Brief Title
A Study of Neoadjuvant Bio-C/T Followed by Concurrent Bio-R/T in High-risk Locally Advanced Oral Squamous Cell Carcinoma
Official Title
A Phase II Study of Neoadjuvant Bio-chemotherapy With Cetuximab, Paclitaxel, and Cisplatin (CPC) Followed by Cetuximab-based Concurrent Bio-radiotherapy in High-risk Locally Advanced Oral Squamous Cell Carcinoma (OSCC)
Brief Summary
Surgical resection followed by concurrent chemoradiotherapy is considered as the standard of care for locally advanced OSCC (LAOSCC). Although the treatment could provide prompt local control, but it is also associated with high incidence of distant failure. Systemic chemotherapy given either before (neoadjuvant) or after (adjuvant) definitive local treatment has been extensively evaluated to improve the clinical outcome in LAOSCC. Regimens of taxane/cisplatin-based combinations have been shown to improve the treatment outcome of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) in neoadjuvant setting. Recently, cetuximab (Erbitux®), a monoclonal antibody against epidermal growth factor receptor (EGFR), has also been proven to be an efficient agent for advanced and/or refractory HNSCC with acceptable toxicity profiles. In current study, we shall evaluate the feasibility, efficacy and safety of a triplet bio-chemotherapy consisting of cetuximab, paclitaxel, and cisplatin followed by cetuximab-based concurrent bio-radiotherapy (CBRT) in patients with LAOSCC.
Detailed Description
Patients with high-risk, locally advanced (TxN2b~3 or T4N0~3, M0) OSCC will be eligible. To detect an interested objective response rate (p1) of 80% versus a non-interested response (p0) rate of 60%, with an α and 1-β of 0.05 and 0.2, respectively (two-sided test), including the estimated dropout rate of 10%, a total of 47 patients will be recruited.
Study Phase
Phase 2
Study Type
Interventional
Primary Outcome
The primary endpoint is the overall response rate after completion of the assigned treatment.
Secondary Outcome
Secondary endpoints include the response rate after neoadjuvant therapy, progression-free survival, overall survival, biomarker prediction, and toxicity.
Condition
Oral Cancer
Intervention
Cetuximab,Paclitaxel,Cisplatin
Study Arms / Comparison Groups
open label
Description: an open-labelled, single-arm
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
47
Start Date
September 2009
Completion Date
November 2013
Primary Completion Date
July 2011
Eligibility Criteria
Inclusion Criteria: 1. High-risk, locally advanced (TxN2b~3 or unresectable T4, M0) OSCC 2. Histologically confirmed squamous cell carcinoma 3. Performance status: Eastern Cooperative Oncology Group performance status (ECOG) 0-1 4. age 18 years or older, less than 70 years of age 5. Having signed informed consent 6. Measurable disease by CT or MRI 7. Adequate hematologic, hepatic and renal function Exclusion Criteria: 1. Prior radiotherapy for targeted lesions, chemotherapy, EGFR pathway targeting therapy 2. Prior surgery for cancer except for the purpose of diagnostic biopsy 3. Concomitant active 2nd malignancies or disease-free of malignancies < 3 years before the study except adequately treated in situ cervical cancer, or non-melanoma skin cancer 4. Concomitant anticancer therapies within the past 28 days 5. Severe cardiopulmonary diseases and other systemic disease under poor control 6. Uncontrolled chronic neuropathy 7. Women who are positive of pregnancy, or in breast-feeding 8. Known allergy to any study treatment 9. Legal incapacity 10. Significant disease which, in the investigator's opinion, would exclude the patient from the study
Gender
All
Ages
18 Years - 70 Years
Accepts Healthy Volunteers
No
Contacts
J Y Chang, M.D., ,
Location Countries
Taiwan
Location Countries
Taiwan
Administrative Informations
NCT ID
NCT00933387
Organization ID
T1309
Secondary IDs
EMR62202-845
Responsible Party
Sponsor
Study Sponsor
National Health Research Institutes, Taiwan
Collaborators
China Medical University Hospital
Study Sponsor
J Y Chang, M.D., Principal Investigator, National Health Research of Institutes
Verification Date
October 2009