A Phase II Study of ZD 1839 (Iressa) in Recurrent or Metastatic Squamous Cell Cancer of the Head and Neck
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed primary squamous cell cancer of the head
and neck that is incurable by surgery or radiotherapy
- Stratum I:
- Failed surgery and/or radiotherapy and received no prior systemic
chemotherapy for recurrent disease OR
- Recurrent disease at least 6 months after prior multimodal primary therapy
including neoadjuvant or concurrent chemotherapy OR
- Metastatic disease at initial diagnosis and received no prior chemotherapy
- Stratum II:
- No more than 1 prior chemotherapy regimen for recurrent disease OR
- Recurrent disease within 6 months after prior primary therapy that included
chemotherapy
- Measurable disease
- At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
- Clear clinical evidence of progression or biopsy-proven residual cancer required
if only site of measurable disease is in a previously irradiated field
- No known brain metastases
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- ECOG 0-2 OR
- Karnofsky 60-100%
Life expectancy:
- More than 3 months
Hematopoietic:
- WBC at least 3,000/mm^3
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
Hepatic:
- Bilirubin normal (no greater than 1.5 times upper limit of normal [ULN] if liver
metastases present)
- AST/ALT no greater than 2.5 times ULN
Renal:
- Creatinine no greater than 1.5 times ULN OR
- Creatinine clearance at least 60 mL/min
Cardiovascular:
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No cardiac arrhythmia
Other:
- No other malignancy within the past 5 years except curatively treated basal cell or
squamous cell skin cancer or carcinoma in situ of the cervix
- No other uncontrolled concurrent illness
- No ongoing or active infection
- No psychiatric illness or social situation that would preclude study compliance
- No prior allergic reactions attributed to compounds of similar chemical or biologic
composition to gefitinib
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior therapy with agents that target epidermal growth factor receptors
Chemotherapy:
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and
recovered
Endocrine therapy:
- No concurrent tamoxifen
Radiotherapy:
- Prior radiotherapy as primary or secondary treatment allowed
- At least 4 weeks since prior radiotherapy and recovered
Surgery:
- Prior surgery as primary or secondary treatment allowed
- At least 4 weeks since prior major surgery
Other:
- No other concurrent investigational agents
- No concurrent combination antiretroviral therapy for HIV
- No concurrent 3A4 inhibitors (e.g., ketoconazole, erythromycin, verapamil)
- No concurrent drugs with known corneal toxicity (e.g., chlorpromazine, amiodarone,
chloroquine)