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Phase II Trial of Cetuximab Plus Cisplatin, 5- Fluorouracil and Radiation in Immunocompetent Patients With Anal Carcinoma


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Anal Cancer

Thank you

Trial Information

Phase II Trial of Cetuximab Plus Cisplatin, 5- Fluorouracil and Radiation in Immunocompetent Patients With Anal Carcinoma


OBJECTIVES:

Primary

- Determine whether the addition of cetuximab to combined modality therapy (CMT)
comprising cisplatin, fluorouracil, and radiotherapy reduces the local failure rate by
≥ 50% at 3 years (compared with historical data) in immunocompetent patients with stage
I-IIIB invasive anal carcinoma.

Secondary

- Determine objective response rate (complete and partial), progression-free survival,
relapse-free survival, colostomy-free survival, and overall survival.

- Determine the overall toxicity of concurrent cisplatin, fluorouracil, and radiation
therapy combined with cetuximab.

- Evaluate the effect of cetuximab and CMT on anogenital herpes papilloma virus (HPV)
infection and anal cytology.

- Evaluate whether moderate to strong expression of epidermal growth factor receptor,
PI3K, and P-Akt (as determined by immunohistochemistry) is associated with an increased
risk of local failure.

OUTLINE: This is a multicenter study. Patients are assigned to 1 of 2 treatment arms.

- Arm I (closed to accrual as of 11/3/2008): Patients receive cisplatin IV over 60
minutes on days 1, 29, 57, and 85 and fluorouracil IV continuously over 96 hours on
days 1-4, 29-32, 57-60, and 85-88. Patients also receive cetuximab IV over 120 minutes
on day 50 and then IV over 60 minutes on days 57, 64, 71, 78, 85, 92, and 99 and
undergo radiotherapy once daily 5 days a week for 5 weeks, beginning on day 57.
Treatment continues in the absence of disease progression or unacceptable toxicity.

- Arm II: Patients receive cetuximab IV over 120 minutes on day 1 and then IV over 60
minutes on days 8, 15, 22, 29, 36, 43, and 50. Patients also receive cisplatin IV over
60 minutes on days 8 and 36, fluorouracil IV continuously over 96 hours on days 8-11
and 36-39, and undergo radiotherapy once daily 5 days a week for 5 weeks beginning on
day 8. Treatment continues in the absence of disease progression or unacceptable
toxicity.

After completion of study treatment, patients are followed periodically for up to 10 years.

PROJECTED ACCRUAL: A total of 62 patients will be accrued for this study.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed anal canal or perianal (anal margin) squamous cell carcinoma

- Stage I-IIIB (closed to accrual as of 11/3/2008)

- Stage II (T3, N0 only), IIIA, or IIIB

- Tumors of nonkeratinizing histology, such as basaloid, transitional cell, or
cloacogenic histology, allowed

- No well-differentiated stage I anal margin cancer

PATIENT CHARACTERISTICS:

- ECOG performance status 0-2

- Hemoglobin ≥ 10 g/dL

- Platelet count ≥ 100,000/mm^3

- Absolute neutrophil count > 1,500/mm^3

- Creatinine ≤ 1.5 times upper limit of normal (ULN) OR creatinine clearance > 60
mL/min

- Bilirubin ≤ 2 times ULN

- AST and ALT < 3 times ULN

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 3 months after
completion of study treatment

- No other malignancies except nonmelanomatous skin cancer

- Prior malignancies must be in remission for ≥ 5 years

- None of the following conditions within the past 6 months:

- Active infection

- Uncontrolled diabetes

- New York Heart Association class II-IV congestive heart failure

- Cerebrovascular accident

- Transient ischemic attack

- Uncontrolled hypertension

- Unstable angina

- Myocardial infarction

- No history of rheumatic disorders, irritable bowel syndrome, or inflammatory bowel
disease

- No known HIV positivity

- No known risk factors for HIV infection

- Patients with a known risk factor for HIV infection must undergo HIV testing
within 90 days before study entry AND must be HIV negative by antibody
detection, culture, or quantitative assay of plasma HIV RNA

PRIOR CONCURRENT THERAPY:

- No prior radiotherapy or chemotherapy for this malignancy

- No prior pelvic radiotherapy

- No prior potentially curative surgery (i.e., abdominal or peritoneal resection) for
anal cancer

- No concurrent intensity-modulated radiotherapy

Type of Study:

Interventional

Study Design:

Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Local failure rate at 3 years

Safety Issue:

No

Principal Investigator

Madhur K. Garg, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Montefiore Medical Center

Authority:

Unspecified

Study ID:

CDR0000470269

NCT ID:

