Clinical Trials /

AMG 319 in HPV Positive and Negative HNSCC

NCT02540928

Description:

The purpose of this study is to determine whether a drug called AMG 319 has an effect on a patient's own immune response to head and neck cancer squamous cell carcinoma (HNSCC). This study is specifically for patients who are having surgery to treat their HNSCC

Related Conditions:
  • Head and Neck Squamous Cell Carcinoma
Recruiting Status:

Terminated

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: AMG 319 in HPV Positive and Negative HNSCC
  • Official Title: A Cancer Research UK Randomised, Double Blind, Placebo Controlled Phase IIa Trial of AMG 319 Given Orally as a Neoadjuvant Therapy in Patients With Human Papillomavirus (HPV) Positive and Negative Head and Neck Squamous Cell Carcinoma (HNSCC)

Clinical Trial IDs

  • ORG STUDY ID: CRUKD/15/004
  • NCT ID: NCT02540928

Conditions

  • Human Papillomavirus (HPV)
  • Positive or Negative Head and Neck Squamous Cell Carcinoma (HNSCC) of the Hypopharynx, Oropharynx, Oral Cavity, Supraglottis or Larynx

Interventions

DrugSynonymsArms
AMG 319 hydrateAMG 319 Hydrate
PlaceboPlacebo

Purpose

The purpose of this study is to determine whether a drug called AMG 319 has an effect on a patient's own immune response to head and neck cancer squamous cell carcinoma (HNSCC). This study is specifically for patients who are having surgery to treat their HNSCC

Detailed Description

      Cancers use 'defence mechanisms' to hide from the immune system and teach the immune system
      not to destroy cancer cells. AMG 319 works by blocking these defence mechanisms in the
      tumour. It targets and blocks an important protein called PI3K delta.

      In the laboratory this leads to removal of a group of inhibitory immune cells. Releasing the
      immune brakes leads to immune attack and destruction of cancer cells.

      AMG 319 looks promising in laboratory studies and in a very early study in a small number of
      patients with leukaemia and we now wish to find out if it will be useful in treating patients
      with head and neck cancer.

      This study is a randomised, doubleblind, placebo controlled Phase II trial looking at the
      effects of giving AMG 319 to patients with either human papilloma virus (HPV) positive or
      negative head and neck cancer squamous cell carcinoma (HNSCC). We propose to treat patients
      prior to resection surgery so that we can study the effect of AMG 319 on the cancer in fine
      detail.

      Approximately 54 patients with HPV positive or negative HNSCC of the hypopharynx, oropharynx,
      oral cavity, supraglottis or larynx will be entered into the study. Patients will be randomly
      assigned to one of two treatment groups and will receive between 20 and 29 days of oral
      dosing with AMG 319 or placebo immediately before resection surgery.
    

Trial Arms

NameTypeDescriptionInterventions
AMG 319 HydrateExperimentalUp to 36 patients will be randomised into the Active Treatment arm to receive AMG 319 400 mg once daily administered orally for a minimum of 20 days and a maximum of 29 days prior to resection surgery
  • AMG 319 hydrate
PlaceboPlacebo ComparatorUp to 18 patients will be randomised into the Placebo arm to receive Placebo once daily administered orally for a minimum of 20 days and a maximum of 29 days prior to resection surgery
  • Placebo

Eligibility Criteria

        Inclusion criteria:

          1. Histologically proven HNSCC of the hypopharynx, oropharynx, oral cavity, supraglottis
             or larynx (except T1 glottic tumours) for whom surgery with curative intent ± post
             operative radiotherapy or chemoradiotherapy is considered the primary treatment of
             choice. Surgery should be scheduled to take place no sooner than 21 days and no later
             than 30 days post first dose of AMG 319 or placebo.

             Patients presenting with recurrence can be considered for inclusion, as long as their
             previous treatment did not include radiotherapy ± chemotherapy or any other anti
             cancer therapy i.e. treated with surgery alone and this did not take place within 6
             months prior to trial entry.

