Cisplatin, Nab-Paclitaxel, and Cetuximab (CACTUX) in Patients With Incurable Head and Neck Squamous Cell Carcinoma



Status:Recruiting
Conditions:Cancer, Cancer, Cancer, Cancer, Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:2/17/2019
Start Date:February 2, 2015
End Date:May 31, 2021
Contact:Douglas R Adkins, M.D.
Email:dadkins@wustl.edu
Phone:314-362-5654

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Phase 2 Single Arm Trial of Cisplatin, Nab-Paclitaxel, and Cetuximab (CACTUX) in Patients With Incurable Head and Neck Squamous Cell Carcinoma (HNSCC)

The purpose of this research study is to look at the effect of a treatment regimen called
CACTUX on head and neck cancer. The CACTUX regimen is a combination of three drugs called
cisplatin, nab-paclitaxel, and cetuximab (although carboplatin may be given in place of
cisplatin if participants have previously had problems receiving cisplatin). The use of
nab-paclitaxel in this combination is different from routine care, in which a drug called 5FU
is often given instead, but the investigators group has conducted previous research where the
investigators incorporated nab-paclitaxel into routine treatment with cisplatin, 5FU, and
cetuximab. The investigators are looking at the incidence of side effects with the CACTUX
regimen as well as response of the disease and health status.


Inclusion Criteria:

- Histologically or cytologically confirmed incurable HNSCC of the oral cavity,
oropharynx, larynx, hypopharynx, and/or Level 1-3 neck node with non-skin SCC and
unknown primary. "Incurable" is defined as metastatic disease or a local or regional
recurrence in a previously irradiated site that is unresectable (or patient declines
resection).

- Measurable disease defined as lesions that can be accurately measured in at least one
dimension (longest diameter to be recorded) as ≥ 10 mm with CT scan, as ≥ 20 mm by
chest x-ray, or ≥ 10 mm with calipers by clinical exam per RECIST 1.1.

- At least 18 years of age.

- ECOG performance status ≤ 1

- Adequate hematologic, renal, and hepatic function as defined below:

- Leukocytes ≥ 3,000/mcL

- Absolute neutrophil count ≥ 1,500/mcl

- Platelets ≥ 100,000/mcl

- Total bilirubin ≤ 1.5 mg/dL

- AST(SGOT)/ALT(SGPT) ≤ 2.5 x IULN, alkaline phosphatase ≤ 2.5 x IULN, unless bone
metastasis is present in the absence of liver metastasis

- Creatinine at or below IULN (males 0.7-1.30 mg/dl; females 0.6-1.10 mg/dl) OR
Creatinine clearance ≥ 60 mL/min/1.73 m2 for patients with creatinine levels
above institutional normal

- At least 4 months since completion of curative therapy, if given previously.

- Availability of diagnostic tumor tissue specimens for correlative studies.

- Women of childbearing potential and men must agree to use adequate contraception
(hormonal or barrier method of birth control, abstinence) prior to study entry, for
the duration of study participation, and for 3 months after completing treatment.
Should a woman become pregnant or suspect she is pregnant while participating in this
study, she must inform her treating physician immediately.

- Ability to understand and willingness to sign an IRB approved written informed consent
document (or that of legally authorized representative, if applicable).

Exclusion Criteria:

- Prior systemic therapy for incurable disease.

- Grade 2 or higher peripheral neuropathy at screening.

- A history of other malignancy ≤ 2 years previous; exceptions are malignancies with a
negligible risk of metastasis or death (e.g., expected 5-year OS > 90%) that were
treated with an expected curative outcome, such as squamous cell carcinoma of the
skin, in-situ carcinoma of the cervix uteri, non-melanomatous skin cancer, carcinoma
in situ of the breast, incidental finding of prostate cancer (TNM stage of T1a or
T1b), or synchronous H&N primaries

- Currently receiving any other investigational agents.

- Known brain metastases. Patients with known brain metastases must be excluded from
this clinical trial because of their poor prognosis and because they often develop
progressive neurologic dysfunction that would confound the evaluation of neurologic
and other adverse events.

- A history of allergic reactions attributed to compounds of similar chemical or
biologic composition to cisplatin, nab-paclitaxel, or other agents used in the study.
Previous grade 1 or 2 allergic reaction to cetuximab is permissible.

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.

- Pregnant and/or breastfeeding. Patient must have a negative pregnancy test within 72
hours of start of study treatment.

- Known HIV-positivity on combination antiretroviral therapy because of the potential
for pharmacokinetic interactions with the study drugs. In addition, these patients are
at increased risk of lethal infections when treated with marrow-suppressive therapy.
Appropriate studies will be undertaken in patients receiving combination
antiretroviral therapy when indicated.
We found this trial at
5
sites
660 S Euclid Ave
Saint Louis, Missouri 63110
(314) 362-5000
Principal Investigator: Douglas Adkins, M.D.
Phone: 314-362-5654
Washington University School of Medicine Washington University Physicians is the clinical practice of the School...
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Saint Louis, MO
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2500 N State St
Jackson, Mississippi 39216
(601) 984-1000
Principal Investigator: Robert Hamilton, M.D.
Phone: 601-984-5590
University of Mississippi Medical Center The University of Mississippi Medical Center, located in Jackson, is...
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Jackson, MS
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529 West Markham Street
Little Rock, Arkansas 72205
(501) 686-7000
Principal Investigator: Omar Atiq, M.D.
Phone: 870-535-2800
University of Arkansas for Medical Sciences The University of Arkansas for Medical Sciences (UAMS) in...
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Fargo, North Dakota 58122
Principal Investigator: Mark Gitau, M.D.
Phone: 701-234-6161
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Fargo, ND
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Sioux Falls, South Dakota 57104
Principal Investigator: Steven Powell, M.D.
Phone: 605-328-8000
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Sioux Falls, SD
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