Trial Outcomes & Findings for Induction Chemotherapy Followed By Cetuximab and Radiation in HPV-Associated Resectable Stage III/IV Oropharynx Cancer (NCT NCT01084083)

NCT ID: NCT01084083

Last Updated: 2023-06-28

Results Overview

24-month progression-free survival is defined as the proportion of patients who were alive and progression-free at 24 months post registration. The primary study population for this endpoint is patients who were confirmed post-induction clinical complete response (CR) at their primary sites and subsequently received 5400 cGy radiation therapy to their primary sites.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

90 participants

Primary outcome timeframe

assessed within 14 days after delivery of the third cycle of induction therapy, and 8 weeks and 6 months after completion of concurrent therapy, then every 6 months until progression or until 3 years from study entry

Results posted on

2023-06-28

Participant Flow

The study was activated on March 17, 2010, accrued its first patient on August 11, 2010, and closed to accrual on October 19, 2011, with an accrual of 90 patients from 16 ECOG-affiliated institutions.

Participant milestones

Participant milestones
Measure
Overall
Patients receive cisplatin IV on day 1 and paclitaxel IV and cetuximab IV on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses. Patients then undergo evaluation of response to induction therapy. Patients with a CR at the primary tumor site proceed to group 1 of concurrent low-dose IMRT and cetuximab. Patients with a PR or SD at the primary tumor site or those with grossly positive disease at the primary tumor site proceed to group 2 of concurrent standard dose IMRT and cetuximab.
Overall Study
STARTED
90
Overall Study
Treated
89
Overall Study
Eligible
81
Overall Study
Eligible and Treated
80
Overall Study
CR to Induction Therapy
56
Overall Study
CR and Treated With 5400 cGy IMRT
44
Overall Study
COMPLETED
78
Overall Study
NOT COMPLETED
12

Reasons for withdrawal

Reasons for withdrawal
Measure
Overall
Patients receive cisplatin IV on day 1 and paclitaxel IV and cetuximab IV on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses. Patients then undergo evaluation of response to induction therapy. Patients with a CR at the primary tumor site proceed to group 1 of concurrent low-dose IMRT and cetuximab. Patients with a PR or SD at the primary tumor site or those with grossly positive disease at the primary tumor site proceed to group 2 of concurrent standard dose IMRT and cetuximab.
Overall Study
Adverse Event
5
Overall Study
Death
1
Overall Study
Withdrawal by Subject
2
Overall Study
Complicating disease
1
Overall Study
Other
2
Overall Study
Never started assigned therapy
1

Baseline Characteristics

Induction Chemotherapy Followed By Cetuximab and Radiation in HPV-Associated Resectable Stage III/IV Oropharynx Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Eligible and Treated Patients
n=80 Participants
Patients receive cisplatin IV on day 1 and paclitaxel IV and cetuximab IV on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses. Patients then undergo evaluation of response to induction therapy. Patients with a CR at the primary tumor site proceed to group 1 of concurrent low-dose IMRT and cetuximab. Patients with a PR or SD at the primary tumor site or those with grossly positive disease at the primary tumor site proceed to group 2 of concurrent standard dose IMRT and cetuximab.
Age, Continuous
57 Years
n=5 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
Sex: Female, Male
Male
76 Participants
n=5 Participants
Region of Enrollment
United States
80 participants
n=5 Participants

PRIMARY outcome

Timeframe: assessed within 14 days after delivery of the third cycle of induction therapy, and 8 weeks and 6 months after completion of concurrent therapy, then every 6 months until progression or until 3 years from study entry

Population: patients who were confirmed post-induction clinical complete response (CR) at their primary sites and subsequently received 5400 cGy radiation therapy to their primary sites

24-month progression-free survival is defined as the proportion of patients who were alive and progression-free at 24 months post registration. The primary study population for this endpoint is patients who were confirmed post-induction clinical complete response (CR) at their primary sites and subsequently received 5400 cGy radiation therapy to their primary sites.

