Squamous Cell Carcinoma Clinical Trial
Official title:
A Phase II Trial of Tarceva (Erlotinib) in Women With Squamous Cell Carcinoma of the Vulvar
In this research study we are looking to see how vulvar cancer responds to erlotinib therapy. Two distinct patient populations are targeted: women with locally advanced measurable squamous cell carcinoma of the vulva, primary or recurrent, who are candidates for definitive treatment with surgery or chemoradiation (Cohort 1) and women with radiographically measurable distant metastatic cancer either at time of presentation or with recurrence (Cohort 2). Another goal of this study is to learn more about the proteins and genes present in vulvar cancer and how they may affect response to erlotinib. Erlotinib treats cancer by preventing cancer cells from growing and multiplying. It does this by blocking certain proteins that are on the surface of some types of cancer cells. Laboratory tests show that vulvar cancer cells have high levels of these proteins.
OBJECTIVES:
Primary
• To determine the clinical efficacy of erlotinib in reducing the size of vulvar squamous
cell cancer and /or metastatic lesions.
Secondary
- To determine the safety and tolerability of oral erlotinib.
- To evaluate apoptosis and assess the Ki67, phospho-EGFR, EGFR mutation and EGFR
amplification status of the vulvar cancer prior to and after therapy and correlate
observed changes with response to therapy.
- To evaluate the impact of medical treatment on the subsequent surgery for vulvar cancer
when surgery is chosen as the definitive therapy.
STATISTICAL DESIGN:
This study used a two-stage design to evaluate efficacy of erlotinib based on response
determined prior to definitive surgery or chemoradiation (cohort 1) or after every 2 cycles
of erlotinib (cohort 2). The null and alternative response rates defined as achieving
partial response (PR) or better were 3.5% and 15%. If 1 or more patients enrolled in stage
one (n=17 patients) achieved PR or better than accrual would proceed to stage two (n=24
patients). There was 0.55 probability of stopping the trial at stage one if the true OR rate
was 3.5%. If 3 or fewer responses were observed by the end of stage two, erlotinib would be
deemed ineffective. The significance level of the study design was 0.0495 with a power of
85% to rule out a poor response rate of less than 3.5%.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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