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Phase 2 Completed N=107 Randomized Single-blind Treatment

A Study Of Lapatinib Versus Placebo Followed By Chemoradiation In Patients With Locally Advanced Head And Neck Cancer

Source: ClinicalTrials.gov NCT00371566 ↗
Enrolled (actual)
107
Serious AEs
26.7%
Results posted
Jan 2010
Primary outcomePrimary: Change From Baseline of the Apoptotic Index During Treatment Phase — 6.2; 4.2 Percentage of positive cells — p=.394

Summary

This is a study comparing the activity of lapatinib versus placebo followed by chemoradiation. This study is designed to explore the effects of lapatinib monotherapy on apoptosis/necrosis, in pre-treatment and post-treatment tumour tissue samples in subjects with locally advanced squamous cell carcinoma of head and neck.

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline of the Apoptotic Index During Treatment Phase
6.2; 4.2 .394
SECONDARY
Change From Baseline of Cell Proliferation Rate of the Ki-67 Proliferative Index in Tumour Biopsy Samples During Treatment Phase
-1.2; -5.6
SECONDARY
Overall Radiological Response After Treatment Phase in mITT Population
0; 1; 0; 3; 10; 12
SECONDARY
Overall Radiological Response After Follow-up Phase in mITT Population
2; 11; 13; 29; 2; 3
SECONDARY
Overall Radiological Response After Treatment Phase in ITT Population
0; 1; 0; 3; 12; 15
SECONDARY
Overall Radiological Response After Follow-up Phase in ITT Population
2; 16; 17; 34; 2; 4
SECONDARY
Number of Circulating Tumor Cells at Baseline in mITT Population
7; 18; 2; 1; 1; 0
SECONDARY
Number of Participants With Circulating Tumor Cells After Treatment Phase in mITT Population
12; 13; 0; 3; 0; 1
SECONDARY
Number of Participants With Circulating Tumor Cells After Chemoradiotherapy Phase in mITT Population
4; 2; 0; 0; 0; 0
SECONDARY
Number of Biomarkers Including ErbB1, ErbB2, pErbB1, and pErb2 at Baseline and During Treatment Phase
2; 0; 2; 0; 2; 2
SECONDARY
Number of Biomarkers Including Tumor Protein 53 and HPV During Treatment Phase
14; 25; 5; 14; 3; 11
SECONDARY
Summary of Adverse Events by Maximum Toxicity Grade Started During Treatment Phase
0; 1; 0; 0; 0; 0
SECONDARY
Summary of Adverse Events by Maximum Toxicity Grade (Grade 3 or Higher) Started During or After the Chemoradiotherapy Phase
3; 24; 0; 2; 0; 0
SECONDARY
Comparison of Overall Response During Treatment Phase Using CT/MRI and PET Information
2; 3; 8; 6; 0; 3
SECONDARY
Comparison of Overall Response During Follow up Phase Using CT/MRI and PET Information
0; 2; 11; 10; 1; 5
SECONDARY
Summary of Adverse Events Experienced by 15% or More Subjects in Either Treatment Group
24; 48; 13; 23; 17; 21
SECONDARY
Summary of Fatal/Serious Adverse Events During or After Chemoradiotherapy Phase
0; 1; 0; 1; 0; 1
SECONDARY
Summary of Serious Adverse Events During or After Chemoradiotherapy Phase
2; 3; 0; 2; 0; 1
SECONDARY
Adverse Events by Maximum Toxicity Grade 3 During or After Chemoradiotherapy Phase
9; 24; 3; 6; 3; 4
SECONDARY
Adverse Events (AEs) by Maximum Toxicity Grade 4 During or After Chemoradiotherapy Phase
0; 2; 0; 1; 1; 0
SECONDARY
Adverse Events by Maximum Toxicity Grade 5 During or After Chemoradiotherapy Phase
0; 1; 1; 0; 1; 0
SECONDARY
Relative Change From Baseline of Ktrans Median (1/Min) After 2 - 4 Weeks of Treatment
-2.70; 6.15
SECONDARY
Relative Change From Baseline of Kep Mean (1/Min) After 2 - 4 Weeks of Treatment
10.30; -14.54
SECONDARY
Relative Change From Baseline of Kep Perfused (1/Min) After 2 - 4 Weeks of Treatment
7.63; -19.96
SECONDARY
Relative Change From Baseline of Kep Whole (1/Min) After 2 - 4 Weeks of Treatment
8.87; -19.64
SECONDARY
Relative Change From Baseline of Ktrans Mean (1/Min) After 2 - 4 Weeks of Treatment
-1.90; 4.02
SECONDARY
Relative Change From Baseline of Ktrans Perfused (1/Min) After 2 - 4 Weeks of Treatment
-1.44; 0.69
SECONDARY
Relative Change From Baseline of Ktrans Whole (1/Min) After 2 - 4 Weeks of Treatment
-2.02; 0.30
SECONDARY
Relative Change From Baseline of IAUC Median (90) After 2 - 4 Weeks of Treatment
-2.07; 14.08
SECONDARY
Relative Change From Baseline of IAUC Mean (90) After 2 - 4 Weeks of Treatment
-3.30; 13.48
SECONDARY
Relative Change From Baseline of Perfused IAUC (90) After 2 - 4 Weeks of Treatment
-2.40; 12.57
SECONDARY
Relative Change From Baseline of Whole IAUC(90) After 2 - 4 Weeks of Treatment
-2.43; 12.52
SECONDARY
Relative Change From Baseline of Kep Median (1/Min) After 2 - 4 Weeks of Treatment
2.88; -9.32