Outcome measures

Outcome measures
Measure
Primary Study Population
n=44 Participants
The primary study population for this endpoint is patients who were confirmed post-induction clinical complete response (CR) at their primary sites and subsequently received 5400 cGy radiation therapy to their primary sites.
24-month Progression-free Survival
64 percentage of participants
Interval 48.0 to 78.0

SECONDARY outcome

Timeframe: assessed within 14 days after delivery of the third cycle of induction therapy, and 8 weeks and 6 months after completion of concurrent therapy, then every 6 months until progression or until 3 years from study entry

Population: eligible and treated patients

OS was defined as the time from registration to death, or censored at last date known alive. Kaplan-Meier method was used to estimate the overall survival rate at 24 months.

Outcome measures

Outcome measures
Measure
Primary Study Population
n=80 Participants
The primary study population for this endpoint is patients who were confirmed post-induction clinical complete response (CR) at their primary sites and subsequently received 5400 cGy radiation therapy to their primary sites.
24-months Overall Survival
91 percentage of participants
Interval 82.0 to 96.0

SECONDARY outcome

Timeframe: assessed within 14 days after delivery of the third cycle of induction therapy

Population: eligible and treated patients

Primary clinical response rate is defined as the proportion of patients with complete response or partial response at their primary sites after induction therapy. Response status for the primary site was classified by clinical examination using endoscopy. If, however, the clinical response status of the primary was unclear based on endoscopy, then the CT or MRI (required at the end of induction) was used to determine status of the primary. If clinical and radiological evaluation of the primary was unclear, a biopsy was considered at the discretion of the treating physician.

Outcome measures

Outcome measures
Measure
Primary Study Population
n=80 Participants
The primary study population for this endpoint is patients who were confirmed post-induction clinical complete response (CR) at their primary sites and subsequently received 5400 cGy radiation therapy to their primary sites.
Primary Clinical Response Rate
73 percentage of participants
Interval 61.0 to 82.0

Adverse Events

All Treated Patients

Serious events: 69 serious events
Other events: 86 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
All Treated Patients
n=89 participants at risk
Patients receive cisplatin IV on day 1 and paclitaxel IV and cetuximab IV on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses. Patients then undergo evaluation of response to induction therapy. Patients with a CR at the primary tumor site proceed to group 1 of concurrent low-dose IMRT and cetuximab. Patients with a PR or SD at the primary tumor site or those with grossly positive disease at the primary tumor site proceed to group 2 of concurrent standard dose IMRT and cetuximab. Adverse events data were reported for all patients received at least one dose of protocol therapy.
Ear and labyrinth disorders
Tinnitus
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Blood and lymphatic system disorders
Anemia
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Blood and lymphatic system disorders
Febrile neutropenia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Cardiac disorders
Chest pain - cardiac
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Cardiac disorders
Myocardial infarction
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
General disorders
Fatigue
7.9%
7/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
General disorders
Pain
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Erythema multiforme
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Palmar-plantar erythrodysesthesia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Rash acneiform
32.6%
29/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Rash maculo-papular
3.4%
3/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Skin ulceration
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Constipation
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Diarrhea
4.5%
4/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Dry mouth
4.5%
4/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Dysphagia
22.5%
20/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Mucositis oral
32.6%
29/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Nausea
9.0%
8/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Oral pain
6.7%
6/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Vomiting
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Gastrointestinal disorders - Other
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Immune system disorders
Anaphylaxis
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Infections and infestations
Anorectal infection
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Infections and infestations
Catheter related infection
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Infections and infestations
Device related infection
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Infections and infestations
Pharyngitis
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Infections and infestations
Sepsis
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Injury, poisoning and procedural complications
Dermatitis radiation
10.1%
9/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Injury, poisoning and procedural complications
Wound complication
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Alanine aminotransferase increased
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Aspartate aminotransferase increased
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Cardiac troponin I increased
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
CD4 lymphocytes decreased
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Lymphocyte count decreased
20.2%
18/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Neutrophil count decreased
11.2%
10/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Weight loss
3.4%
3/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
White blood cell decreased
5.6%
5/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Anorexia
11.2%
10/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Dehydration
7.9%
7/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hyperkalemia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypermagnesemia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypoalbuminemia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypokalemia
7.9%
7/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypomagnesemia
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hyponatremia
4.5%
4/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypophosphatemia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Musculoskeletal and connective tissue disorders
Arthralgia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Musculoskeletal and connective tissue disorders
Myalgia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Musculoskeletal and connective tissue disorders
Osteonecrosis of jaw
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Musculoskeletal and connective tissue disorders
Pain in extremity
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Musculoskeletal and connective tissue disorders
Superficial soft tissue fibrosis
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Nervous system disorders
Headache
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Nervous system disorders
Neuralgia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Nervous system disorders
Peripheral motor neuropathy
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Nervous system disorders
Peripheral sensory neuropathy
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Tumor pain
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Respiratory, thoracic and mediastinal disorders
Aspiration
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Respiratory, thoracic and mediastinal disorders
Dyspnea
3.4%
3/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Respiratory, thoracic and mediastinal disorders
Hypoxia
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Respiratory, thoracic and mediastinal disorders
Sore throat
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Renal and urinary disorders
Renal and urinary disorders - Other
1.1%
1/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Vascular disorders
Hypotension
2.2%
2/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Vascular disorders
Thromboembolic event
4.5%
4/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities

