Phase I Chemoprevention Trial With Green Tea Polyphenon E & Erlotinib in Patients With Premalignant Lesions of the Head & Neck

NCT01116336 | Completed Phase 1 DMC

• 3 other identifiers: IRB00014010WCI1549-085P50CA128613
• Study Type: interventional
• Target: 25
• Locations: 1 country
• Sites: 3

Brief Summary

The purpose of this study is to test the preventive effects of a combination of drugs: polyphenon E (PPE) derived from green tea extracts, and erlotinib. Because this combination of drugs has not been tested in humans before for the prevention of cancer, it is not clear which dose of each agent will be optimal in combination. We will test the safety of the combination of PPE and erlotinib and see what effects (good and/or bad) it has on the patient's premalignant lesion, and find the highest dose of each agent that can be given in combination without causing severe side effects.

Conditions

Cancer of Head and Neck; Neoplasms, Head and Neck

Keywords

Pre-cancerous conditions; Head and neck tumors; Cancer of head and neck

Outcome Measures

Primary Outcomes (1)

• Maximum tolerated dose (MTD) of erlotinib when administered with a constant dose of green tea polyphenon E (PPE).

  Define MTD as the dose level of erlotinib when administered with a constant dose of 200 mg (EGCG) TID of Green Tea Polyphenon E (PPE) to a patient results in a probability equal to θ = 0.33 that a dose-limiting toxicity (DLT) will be manifest within 1 cycle defined as 28 days.

  Cytobrush/biopsy at three months

Secondary Outcomes (1)

• To assess the safety of the combination of PPE and erlotinib in patients receiving 3 different doses of erlotinib (50 mg, 75 mg, and 100 mg) in combination with PPE (200 mg EGCG TID) for 6 months.

  Baseline, 3, 6, and 12 months

Study Arms (1)

Erlotinib and Green Tea Polyphenon E

EXPERIMENTAL

Patients will receive erlotinib, at pre-defined dose level, with polyphenon E.

Drug: Erlotinib; Dietary Supplement: Green Tea Polyphenon E

Interventions

Erlotinib DRUG

Participants will be given erlotinib orally (dose escalation from 50 mg, 75 mg, or 100 mg daily continuously for 6 cycles (each cycle is 28 days).

Also known as: OSI-774, Tarceva

Erlotinib and Green Tea Polyphenon E

Green Tea Polyphenon E DIETARY_SUPPLEMENT

Participants will also be given PPE orally (200 mg EGCG) three times daily for 6 cycles (each cycle is 28 days). PPE capsules will be taken on a full stomach, within one hour after eating a substantial meal.

Also known as: EGCG

Erlotinib and Green Tea Polyphenon E

Eligibility Criteria

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

You may qualify if:

• Participants with premalignant lesions (mild dysplasia, moderate dysplasia, severe dysplasia, or carcinoma in situ) of the head and neck, as confirmed by biopsy within the 4 months prior to study entry or a treated primary T1N0 or T2N0 squamous cell carcinoma will be eligible.
• For patients with T1N0 or T2N0 treated squamous cell carcinoma, they must have been free of disease for a minimum period of 8 weeks, up to a maximum of 3 years following completion of surgery and/or radiotherapy.
• Eligible tumor and premalignant lesion sites include oral cavity (buccal mucosal, gingival, floor of mouth, dorsal/ventral tongue, pharyngeal wall), oropharynx, larynx (glottis, supraglottis, subglottis, epiglottis), hypopharynx paranasal sinus and nasal cavity.
• Patients with a treated tumor 1-node 0 (T1N0) or tumor 2-node 0 (T2N0) squamous cell carcinoma may have oral premalignant lesions (i.e., hyperplasia, dysplasia, carcinoma in situ) at the time of study entry (provided their Stage I or II disease has been definitively treated).
• Lesion sites include oral cavity (buccal mucosa, gingival, floor of mouth, dorsal/ventral tongue, pharyngeal wall), oropharynx, hypopharynx,larynx (glottis, supraglottis, subglottis, epiglottis), nasopharynx and paranasal sinuses.
• Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status of 0-1.
• No medical contraindications for flexible laryngoscopy using topical anesthesia, and in the setting of a contraindication to topical anesthesia, general anesthesia may not be used as a substitute.
• General anesthesia, if indicated, is acceptable in patients whose lesions would require general anesthesia for laryngoscopy and biopsy according to routine standard of care.
• Blood counts: total neutrophil count \> 1,500/mm³; platelet count \> 100,000/mm³.
• Adequate liver function:
• Total bilirubin level ≤ 1.5 times upper limit normal (ULN)
• Albumin \> 2.5 g/dl
• Alkaline phosphatase, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times ULN
• Adequate renal function: serum creatinine \< 1.5 mg/dl.
• Hemoglobin level ≥ 11gm/dl (age adjusted if appropriate) provided by the reference laboratory performing the test.

You may not qualify if:

• Because no dosing or adverse event data are currently available on the use of Polyphenon E in participants \< 18 years of age, children are excluded from this study.
• Participants with hyperplasia, in absence of dysplasia or carcinoma in situ, will be excluded because there is possibly no benefit.
• Participants with acute intercurrent illness or those who had surgery within the preceding 4 weeks unless they have fully recovered.
• History of previous malignancies unless the cancer was stage I or II and rendered free of disease more than 1 year.
• Participants who are pregnant or breast feeding. Pregnant women are excluded from this study because Polyphenon E is an investigational agent with 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 Polyphenon E, breastfeeding should be discontinued if the mother is treated with Polyphenon E.
• Not practicing adequate contraception if the participants are of child bearing potential.
• Uncontrolled intercurrent illness including, but not limited to, severe active infection, symptomatic congestive heart failure, myocardial infarction within the past six months, unstable angina pectoris, serious cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements are excluded.
• Documented history of coagulopathy such as hemophilia or Von Willebrand's disease or inherited thrombophilia.
• Hypertension not adequately controlled by medication (i.e. systolic blood pressure ≥ 150 and/or diastolic blood pressure ≥ 90 on at least two separate readings).
• History of congestive heart failure (CHF) greater than New York Heart Association (NYHA) Grade II.
• Participants who exhibit confusion, disorientation, or have a history of major psychiatric illness which may impair their understanding of the informed consent.
• Taking epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors within 3 months of study entry.
• Documented history of interstitial lung disease or pulmonary fibrosis.
• Known connective tissue disease.
• Patients who have participated in a clinical trial of an investigational drug within 12 months prior to enrollment.

Sponsors & Collaborators

• Emory University: lead
• Astellas Pharma Inc: collaborator
• Polyphenon Pharma: collaborator
• National Cancer Institute (NCI): collaborator

Study Sites (3)

Emory University Hospital Midtown

Atlanta, Georgia, 30308, United States

Location

Emory University Winship Cancer Institute

Atlanta, Georgia, 30322, United States

Location

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

Baltimore, Maryland, 21287, United States

Location

MeSH Terms

Conditions

Head and Neck Neoplasms

Interventions

Erlotinib Hydrochloride

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms

Intervention Hierarchy (Ancestors)

Quinazolines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds

Study Officials

• Dong M. Shin, MD

  Emory University Winship Cancer Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 9, 2010
• First Posted: May 5, 2010
• Study Start: March 1, 2010
• Primary Completion: May 1, 2018
• Study Completion: May 1, 2018
• Last Updated: December 5, 2018

Record last verified: 2018-12

Locations

US (3)