Irinotecan and Cisplatin in Treating Patients With Recurrent or Metastatic Head and Neck Cancer
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Purpose
RATIONALE: Drugs used in chemotherapy, such as irinotecan and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
PURPOSE: To determine if CPT-11 given together with cisplatin is effective in treating recurrent or metastatic head and neck cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Head and Neck Cancer |
Drug: cisplatin Drug: irinotecan hydrochloride |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Trial of Irinotecan Plus Cisplatin in Patients With Recurrent or Metastatic Squamous Carcinoma of the Head and Neck |
- Patient Response [ Time Frame: 6 weeks after last chemotherapy treatment ] [ Designated as safety issue: No ]Number of patients in each response category according to RECIST criteria: Progressive disease (PD): >=20% increase in sum of longest diameter (LD) of target lesion(s), taking as reference smallest sum LD recorded since treatment started. Complete response (CR): disappearance of all target lesions. Partial response (PR): >=30% decrease in sum of LD of target lesion(s), taking as reference baseline sum LD. Stable disease (SD): neither sufficient shrinkage to qualify as PR nor sufficient increase to qualify as PD.
- Number of Patients With Each Worst-grade Toxicity [ Time Frame: 6 weeks after last chemotherapy ] [ Designated as safety issue: Yes ]Number of patients with worst-grade toxicity response of each grade (grade 1 to 5) following NCI Common Toxicity Criteria, with grade 1=mild adverse event; 2=moderate adverse event; 3=severe and undesirable adverse event; 4=life-threatening or disabling adverse event; 5=death
| Enrollment: | 41 |
| Study Start Date: | February 2002 |
| Study Completion Date: | July 2008 |
| Primary Completion Date: | May 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Therapeutic Intervention |
Drug: cisplatin
Starting dose 30 mg/m2 Dose level -1 20 mg/m2
Other Name: Platinol,Platinol-AQ,cisdamminedichloroplatinum(II),kCDDP,DDP,DACP,cisplatinum,platinum
Drug: irinotecan hydrochloride
50 mg/m2 IV over 60 minutes, plus Cisplatin 30mig/m2 IV, repeated weekly for two weeks. followed by a one-week rest. This 3-week schedule given two times to equal one 6-week cycle. Maximum of 6 cycles.
Other Name: CPT-11
|
Detailed Description:
OBJECTIVES:
- Evaluate the efficacy of irinotecan hydrochloride and cisplatin in patients with local-regionally recurrent or metastatic squamous cell carcinoma of the head and neck.
- Evaluate the toxicity of irinotecan hydrochloride and cisplatin in these patients.
- Determine the palliative effect of irinotecan hydrochloride and cisplatin on head and neck cancer symptoms using the Vanderbilt Cancer Center (VICC) Head and Neck Cancer Symptom Survey.
OUTLINE: Patients receive irinotecan hydrochloride IV over 60 minutes and cisplatin IV on days 1, 8, 22, and 29. Treatment repeats every 6 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Patients complete the Vanderbilt Cancer Center (VICC) Head and Neck Cancer Symptom Survey at baseline, before each course, at the completion of study therapy, and then at each follow-up visit.
