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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT01824823
Other study ID # E1311
Secondary ID NCI-2013-00357U1
Status Terminated
Phase Phase 2
First received
Last updated
Start date June 30, 2014
Est. completion date December 2020

Study information

Verified date June 2023
Source Eastern Cooperative Oncology Group
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This randomized phase II trial studies how well giving afatinib after chemoradiation and surgery works in treating patients with stage III-IV squamous cell carcinoma of the head and neck at high-risk of recurrence. Afatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.


Description:

PRIMARY OBJECTIVES: I. Examine disease-free survival (DFS) given afatinib/placebo adjuvant therapy in patients with viable tumors in lymph nodes after neck dissection for suspected residual disease after concurrent chemoradiation. SECONDARY OBJECTIVES: I. Evaluate the recurrence rate, recurrence patterns, development of second primary malignancies, overall survival (OS) and toxicity of afatinib/placebo. II. Evaluate on-target inhibition by afatinib, and determine circulating deoxyribonucleic acid (DNA) as a biomarker of afatinib resistance. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM A: Patients receive afatinib orally (PO) once daily (QD) on days 1-28. ARM B: Patients receive placebo PO QD on days 1-28. In both Arms, treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 1 year and then every 12 months for 2 years.


Recruitment information / eligibility

Status Terminated
Enrollment 3
Est. completion date December 2020
Est. primary completion date December 13, 2015
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 - Patients must have pathological evidence of persistent primary and/or lymph node disease with viable tumor cells following primary concurrent chemoradiotherapy of locoregionally advanced (stage III/IV) HNSCC of the oral cavity, oropharynx, larynx, hypopharynx or p16-positive unknown primary of the head and neck region; persistent primary and/or lymph node disease with viable tumor cells will be determined by the histological determination of tumor viability defined as tumor cells with intact cellular compartments (i.e. cytoplasm and nucleus) that do not exhibit karyolysis, pyknosis, or karyorrhexis on haematoxylin and eosin (H&E) staining - Patients must have undergone a neck dissection following completion of chemoradiotherapy and must have involved at the minimum a compartment dissection of nodal levels with residual abnormalities on post-treatment imaging studies and/or received a complete resection of the residual primary lesion with negative margins - Patients must have achieved a complete response at the primary disease site after chemoradiotherapy or complete resection of the residual primary site disease with negative margins - All persistent lymph node disease must have received at least 66 Gy of radiotherapy and must have been completely surgically resected prior to registration, and surgical incisions should be adequately healed - Patients with extracapsular lymph node extension, perineural or lymphovascular invasion will be eligible - Patients must be at least 6 weeks (42 days) and no more than 36 weeks (252 days) from completion of chemoradiation at the time of registration - Patients will be eligible regardless of ability to swallow; patients with dysphagia may have afatinib/placebo administered via gastrostomy tube - Absolute neutrophil count >= 1,000/mm^3 - Platelets >= 100,000/mm^3 - Total bilirubin =< 1.5 x the upper limit of normal (ULN) - Aspartate amino transferase (AST) =< 3 x the ULN - Alanine amino transferase (ALT) =< 3 x the ULN - Calculated creatinine clearance must be >= 50 ml/min using the Cockcroft-Gault formula - Prior cetuximab or any epidermal growth factor receptor (EGFR) inhibitors will not be permitted including cetuximab administered with a chemoradiotherapy or radiotherapy regimen - As all patients in this study will have received prior full dose, curative-intent external-beam radiotherapy to the involved neck, no additional external-beam radiotherapy will be permitted prior to or during study participation - Women of childbearing potential and sexually active males must be strongly advised to use an accepted and effective method of contraception - Patients must have electrocardiogram (ECG) within 8 weeks prior to randomization to the study - Patients must be assessed for cardiac function by echocardiogram (ECHO) or multi-gated acquisition scan (MUGA) within 8 weeks prior to randomization Exclusion Criteria: - Patients with known distant metastatic disease or with any gross residual disease following salvage primary tumor resection or neck dissection - Known hypersensitivity to afatinib or any of the excipients of this product - Prior adjuvant chemotherapy (aside from the initial induction chemotherapy followed by chemoradiotherapy or chemoradiotherapy regimen) - History of acute myocardial infarction within 3 months prior to registration, and any history of uncontrolled angina, uncontrolled arrhythmia, or uncontrolled heart failure - Pregnant or breast-feeding women - Active infections, other cancers, or history of other cancers - Participation in any other clinical trials or taking any other experimental medications - Left ventricular dysfunction - Evidence of interstitial lung disease

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
afatinib
Given PO
Other:
placebo
Given PO

Locations

Country Name City State
United States Bixby Medical Center Adrian Michigan
United States Hickman Cancer Center Adrian Michigan
United States Akron General Medical Center Akron Ohio
United States New York Oncology Hematology PC - Albany Albany New York
United States New York Oncology Hematology PC -Albany Medical Center Albany New York
United States Mary Greeley Medical Center Ames Iowa
United States McFarland Clinic PC-William R Bliss Cancer Center Ames Iowa
United States Alaska Breast Care and Surgery LLC Anchorage Alaska
United States Alaska Women's Cancer Care Anchorage Alaska
United States Anchorage Oncology Centre Anchorage Alaska
United States Katmai Oncology Group Anchorage Alaska
United States Providence Alaska Medical Center Anchorage Alaska
United States Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor Michigan
United States Saint Joseph Mercy Hospital Ann Arbor Michigan
United States Langlade Hospital and Cancer Center Antigo Wisconsin
United States Randolph Hospital Asheboro North Carolina
United States Emory University/Winship Cancer Institute Atlanta Georgia
United States Auburn Regional Medical Center Auburn Washington
United States Harold Alfond Center for Cancer Care Augusta Maine
United States University Medical Center Brackenridge Austin Texas
United States Greater Baltimore Medical Center Baltimore Maryland
United States Eastern Maine Medical Center Bangor Maine
United States Bronson Battle Creek Battle Creek Michigan
United States Overlake Hospital Medical Center Bellevue Washington
United States Constantinou, Costas L MD (UIA Investigator) Bettendorf Iowa
United States Spectrum Health Big Rapids Hospital Big Rapids Michigan
United States Billings Clinic Billings Montana
United States Montana Cancer Consortium CCOP Billings Montana
United States Saint Vincent Healthcare Billings Montana
United States Saint Alphonsus Cancer Care Center-Boise Boise Idaho
United States McFarland Clinic PC-Boone Boone Iowa
United States Toledo Clinic Cancer Centers-Bowling Green Bowling Green Ohio
United States Bozeman Deaconess Hospital Bozeman Montana
United States Wellmont Bristol Regional Medical Center Bristol Tennessee
United States Albert Einstein College of Medicine Bronx New York
United States Montefiore Medical Center - Moses Campus Bronx New York
United States Montefiore Medical Center-Einstein Campus Bronx New York
United States Fairview Ridges Hospital Burnsville Minnesota
United States Saint James Community Hospital and Cancer Treatment Center Butte Montana
United States Saint Francis Medical Center Cape Girardeau Missouri
United States Memorial Hospital of Carbondale Carbondale Illinois
United States Rocky Mountain Oncology Casper Wyoming
United States Centralia Oncology Clinic Centralia Illinois
United States Providence Regional Cancer System-Centralia Centralia Washington
United States Cancer Center of Kansas - Chanute Chanute Kansas
United States West Virginia University Charleston Charleston West Virginia
United States John H Stroger Jr Hospital of Cook County Chicago Illinois
United States Saint Joseph Hospital Chicago Illinois
United States University of Illinois Chicago Illinois
United States University of Cincinnati Cincinnati Ohio
United States Clackamas Radiation Oncology Center Clackamas Oregon
United States Cleveland Clinic Foundation Cleveland Ohio
United States Southeastern Medical Oncology Center-Clinton Clinton North Carolina
United States Medical Oncology and Hematology Associates-West Des Moines Clive Iowa
United States Mercy Cancer Center-West Lakes Clive Iowa
United States Big Horn Basin Cancer Center Cody Wyoming
United States Billings Clinic-Cody Cody Wyoming
United States Kootenai Medical Center Coeur d'Alene Idaho
United States Mercy Hospital Coon Rapids Minnesota
United States Geisinger Medical Center Danville Pennsylvania
United States Oakwood Hospital and Medical Center Dearborn Michigan
United States Cancer Care Center of Decatur Decatur Illinois
United States Decatur Memorial Hospital Decatur Illinois
United States Iowa Lutheran Hospital Des Moines Iowa
United States Iowa Methodist Medical Center Des Moines Iowa
United States Iowa Oncology Research Association CCOP Des Moines Iowa
United States Medical Oncology and Hematology Associates-Des Moines Des Moines Iowa
United States Medical Oncology and Hematology Associates-Laurel Des Moines Iowa
United States Mercy Medical Center - Des Moines Des Moines Iowa
United States Saint John Hospital and Medical Center Detroit Michigan
United States Cancer Center of Kansas - Dodge City Dodge City Kansas
United States Greenville Health System Cancer Institute-Easley Easley South Carolina
United States Fairview-Southdale Hospital Edina Minnesota
United States Crossroads Cancer Center Effingham Illinois
United States Cancer Center of Kansas - El Dorado El Dorado Kansas
United States Providence Regional Cancer Partnership Everett Washington
United States Saint Francis Hospital Federal Way Washington
United States Genesys Hurley Cancer Institute Flint Michigan
United States Hurley Medical Center Flint Michigan
United States Poudre Valley Hospital Fort Collins Colorado
United States McFarland Clinic PC-Trinity Cancer Center Fort Dodge Iowa
United States Cancer Center of Kansas - Fort Scott Fort Scott Kansas
United States Fredericksburg Oncology Inc Fredericksburg Virginia
United States Unity Hospital Fridley Minnesota
United States Adams Cancer Center Gettysburg Pennsylvania
United States Southeastern Medical Oncology Center-Goldsboro Goldsboro North Carolina
United States Wayne Memorial Hospital Goldsboro North Carolina
United States Grand Rapids Clinical Oncology Program Grand Rapids Michigan
United States Mercy Health Saint Mary's Grand Rapids Michigan
United States Spectrum Health at Butterworth Campus Grand Rapids Michigan
United States Benefis Healthcare- Sletten Cancer Institute Great Falls Montana
United States Cone Health Cancer Center Greensboro North Carolina
United States Greenville Health System Cancer Institute-Andrews Greenville South Carolina
United States Greenville Health System Cancer Institute-Butternut Greenville South Carolina
United States Greenville Health System Cancer Institute-Eastside Greenville South Carolina
United States Greenville Health System Cancer Institute-Faris Greenville South Carolina
United States Greenville Memorial Hospital Greenville South Carolina
United States Greenville Health System Cancer Institute-Greer Greer South Carolina
United States Cherry Tree Cancer Center Hanover Pennsylvania
United States Saint Francis Hospital and Medical Center Hartford Connecticut
United States Geisinger Medical Center-Cancer Center Hazleton Hazleton Pennsylvania
United States Saint Peter's Community Hospital Helena Montana
United States Margaret R Pardee Memorial Hospital Hendersonville North Carolina
United States Hinsdale Hematology Oncology Associates Incorporated Hinsdale Illinois
United States New York Oncology Hematology PC-Hudson Hudson New York
United States Hutchinson Area Health Care Hutchinson Minnesota
United States Cancer Center of Kansas-Independence Independence Kansas
United States Allegiance Health Jackson Michigan
United States University of Mississippi Medical Center Jackson Mississippi
United States Southeastern Medical Oncology Center-Jacksonville Jacksonville North Carolina
United States McFarland Clinic PC-Jefferson Jefferson Iowa
United States Wellmont Medical Associates Oncology and Hematology-Johnson City Johnson City Tennessee
United States Borgess Medical Center Kalamazoo Michigan
United States Bronson Methodist Hospital Kalamazoo Michigan
United States West Michigan Cancer Center Kalamazoo Michigan
United States Kalispell Regional Medical Center Kalispell Montana
United States Cancer Center of Kansas-Kingman Kingman Kansas
United States Wellmont Holston Valley Hospital and Medical Center Kingsport Tennessee
United States Wellmont Medical Associates Oncology and Hematology-Kingsport Kingsport Tennessee
United States Kinston Medical Specialists PA Kinston North Carolina
United States Thompson Cancer Survival Center Knoxville Tennessee
United States Gundersen Lutheran Medical Center La Crosse Wisconsin
United States Providence Regional Cancer System-Lacey Lacey Washington
United States Saint Clare Hospital Lakewood Washington
United States Sparrow Hospital Lansing Michigan
United States New York Oncology Hematology PC - Latham Latham New York
United States Lawrence Memorial Hospital Lawrence Kansas
United States Beebe Medical Center Lewes Delaware
United States Geisinger Medical Oncology at Evangelical Community Hospital Lewisburg Pennsylvania
United States Saint Joseph Regional Medical Center Lewiston Idaho
United States Lewistown Hospital Lewistown Pennsylvania
United States Cancer Center of Kansas-Liberal Liberal Kansas
United States Lima Memorial Hospital Lima Ohio
United States Saint Rita's Medical Center Lima Ohio
United States Nebraska Cancer Research Center Lincoln Nebraska
United States Nebraska Hematology and Oncology Lincoln Nebraska
United States Veteran's Administration Medical Center Little Rock Arkansas
