Induction Chemotherapy Followed by Cetuximab Plus Definitive Radiotherapy Versus Radiation Plus Cisplatin

NCT ID: NCT00999700

Last Updated: 2017-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

282 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-09-30

Study Completion Date

2021-12-31

Brief Summary

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A phase III trial of induction chemotherapy followed by definitive radiotherapy plus Cetuximab versus chemoradiation in unresectable, locally advanced, squamous cell carcinoma of the head and neck (HNC).

Detailed Description

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The objective of this trial is to determine whether Cetuximab and radiation preceded by an induction chemotherapy, may be superior to an established chemoradiation program for HNC (RTOG regimen, Adelstein DJ J.Clin.Oncol. 2003;21:92-98).

Conditions

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Squamous Cell Carcinoma of the Head and Neck

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ARM A

Induction chemotherapy: TCF (Vermorken, N Eng J Med 2007) Definitive treatment: RT + C-mab (Bonner, N Eng J Med 2006)

Group Type EXPERIMENTAL

docetaxel - cisplatin - 5-fluorouracil

Intervention Type DRUG

docetaxel 75 mg/sqm day1 cisplatin 75 mg/sqm day1 5-fluorouracil 750 mg/sqm/d c.i. day1 to day4 q21

radiotherapy

Intervention Type RADIATION

Conformal radiotherapy or IMRT should be employed.

Standard radiotherapy:

Minimum radiation dose 70 Gy. Additional boost up to 10 Gy if clinically indicated.

cetuximab

Intervention Type DRUG

400 mg/sqm at the 1st infusion - before starting RT 250 mg/sqm weekly - concurrent with RT up to the last week of treatment

ARM B

RT + Cddp (RTOG, Adelstein, J Clin Oncol 2003)

Group Type ACTIVE_COMPARATOR

cisplatin

Intervention Type DRUG

Cisplatin, 100 mg/sqm every 3 weeks, three times, concurrent with RT, starting from day 1 of treatment.

radiotherapy

Intervention Type RADIATION

Conformal radiotherapy or IMRT should be employed.

Standard radiotherapy:

Minimum radiation dose 70 Gy. Additional boost up to 10 Gy if clinically indicated.

Interventions

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docetaxel - cisplatin - 5-fluorouracil

docetaxel 75 mg/sqm day1 cisplatin 75 mg/sqm day1 5-fluorouracil 750 mg/sqm/d c.i. day1 to day4 q21

Intervention Type DRUG

radiotherapy

Conformal radiotherapy or IMRT should be employed.

Standard radiotherapy:

Minimum radiation dose 70 Gy. Additional boost up to 10 Gy if clinically indicated.

Intervention Type RADIATION

cetuximab

400 mg/sqm at the 1st infusion - before starting RT 250 mg/sqm weekly - concurrent with RT up to the last week of treatment

Intervention Type DRUG

cisplatin

Cisplatin, 100 mg/sqm every 3 weeks, three times, concurrent with RT, starting from day 1 of treatment.

Intervention Type DRUG

radiotherapy

Conformal radiotherapy or IMRT should be employed.

Standard radiotherapy:

Minimum radiation dose 70 Gy. Additional boost up to 10 Gy if clinically indicated.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* \> 18 years of age
* Histologically or cytologically confirmed diagnosis of HNSCC
* Stage III/IV, not suitable for surgery (definitive cure rate improbable, technically unresectable or medical contraindication for surgery)
* At least one uni-dimensional measurable lesion either by CT scan or MRI
* Signed written informed consents prior to beginning protocol

Specific procedures:

* Tumor tissue available for immunohistochemical staining of EGFR expression and HPV
* Life expectancy of \> 3 months at study entry
* ECOG Performance Status of \<2 at study entry.
* Effective contraception if risk of conception exists.
* Neutrophils \> 2.0/mm³, platelet count \> 100,000/mm³, and hemoglobin \> 10 g/dl
* Normal liver function
* Serum creatinine \> 1.25 x ULN and/or creatinine clearance \> 60 ml/min

