Ponatinib for Squamous Cell Lung and Head and Neck Cancers

This study has suspended participant recruitment.
(Clinical hold enacted due to increased risk of blood clot.)
Sponsor:
Information provided by (Responsible Party):
Peter S. Hammerman, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier:
NCT01761747
First received: September 26, 2012
Last updated: October 22, 2013
Last verified: October 2013
  Purpose

This research study is a Phase II clinical trial, which tests the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific cancer. "Investigational" means that the drug is being studied. It also means that the FDA has not yet approved ponatinib for use in patients, including people with your type of cancer.

In order to participate on this study, it must first be determined whether or not a patient's lung or head and neck squamous cell cancer (SCC) has an alteration in FGFR kinase is made from an experimental test on your squamous cell cancer tissue sample. This experimental test is a "genetic test" or "genotyping test", which is a method used to study a tumor's genes. The results are for research purposes only and are not considered "genetic testing" for the purpose of diagnosing medical conditions. Cancers develop as a result of changes that occur in human genetic material (DNA); these changes are called mutations or alterations. This experimental test gives no information about any of the genes in the normal cells of the patient's body, but it helps identify abnormal genes (like FGFR kinase mutations or alterations) usually found only in cancer cells. We will use this experimental test to determine whether or not a tumor contains a required alteration/mutation and thus may respond to ponatinib.

Ponatinib is an investigational, oral anti-cancer drug designed to inhibit abnormal proteins found in cancer cells and may cause those cancer cells to die. In laboratory testing, ponatinib has been shown to inhibit a family of proteins called FGFR kinases, and this genetic alteration/mutation has been found in some squamous cell lung cancers. There is laboratory evidence that alterations/mutations in FGFR kinases in squamous cell lung cancers may be driving the growth of these tumors and that inhibiting these FGFR kinases with ponatinib may decrease or stop the growth of lung SCC.

In this research study, we are looking to see if the study drug, ponatinib, can keep cancer from growing.


Condition Intervention Phase
Non-Small Cell Lung Cancer, Head and Neck Cancer
Drug: ponatinib
Phase 2
Phase 3

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Study of Ponatinib in Advanced Lung and Head and Neck Cancers With FGFR Kinase Alterations

Resource links provided by NLM:


Further study details as provided by Dana-Farber Cancer Institute:

Primary Outcome Measures:
  • Response rate of patients with lung or head and neck SCC treated with ponatinib [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Investigate the response rate of patients with previously treated lung or head and neck SCC to ponatinib as defined by the proportion of subjects with investigator-assessed confirmed complete response (CR) or partial response (PR)


Secondary Outcome Measures:
  • Quantify the prevalence FGFR amplifications/mutations [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Test tumor DNA using molecular assays to measure the frequency of FGFR amplifications and mutations in study patients

  • Progression-free survival rate [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Establish the progression-free survival of patients with SCC treated with ponatinib

  • Define toxicities of ponatinib [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
    Number of Participants with Adverse Events as a Measure of Safety and Tolerability

  • Overall survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Measure the overall survival time of patients treated with ponatinib

  • Disease control [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Measure the disease control rate of patients treated with ponatinib

  • Determine the correlation FGFR amplifications/mutations with patient age, sex, disease stage, prior response to treatment and smoking history [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    For subjects with FGFR amplifications and for FGFR mutations we will ascertain the age, sex, disease stage, prior response to treatment and smoking history from past medical records and measure whether there are differences in these variables among subjects with amplification versus mutation.

  • Define the response rate to ponatinib is patients with FGFR amplifications versus mutations [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Identify the response rate to ponatinib for FGFR specific FGFR amplifications/mutations.


Estimated Enrollment: 40
Study Start Date: January 2013
Estimated Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Ponatinib Treatment Arm
Ponatinib taken by mouth daily
Drug: ponatinib
Other Name: AP24534

Detailed Description:

Patients will be asked to undergo some screening tests or procedures to find out if they can be in the research study. Many of these tests and procedures are likely to be part of regular cancer care and may be done even if it turns out that an individual does not take part in the research study. If a patient has had some of these tests or procedures recently, they may or may not have to be repeated. These screening tests include: medical history, physical examination, vital signs, performance status, assessment of tumor(s), CT scan or MRI scan of brain, routine blood tests, urine pregnancy test for women of childbearing potential and electrocardiogram. Additionally at the time of screening patients will undergo collection of an archival tumor tissue sample for tumor mutation testing.

If a patient takes part in this research study, he or she will be given a study drug-dosing calendar for each treatment cycle. Each treatment cycle lasts 4 weeks during which time the patient will be taking the study drug by mouth daily. The number of cycles the patient will receive will depend on how the patient is tolerating the ponatinib and if your cancer has worsened.

There is a possibility that the following tests or procedures may need to be done at times other than those listed below. These may be done if the research doctors determine they are medically necessary to monitor illness or any side effects a patient may be experiencing. It is important that patients call their research doctor if at any time they are experiencing side effects they cannot tolerate.

During all cycles patients will have a physical exam and be asked questions about their general health and specific questions about any problems that they might be having and any medications they might be taking.

If the patient's disease progresses while you are on this study, they will be given the option of consenting to a new biopsy for research purposes at no financial cost to the patient.

The investigators would like to keep track of your medical condition for the rest of each patient's life. The investigators would like to do this by calling every six months to see how the patients are doing. Keeping in touch with checking their condition helps the investigators look at the long-term effects of the research study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Measurable disease
  • Documented evidence of disease progression following most recent therapy
  • Estimated life expectancy greater than 12 weeks

Exclusion Criteria:

  • Pregnant or breastfeeding
  • Prior chemotherapy or brain radiotherapy within 4 weeks of entering study
  • Receiving other investigational agents
  • Untreated or progressive brain metastases
  • Prior treatment with or allergic reactions attributed to compounds of similar chemical or biologic composition to ponatinib
  • Known HIV positive on combination antiretroviral therapy
  • Clinically uncontrolled hypertension
  • Previous or concurrent malignancy except adequately treated basal or squamous cell skin cancer, in situ carcinoma of the cervix, or other solid tumor treated curatively and without evidence of recurrence for at least 5 years
  • Active or uncontrolled clinically significant infection
  • Chronic GI disease that may affect bioavailability of ponatinib
  • History of significant bleeding disorder unrelated to cancer
  • Uncontrolled intercurrent illness
  • Clinically significant ventricular arrythmia
  • History of chronic pancreatitis, alcohol abuse or uncontrolled hypertriglyceridemia
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01761747

Locations
United States, Massachusetts
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02215
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02215
Massachusetts General Hospital
Boston, Massachusetts, United States, 02214
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Sponsors and Collaborators
Dana-Farber Cancer Institute
Investigators
Principal Investigator: Peter Hammerman, MD, PhD Dana-Farber Cancer Institute
  More Information

No publications provided

Responsible Party: Peter S. Hammerman, Principal Investigator, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier: NCT01761747     History of Changes
Other Study ID Numbers: 12-327
Study First Received: September 26, 2012
Last Updated: October 22, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Dana-Farber Cancer Institute:
Squamous Cell Carcinoma

Additional relevant MeSH terms:
Carcinoma, Non-Small-Cell Lung
Head and Neck Neoplasms
Carcinoma, Bronchogenic
Bronchial Neoplasms
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Ponatinib
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 30, 2014