Trial of Radiotherapy and Panitumumab in Salivary Gland Malignancies

NCT00984217 | Withdrawn Phase 2 DMC

• 1 other identifier: 08-112
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 27

Brief Summary

Standard therapy for high-risk or locally advanced salivary gland malignancies is surgery followed by postoperative radiation therapy. Retrospective studies have shown the superiority of combined modality therapy compared to surgery alone for patients with advanced T or N stage. Despite the addition of postoperative radiation therapy, the five-year survival for locally advanced salivary gland malignancies is poor (less than 60%). In salivary gland malignancies, the epidermal growth factor receptor (EGFR) is expressed in 25-85%; in certain histological types, like salivary duct carcinomas, the expression is higher. EGFR is a promising target of anticancer therapy. In squamous cell carcinoma of the head and neck, a phase III trial utilizing cetuximab added to radiation therapy improved both locoregional control and overall survival compared to radiation alone. Panitumumab is a novel, human, IgG2 EGFR monoclonal antibody that may be better tolerated and more efficacious than cetuximab. Here, the investigators suggest that the addition of panitumumab to standard radiotherapy in locally-advanced salivary gland malignancies will improve recurrence-free survival (RFS).

Conditions

Adenoma, Pleomorphic; Mixed Salivary Gland Tumor; Salivary Gland Tumor, Mixed; Syringoma, Chondroid

Keywords

panitumumab; salivary gland malignancies; radiotherapy

Outcome Measures

Primary Outcomes (1)

• To evaluate the recurrence-free survival of advanced salivary gland cancer patients undergoing postoperative chemoradiotherapy with panitumumab compared to historical control data

  3 years

Secondary Outcomes (3)

• To evaluate the overall survival, local recurrence-free survival, distant recurrence-free survival and toxicities.

  3 years

• To correlate efficacy parameters with a) EGFR and downstream pathway activation, b) FcyR polymorphisms, and c) serum cytokine profiles.

  3 years

• To collect tumor tissue from pretreatment biopsies for cytokine/chemokine and immune biomarker studies on tumor tissue.

  3 years

Study Arms (1)

Panitumumab

EXPERIMENTAL

Panitumumab 2.5 mg/Kg IV, weekly during radiation (total of 6-8 doses).

Radiation: Radiation; Drug: Panitumumab

Interventions

Radiation RADIATION

Radiation 64-70Gy (2.0 Gy/day, 5 days/week)

Panitumumab

Panitumumab DRUG

2.5 mg/Kg IV, weekly during RT. 6-7 weeks

Panitumumab

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Pathologically determined salivary gland cancer of the major or minor salivary glands of the head and neck (any histology) status post potentially curative surgical resection with no macroscopic residual disease. Patients should have AJCC 6th edition stage III with:
• extracapsular extension,
• perineural invasion,
• positive surgical margins or
• high grade histology (i.e., high grade mucoepidermoid carcinoma, adenocarcinoma except basal cell adenocarcinoma, salivary duct carcinoma, squamous cell carcinoma, or adenoid cystic carcinoma) or stage IVA or IVB.
• No distant metastasis.
• No prior chemotherapy, biologic/targeted therapy (including any prior therapy which specifically and directly targets the EGFR pathway), or radiotherapy for head and neck cancer.
• No more than 10 weeks (minimum of 3 weeks) should elapse between surgery and treatment on study.
• ECOG performance status of 0-2
• Patients must have normal organ and marrow function as defined below:
• Absolute neutrophil count: Greater than or equal to 1500/uL
• Platelets: Greater than or equal to 100,000/uL
• Hemoglobin: Greater than or equal to 10g/dL
• Total bilirubin: \< 1.5x normal institutional limits
• Creatinine clearance: \> 45 mL/min

You may not qualify if:

• Informed consent must be obtained from all patients prior to beginning therapy. Patients should have the ability to understand and the willingness to sign a written informed consent document.
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements.
• Significant history of uncontrolled cardiac disease; i.e., uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, and cardiomyopathy with decreased ejection fraction. All patients will have a baseline EKG. If abnormalities consistent with active coronary artery disease are detected, the patient will be referred to a cardiologist for appropriate evaluation and management prior to treatment on study.
• Patients may not be receiving any other investigational agents.
• No history of prior malignancy, with the exception of basal carcinoma of the skin or in situ cervical cancer, or malignancy that has been treated with a curative intent with a 3-year disease-free survival.
• Pregnant women are excluded from this study because chemotherapy and radiation therapy have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with chemotherapy, breastfeeding should be discontinued if the mother is treated with chemotherapy. Prior to study enrollment, women of childbearing potential (WOCBP) must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. In addition, men enrolled on this study should understand the risks to any sexual partner of childbearing potential and should practice an effective method of birth control.
• All WOCBP MUST have a negative urine pregnancy test at baseline, or within 7 days prior to receiving investigational product. The minimum sensitivity of the pregnancy test must be 25 IU/L or equivalent units of HCG. If the urine pregnancy test is positive, a serum pregnancy test will then be performed to confirm the result. In the event that both the urine and serum pregnancy tests are positive, the subject must not receive investigational product and must not be enrolled in the study.
• In addition, all WOCBP should be instructed to contact the Investigator immediately if they suspect they might be pregnant (e.g., missed or late menstrual period) at any time during study participation.
• The Investigator must immediately notify Amgen in the event of a confirmed pregnancy in a patient participating in the study.
• Prior severe infusion reaction to a human monoclonal antibody.
• Prior radiotherapy, chemotherapy or EGFR inhibitor for head and neck cancer.

