GSK1120212 in Surgically Resectable Oral Cavity Squamous Cell Cancer
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Purpose
This phase II trial studies how trametinib effects tumor cells in patients with oral cavity squamous cell carcinoma that can be removed by surgery. Trametinib may shrink the tumor by blocking an enzyme pathway needed for cell growth.
| Condition | Intervention | Phase |
|---|---|---|
|
Neoplasms, Oral Mouth Neoplasms |
Drug: GSK1120212 |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Window of Opportunity Trial With GSK1120212 in Surgically Resectable Oral Cavity Squamous Cell Cancer |
- To analyze tumor specific changes in putative tumor initiating cell populations as defined by cell surface CD44 and intracellular phospho-ERK1/2 staining after treatment with GSK1120212. [ Time Frame: 14 days ] [ Designated as safety issue: No ]
- Tumor specific findings will be analyzed for pathologic changes including proliferation (Ki-67 staining), tumor vasculature staining (microvessel density), ERK1/2 mediated changes in p27 (Kip1) & flow cytometric analysis of the peripheral blood & tumor. [ Time Frame: 14 days ] [ Designated as safety issue: No ]
- To measure the size of the tumors by clinical exam using WHO criteria to define whether GSK1120212 induces a clinical response [ Time Frame: 14 days ] [ Designated as safety issue: No ]
- 2. To use FDG-PET/CT imaging and established criteria (Young et al., Eur J Cancer, 35:1773-82) to define whether GSK1120212 induces radiologically detectable intratumoral metabolic changes in Oral Cavity Squamous Cell Carcinoma [ Time Frame: 14 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 20 |
| Study Start Date: | February 2013 |
| Estimated Study Completion Date: | October 2014 |
| Estimated Primary Completion Date: | October 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: GSK1120212 |
Drug: GSK1120212
GSK1120212 2mg PO daily for 14 days followed by FDG-PET/CT on Day 14.
|
Detailed Description:
The rationale for this study in oral cavity squamous cell carcinomas rests on pre-clinical findings demonstrating that (a) activation of the ERK1/2 kinases is associated with aggressive features, (b) this aggressive phenotype is directly linked to expression of CD44, a cell surface hyaluronan receptor and (c) this association between activated ERK1/2 and CD44 is also identified in human cell lines and primary tumors. These data suggest that ERK1/2 is targetable biochemical pathway in CD44 expressing cells. These cells represent putative cancer stem cells or tumor initiating cells that have been associated with worse patient outcomes. Thus, the application of GSK1120212 to target OCSCC is a specific translational application of our laboratory findings.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient must have histologically or cytologically confirmed oral cavity squamous cell carcinoma of stage 2, 3, 4a, or 4b.
- Patients by definition have disease at the primary tumor site of at least >2 centimeters.
- Patient's treatment plan must include primary tumor site biopsy followed by gross excision of the primary tumor site at a separate operative procedure.
Patient must be ≥ 18 years of age.
5.-Patient must have an ECOG performance status ≤ 2 (see Appendix 1).
- Patient must have normal bone marrow and organ function as defined below:
- Absolute neutrophil count ≥1,200/mcl
- Hemoglobin ≥9.0 g/dL
- Platelets ≥75,000/mcl
- PT/INR and PTT ≤1.5 x IULN
- LVEF ≥ILLN (by ECHO)
- Albumin ≥2.5 g/dL
- Total bilirubin ≤1.5 x IULN
- AST(SGOT)/ALT(SGPT) ≤2.5 x IULN
- Creatinine ≤1.5 x IULN OR
- Creatinine clearance ≥50 mL/min/1.73 m2 for patients with creatinine levels above institutional normal
- Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
- Patient must have the ability to swallow and retain orally administered medication.
- Patient (or legally authorized representative if applicable) must be able to understand and willing to sign an IRB approved written informed consent document.
- Both men and women and members of all races and ethnic groups are eligible for this trial.
Exclusion Criteria:
- Patients must not have had any prior head and neck cancer treatment.
- Patient must not have a history of other malignancy ≤ 3 years previous with the exception of basal cell or squamous cell carcinoma of the skin which were treated with local resection only or carcinoma in situ of the cervix.
