Erlotinib Erlotinib hydrochloride Cetuximab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label
Official Title: A Phase I/II Clinical and Biological Evaluation of Combined EGFR Blockade With Erlotinib and Cetuximab in Patients With Advanced Cancer (Phase I) or Advanced Colorectal Cancer (Phase II)

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Maximum tolerated dose and recommended phase II dose of erlotinib hydrochloride when administered with cetuximab (phase I) [ Designated as safety issue: Yes ]
  • Response rate (phase II) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Dose-limiting toxicity (phase I) [ Designated as safety issue: Yes ]
  • Optimal biological dose (phase I) [ Designated as safety issue: No ]
  • Antitumor effect (phase I) [ Designated as safety issue: No ]
  • Progression-free survival rate at 4 months (phase II) [ Designated as safety issue: No ]
  • Time to tumor progression (phase II) [ Designated as safety issue: No ]
  • Median survival (phase II) [ Designated as safety issue: No ]
  • Safety and tolerability (phase II) [ Designated as safety issue: Yes ]

Estimated Enrollment: 55
Study Start Date: December 2006
Estimated Primary Completion Date: October 2007 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of erlotinib hydrochloride when administered with cetuximab in patients with advanced gastrointestinal, head and neck, or non-small cell lung cancer. (Phase I)
  • Determine the recommended phase II dose of this regimen in these patients. (Phase I)
  • Determine the response rate in patients with refractory advanced colorectal cancer treated with this regimen. (Phase II)

Secondary

  • Determine the dose-limiting toxicity of this regimen in these patients. (Phase I)
  • Determine the optimal biological dose of this regimen in these patients. (Phase I)
  • Describe any antitumor effect of this regimen in these patients. (Phase I)
  • Determine the 4-month progression-free survival rate in patients treated with this regimen. (Phase II)
  • Determine the time to tumor progression in patients treated with this regimen. (Phase II)
  • Determine the median survival of patients treated with this regimen. (Phase II)
  • Determine safety and tolerability of this regimen in these patients. (Phase II)

OUTLINE: This is a phase I, nonrandomized, dose-escalation study of erlotinib hydrochloride followed by a phase II, open-label study.

  • Phase I: Patients receive cetuximab IV over 1-2 hours on days 1, 8, and 15 and oral erlotinib hydrochloride once daily on days 8-21. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of erlotinib hydrochloride until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

  • Phase II: Patients receive cetuximab and erlotinib hydrochloride as in phase I at the MTD.

After completion of study treatment, patients are followed for 4 weeks.

PROJECTED ACCRUAL: A total of 55 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed diagnosis of 1 of the following:

    • Gastrointestinal cancer*
    • Head and neck cancer*
    • Non-small cell lung cancer*
    • Colorectal adenocarcinoma** meeting the following criteria:

      • Unresectable disease
      • Evidence of new or progressive metastatic lesions within the past 6 months
      • At least 1 metastatic tumor site must be accessible for biopsy
  • KRAS wild type by PCR assay or directed sequencing of KRAS exon and codons 12 and 13

    • May undergo a needle or excisional biopsy of a malignant site prior to enrollment if KRAS mutational status cannot be determined on archived tumor tissue
  • Incurable, advanced disease
  • Received ≥ 1 prior systemic regimen for advanced/metastatic disease, including fluorouracil and leucovorin calcium and either oxaliplatin or irinotecan hydrochloride**

    • Any type of prior antineoplastic therapy allowed, except for epidermal growth factor receptor (EGFR) inhibitors
  • Measurable disease**, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan

    • Target lesions may not be in a previously irradiated field unless progression of the lesion has been documented
  • History of brain metastases allowed provided ≥ 1 of the following criteria are met:

    • Metastases have been surgically resected
    • Radiographically and clinically stable for 2 months after completion of radiotherapy NOTE: *Phase I only