Exclusion Criteria

* Prior systemic chemotherapy and/or radiotherapy
* Known peripheral neuropathy \> grade 2 NCI-CTC version 3.0
* Known chronic heart failure
* Prior surgery, excluding prior diagnostic biopsy
* Known drug abuse
* Active uncontrolled infection
* Other concomitant anticancer therapy
* Distant metastasis
* Concurrent chronic systemic immune therapy, chemotherapy for disease other than cancer, or hormone therapy not indicated in the study protocol
* Clinically relevant coronary artery disease or history of a myocardial infarction within the last 12 months before study entry
* Medical or psychological condition that would not permit the patient to complete the trial or sign informed consent
* Nasopharyngeal carcinoma WHO type II or III
* Known allergic reaction against any of the components of the treatment
* Pregnancy (absence confirmed by beta-HCG test) or lactation period
* Any prior or on-going investigational medication
* Previous or current malignancy except basal cell carcinoma of the skin or pre-invasive carcinoma of the cervix
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gruppo Oncologico del Nord-Ovest

OTHER

Sponsor Role lead

Responsible Party

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MARCO MERLANO

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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MARCO MERLANO, MD

Role: PRINCIPAL_INVESTIGATOR

ASCO, ESMO, AIOM, G.O.N.O.

Locations

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Ospedale S. Giacomo

Novi Ligure (al), Italy, Italy

Site Status

Irccs Centro Di Riferimento Oncologico Di Basilicata (Crob)

Rionero in Vulture (pz), Italy, Italy

Site Status

Ospedale Civile Ss. Antonio E Biagio

Alessandria, , Italy

Site Status

Ausl Della Valle D' Aosta

Aosta, , Italy

Site Status

Policlinico S. Orsola-Malpighi

Bologna, , Italy

Site Status

Asl 8 - Ospedale Businco

Cagliari, , Italy

Site Status

A.S.O. S. Croce E Carle

Cuneo, , Italy

Site Status

Irccs - Aou S. Martino - Oncology

Genoa, , Italy

Site Status

Irccs - Aou San Martino - Radiotherapy

Genoa, , Italy

Site Status

Asl 3 Genovese

Genova, , Italy

Site Status

E.O. Ospedali Galliera

Genova, , Italy

Site Status

Azienda Ospedaliera Villa Scassi - Asl3

Italy, , Italy

Site Status

Istituto Nazionale Dei Tumori

Milan, , Italy

Site Status

Azienda Ospedaliero Universitaria Di Modena

Modena, , Italy

Site Status

Azienda Ospedaliero-Universitaria Di Parma

Parma, , Italy

Site Status

Azienda Ospedaliera Ospedali Riuniti Di Fano

Pesaro, , Italy

Site Status

Arcispedale S. Maria Nuova

Reggio Emilia, , Italy

Site Status

Ospedale S. Filippo Neri

Roma, , Italy

Site Status

Ospedale S. Paolo

Savona, , Italy

Site Status

A.O. Universitaria S. Giovanni Battista-Molinette Di Torino Torino (to)

Turin, , Italy

Site Status

A.O. Universitaria S. Giovanni Battista-Molinette Di Torino

Turin, , Italy

Site Status

Countries

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Italy

References

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- J.P. Pignon et al. Lancet 2000

Reference Type RESULT

- A. Forastiere et al., New Engl J Med 2001

Reference Type RESULT

- Adelstein DJ J.Clin.Oncol. 2003

Reference Type RESULT

- Henke, New England 2004

Reference Type RESULT

- J.A. Bonner et al., New Engl J Med 2006

Reference Type RESULT

Merlano M. Alternating chemotherapy and radiotherapy in locally advanced head and neck cancer: an alternative? Oncologist. 2006 Feb;11(2):146-51. doi: 10.1634/theoncologist.11-2-146.

Reference Type RESULT
PMID: 16476835 (View on PubMed)

- Posner M et al, New Engl J Med 2007

Reference Type RESULT

- Vermorken J et al, New Engl J Med 2007

Reference Type RESULT

- Lo Nigro, Journal of Cancer Research Clinical Oncology 2009

Reference Type RESULT

Merlano M, Marchetti G. Radiochemotherapy in head and neck cancer. Cancer Treat Rev. 2003 Aug;29(4):291-6. doi: 10.1016/s0305-7372(03)00022-7.

Reference Type RESULT
PMID: 12927569 (View on PubMed)

Related Links

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http://www.reteoncologica.it/

click on "trials" for more informations

Other Identifiers

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EUDRACT NUMBER 2009-013402-14

Identifier Type: -

Identifier Source: org_study_id

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