Salivary Gland Malignancy Clinical Trial
Official title:
Phase II Trial of Postoperative Radiotherapy and Panitumumab in High-Risk Salivary Gland Malignancies
Standard therapy for high-risk or locally advanced salivary gland malignancies is surgery followed by postoperative radiation therapy. Studies have shown the superiority of combined modality therapy compared to surgery alone. Despite the addition of postoperative radiation therapy, the five-year survival for locally advanced salivary gland malignancies is poor (less than 60%). In salivary gland malignancies, the epidermal growth factor receptor (EGFR) is expressed in 25-85%; in certain histological types, like salivary duct carcinomas, the expression is higher. EGFR is a promising target of anticancer therapy. In squamous cell carcinoma of the head and neck, a phase III trial utilizing cetuximab added to radiation therapy improved both locoregional control and overall survival compared to radiation alone. Panitumumab is a novel, human, IgG2 EGFR monoclonal antibody that may be better tolerated and more efficacious than cetuximab. Here, the investigators hypothesize that the addition of panitumumab to standard radiotherapy in locally advanced salivary gland malignancies will improve recurrence-free survival (RFS).
Specific Aims To determine the recurrence-free survival (primary endpoint), overall
survival, local and distant recurrence-free survival, and treatment-related toxicities.
Also, the investigators plan to study EGFR-related and immune biomarkers in baseline tumor
tissue as well as blood samples obtained prior and after therapy.
Subject Population We will enroll patients with completely resected, locally advanced
salivary gland cancers.
Treatment Plan Standard radiation 64-70Gy with 2.0 Gy daily fractions in 6-7 weeks.
Panitumumab 2.5 mg/Kg IV, weekly during radiation (total of 6-7 doses).
Statistical Design and Sample Size Phase II, one-stage, study with the 3-year
recurrence-free survival (RFS) as the primary endpoint. The sample size is 30 patients.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment