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Phase I Study of Induction Chemotherapy Comprising Carboplatin and Capecitabine Followed By Concurrent Carboplatin, Capecitabine, and Intensity-Modulated Radiotherapy in Patients With Stage III-IVB Squamous Cell Carcinoma of the Head and Neck
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Trial Contact Information Registry Information
Alternate Title
Carboplatin, Capecitabine, and Radiation Therapy in Treating Patients With Stage III or Stage IV Head and Neck Cancer
Basic Trial Information
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Protocol IDs
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Phase I
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Treatment
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Completed
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18 and over
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NCI, Pharmaceutical / Industry
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UVACC-HIC-10519 UVACC-27402, BMS-UVACC-HIC-10519, NCT00114153
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Objectives Primary - Determine the maximum tolerated dose (MTD) of capecitabine when administered with carboplatin as induction chemotherapy in patients with stage III-IVB squamous cell carcinoma of the head and neck.
- Determine the MTD of capecitabine when administered with concurrent carboplatin and intensity-modulated radiotherapy in these patients.
- Determine the toxicity of this regimen in these patients.
Secondary - Determine, preliminarily, tumor response in patients treated with this regimen.
- Determine the quality of life of patients treated with this regimen.
Entry Criteria Disease Characteristics:
- Histologically confirmed squamous cell carcinoma of the head and neck, including 1 of the following types:
- Oral cavity
- Oropharynx
- Hypopharynx
- Clinical stage III-IVB (T2-T4, N0-N3, M0) disease
- Measurable disease by physical exam, endoscopy, and/or CT scan or MRI
- Residual measurable disease after fine needle aspiration, core needle biopsy, or incisional or excisional biopsy of the primary tumor
- No evidence of distant metastases (M1)
Prior/Concurrent Therapy:
Biologic therapy Chemotherapy - More than 5 years since prior chemotherapy
Endocrine therapy Radiotherapy - No prior radiotherapy for head and neck tumor
- No prior radiotherapy to the region of planned study radiotherapy fields
Surgery - Recovered from prior surgery
- No unhealed surgical wounds
Other - More than 4 weeks since prior investigational drugs
- No concurrent warfarin, diphenylhydantoin, or fluconazole unless willing to undergo careful monitoring and appropriate dose adjustments
Patient Characteristics:
Age Performance status Life expectancy Hematopoietic - Absolute neutrophil count > 1,500/mm3
- Platelet count > 100,000/mm3
- Hemoglobin > 9 g/dL
- No uncontrolled coagulopathy
Hepatic - AST < 2 times normal
- Alkaline phosphatase < 2 times normal
- Bilirubin normal
Renal - Creatinine < 2.0 mg/dL
OR - Creatinine clearance > 50 mL/min
Cardiovascular - No congestive heart failure
- No symptomatic coronary artery disease
- No uncontrolled cardiac arrhythmias
- No myocardial infarction within the past year
- No other clinically significant cardiac disease
Other - Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for at least 30 days after completion of study treatment
- Nutritional and general physical condition must be compatible with proposed study treatment
- Mentally reliable
- No pre-existing peripheral neuropathy > grade 1
- No history of hypersensitivity to fluorouracil, capecitabine, or carboplatin
- No active infection
- No other malignancy within the past 5 years except nonmelanoma skin cancer
- No major medical, psychiatric, or neurologic illness that would preclude study participation or giving informed consent
Expected Enrollment 48Approximately 6-48 patients will be accrued for this study. Outline This is a dose-escalation study of capecitabine. - Induction chemotherapy: Patients receive carboplatin IV on days 1, 8, 15, 22, 29, and 36 and oral capecitabine twice daily on days 1-14 and 22-35.
- Concurrent chemoradiotherapy: Beginning 2 weeks after completion of induction chemotherapy, patients receive carboplatin and capecitabine as in induction chemotherapy. Patients also undergo intensity-modulated radiotherapy (IMRT) once daily on days 1-5, 8-12, 15-19, 22-26, and 29-33 and non-IMRT boost once daily on days 36-40 and 43-47.
Treatment continues in the absence of disease progression or unacceptable toxicity. Within 4-8 weeks after completion of concurrent chemoradiotherapy, patients who achieve a clinical complete response or who are medically operable with resectable persistent or recurrent disease undergo neck dissection (salvage surgery). Cohorts of 3-6 patients receive escalating doses of capecitabine (during both induction chemotherapy and concurrent chemoradiotherapy) until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Quality of life is assessed at baseline, after completion of induction chemotherapy, and then at 1 week and 3, 6, and 12 months after completion of concurrent chemoradiotherapy. After completion of study therapy, patients are followed monthly for 3 months and then every 3 months for 1 year.
Trial Contact Information
Trial Lead Organizations University of Virginia Cancer Center | | | Christopher Thomas, MD, Principal investigator | | | | Paul Read, MD, PhD, Principal investigator | | | |
Registry Information | | Official Title | | Phase I Trial of Induction Paraplatin® and Xeloda® Followed by Concurrent Paraplatin and Xeloda with Intensity Modulated Radiotherapy for Locally Advanced Squamous Cell Carcinoma of the Head and Neck | | Trial Start Date | | 2003-06-30 | | Registered in ClinicalTrials.gov | | NCT00114153 | | Date Submitted to PDQ | | 2005-04-29 | | Information Last Verified | | 2007-04-09 | | NCI Grant/Contract Number | | CA44579 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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