Study of Adding Cetuximab to Chemotherapy for the Treatment of Advanced and/or Recurrent Cervical Cancer (MITO CERV 2)
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Purpose
This study aims to assess the activity of a combination of cetuximab (weekly) with carboplatin + paclitaxel (every three weeks) comparing it to chemotherapy alone in terms of event-free survival (EFS).
| Condition | Intervention | Phase |
|---|---|---|
|
Cervical Cancer |
Drug: paclitaxel Drug: carboplatin Drug: cetuximab |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomized Phase II Study of Carboplatin and Paclitaxel +/- Cetuximab, in Advanced and/or Recurrent Cervical Cancer |
- event free survival [ Time Frame: after 3 and 6 cycles of treatment, and every 3 months thereafter ] [ Designated as safety issue: No ]
- toxicity [ Time Frame: after each treatment cycle ] [ Designated as safety issue: No ]
- overall survival [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- skin toxicity and correlation with cetuximab activity [ Time Frame: after 3 and 6 cycles of therapy, and every 3 months thereafter ] [ Designated as safety issue: No ]
- EGFR/KRAS expression and correlation with cetuximab activity [ Time Frame: at 18 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 108 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm A
chemotherapy plus cetuximab
|
Drug: paclitaxel
175 mg/m2 IV day 1, every 21 days
Drug: carboplatin
AUC 5 IV day 1 every 21 days
Drug: cetuximab
400 mg/m2 IV, one week before starting carboplatin and paclitaxel; then 250 mg/m2 IV day 1, weekly
|
|
Active Comparator: Arm B
chemotherapy
|
Drug: paclitaxel
175 mg/m2 IV day 1, every 21 days
Drug: carboplatin
AUC 5 IV day 1 every 21 days
|
Detailed Description:
The poor long-term results in the standard treatment of chemotherapy for cervical cancer make research into new, more beneficial treatment strategies necessary. Cetuximab is a new type of drug that blocks the epidermal growth factor receptor (anti-EFGR), and has shown significant activity in other cancers (colon, head and neck) where expression of EGFR is high. Cervical cancer cells express EGFR in a very high proportion of cases, especially in recurrent or resistant disease. This study evaluates the activity of the addition of cetuximab to full doses of carboplatin and paclitaxel.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Advanced and/or metastatic cervical cancer patients untreated or having failed only one previous chemotherapy (with at least 6 months of progression free interval, with or without concomitant or sequential radiotherapy).
- At baseline, presence of at least one measurable target lesion (a lesion that can be accurately measured in at least one dimension i.e. longest diameter at least 20 mm with conventional CT scan or at least 10 mm with spiral CT scan according to RECIST Criteria).
- Not amenable to surgery and/or radiotherapy.
- PS 0-1 according to ECOG.
- Age >18.
- Life expectancy of at least 3 months.
Adequate organ functions
- Hematopoietic: Leukocytes > 3,000/mm3; Absolute neutrophil count > or = 1,500/mm3; Platelets count > or = 100,000/mm3; Hemoglobin > or = 9 g/dL
Hepatic: AST and ALT < or = 3 times upper limit of normal (ULN)*; Alkaline phosphatase < or = 3 times ULN*; Bilirubin < or = 1.5 times ULN
*: < or = 5 times ULN if liver metastases are present
- Renal: Creatinine clearance > or = 45 mL/min
- No other invasive malignancy within the past 5 years except non-melanoma skin cancer.
- All radiology studies must be performed within 28 days prior to randomization.
- Absence of any psychological, familial, sociological or geographical conditions potentially hampering compliance with the study protocol and follow-up schedule.
- Written informed consent.
Exclusion Criteria:
- Pregnant (potentially fertile patients must use contraceptive measures to avoid pregnancy during and for at least 3 months after study participation and must have a negative serum pregnancy test at baseline).
- Patients should not be breast-feeding during treatment and for 2 months following the end of treatment.
- More than one previous chemotherapy line.
- Active infection requiring antibiotics.
- Symptomatic peripheral neuropathy >grade 2 according to the CTCAE.
- Congestive heart failure or angina pectoris even if it is medically controlled. Previous history of myocardial infarction within 1 year from study entry, uncontrolled high risk hypertension or arrhythmia.
- Known hypersensitivity to the study drugs or to drugs with similar chemical structures.
- Concurrent treatment with other experimental drugs.
- Participation in another clinical trial with any investigational drug within 30 days prior to study screening.
Contacts and Locations| Contact: Sandro Pignata, M.D., Ph.D. | +39 081 5903637 | sandro.pignata@istitutotumori.na.it |
| Contact: Francesco Perrone, M.D., Ph.D. | +39 081 5903571 | francesco.perrone@usc-intnapoli.net |
| Italy | |
| Ospedale Senatore Antonio Perrino | Recruiting |
| Brindisi, Italy | |
| Ospedale Oncologico A. Businco | Recruiting |
| Cagliari, Italy | |
| Universita Cattolica del Sacro Cuore | Recruiting |
| Campobasso, Italy | |
| Istituto Romagnolo per lo Studio e la Cura dei Tumori | Recruiting |
| Meldola, Italy | |
| Istituto Nazionale Tumori | Recruiting |
| Milano, Italy | |
| A.O. Unversitaria Policlinico | Recruiting |
| Modena, Italy | |
| Istituto Nazionale dei Tumori , Oncologia Medica - Dipartimento Uro-Ginecologico | Recruiting |
| Napoli, Italy, 80131 | |
| Seconda Università di Napoli | Recruiting |
| Napoli, Italy | |
| A.O. Universitaria Federico II | Recruiting |
| Napoli, Italy | |
| Istituto Oncologico Veneto | Recruiting |
| Padova, Italy | |
| Ospedale Silvestrini | Recruiting |
| Perugia, Italy | |
| Istituto Regina Elena | Recruiting |
| Roma, Italy | |
| Universita Cattolica del Sacro Cuore | Recruiting |
| Roma, Italy | |
| Ospedale S. Chiara | Recruiting |
| Trento, Italy | |
| A.O. di Udine S. Maria della Misericordia | Recruiting |
| Udine, Italy | |
| Principal Investigator: | Sandro Pignata, M.D., Ph.D. | National Cancer Institute, Naples |
| Principal Investigator: | Francesco Perrone, M.D., Ph.D. | National Cancer Institute, Naples |
| Principal Investigator: | Alessandro Morabito, M.D., | National Cancer Institute, Naples |
| Principal Investigator: | Ciro Gallo, M.D., Ph.D. | Second University of Naples |
More Information
No publications provided
| Responsible Party: | National Cancer Institute, Naples |
| ClinicalTrials.gov Identifier: | NCT00997009 History of Changes |
| Other Study ID Numbers: | MITO CERV 2, 2009-010099-74 |
| Study First Received: | October 15, 2009 |
| Last Updated: | January 15, 2013 |
| Health Authority: | Italy: Ethics Committee |
Keywords provided by National Cancer Institute, Naples:
|
EGFR chemotherapy |
Additional relevant MeSH terms:
|
Uterine Cervical Neoplasms Uterine Neoplasms Genital Neoplasms, Female Urogenital Neoplasms Neoplasms by Site Neoplasms Uterine Cervical Diseases Uterine Diseases Genital Diseases, Female Cetuximab |
Carboplatin Paclitaxel Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action Antineoplastic Agents, Phytogenic |
ClinicalTrials.gov processed this record on May 23, 2013