Eligibility Criteria

Inclusion criteria

  • Willing and able to sign a written informed consent.
  • Histologically or cytologically confirmed diagnosis of SCCHN.
  • Stage III, IVA and IVB disease will be eligible, who are to receive chemoradiation therapy as primary treatment (total dose ≥ 65 Gy). Subjects with distant metastases (stage IVC) will be excluded.
  • Willing and able to have a tumour biopsy taken at screening and a second tumour biopsy taken during lapatinib/placebo administration.
  • Male or female ≥18 years of age.

Criteria for female subjects or female partners of male subjects: Non-child-bearing potential (i.e., women with functioning ovaries who have a current documented tubal ligation or hysterectomy, or women who are postmenopausal); Child-bearing potential (i.e., women with functioning ovaries and no documented impairment of oviductal or uterine function that would cause sterility.) This category includes women with oligomenorrhoea (severe), women who are perimenopausal, and young women who have begun to menstruate. These subjects must have a negative serum pregnancy test at screening and agree to one of the following:

Complete abstinence from intercourse from 2 weeks prior to administration of the first dose of study medication until 28 days after the final dose of study medication; or

Consistent and correct use of one of the following acceptable methods of birth control:

male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female subject; implants of levonorgestrel; injectable progestogen; any intrauterine device (IUD) with a documented failure rate of less than 1% per year; oral contraceptives (either combined or progestogen only); or barrier methods, including diaphragm or condom with a spermicide.

  • Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2.
  • Subjects must have adequate haematological, renal and hepatic function. Calculated creatinine clearance ≥50 ml/min as determined by the method of Cockcroft and Gault [Cockcroft, 1976] or by the EDTA method.

Absolute neutrophil count ≥1,500/μl, platelets ≥100,000/μl. Haemoglobin ≥9gm/dL (5mmol/L). Aspartate (AST) and alanine transaminase (ALT) less than three times the upper limit of the normal range (ULN).

Total bilirubin ≤2.0 mg/dL.

  • Left ventricular ejection fraction (LVEF) within the institutional normal ranges as measured by echocardiogram (ECHO) or Multigated Acquisition (MUGA) scans.
  • Able to swallow tablet whole or swallow a suspension of the tablet dissolved in water at study inclusion. If necessary, the suspension may be administered via percutaneous endoscopic gastrostomy (PEG), percutaneous jejunostomy tube (JTube), or a nasogastric tube (NG or Dobhoff type tube).
  • Life expectancy of at least 6 months as judged by the investigator.

Exclusion criteria

  • Subjects with paranasal sinuses, nasopharyngeal and nasal cavity tumours;
  • Subjects who have received prior systemic chemotherapy given with curative intent;
  • Subjects who received prior radiotherapy;
  • Prior or concurrent treatment with tyrosine kinase inhibitors;
  • Use of any investigational agent within 30 days or 5 half-lives, whichever is longer, preceding the first dose of lapatinib;
  • Concurrent use of CYP3A4 inducers or inhibitors;
  • Subjects with known history of uncontrolled or symptomatic angina, arrhythmias, or congestive heart failure;
  • History of another malignancy within the last 5 years, with the exception of completely resected basal or squamous cell skin cancer, or successfully treated in situ carcinoma. History of non-invasive lesion or in-situ carcinoma of head and neck that was successfully treated with surgery, photodynamics or laser, will be permitted;
  • Distant metastases, ie Stage IVC;
  • Females or males of child-bearing potential who are sexually active, if they do not agree to practice an effective method of contraception. (For example oral contraceptives, IUD or diaphragm plus spermicide);

*

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00371566). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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