             Patients presenting with a second primary HNSCC can be considered for inclusion, as
             long as any previous radiotherapy, chemotherapy or any other anti cancer therapy was
             completed more than 5 years prior to trial entry.

          2. Patients considered fit to undergo curative resection surgery.

          3. Haematological and biochemical indices within the ranges shown below:

             Laboratory Test Value required

             Haemoglobin (Hb) ≥100 g/L

             Absolute neutrophil count ≥1.5 x 109/L

             Platelet count ≥100 x 109/L

             Bilirubin ≤1.5 x upper limit of normal (ULN) Alanine aminotransferase (ALT) and/or
             aspartate aminotransferase (AST) ≤2.5 x ULN

             Alkaline Phosphatase (alk phos/ALP) ≤2.5 x ULN

             Amylase ≤2.0 x ULN

             Calculated creatinine clearance (using the Wright or Cockcroft-Gault formula) ≥50
             mL/min

          4. 18 years or over at the time informed consent is given.

          5. Written (signed and dated) informed consent and capable of co-operating with treatment
             and follow up.

        Exclusion criteria:

          1. Prior radiotherapy, immunotherapy, chemotherapy or other anti-cancer therapy
             (excluding surgery) for current HNSCC.

          2. Patients should be excluded from the trial if they have active or previous
             malignancies of other types which in the Investigator's opinion would mean they are
             not a good candidate for the clinical trial.

          3. Female patients who are able to become pregnant (or already pregnant or lactating).
             However, those patients who have a negative serum or urine pregnancy test before
             enrolment and agree to use two highly effective forms of contraception (oral; injected
             or implanted hormonal contraception and condom; have an intra uterine device and
             condom; diaphragm with spermicidal gel and condom) effective at the first
             administration of AMG 319, throughout the trial and for 6 months afterwards are
             considered eligible.

          4. Male patients with partners of child bearing potential (unless they agree to take
             measures not to father children by using one form of highly effective contraception
             [condom plus spermicide] effective at the first administration of AMG 319, throughout
             the trial and for 6 months afterwards). Men with pregnant or lactating partners must
             be advised to use barrier method contraception (for example: condom plus spermicidal
             gel) to prevent exposure to the foetus or neonate.

          5. Patients unable to swallow oral medications (trial medication must not be chewed,
             crushed, dissolved or divided).

          6. Major thoracic or abdominal surgery from which the patient has not yet recovered.

          7. At high medical risk because of non malignant systemic disease including active
             uncontrolled infection.

          8. Active or uncontrolled auto immune disease which may require systemic immunomodulator
             therapy during the trial treatment period. Exceptions to this are atopic dermatitis
             and psoriasis not requiring systemic treatment.

          9. Long term use of systemic corticosteroids with the exception of replacement treatment.
             Discontinuation of steroid use within seven days prior to receiving the first dose of
             AMG 319 or placebo would be acceptable. Inhaled and topical steroids are permitted.

         10. Known to be serologically positive for hepatitis B, hepatitis C or human
             immunodeficiency virus (HIV). If there is clinical suspicion of infection this must be
             ruled out by appropriate serological and PCR testing.

         11. QTc >470 msec (Friderica [QTc F] correction) or a history or family history of QT
             prolongation.

         12. Regular and/or prolonged treatment with medications known to cause QTc interval
             prolongation within seven days prior to receiving the first dose of AMG 319 or
             placebo.

         13. Is a participant or plans to participate in another interventional clinical trial,
             whilst taking part in this Phase IIa trial of AMG 319. Participation in an
             observational trial or interventional clinical trial which does not involve
             administration of an IMP would be acceptable.

         14. Any other condition which in the Investigator's opinion would not make the patient a
             good candidate for the clinical trial.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Changes in CD8+ effector T cell numbers in tumour tissue
Time Frame:Screening and Surgery
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Steady State AMG 319 concentration in blood
Time Frame:Days 8, 15 pre dose & Day 22
Safety Issue:
Description:
Measure:Changes in tumour size
Time Frame:Screening and Pre-surgery
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Terminated
Lead Sponsor:Cancer Research UK

Last Updated

July 18, 2018