Trial Outcomes & Findings for Phase I/II Study of Chemoprevention With EGFR and COX-2 Inhibitor (NCT NCT00314262)

NCT ID: NCT00314262

Last Updated: 2014-10-24

Results Overview

Participants received a fixed dose of celecoxib 400 mg orally BID continuously for 6 months. Erlotinib was dose escalated at 3 dose levels of 50, 75, and 100 mg orally every day for 6 months. Dose escalation followed a standard 3+3 escalation design.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

17 participants

Primary outcome timeframe

12 months from time of enrollment

Results posted on

2014-10-24

Participant Flow

Between October 24, 2006, and June 28, 2012, 36 subjects with documented premalignant lesions, including mild (mild-D), moderate, or severe oral leukoplakia, and carcinoma in situ (CIS) were screened. Lesion sites included oral cavity oropharynx, and the larynx.

Seventeen subjects were enrolled on the study, 3 of whom withdrew consent (one male of 69 years of age, and two females of 43 and 42 years of age). Two patients who signed informed consent were deemed to be screen failures, one secondary to prior history of oral squamous cell carcinoma and the other secondary to a history of cardiac arrhythmias.

Participant milestones

Participant milestones
Measure
Erlotinib & Celecoxib
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Overall Study
STARTED
12
Overall Study
COMPLETED
7
Overall Study
NOT COMPLETED
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Erlotinib & Celecoxib
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Overall Study
Adverse Event
2
Overall Study
Withdrawal by Subject
2
Overall Study
Physician Decision
1

Baseline Characteristics

Phase I/II Study of Chemoprevention With EGFR and COX-2 Inhibitor

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Erlotinib & Celecoxib
n=12 Participants
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Age, Customized
40-49 years old
4 participants
n=5 Participants
Age, Customized
50-59 years old
2 participants
n=5 Participants
Age, Customized
60-69 years old
4 participants
n=5 Participants
Age, Customized
70-79 years old
1 participants
n=5 Participants
Age, Customized
80-89 years old
1 participants
n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
Sex: Female, Male
Male
4 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 12 months from time of enrollment

Participants received a fixed dose of celecoxib 400 mg orally BID continuously for 6 months. Erlotinib was dose escalated at 3 dose levels of 50, 75, and 100 mg orally every day for 6 months. Dose escalation followed a standard 3+3 escalation design.

Outcome measures

Outcome measures
Measure
Erlotinib & Celecoxib
n=7 Participants
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Fatigue, Grade 1
6 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hyperbilirubinemia, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Strep throat, Grade 2
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Abdominal cramping, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Alopecia, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Anemia, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Anemia, Grade 2
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Anxiety, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Decreased protein, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Leukopenia, Grade 1
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Leukopenia, Grade 2
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Depression, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Diarrhea, Grade 1
5 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Dry eyes, Grade 1
4 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Dry skin, Grade 1
6 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Elevated LDH, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Elevated serum creatinine, Grade 1
4 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Elevated serum creatinine, Grade 2
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Elevated alkaline phosphatase, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Elevated ALT, Grade 1
5 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Elevated AST, Grade 4
4 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypercholesterolemia, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hyperglycemia, Grade 1
7 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hyperglycemia, Grade 2
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypoalbuminemia, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypoalbuminemia, Grade 2
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypocalcemia, Grade 1
4 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypoglycemia, Grade 1
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypoglycemia, Grade 2
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hypokalemia, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Hyponatremia, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Mouth sores, Grade 1
9 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Mouth sores, Grade 2
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Mucositis, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Mucositis, Grade 3
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Nausea, Grade 1
4 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Neuropathy, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Pruritis, Grade 1
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Rash, Grade 1
8 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Rash, Grade 3
2 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Shortness of breath, Grade 1
3 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Urosepsis, Grade 3
1 participants
Dose Escalation and Toxicity: Toxicities Including Grades 1 to 4
Vomiting, Grade 1
2 participants

PRIMARY outcome

Timeframe: 12 months from time of enrollment

Response evaluation was based on pathologic examination of the degree of dysplasia observed and recorded by an expert head and neck pathologist. Pathologic complete response was defined as complete disappearance of dysplasia from the epithelium. Pathologic partial response was defined as improvement of dysplasia by at least one degree (i.e., severe dysplasia becomes moderate dysplasia). Pathologic minor response or stable disease was defined as minor focal improvement without change of degree of dysplasia (i.e., focal improvement from moderate to mild dysplasia with still moderate dysplasia overall) or no pathologic changes after treatment. Pathologic progressive disease was defined as worsening by at least one degree of dysplasia (i.e., mild to moderate dysplasia) or development of invasive cancer on or following treatment.

Outcome measures

Outcome measures
Measure
Erlotinib & Celecoxib
n=7 Participants
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Clinical Outcome: Documented Progression
Complete remission (CR)
3 participants
Clinical Outcome: Documented Progression
Partial remission (PR)
1 participants
Clinical Outcome: Documented Progression
Progressive disease (PD)
1 participants
Clinical Outcome: Documented Progression
Stable disease (SDi)
2 participants

PRIMARY outcome

Timeframe: Up to 55 months from initiation of therapy. Median duration of follow-up was 36 months.