NCT00316888

Start Date:

January 2007

Completion Date:

Related Keywords:

  • Anal Cancer
  • squamous cell carcinoma of the anus
  • stage I anal cancer
  • stage II anal cancer
  • stage IIIA anal cancer
  • stage IIIB anal cancer
  • basaloid carcinoma of the anus
  • cloacogenic carcinoma of the anus
  • Anus Neoplasms

Name

Location

CCOP - Wichita Wichita, Kansas  67214-3882
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Cedar Rapids Oncology Associates Cedar Rapids, Iowa  52403
Mercy Medical Center - Sioux City Sioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLP Sioux City, Iowa  51101
St. Luke's Regional Medical Center Sioux City, Iowa  51104
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Hutchinson Area Health Care Hutchinson, Minnesota  55350
HealthEast Cancer Care at St. John's Hospital Maplewood, Minnesota  55109
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
St. Francis Cancer Center at St. Francis Medical Center Shakopee, Minnesota  55379
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Madison, Wisconsin  53792-6164
Marshfield Clinic - Marshfield Center Marshfield, Wisconsin  54449
Marshfield Clinic - Indianhead Center Rice Lake, Wisconsin  54868
CCOP - Columbus Columbus, Ohio  43206
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Overlook Hospital Summit, New Jersey  07902-0220
Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, New Jersey  07962
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Albert Einstein Cancer Center at Albert Einstein College of Medicine Bronx, New York  10461
NYU Cancer Institute at New York University Medical Center New York, New York  10016
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
Adena Regional Medical Center Chillicothe, Ohio  54601
Doctors Hospital at Ohio Health Columbus, Ohio  43228
Riverside Methodist Hospital Cancer Care Columbus, Ohio  43214
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Strecker Cancer Center at Marietta Memorial Hospital Marietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial Hospital Newark, Ohio  43055
Community Hospital of Springfield and Clark County Springfield, Ohio  45505
Genesis - Good Samaritan Hospital Zanesville, Ohio  43701
Swedish-American Regional Cancer Center Rockford, Illinois  61104-2315
Indiana University Melvin and Bren Simon Cancer Center Indianapolis, Indiana  46202-5289
University of Virginia Cancer Center Charlottesville, Virginia  22908
Robert H. Lurie Comprehensive Cancer Center at Northwestern University Chicago, Illinois  60611
Decatur Memorial Hospital Cancer Care Institute Decatur, Illinois  62526
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
Front Range Cancer Specialists Fort Collins, Colorado  80528
Hematology Oncology Associates - Skokie Skokie, Illinois  60076
Joan Karnell Cancer Center at Pennsylvania Hospital Philadelphia, Pennsylvania  19107
Poudre Valley Hospital Fort Collins, Colorado  80524
Hematology and Oncology Associates Chicago, Illinois  60611
North Shore Oncology and Hematology Associates, Limited - Libertyville Libertyville, Illinois  60048
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
Cancer Center of Kansas, PA - Dodge City Dodge City, Kansas  67801
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Community Cancer Center of Monroe Monroe, Michigan  48162
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Wood County Oncology Center Bowling Green, Ohio  43402
Lima Memorial Hospital Lima, Ohio  45804
Northwest Ohio Oncology Center Maumee, Ohio  43537
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
Fulton County Health Center Wauseon, Ohio  43567
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Stanford Cancer Center Stanford, California  94305-5824
Kellogg Cancer Care Center Highland Park, Illinois  60035
Cancer Care and Hematology Specialists of Chicagoland - Niles Niles, Illinois  60714
William N. Wishard Memorial Hospital Indianapolis, Indiana  46202
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Lawrence Memorial Hospital Lawrence, Kansas  66044
Cancer Center of Kansas, PA - Liberal Liberal, Kansas  67905
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Greater Baltimore Medical Center Cancer Center Baltimore, Maryland  21204
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Grant Medical Center Cancer Care Columbus, Ohio  43215
Hematology Oncology Center Elyria, Ohio  44035
Community Cancer Center Elyria, Ohio  44035
Knox Community Hospital Mount Vernon, Ohio  43050
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
Marshfield Clinic - Chippewa Center Chippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Marshfield Clinic at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Marshfield Clinic - Wausau Center Wausau, Wisconsin  54401
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Provena St. Mary's Regional Cancer Center - Kankakee Kankakee, Illinois  60901
Minnesota Oncology - Maplewood Maplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Minnesota Oncology - Woodbury Woodbury, Minnesota  55125
Lakeside Hospital Omaha, Nebraska  68130
Southern Ohio Medical Center Cancer Center Portsmouth, Ohio  45662