NOTE: **Phase II only

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • WBC ≥ 3,000/mm³
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Bilirubin normal
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for ≥ 60 days after completion of study treatment
  • Other prior malignancies allowed provided prior therapy has been discontinued and there is no evidence of disease
  • Able to take and retain oral medications
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to erlotinib hydrochloride or cetuximab
  • No significant traumatic injury within the past 21 days
  • No abnormalities of the cornea based on history (e.g., dry eye syndrome or Sjögren's syndrome), congenital abnormality (e.g., Fuch's dystrophy), abnormal slit-lamp examination using a vital dye (e.g., fluorescein or Bengal-Rose), and/or an abnormal corneal sensitivity test (Schirmer test or similar tear production test)
  • No gastrointestinal tract disease resulting in an inability to take oral medication
  • No requirement for IV alimentation
  • No active peptic ulcer disease
  • No uncontrolled intercurrent illness, including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situation that would preclude study compliance

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • At least 4 weeks since prior biologic therapy, chemotherapy, or radiotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered
  • No prior EGFR-targeting therapies
  • No prior surgical procedures affecting absorption
  • At least 21 days since prior major surgery or biopsy of a parenchymal organ
  • No concurrent CYP3A4-inducing agents
  • No other concurrent investigational agents
  • No other concurrent anticancer agents or therapies
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00397384

Locations
United States, Tennessee
Vanderbilt-Ingram Cancer Center - Cool Springs
Nashville, Tennessee, United States, 37064
Vanderbilt-Ingram Cancer Center at Franklin
Nashville, Tennessee, United States, 37064
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States, 37232-6838
Sponsors and Collaborators
Vanderbilt-Ingram Cancer Center
Investigators
Study Chair: Laura Goff, MD Vanderbilt-Ingram Cancer Center
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000511880, VU-VICC-GI-0622, NCI-6980
Study First Received: November 8, 2006
Last Updated: December 3, 2008
ClinicalTrials.gov Identifier: NCT00397384  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the colon
recurrent colon cancer
stage IV colon cancer
recurrent rectal cancer
stage IV rectal cancer
adenocarcinoma of the rectum
recurrent non-small cell lung cancer
stage IV non-small cell lung cancer
metastatic gastrointestinal carcinoid tumor
recurrent gastrointestinal carcinoid tumor
stage IV squamous cell carcinoma of the hypopharynx
stage IV squamous cell carcinoma of the larynx
stage IV verrucous carcinoma of the larynx
stage IV basal cell carcinoma of the lip
stage IV mucoepidermoid carcinoma of the oral cavity
stage IV verrucous carcinoma of the oral cavity
stage IV adenoid cystic carcinoma of the oral cavity
stage IV squamous cell carcinoma of the lip and oral cavity
metastatic squamous neck cancer with occult primary
stage IV lymphoepithelioma of the nasopharynx
stage IV squamous cell carcinoma of the nasopharynx
stage IV lymphoepithelioma of the oropharynx
stage IV squamous cell carcinoma of the oropharynx
stage IV esthesioneuroblastoma of the paranasal sinus and nasal cavity
stage IV inverted papilloma of the paranasal sinus and nasal cavity
stage IV midline lethal granuloma of the paranasal sinus and nasal cavity
stage IV squamous cell carcinoma of the paranasal sinus and nasal cavity
stage IV salivary gland cancer
recurrent squamous cell carcinoma of the hypopharynx
recurrent squamous cell carcinoma of the larynx

Study placed in the following topic categories:
Thoracic Neoplasms
Rectal Neoplasms
Pancreatic Neoplasms
Colonic Diseases
Rectal Diseases
Dental Caries
Carcinoma, Adenoid Cystic
Lung Neoplasms
Metastatic squamous neck cancer with occult primary
Laryngeal carcinoma
Salivary Gland Diseases
Rectal cancer
Erlotinib
Non-small cell lung cancer
Digestive System Neoplasms
Carcinoma, Basal Cell
Stomach cancer
Gall bladder cancer
Carcinoma
Lung Diseases
Gastrointestinal Neoplasms
Carcinoid Tumor
Esophageal Diseases
Gallbladder Neoplasms
Carcinoma, Squamous Cell
Anus Neoplasms
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial
Leiomyosarcoma
Gastrointestinal Diseases

Additional relevant MeSH terms:
Respiratory Tract Neoplasms
Neoplasms
Neoplasms by Site
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 14, 2009