Trial Outcomes & Findings for A Study of Carboplatin, Cetuximab and RAD001 in Advanced Head and Neck Cancer (NCT NCT01283334)

NCT ID: NCT01283334

Last Updated: 2014-12-04

Results Overview

This phase 1 clinical trial used a standard 3 + 3 design. Four dose levels of everolimus were planned to be evaluated, and the standard 3 + 3 design with dose de-escalation was used in the trial. Namely, 3 patients were assigned to starting dose level 1. If no dose-limiting toxicity (DLT) was observed, the trial proceeded to the next dose level, and another cohort of 3 patients was enrolled. If at least 2 of the 3 patients experienced at least 1 DLT, then the dose level decreased; otherwise, if only 1 patient experienced DLT, then 3 more patients were enrolled at the same dose level. If none of the 3 additional patients experienced DLT, the dose was escalated; otherwise, the dose level decreased. Dose reduction continued until a dose level was reached at which 6 patients had been treated and at most 1 DLT was observed.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

20 participants

Primary outcome timeframe

Within the first 21 days of therapy

Results posted on

2014-12-04

Participant Flow

After institutional review board approval, the study enrolled 20 patients with recurrent or metastatic squamous cell carcinoma of the head and neck (RMSCCHN).

Participant milestones

Participant milestones
Measure
Carboplatin, Cetuximab and Everolimus
Carboplatin, cetuximab and RAD001 (everolimus) Carboplatin, cetuximab and RAD001: For phase I, dose escalation will be 2.5mg, 5mg, 7.5mg or 10mg given orally on a daily basis
Overall Study
STARTED
20
Overall Study
COMPLETED
13
Overall Study
NOT COMPLETED
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Carboplatin, Cetuximab and Everolimus
Carboplatin, cetuximab and RAD001 (everolimus) Carboplatin, cetuximab and RAD001: For phase I, dose escalation will be 2.5mg, 5mg, 7.5mg or 10mg given orally on a daily basis
Overall Study
Withdrawal by Subject
1
Overall Study
Inability to Swallow Everolimus Pills
1
Overall Study
Adverse Event
4
Overall Study
Physician Decision
1

Baseline Characteristics

A Study of Carboplatin, Cetuximab and RAD001 in Advanced Head and Neck Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Carboplatin, Cetuximab and Everolimus
n=20 Participants
Carboplatin, cetuximab and RAD001 (everolimus) Carboplatin, cetuximab and RAD001: For phase I, dose escalation will be 2.5mg, 5mg, 7.5mg or 10mg given orally on a daily basis
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
11 Participants
n=5 Participants
Age, Categorical
>=65 years
9 Participants
n=5 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
Sex: Female, Male
Male
18 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
Race (NIH/OMB)
White
14 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants
n=5 Participants
Region of Enrollment
United States
20 participants
n=5 Participants

PRIMARY outcome

Timeframe: Within the first 21 days of therapy

This phase 1 clinical trial used a standard 3 + 3 design. Four dose levels of everolimus were planned to be evaluated, and the standard 3 + 3 design with dose de-escalation was used in the trial. Namely, 3 patients were assigned to starting dose level 1. If no dose-limiting toxicity (DLT) was observed, the trial proceeded to the next dose level, and another cohort of 3 patients was enrolled. If at least 2 of the 3 patients experienced at least 1 DLT, then the dose level decreased; otherwise, if only 1 patient experienced DLT, then 3 more patients were enrolled at the same dose level. If none of the 3 additional patients experienced DLT, the dose was escalated; otherwise, the dose level decreased. Dose reduction continued until a dose level was reached at which 6 patients had been treated and at most 1 DLT was observed.

Outcome measures

Outcome measures
Measure
Everolimus Dose Level 1 DLT
n=6 Participants
Carboplatin, cetuximab and RAD001 (everolimus) at Dose Level 1 (2.5 mg/day)
Everolimus Dose Level -1 DLT
n=6 Participants
Carboplatin, cetuximab and RAD001 (everolimus) at Dose Level -1 (2.5 mg every other day)
To Measure the Safety and Clinical Effectiveness of the Combination of Carboplatin, Cetuximab and RAD001 in Patients With Advanced (Recurrent or Metastatic) Head and Neck Cancer
2 participants
1 participants

SECONDARY outcome

Timeframe: The time of PFS was calculated as the time from study enrollment to the disease progression date, death date, or last contact, whichever came first, up to 25 months

Objective tumor responses were assessed every 2 cycles of chemotherapy with computed tomography or positron emission tomography/ computed tomography scans in accordance with Response Evaluation Criteria In Solid Tumors (RECIST) criteria.

Outcome measures

Outcome measures
Measure
Everolimus Dose Level 1 DLT
n=13 Participants
Carboplatin, cetuximab and RAD001 (everolimus) at Dose Level 1 (2.5 mg/day)
Everolimus Dose Level -1 DLT
Carboplatin, cetuximab and RAD001 (everolimus) at Dose Level -1 (2.5 mg every other day)
Progression-free Survival (PFS)
8.15 months
Interval 1.0 to 37.0

Adverse Events

Carboplatin, Cetuximab and Everolimus

Serious events: 2 serious events
Other events: 7 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Carboplatin, Cetuximab and Everolimus
n=20 participants at risk
Carboplatin, cetuximab and RAD001 (everolimus) Carboplatin, cetuximab and RAD001: For phase I, dose escalation will be 2.5mg, 5mg, 7.5mg or 10mg given orally on a daily basis
Gastrointestinal disorders
Nausea and vomiting
5.0%
1/20 • Up to 25 months
Gastrointestinal disorders
Hemoptysis and death
5.0%
1/20 • Up to 25 months

Other adverse events

Other adverse events
Measure
Carboplatin, Cetuximab and Everolimus
n=20 participants at risk
Carboplatin, cetuximab and RAD001 (everolimus) Carboplatin, cetuximab and RAD001: For phase I, dose escalation will be 2.5mg, 5mg, 7.5mg or 10mg given orally on a daily basis
Blood and lymphatic system disorders
Neutropenia
35.0%
7/20 • Up to 25 months
Metabolism and nutrition disorders
Hyperglycemia
25.0%
5/20 • Up to 25 months
Immune system disorders
Anaphylaxis
20.0%
4/20 • Up to 25 months
Blood and lymphatic system disorders
Hypokalemia
20.0%
4/20 • Up to 25 months
Blood and lymphatic system disorders
Leukopenia
20.0%
4/20 • Up to 25 months
Blood and lymphatic system disorders
Hypophosphatemia
30.0%
6/20 • Up to 25 months
Skin and subcutaneous tissue disorders
Rash
15.0%
3/20 • Up to 25 months
General disorders
Fatigue
10.0%
2/20 • Up to 25 months
Blood and lymphatic system disorders
Hyponatremia
10.0%
2/20 • Up to 25 months
Blood and lymphatic system disorders
Anemia
5.0%
1/20 • Up to 25 months
Respiratory, thoracic and mediastinal disorders
Aspiration pneumonia
5.0%
1/20 • Up to 25 months
Gastrointestinal disorders
Diarrhea
5.0%
1/20 • Up to 25 months
Infections and infestations
Sepsis
5.0%
1/20 • Up to 25 months
Blood and lymphatic system disorders
Thrombocytopenia
5.0%
1/20 • Up to 25 months
Skin and subcutaneous tissue disorders
Mucositis
15.0%
3/20 • Up to 25 months

Additional Information

Nabil F. Saba, MD

Emory University

Phone: 404-778-1900

Results disclosure agreements

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