A Pilot Phase I Dose Escalation Study Of The EGFR Tyrosine Kinase Inhibitor Gefitinib (Iressa) Combined With Paclitaxel (Taxol) And External Beam Radiation Therapy In Patients With Advanced Squamous Cell Carcinoma Of The Head And Neck (SCCHN)
Data Collection
Squamous Cell Carcinoma of Head and Neck+6
+ Carcinoma
+ Carcinoma, Squamous Cell
Treatment Study
Summary
Study start date: May 1, 2004
Actual date on which the first participant was enrolled.OBJECTIVES: Primary * Determine the dose-limiting toxicity, toxicity profile, and maximum tolerated dose (MTD) of gefitinib and paclitaxel administered with radiotherapy in patients with advanced or recurrent squamous cell carcinoma of the head and neck. Secondary * Determine the efficacy of this regimen in patients treated at the MTD. OUTLINE: This is a pilot, dose-escalation study of gefitinib and paclitaxel. Patients receive oral gefitinib once daily beginning on day 1 and continuing until completion of radiotherapy. Patients receive paclitaxel IV over 1 hour on days 8, 15, 22, 29, 36, and 43 and undergo radiotherapy once daily on days 8-12, 15-19, 22-26, 29-33, 36-40, 43-47, 50-54, and 57-61. Treatment continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of gefitinib and paclitaxel until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. A cohort of 6 additional patients receive treatment at the MTD. Patients are followed monthly for 1 year, every 2 months for 1 year, and then every 3 months for 3 years. PROJECTED ACCRUAL: A total of 15-30 patients will be accrued for this study within 2 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.30 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed squamous cell (epidermoid) carcinoma of the oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, or maxillary sinus * Stage III or IV disease * Distant metastases allowed provided both of the following are true: * Metastases are confined to the head and neck region * Metastases are encompassable in a radiotherapy field with curative intent * Locally recurrent disease after primary surgery allowed * Meets 1 of the following criteria: * Unresectable disease * Patient prefers chemoradiotherapy over surgery * Measurable disease * No brain metastases and/or carcinomatous meningitis PATIENT CHARACTERISTICS: Age * 18 and over Performance status * Not specified Life expectancy * Not specified Hematopoietic * WBC ≥ 3,000/mm\^3 * Hemoglobin \> 10 g/dL * Platelet count \> 100,000/mm\^3 * Absolute neutrophil count ≥ 1,500/mm\^3 Hepatic * Bilirubin \< 2.0 times upper limit of normal (ULN) * AST/ALT ≤ 2.5 times ULN Renal * Creatinine \< 1.5 times ULN OR * Creatinine clearance ≥ 60 mL/min Cardiovascular * No symptomatic congestive heart failure * No unstable angina pectoris * No cardiac arrhythmia Pulmonary * No clinically active interstitial lung disease * Chronic, stable, asymptomatic radiographic changes allowed Other * No prior allergic reaction attributed to compounds of similar chemical or biological composition to study drugs or Cremophor\^® EL * No AIDS or primary immunodeficiencies * No other malignancy within the past 5 years except curatively treated squamous cell or basal cell skin cancer or carcinoma in situ of the cervix * Probability of recurrence of the prior malignancy \< 5% * No other concurrent uncontrolled illness * No ongoing or active serious infection * No psychiatric illness or situation that would preclude study compliance or giving informed consent * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * No prior chemotherapy for cancer * No other concurrent chemotherapy Endocrine therapy * Not specified Radiotherapy * No prior therapeutic radiotherapy to the head and neck region * No prior radiotherapy for cancer Surgery * See Disease Characteristics * At least 4 weeks since prior major surgery and recovered Other * No prior gefitinib or other epidermal growth factor receptor inhibitors * More than 4 weeks since prior non-approved or investigational agents * No concurrent administration of any of the following: * Phenytoin * Carbamazepine * Barbiturates * Rifampin * Hypericum perforatum (St. John's wort) * Oxcarbazepine * Rifapentine * Amifostine * Modafinil * Other CYP3A4 enzyme inducers * Other anticancer agents or investigational drugs * Combination antiretroviral therapy for HIV-positive patients
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.Study Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 2 locations
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
Bethesda, United StatesSee the locationNCI - Metabolism Branch;MET
Bethesda, United States