Circulating Tumor Cells as an Early Predictive head-and -Neck Squamous-cell Carcinoma

NCT02119559 | Unknown

• 2 other identifiers: 8825ID-RCB:2011-A01174-37
• Study Type: interventional
• Target: 115
• Locations: 1 country
• Sites: 1

Brief Summary

In France, the incidence of head and neck squamous cell carcinomas (HNSCC) is 16 000 new cases/year. During these last years, many new chemotherapies and targeted therapies have been developed improving significantly the overall survival of patients notably anti-HER molecules. In inoperable recurrent and/or metastatic HNSCC, the best treatment is based on an anti-Human Epidermal Growth Factor Receptor (EGFR) antibody, targeting Human Epidermal Growth Factor Receptor 1 (HER1), the Cetuximab combined with platinum +/- 5 Fluoro Uracil (5FU): " Extreme protocol ". However, no clinical or biological criteria predictive of drug efficacy have been reported yet. Thus, the development of such a predictive factor is an urgent need in HNSCC at both the clinical and pharmacy-economic level, to propose the best personalized treatment. One idea would be to enumerate and characterize the circulating tumor cells (CTC) which could give us an early evaluation of the therapeutic efficiency. In this context, the investigators have developed an innovative technology, the EPISPOT assay (patent of the University Medical Center of Montpellier), that allows the detection \& characterization of viable CTC in the peripheral blood. The EPISPOT technology has been already evaluated in the breast and prostate cancer.Thus, the investigators would like for the first time to perform a prospective study on a cohort of patients treated following the Extreme protocol, with this technology, to assess the predictive value of CTC count. The investigators will use the CellSearch® system as the reference test.

Conditions

Metastatic Head-and-neck Squamous-cell Carcinoma

Keywords

Circulating Tumor Cells; Treatment Efficiency; Biomarker

Outcome Measures

Primary Outcomes (1)

• Predictive value of the CTC on the Progression Free Survival

  The primary outcome aims to evaluate the predictive value of the early progression of the CTC performed with the EPISPOT assay on the progression free survival in a cohort of patients treated with protocol "Extreme". The progression disease is assessed based on imagery techniques.

  Duration study 2 years

Secondary Outcomes (6)

• Prognostic value of the CTC at baseline (EPISPOT) and to compare for the first time the results with those obtained with the CellSearch system.

  Duration study 2 years

• Prognostic value of the CTC at baseline (EPISPOT)

  Duration study 2 years

• Predictive value of the early progression of CTC (EPISPOT) on the overall survival

  Duration study 2 years

• Compare for the first time the results with those obtained with the CellSearch® system

  Duration study 2 years

• Evaluate the expression of EGFR in CTCs before and after administration of cetuximab (Erbitux) with both technologies and EPISPOT CellSearch ®

  Duration study 2 years

Study Arms (1)

CTC assay, Cetuximab

OTHER

Detection \& characterization of viable CTC in the peripheral blood.

Other: Blood analysis by EPISPOT and CellSearch®

Interventions

Blood analysis by EPISPOT and CellSearch® OTHER

Also known as: A counting of CTC using three technologies: EPISPOT, CellSearch®, flow cytometer sorter/analyzer.

CTC assay, Cetuximab

Eligibility Criteria

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

You may qualify if:

• Age \> 18 yo.
• Histologically or cytologically confirmed recurrent and/or metastatic Squamous Cell Carcinoma Head and Neck (SCCHN) (excluding nasopharyngeal carcinoma) not suitable for local therapy : surgery and/or radiotherapy ; or metastatic disease with or without primary evolving tumor.
• Target definable with Response Evaluation Tumors Criteria in Solid (RECIST) 1.1 criteria.
• WHO performance status 0,1 or 2.
• Patient eligible for first line chemotherapy based on cisplatin (100 mg/m2 as a 1-hour intravenous (IV) infusion on day 1) or carboplatin (AUC 5 mg/ml.min by 1-hour IV infusion, day 1) and an infusion of 5-FU (1000 mg/m2/day for 4 days) every 3 weeks, with cetuximab (initial dose of 400 mg/m2 \[2-hour IV infusion\] followed by subsequent weekly doses of 250 mg/m2 \[1-hour IV infusion\], ending at least 1 hour before the start of chemotherapy).
• Consent form for participation signed.

You may not qualify if:

• Other chemotherapy protocol not involving platinum and cetuximab.
• Other proven synchronous evolving cancer.
• Evolving infectious disease or severe other disease preventing the patient from receiving treatment.
• Patient refusal.
• Patient unable to consent.
• Pregnant or breastfeeding, or premenopausal women not taking effective contraception.
• Current Participation to other clinical trial except experimental molecules.
• Vulnerable persons protected by law.
• People under guardianship

Sponsors & Collaborators

• University Hospital, Montpellier: lead
• National Cancer Institute, France: collaborator

Study Sites (1)

Department of Otorhinolaryngology, CHU Gui de Chauliac

Montpellier, 34295, France

RECRUITING

Related Publications (2)

• Garrel R, Mazel M, Perriard F, Vinches M, Cayrefourcq L, Guigay J, Digue L, Aubry K, Alfonsi M, Delord JP, Lallemant B, Even C, Daures JP, Landais P, Cupissol D, Alix-Panabieres C. Circulating Tumor Cells as a Prognostic Factor in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: The CIRCUTEC Prospective Study. Clin Chem. 2019 Oct;65(10):1267-1275. doi: 10.1373/clinchem.2019.305904. Epub 2019 Aug 6.

  PMID: 31387885 DERIVED

• Le Louedec F, Alix-Panabieres C, Lafont T, Allal BC, Garrel R, Digue L, Guigay J, Cupissol D, Delord JP, Lallemant B, Alfonsi M, Aubry K, Mazel M, Becher F, Perriard F, Chatelut E, Thomas F. Cetuximab pharmacokinetic/pharmacodynamics relationships in advanced head and neck carcinoma patients. Br J Clin Pharmacol. 2019 Jun;85(6):1357-1366. doi: 10.1111/bcp.13907. Epub 2019 Apr 13.

  PMID: 30811063 DERIVED

MeSH Terms

Conditions

Squamous Cell Carcinoma of Head and Neck; Neoplastic Cells, Circulating

Condition Hierarchy (Ancestors)

Carcinoma, Squamous Cell; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Head and Neck Neoplasms; Neoplasms by Site; Neoplasm Metastasis; Neoplastic Processes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• RENAUD GARREL, MD

  CHU GUI DE CHAULIAC

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Catherine Alix Panabieres, PhD

CONTACT

+33467330305; c-panabieres@chu-montpellier.fr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 28, 2014
• First Posted: April 21, 2014
• Study Start: September 1, 2012
• Primary Completion: October 1, 2017
• Study Completion: March 1, 2018
• Last Updated: December 3, 2014

Record last verified: 2012-09

Locations

FR (1)