Cilengitide in Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN) (ADVANTAGE)

Merck KGaA (EMD Serono)

Status and phase: Completed; Phase 2; Phase 1

Conditions: Squamous Cell Cancer

Treatments: Drug: Cetuximab; Drug: Cisplatin; Drug: Cilengitide 2000 mg once weekly; Drug: 5-fluorouracil (5-FU); Drug: Cilengitide 2000 mg twice weekly

Study type: Interventional

Funder types: Industry

Identifiers

NCT00705016

2008-000615-15 (EudraCT Number)

EMR 200052-013

Details and patient eligibility

About

The purpose of this open-label, randomized, controlled, Phase 1/2 study of the integrin inhibitor cilengitide is to evaluate the safety and efficacy of the combination of different regimens of cilengitide added to cisplatin, 5-fluorouracil (5-FU), and cetuximab in participants with recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN).

The Phase 1 part was conducted in dedicated study centers. In the Phase 2 part of this trial, cilengitide is administered at two different doses to two experimental groups. The third group will only receive cisplatin, 5-FU and cetuximab. In the Phase 1 part of this trial, the dose of cilengitide in combination with cisplatin, 5-FU and cetuximab was determined.

Cilengitide is an experimental anti-cancer substance interacting with so-called integrins. Integrins are protein molecules that are known to be present on the surface of certain cancer cells. Integrins are also found on certain cells that belong to growing blood vessels (endothelial cells). Integrins potentially facilitate the blood vessels' support of the tumor (angiogenesis) as well as the tumor's growth and further spread throughout the body (metastasis). By inhibiting integrins on the tumor cell surface, cilengitide potentially kills cancer cells, and potentially sensitizes cancer cells to other co-administered therapeutics. By inhibiting integrins on the endothelial cell surface, it potentially inhibits the ingrowth of additional blood vessels towards the tumor.

Cilengitide is given as an intravenous infusion (given by a drip in one vein of your arm). If any unacceptable side effect occurs, treatment with the study drug will be stopped.

Enrollment: 184 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Histologically or cytologically confirmed diagnosis of SCCHN
• At least one measurable lesion either by computerized tomography (CT) scan or magnetic resonance imaging (MRI)
• Karnofsky performance status (KPS) of greater than or equal to 70 or eastern cooperative oncology group performance status (ECOG PS) of 0-1 at trial entry

Exclusion criteria

• Prior systemic chemotherapy, except if given as part of a multimodal treatment for locally advanced disease, which was completed more than 6 months prior to trial entry
• Surgery (excluding prior diagnostic biopsy) or irradiation within 4 weeks before trial entry
• Nasopharyngeal Carcinoma
• Documented or symptomatic brain or leptomeningeal metastasis
• Previous treatment with epidermal growth factor receptor (EGFR) targeting therapy or signal transduction inhibitors

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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184 participants in 3 patient groups

Cilengitide 2000 mg once weekly+Cetuximab+5-FU+Cisplatin

Experimental group

Treatment:

Drug: 5-fluorouracil (5-FU)

Drug: Cisplatin

Drug: Cilengitide 2000 mg once weekly

Drug: Cetuximab

Cilengitide 2000 mg twice weekly+Cetuximab+5-FU+Cisplatin

Experimental group

Treatment:

Drug: 5-fluorouracil (5-FU)

Drug: Cilengitide 2000 mg twice weekly

Drug: Cisplatin

Drug: Cetuximab

Cetuximab+5-FU+Cisplatin

Active Comparator group

Treatment:

Drug: 5-fluorouracil (5-FU)

Drug: Cisplatin

Drug: Cetuximab