After completion of study therapy, patients are followed every 6 weeks for 1 year and then every 3 months thereafter.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically confirmed squamous cell carcinoma of the head and neck that is considered incurable with surgery or radiotherapy
Meets one of the following criteria:
Previously untreated disease
- Newly diagnosed disease with distant metastases
Recurrent or persistent disease
Local-regional recurrence/persistence or distant metastases after initial treatment with surgery or radiotherapy
- No locally advanced unresectable disease that was not previously treated with radiotherapy
Bidimensionally measurable disease
- If the only measurable disease is within the radiotherapy port, there must be biopsy-proven recurrence ≥ 8 weeks after the completion of radiotherapy
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Life expectancy ≥ 12 weeks
- Creatinine clearance ≥ 50 mL/min
- SGOT ≤ 3 times upper limit of normal
- Serum bilirubin < 1.5 mg/dL
- Granulocytes ≥ 1,500/mm ^3
- Platelet count > 100,000/mm^3
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No significant detectable infection
- No co-morbid disease unless under adequate control
- No other cancer within the past 3 years except basal cell or squamous cell skin cancer or early-stage prostate cancer
Exclusion Criteria:
-Pregnant or lactating women
Not specified
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Recovered from any prior major surgery
No prior chemotherapy for recurrent or metastatic disease
- Patients who completed neoadjuvant, concurrent, or adjuvant chemotherapy ≥ 3 months prior to recurrence will be considered chemotherapy-naive
- Patients who completed neoadjuvant, concurrent, or adjuvant chemotherapy < 3 months prior to recurrence will be considered chemotherapy failures
- No prior therapy with topotecan or irinotecan hydrochloride
- At least 4 weeks since prior biologic therapy (e.g., interleukin-2, interferon, megestrol acetate)
Contacts and Locations| United States, Georgia | |
| Central Georgia Hematology Oncology Associates, P.C. | |
| Macon, Georgia, United States | |
| United States, Tennessee | |
| Erlanger Health System | |
| Chattanooga, Tennessee, United States | |
| Jackson-Madison County Hospital | |
| Jackson, Tennessee, United States | |
| East Tennessee State University | |
| Johnson City, Tennessee, United States | |
| Center for Biomedical Research | |
| Knoxville, Tennessee, United States | |
| VA Tennessee Valley Healthcare Center | |
| Nashville, Tennessee, United States | |
| Meharry Medical College | |
| Nashville, Tennessee, United States | |
| Vanderbilt-Ingram Cancer Center | |
| Nashville, Tennessee, United States | |
| Study Chair: | Barbara A. Murphy, MD | Vanderbilt-Ingram Cancer Center |
More Information
Publications:
| Responsible Party: | Barbara Murphy, MD, Professor of Medicine; Director, Cancer Supportive Care Program; Director, Head and Neck Research Program; Medical Oncologist, Vanderbilt-Ingram Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00639769 History of Changes |
| Other Study ID Numbers: | VICC HN 0164, VU-VICC-HN-0164, VU-VICC-01-0847 |
| Study First Received: | March 19, 2008 |
| Results First Received: | October 11, 2010 |
| Last Updated: | September 7, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by Vanderbilt-Ingram Cancer Center:
|
recurrent squamous cell carcinoma of the hypopharynx stage IV squamous cell carcinoma of the hypopharynx stage IV squamous cell carcinoma of the larynx stage IV verrucous carcinoma of the larynx recurrent squamous cell carcinoma of the larynx recurrent verrucous carcinoma of the larynx recurrent squamous cell carcinoma of the lip and oral cavity stage IV squamous cell carcinoma of the lip and oral cavity recurrent verrucous carcinoma of the oral cavity stage IV verrucous carcinoma of the oral cavity metastatic squamous neck cancer with occult primary squamous cell carcinoma |
recurrent metastatic squamous neck cancer with occult primary untreated metastatic squamous neck cancer with occult primary recurrent squamous cell carcinoma of the nasopharynx stage IV squamous cell carcinoma of the nasopharynx recurrent squamous cell carcinoma of the oropharynx stage IV squamous cell carcinoma of the oropharynx recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity stage IV squamous cell carcinoma of the paranasal sinus and nasal cavity recurrent salivary gland cancer salivary gland squamous cell carcinoma stage IV salivary gland cancer |
Additional relevant MeSH terms:
|
Head and Neck Neoplasms Neoplasms by Site Neoplasms Irinotecan Cisplatin Camptothecin Antineoplastic Agents Therapeutic Uses |
Pharmacologic Actions Radiation-Sensitizing Agents Physiological Effects of Drugs Antineoplastic Agents, Phytogenic Topoisomerase I Inhibitors Topoisomerase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 21, 2013