RATIONALE: Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Giving erlotinib after chemoradiotherapy may kill more tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of adjuvant erlotinib when given after completing chemoradiotherapy in treating patients with locally advanced squamous cell carcinoma (cancer) of the head and neck.
OBJECTIVES: Primary * Determine the recommended dose of adjuvant erlotinib after the completion of chemoradiotherapy in patients with stage III, IVA, or IVB squamous cell carcinoma of the head and neck. * Determine the toxicity of this drug in these patients. * Determine the effects of this drug on plasma and urinary angiogenic factors (specifically vascular endothelial growth factor receptor \[VEGFR\], VEGFR1, VEGFR2, and basic fibroblast growth factor levels) in these patients. * Compare the disease-free survival of patients treated with this drug after chemoradiotherapy vs historical control patients treated with chemoradiotherapy alone. * Correlate levels of angiogenic factors with initial blood vessel concentration in the tumor and the presence or absence of EGFRvIII mutation in patients treated with this drug. OUTLINE: This is an open-label, dose-escalation, multicenter study. Patients receive oral erlotinib once daily on days 1-28. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 6 patients receive escalating doses of erlotinib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, an additional 8 patients are treated at that dose level. Patients are followed at 4 weeks, every 12 weeks for 3 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 6-20 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
19
London Regional Cancer Program
London, Canada
CHUM - Hopital Notre-Dame
Montreal, Canada
Toxicity/feasibility assessed by NCI CTC v2.0 at the end of course 1
Recommended phase II dose at the end of course 1
Correlative studies (archival and prospective) at accrual completion
Disease-free survival
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