NCT02381535

Brief Summary

This phase I trial studies the side effects and best dose of onalespib when given together with intensity-modulated radiation therapy (IMRT) and cisplatin in treating patients with squamous cell carcinoma of the head and neck that has spread from where it started to nearby tissue or lymph nodes. Onalespib works by blocking a protein called HSP90. HSP90 helps protect cells from stress and supports many other proteins that cause cell growth. When HSP90 is blocked, tumor cell growth may be slowed or stopped and may die more easily when treated with chemotherapy and radiation. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. IMRT is a specialized radiation therapy that delivers beams of radiation of different intensities aimed at the tumor from many angles and may kill more tumor cells and cause less damage to normal tissue. Giving onalespib with cisplatin and IMRT may kill more tumor cells.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2

participants targeted

Target at below P25 for phase_1

Timeline
Completed

Started Oct 2015

Longer than P75 for phase_1

Geographic Reach
2 countries

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 5, 2015

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 6, 2015

Completed
8 months until next milestone

Study Start

First participant enrolled

October 22, 2015

Completed
4.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 24, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 24, 2020

Completed
Last Updated

February 11, 2025

Status Verified

February 1, 2025

Enrollment Period

4.5 years

First QC Date

March 5, 2015

Last Update Submit

February 8, 2025

Conditions

Outcome Measures

Primary Outcomes (3)

  • Maximum tolerated dose determined by dose-limiting toxicity (DLT) of onalespib in combination with concurrent cisplatin and radiation therapy graded according to National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0

    8 weeks

  • Pharmacokinetic (PK) profile of onalespib in combination with cisplatin and radiation therapy

    Attempts to model associations between pharmacokinetic data with toxicity profiles will be performed primarily using descriptive statistics; however, logistic regression may be used if warranted.

    Baseline, 0.5, 1, 2, 3, 4, 6, 8, 9, and 24 hours on day -7; baseline, 0.5, 1, 2, 3, 4, 6, 8, 9, 24 hours on day 9; and baseline on day 24

  • PK profile of cisplatin in combination with concurrent onalespib and radiotherapy

    Attempts to model associations between pharmacokinetic data with toxicity profiles will be performed primarily using descriptive statistics; however, logistic regression may be used if warranted.

    Baseline, at end of cisplatin infusion, at 2, 4, 6, and 8-9 on day 8, and 24 hours on day 9, and at baseline on days 22 and 29

Secondary Outcomes (3)

  • Incidence of non-DLT adverse events (AEs)

    Up to 2 years

  • Antitumor activity

    Up to 2 years

  • Predictive biomarkers for individual cancer patients utilizing biopsies and genomic sequencing technologies

    Up to week 7

Study Arms (1)

Treatment (onalespib, cisplatin, IMRT)

EXPERIMENTAL

Patient receive onalespib IV over 1 hour on days -7, 3, 10, 24, 31, and 38 and cisplatin IV over 1 hour on days 1, 8, 15, 22, 29, 36 and 43. Patients also undergo IMRT QD, 5 days a week over 7 weeks for a total of 35 fractions. Treatment continues in the absence of disease progression or unacceptable toxicity.

Drug: CisplatinRadiation: Intensity-Modulated Radiation TherapyOther: Laboratory Biomarker AnalysisDrug: OnalespibOther: Pharmacological Study

Interventions

Given IV

Also known as: Abiplatin, Blastolem, Briplatin, CDDP, Cis-diammine-dichloroplatinum, Cis-diamminedichloridoplatinum, Cis-diamminedichloro Platinum (II), Cis-diamminedichloroplatinum, Cis-dichloroammine Platinum (II), Cis-platinous Diamine Dichloride, Cis-platinum, Cis-platinum II, Cis-platinum II Diamine Dichloride, Cismaplat, Cisplatina, Cisplatinum, Cisplatyl, Citoplatino, Citosin, Cysplatyna, DDP, Lederplatin, Metaplatin, Neoplatin, Peyrone's Chloride, Peyrone's Salt, Placis, Plastistil, Platamine, Platiblastin, Platiblastin-S, Platinex, Platinol, Platinol- AQ, Platinol-AQ, Platinol-AQ VHA Plus, Platinoxan, Platinum, Platinum Diamminodichloride, Platiran, Platistin, Platosin
Treatment (onalespib, cisplatin, IMRT)

Undergo IMRT

Also known as: IMRT, Intensity modulated radiation therapy (procedure), Intensity Modulated RT, Intensity-Modulated Radiotherapy, Radiation, Intensity-Modulated Radiotherapy
Treatment (onalespib, cisplatin, IMRT)

Correlative studies

Treatment (onalespib, cisplatin, IMRT)

Given IV

Also known as: AT 13387, AT-13387, AT13387
Treatment (onalespib, cisplatin, IMRT)

Correlative studies

Treatment (onalespib, cisplatin, IMRT)