Sponsors & Collaborators

• University of Pittsburgh: lead
• Amgen: collaborator

Study Sites (27)

UPMC Cancer Center - Teramana Cancer Center - Steubenville

Steubenville, Ohio, 43952, United States

Location

UPMC Cancer Center - Beaver

Beaver, Pennsylvania, 15009, United States

Location

UPMC Cancer Center - Clairton

Clairton, Pennsylvania, 15025, United States

Location

UPMC Cancer Center - Arnold Palmer Pavilion - Greensburg

Greensburg, Pennsylvania, 15601, United States

Location

UPMC Cancer Center - Oakbrook Commons - Greensburg

Greensburg, Pennsylvania, 15601, United States

Location

UPMC Cancer Center - Oakbrook Commons

Greensburg, Pennsylvania, 15601, United States

Location

UPMC Cancer Center -Arnold Palmer Pavilion

Greensburg, Pennsylvania, 15601, United States

Location

UPMC Cancer Center - Indiana

Indiana, Pennsylvania, 15701, United States

Location

UPMC Cancer Center - John P. Murtha Pavilion - Johnstown

Johnstown, Pennsylvania, 15901, United States

Location

UPMC Cancer Center - McKeesport

McKeesport, Pennsylvania, 15132, United States

Location

UPMC Cancer Center - Monroeville

Monroeville, Pennsylvania, 15146, United States

Location

UPMC Cancer Center - Sewickley Medical Oncology/Hematology Group

Moon Township, Pennsylvania, 15108, United States

Location

UPMC Cancer Center -Mt. Pleasant

Mount Pleasant, Pennsylvania, 15666, United States

Location

UPMC Cancer Center - New Castle

New Castle, Pennsylvania, 16105, United States

Location

UPMC Presbyterian -Radiation Oncology

Pittsburgh, Pennsylvania, 15213, United States

Location

UPMC Cancer Center - St. Margaret's

Pittsburgh, Pennsylvania, 15215, United States

Location

UPMC Cancer Center -Delafield Rd.

Pittsburgh, Pennsylvania, 15215, United States

Location

Hillman Cancer Center: University of Pittsburgh Cancer Institute / UPMC Department of Radiology

Pittsburgh, Pennsylvania, 15232, United States

Location

UPMC Cancer Center -UPMC Shadyside

Pittsburgh, Pennsylvania, 15232, United States

Location

UPMC Cancer Centers

Pittsburgh, Pennsylvania, 15232, United States

Location

UPMC Cancer Center - Passavant

Pittsburgh, Pennsylvania, 15237, United States

Location

UPMC Cancer Center - Upper St. Clair

Pittsburgh, Pennsylvania, 15241, United States

Location

UPMC Cancer Center -Drake

Pittsburgh, Pennsylvania, 15241, United States

Location

UPMC Cancer Center -UPMC Northwest

Seneca, Pennsylvania, 16346, United States

Location

UPMC Cancer Center - Uniontown

Uniontown, Pennsylvania, 15401, United States

Location

UPMC Cancer Center - Washington

Washington, Pennsylvania, 15301, United States

Location

UPMC Cancer Center - North Hills

Wexford, Pennsylvania, 15090, United States

Location

MeSH Terms

Conditions

Adenoma, Pleomorphic

Interventions

Radiation; Panitumumab

Condition Hierarchy (Ancestors)

Neoplasms, Complex and Mixed; Neoplasms by Histologic Type; Neoplasms; Adenoma; Neoplasms, Glandular and Epithelial

Intervention Hierarchy (Ancestors)

Physical Phenomena; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins

Study Officials

• Michael K. Gibson, MD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 23, 2009
• First Posted: September 25, 2009
• Study Start: August 1, 2011
• Primary Completion: August 1, 2011
• Study Completion: August 1, 2011
• Last Updated: January 8, 2016

Record last verified: 2016-01

Locations

US (27)