- Patients must not be receiving any other investigational agents.
- Patient must not have a history or current evidence/risk of retinal vein occlusion (RVO) or central serous retinopathy (CSR), including a history of predisposing factors to RVO or CSR (e.g., uncontrolled glaucoma or ocular hypertension, uncontrolled systemic disease such as hypertension, diabetes mellitus, or history of hyperviscosity or hypercoagulability syndromes) or visible retinal pathology as assessed by ophthalmic exam that is considered a risk factor for RVO or CSR (such as evidence of new optic disc cupping, evidence of new visual field defects, or intraocular pressure > 21 mmHg).
- Patient must not have known symptomatic leptomeningeal or brain metastases or spinal cord compression.
- Patient must not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to GSK1120212 or other agents used in the study.
- Patient must not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels.
- Patient must not have an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Patient must not be pregnant and/or breastfeeding.
- Patient must not be known to be HIV-positive, hepatitis B-positive, or hepatitis C-positive (with the exception of chronic or cleared HBV or HCV infection, which will be allowed).
- Patient must not be taking any herbal supplements during the study (including but not limited to St. John's wort, kava, ephedra (ma huang), gingko biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, or ginseng). If a potential patient is taking any herbal supplements, s/he must discontinue prior to beginning study treatment.
- Patient must not have any history or evidence of cardiovascular risk including any of the following:
- QTcB ≥ 480 msec
- History or evidence of current clinically significant uncontrolled arrhythmias (exception: subjects with controlled atrial fibrillation for > 30 days prior to registration are eligible)
- History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within 6 months prior to registration
- History or evidence of current > Class II congestive heart failure as defined by New York Heart Association.
Contacts and Locations| Contact: Ravindra Uppaluri, M.D., Ph.D. | 314-362-6599 | uppalurir@ent.wustl.edu |
| Contact: Farley Johnson, MA, BA, CCRP | 314-747-9202 | johnsonf@wudosis.wustl.edu |
| United States, Missouri | |
| Washington University School of Medicine | Recruiting |
| St. Louis, Missouri, United States, 63110 | |
| Contact: Ravindra Uppaluri, M.D., Ph.D. 314-362-6599 uppalurir@ent.wustl.edu | |
| Contact: Farley Johnson, MA, BA, CCRP 314-747-9202 farleyj@wudosis.wustl.edu | |
| Sub-Investigator: Douglas Adkins, M.D. | |
| Sub-Investigator: Rajendra Apte, M.D. | |
| Sub-Investigator: Farrokh Dehdashti, M.D. | |
| Sub-Investigator: Jason Diaz, M.D. | |
| Sub-Investigator: Bruce Haughley, MB. ChB | |
| Sub-Investigator: Dorina Kallogjeri, M.D., MPH | |
| Sub-Investigator: James Lewis, M.D. | |
| Principal Investigator: Loren Michel, M.D. | |
| Sub-Investigator: Bruce Nussenbaum, M.D. | |
| Sub-Investigator: Randal Paniello, M.D. | |
| Sub-Investigator: Jay Piccirillo, M.D. | |
| Sub-Investigator: Jason Rich, M.D. | |
| Sub-Investigator: Barry Siegel, M.D. | |
| Sub-Investigator: Tanya Wildes, M.D. | |
| Principal Investigator: | Ravindra Uppaluri, M.D. Ph.D. | Washington University School of Medicine |
More Information
Additional Information:
Publications:
| Responsible Party: | Washington University School of Medicine |
| ClinicalTrials.gov Identifier: | NCT01553851 History of Changes |
| Other Study ID Numbers: | 201205124 |
| Study First Received: | March 12, 2012 |
| Last Updated: | February 12, 2013 |
| Health Authority: | United States: Institutional Review Board United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Neoplasms Carcinoma, Squamous Cell Neoplasms, Squamous Cell Mouth Neoplasms Carcinoma Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Head and Neck Neoplasms Neoplasms by Site Mouth Diseases Stomatognathic Diseases |
ClinicalTrials.gov processed this record on May 22, 2013