United States Saint Mary Mercy Hospital Livonia Michigan
United States Saint John Medical Center Longview Washington
United States Medical Center of Central Georgia Macon Georgia
United States Cancer Center of Kansas-Manhattan Manhattan Kansas
United States Minnesota Oncology Hematology PA-Maplewood Maplewood Minnesota
United States Saint John's Hospital - Healtheast Maplewood Minnesota
United States McFarland Clinic PC-Marshalltown Marshalltown Iowa
United States Toledo Clinic Cancer Centers-Maumee Maumee Ohio
United States Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee Ohio
United States Cancer Center of Kansas - McPherson McPherson Kansas
United States Orange Regional Medical Center Middletown New York
United States Froedtert and the Medical College of Wisconsin Milwaukee Wisconsin
United States Providence Milwaukie Hospital Milwaukie Oregon
United States Abbott-Northwestern Hospital Minneapolis Minnesota
United States Health Partners Inc Minneapolis Minnesota
United States Hennepin County Medical Center Minneapolis Minnesota
United States Community Medical Hospital Missoula Montana
United States Saint Patrick Hospital - Community Hospital Missoula Montana
United States Garneau, Stewart C MD (UIA Investigator) Moline Illinois
United States Porubcin, Michael MD (UIA Investigator) Moline Illinois
United States Spector, David MD (UIA Investigator) Moline Illinois
United States Trinity Medical Center Moline Illinois
United States Community Cancer Center of Monroe Monroe Michigan
United States Mercy Memorial Hospital Monroe Michigan
United States West Virginia University Healthcare Morgantown West Virginia
United States Good Samaritan Regional Health Center Mount Vernon Illinois
United States Mercy Health Mercy Campus Muskegon Michigan
United States Meharry Medical College Nashville Tennessee
United States Cancer Center of Western Wisconsin New Richmond Wisconsin
United States New Ulm Medical Center New Ulm Minnesota
United States Christiana Care Health System-Christiana Hospital Newark Delaware
United States Christiana Gynecologic Oncology LLC Newark Delaware
United States Delaware Clinical and Laboratory Physicians PA Newark Delaware
United States Helen F Graham Cancer Center Newark Delaware
United States Medical Oncology Hematology Consultants PA Newark Delaware
United States Regional Hematology and Oncology PA Newark Delaware
United States Providence Newberg Medical Center Newberg Oregon
United States Cancer Center of Kansas - Newton Newton Kansas
United States Lakeland Community Hospital Niles Michigan
United States Southwest VA Regional Cancer Center Norton Virginia
United States University of Oklahoma Health Sciences Center Oklahoma City Oklahoma
United States Capital Medical Center Olympia Washington
United States Providence - Saint Peter Hospital Olympia Washington
United States Alegent Health Bergan Mercy Medical Center Omaha Nebraska
United States Alegent Health Immanuel Medical Center Omaha Nebraska
United States Alegent Health Lakeside Hospital Omaha Nebraska
United States Creighton University Medical Center Omaha Nebraska
United States Missouri Valley Cancer Consortium Omaha Nebraska
United States Nebraska Methodist Hospital Omaha Nebraska
United States Oncology Hematology West Omaha Nebraska
United States Oncology Hematology West PC Omaha Nebraska
United States Urology Cancer Center PC Omaha Nebraska
United States Saint Charles Hospital Oregon Ohio
United States Toledo Clinic Cancer Centers-Oregon Oregon Ohio
United States Providence Willamette Falls Medical Center Oregon City Oregon
United States Cancer Center of Kansas - Parsons Parsons Kansas
United States Saint Joseph Mercy Oakland Pontiac Michigan
United States Saint Joseph Mercy Port Huron Port Huron Michigan
United States Providence Portland Medical Center Portland Oregon
United States Providence Saint Vincent Medical Center Portland Oregon
United States Western Oncology Research Consortium Portland Oregon
United States Kootenai Cancer Center Post Falls Idaho
United States Pottstown Memorial Medical Center Pottstown Pennsylvania
United States Geisinger Medical Oncology-Pottsville Pottsville Pennsylvania
United States Cancer Center of Kansas - Pratt Pratt Kansas
United States Good Samaritan Community Hospital Puyallup Washington
United States Spectrum Health Reed City Hospital Reed City Michigan
United States Beebe Health Campus Rehoboth Beach Delaware
United States Annie Penn Memorial Hospital Reidsville North Carolina
United States North Memorial Medical Health Center Robbinsdale Minnesota