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients must have a histologically or cytologically confirmed, previously untreated squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx
  • Tumors must be staged T1-4, N2b-3, M0 (human papillomavirus positive \[HPV\]+ or HPV negative \[-\]); patients with HPV+ tumors should have at least one high risk feature such as T4, N3, or smoking history of \> 10 pack years
  • The disease must be considered to be potentially curable by combined radiotherapy and cisplatin based chemotherapy
  • Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (Karnofsky \>= 70%)
  • Life expectancy of greater than 6 months
  • Absolute neutrophil count (ANC) \>= 1.5 x 10\^9/L
  • Hemoglobin \>= 9 g/dL
  • Platelets \>= 100 x 10\^9/L
  • Serum creatinine =\< 1.5 mg/dL (=\< 120 umol/L) OR calculated creatinine clearance (Cockcroft-Gault formula) \>= 50 mL/min OR 24-hour urine creatinine clearance \>= 50 mL/min
  • Bilirubin =\< 1.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) =\< 2.5 x ULN
  • Alanine aminotransferase (ALT) =\< 2.5 x ULN
  • Proteinuria =\< +1 on dipstick or =\< 1 gram/24 hours
  • Corrected QT using the Fridericia formula (QTcF) \< 470 msec
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, during the study participation, and for three months after the last dose of the drug; women of child-bearing potential must have a negative serum pregnancy test within 14 days prior to registration and agree to use effective contraception throughout the treatment period and for 3 months after the last dose of study treatment; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; men with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception; males should avoid fathering children during and for at least three months after therapy is completed
  • +2 more criteria

You may not qualify if:

  • Patients with nasopharyngeal, paranasal sinus, skin, or unknown primary site disease
  • Presence of distance metastases (M1)
  • History of another malignancy; exception: patients who have been disease-free for \> 3 years, or patients with a history of completely resected non-melanoma skin cancer and/or patients with indolent secondary malignancies, are eligible; consult the Cancer Therapy Evaluation Program (CTEP) Medical Monitor if unsure whether second malignancies meet the requirements specified above
  • Previous head and neck radiation therapy
  • Symptomatic peripheral neuropathy \> grade 2 by Common Terminology Criteria for Adverse Events (CTCAE) criteria
  • Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to AT13387
  • Current use of a prohibited medication; the following medications or non-drug therapies are prohibited: the concurrent use of all herbal supplements is prohibited during the study (including, but not limited to, St. John's wort, kava, ephedra \[ma huang\], ginkgo biloba, dehydroepiandrosterone \[DHEA\], yohimbe, saw palmetto, or ginseng)
  • History or current evidence/risk of visual loss syndromes, including but not limited to retinal vein occlusion (RVO), retinal detachment, macular degeneration, or visual migraine headaches
  • History or evidence of cardiovascular risk including any of the following:
  • History or evidence of current clinically significant uncontrolled arrhythmias (exception: patients with controlled atrial fibrillation for \> 30 days prior to randomization are eligible)
  • History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty, or stenting within 6 months prior to randomization
  • History or evidence of current \>= class II congestive heart failure as defined by the New York Heart Association (NYHA) functional classification system
  • Treatment-refractory hypertension defined as a blood pressure of systolic \> 140 mmHg and/or diastolic \> 90 mmHg which cannot be controlled by anti-hypertensive therapy
  • Patients with intra-cardiac defibrillators
  • Known hepatitis B virus (HBV), or hepatitis C virus (HCV) infection (patients with chronic or cleared HBV and HCV infection are eligible); patients with known human immunodeficiency virus (HIV) infection are eligible if not on antiviral agents and cluster of differentiation (CD)4 counts are adequate (\>= 500)
  • +4 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Yale University

New Haven, Connecticut, 06520, United States

Location

University Health Network-Princess Margaret Hospital

Toronto, Ontario, M5G 2M9, Canada

Location

MeSH Terms

Conditions

Squamous Cell Carcinoma of Head and Neck

Interventions

Cisplatin1,2-diaminocyclohexaneplatinum II citratePlatinumRadiotherapy, Intensity-Modulated(2,4-dihydroxy-5-isopropylphenyl)-(5-(4-methylpiperazin-1-ylmethyl)-1,3-dihydroisoindol-2-yl)methanone

Condition Hierarchy (Ancestors)

Carcinoma, Squamous CellCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasmsHead and Neck NeoplasmsNeoplasms by Site

Intervention Hierarchy (Ancestors)

Chlorine CompoundsInorganic ChemicalsNitrogen CompoundsPlatinum CompoundsMetals, HeavyElementsTransition ElementsMetalsRadiotherapy, ConformalRadiotherapy, Computer-AssistedRadiotherapyTherapeutics

Study Officials

  • Andrew J Hope

    University Health Network Princess Margaret Cancer Center LAO

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 5, 2015

First Posted

March 6, 2015

Study Start

October 22, 2015

Primary Completion

April 24, 2020

Study Completion

April 24, 2020

Last Updated

February 11, 2025

Record last verified: 2025-02

Locations