Anal Cancer Clinical Trial
Official title:
Phase II Trial of Combined Modality Therapy Plus Cetuximab in HIV-Associated Anal Carcinoma
RATIONALE: Drugs used in chemotherapy, such as cisplatin and fluorouracil, work in different
ways to stop the growth of tumor cells, either by killing the cells or by stopping them from
dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways.
Some block the ability of tumor cells to grow and spread. Others find tumor cells and help
kill them or carry tumor-killing substances to them. Radiation therapy uses high-energy
x-rays to kill tumor cells. Giving cisplatin, fluorouracil, and cetuximab together with
radiation therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving cisplatin, fluorouracil, and
cetuximab together with radiation therapy works in treating patients with HIV and stage I,
stage II, or stage III anal cancer.
OBJECTIVES:
Primary
- Determine the 2-year local failure rate in patients with HIV-associated stage I-IIIB
anal carcinoma treated with cisplatin, fluorouracil, cetuximab, and radiotherapy.
- Determine the objective response rate (complete and partial), progression-free survival,
relapse-free survival, colostomy-free survival, overall survival, quality of life, and
overall toxicity in patients treated with this regimen.
Secondary
- Characterize the effect of this regimen on the underlying HIV condition by describing
changes in viral load, CD4 counts, and the incidence of opportunistic illnesses,
including the development of AIDS during and in the first year after treatment.
- Evaluate the effect of this regimen on anogenital human papilloma virus (HPV) infection
and anal cytology.
OUTLINE: This is an open-label, multicenter study.
Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, and 35*, fluorouracil
IV continuously on days 1-4 and 29-32, and cisplatin IV over 1 hour on days 1 and 29.
Beginning on day 1, patients undergo concurrent radiotherapy to the primary tumor 5 days a
week for 5-7 weeks. Treatment continues in the absence of disease progression or unacceptable
toxicity.
NOTE: *Patients receiving 7 weeks of radiotherapy also receive cetuximab on days 42 and 49.
Quality of life is assessed at baseline, at the completion of study treatment, and then at
months 3, 6, 12, 24, and 36.
After completion of study treatment, patients are followed periodically for 5 years.
PROJECTED ACCRUAL: A total of 47 patients will be accrued for this study.
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