United States Penobscot Bay Medical Center Rockport Maine
United States Phelps County Regional Medical Center Rolla Missouri
United States Saint John's Clinic-Rolla-Cancer and Hematology Rolla Missouri
United States Saint Mary's of Michigan Saginaw Michigan
United States Lakeland Hospital Saint Joseph Michigan
United States Marie Yeager Cancer Center Saint Joseph Michigan
United States Saint John's Mercy Medical Center Saint Louis Missouri
United States Metro-Minnesota CCOP Saint Louis Park Minnesota
United States Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota
United States Regions Hospital Saint Paul Minnesota
United States United Hospital Saint Paul Minnesota
United States Cancer Center of Kansas - Salina Salina Kansas
United States Kootenai Cancer Sandpoint Idaho
United States Nanticoke Memorial Hospital Seaford Delaware
United States Greenville Health System Cancer Institute-Seneca Seneca South Carolina
United States Saint Francis Regional Medical Center Shakopee Minnesota
United States Welch Cancer Center Sheridan Wyoming
United States Mercy Medical Center-Sioux City Sioux City Iowa
United States Saint Luke's Regional Medical Center Sioux City Iowa
United States Siouxland Hematology Oncology Associates Sioux City Iowa
United States Greenville Health System Cancer Institute-Spartanburg Spartanburg South Carolina
United States CoxHealth South Hospital Springfield Missouri
United States Memorial Medical Center Springfield Illinois
United States Mercy Hospital Springfield Springfield Missouri
United States Ozark Health Ventures LLC-Cancer Research for The Ozarks Springfield Springfield Missouri
United States Geisinger Medical Group State College Pennsylvania
United States Lakeview Hospital Stillwater Minnesota
United States Flower Hospital Sylvania Ohio
United States Allenmore Hospital Tacoma Washington
United States Multicare Health System Tacoma Washington
United States Northwest CCOP Tacoma Washington
United States Northwest Medical Specialties PLLC Tacoma Washington
United States Saint Joseph Medical Center Tacoma Washington
United States Mercy Hospital of Tiffin Tiffin Ohio
United States Mercy Saint Anne Hospital Toledo Ohio
United States Saint Vincent Mercy Medical Center Toledo Ohio
United States The Toledo Hospital/Toledo Children's Hospital Toledo Ohio
United States Toledo Clinic Cancer Centers-Toledo Toledo Ohio
United States Toledo Community Hospital Oncology Program CCOP Toledo Ohio
United States University of Toledo Toledo Ohio
United States Munson Medical Center Traverse City Michigan
United States New York Oncology Hematology PC - Troy Troy New York
United States Tulsa Cancer Institute Tulsa Oklahoma
United States PeaceHealth Southwest Medical Center Vancouver Washington
United States Ridgeview Medical Center Waconia Minnesota
United States Saint John Macomb-Oakland Hospital Warren Michigan
United States Aspirus Regional Cancer Center Wausau Wisconsin
United States Fulton County Health Center Wauseon Ohio
United States Cancer Center of Kansas - Wellington Wellington Kansas
United States University Pointe West Chester Ohio
United States Mercy Medical Center-West Lakes West Des Moines Iowa
United States Methodist West Hospital West Des Moines Iowa
United States Associates In Womens Health Wichita Kansas
United States Cancer Center of Kansas - Main Office Wichita Kansas
United States Cancer Center of Kansas-Wichita Medical Arts Tower Wichita Kansas
United States Via Christi Regional Medical Center Wichita Kansas
United States Wichita CCOP Wichita Kansas
United States Geisinger Wyoming Valley Wilkes-Barre Pennsylvania
United States Rice Memorial Hospital Willmar Minnesota
United States Christiana Care Health System-Wilmington Hospital Wilmington Delaware
United States Southeastern Medical Oncology Center-Wilson Wilson North Carolina
United States Cancer Center of Kansas - Winfield Winfield Kansas
United States Riverview Hospital Wisconsin Rapids Wisconsin
United States Minnesota Oncology and Hematology PA-Woodbury Woodbury Minnesota
United States WellSpan Health-York Hospital York Pennsylvania

Sponsors (2)

Lead Sponsor Collaborator
ECOG-ACRIN Cancer Research Group National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Disease-free Survival (DFS) DFS is defined as the time from randomization to the earlier of disease recurrence, second primary cancer, or death without recurrence. Assessed every 3 months for patients < 2 years from registration and every 6 months if patient is 2-3 years from registration and every 12 months if patient is 4-5 years from registration
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