Other adverse events

Other adverse events
Measure
All Treated Patients
n=89 participants at risk
Patients receive cisplatin IV on day 1 and paclitaxel IV and cetuximab IV on days 1, 8, and 15. Treatment repeats every 21 days for 3 courses. Patients then undergo evaluation of response to induction therapy. Patients with a CR at the primary tumor site proceed to group 1 of concurrent low-dose IMRT and cetuximab. Patients with a PR or SD at the primary tumor site or those with grossly positive disease at the primary tumor site proceed to group 2 of concurrent standard dose IMRT and cetuximab. Adverse events data were reported for all patients received at least one dose of protocol therapy.
Blood and lymphatic system disorders
Anemia
15.7%
14/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
General disorders
Fatigue
50.6%
45/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Alopecia
43.8%
39/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Dry skin
5.6%
5/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Pruritus
7.9%
7/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Rash acneiform
71.9%
64/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Skin and subcutaneous tissue disorders
Rash maculo-papular
18.0%
16/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Constipation
11.2%
10/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Diarrhea
10.1%
9/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Dry mouth
40.4%
36/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Dysphagia
30.3%
27/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Mucositis oral
56.2%
50/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Nausea
36.0%
32/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Oral pain
15.7%
14/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Gastrointestinal disorders
Vomiting
9.0%
8/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Injury, poisoning and procedural complications
Dermatitis radiation
25.8%
23/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Lymphocyte count decreased
15.7%
14/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Neutrophil count decreased
16.9%
15/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
Weight loss
34.8%
31/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Investigations
White blood cell decreased
25.8%
23/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Anorexia
32.6%
29/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Dehydration
13.5%
12/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hyperglycemia
10.1%
9/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypocalcemia
5.6%
5/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Metabolism and nutrition disorders
Hypomagnesemia
18.0%
16/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Nervous system disorders
Dysgeusia
29.2%
26/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Nervous system disorders
Peripheral sensory neuropathy
14.6%
13/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities
Respiratory, thoracic and mediastinal disorders
Sore throat
12.4%
11/89 • Assessed every cycle while on treatment and for 3 months after completion of concurrent treatment to capture late radiation toxicities

Additional Information

ECOG-ACRIN statistician

ECOG-ACRIN Statistical Office

Phone: 617-632-3012

Results disclosure agreements

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

Restriction type: LTE60