Response evaluation was based on pathologic examination of the degree of dysplasia observed and recorded by an expert head and neck pathologist. Pathologic complete response was defined as complete disappearance of dysplasia from the epithelium. Pathologic partial response was defined as improvement of dysplasia by at least one degree (i.e., severe dysplasia becomes moderate dysplasia). Pathologic minor response or stable disease was defined as minor focal improvement without change of degree of dysplasia (i.e., focal improvement from moderate to mild dysplasia with still moderate dysplasia overall) or no pathologic changes after treatment. Pathologic progressive disease was defined as worsening by at least one degree of dysplasia (i.e., mild to moderate dysplasia) or development of invasive cancer on or following treatment.

Outcome measures

Outcome measures
Measure
Erlotinib & Celecoxib
n=7 Participants
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Stage I invasive carcinoma
1 participants
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Stage II oral cavity carcinoma
1 participants
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Invasive squamous cell carcinoma
1 participants
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Recurrent moderate dysplasia
1 participants
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Recurrent severe dysplasia
1 participants
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Recurrent high-grade dysplasia
1 participants
Clinical Outcome: Progression to a Higher-grade Dysplasia or Carcinoma
Complete remission
1 participants

Adverse Events

Erlotinib & Celecoxib

Serious events: 2 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Erlotinib & Celecoxib
n=12 participants at risk
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Skin and subcutaneous tissue disorders
Rash (Grade 3)
8.3%
1/12
Gastrointestinal disorders
Mucositis (Grade 3)
8.3%
1/12
Infections and infestations
Urosepsis (Grade 3)
8.3%
1/12

Other adverse events

Other adverse events
Measure
Erlotinib & Celecoxib
n=12 participants at risk
Erlotinib \& Celecoxib: Erlotinib given orally, once daily (dose escalation from 50 mg, 75 mg, or 100 mg) continuously for 6 months in the phase I portion. Celecoxib given 400 mg orally BID continuously for 6 months.
Gastrointestinal disorders
Abdominal cramping (Grade 1)
16.7%
2/12
Renal and urinary disorders
Alopecia (Grade 1)
16.7%
2/12
Blood and lymphatic system disorders
Anemia (Grade 1)
16.7%
2/12
Blood and lymphatic system disorders
Anemia (Grade 2)
8.3%
1/12
Psychiatric disorders
Anxiety (Grade 1)
16.7%
2/12
Blood and lymphatic system disorders
Decreased protein (Grade 1)
16.7%
2/12
Immune system disorders
Leukopenia (Grade 1)
8.3%
1/12
Immune system disorders
Leukopenia (Grade 2)
8.3%
1/12
Psychiatric disorders
Depression (Grade 1)
25.0%
3/12
Gastrointestinal disorders
Diarrhea (Grade 1)
41.7%
5/12
Eye disorders
Dry Eyes (Grade 1)
33.3%
4/12
Skin and subcutaneous tissue disorders
Dry Skin (Grade 1)
50.0%
6/12
Blood and lymphatic system disorders
Elevated Lactate Dehydrogenase (Grade 1)
25.0%
3/12
Renal and urinary disorders
Elevated Serum Creatinine (Grade 1)
33.3%
4/12
Blood and lymphatic system disorders
Elevated Alkaline Phosphatase (Grade 1)
25.0%
3/12
Blood and lymphatic system disorders
Elevated Alanine Aminotransferase (Grade 1)
41.7%
5/12
Blood and lymphatic system disorders
Elevated Aspartate Aminotransferase (Grade 1)
33.3%
4/12
General disorders
Fatigue (Grade 1)
50.0%
6/12
Blood and lymphatic system disorders
Hyperbilirubinemia (Grade 1)
16.7%
2/12
Blood and lymphatic system disorders
Hypercholesterolemia (Grade 2)
16.7%
2/12
Blood and lymphatic system disorders
Hyperglycemia (Grade 1)
58.3%
7/12
Blood and lymphatic system disorders
Hyperglycemia (Grade 2)
16.7%
2/12
Blood and lymphatic system disorders
Hypoalbuminemia (Grade 1)
25.0%
3/12
Blood and lymphatic system disorders
Hypoalbuminemia (Grade 2)
8.3%
1/12
Blood and lymphatic system disorders
Hypocalcemia (Grade 1)
33.3%
4/12
Blood and lymphatic system disorders
Hypoglycemia (Grade 1)
8.3%
1/12
Blood and lymphatic system disorders
Hypoglycemia (Grade 2)
8.3%
1/12
Blood and lymphatic system disorders
Hypokalemia (Grade 1)
16.7%
2/12
Blood and lymphatic system disorders
Hyponatremia (Grade 1)
25.0%
3/12
Skin and subcutaneous tissue disorders
Mouth Sores (Grade 1)
75.0%
9/12
Skin and subcutaneous tissue disorders
Mouth Sores (Grade 2)
25.0%
3/12
Gastrointestinal disorders
Mucositis (Grade 1)
25.0%
3/12
General disorders
Nausea (Grade 1)
33.3%
4/12
Nervous system disorders
Neuropathy (Grade 1)
25.0%
3/12
Skin and subcutaneous tissue disorders
Pruritis (Grade 1)
16.7%
2/12
Skin and subcutaneous tissue disorders
Rash (Grade 1)
66.7%
8/12
General disorders
Shortness of Breath (Grade 1)
25.0%
3/12
Infections and infestations
Strep Throat (Grade 2)
8.3%
1/12
Gastrointestinal disorders
Vomiting (Grade 1)
16.7%
2/12

Additional Information

Dong Shin, MD

Emory University School of Medicine

Phone: 404-778-2980

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place