This phase II trial studies how trametinib effects tumor cells in patients with oral cavity squamous cell carcinoma that can be removed by surgery. Trametinib may shrink the tumor by blocking an enzyme pathway needed for cell growth.
The rationale for this study in oral cavity squamous cell carcinomas rests on pre-clinical findings demonstrating that (a) activation of the ERK1/2 kinases is associated with aggressive features, (b) this aggressive phenotype is directly linked to expression of CD44, a cell surface hyaluronan receptor and (c) this association between activated ERK1/2 and CD44 is also identified in human cell lines and primary tumors. These data suggest that ERK1/2 is targetable biochemical pathway in CD44 expressing cells. These cells represent putative cancer stem cells or tumor initiating cells that have been associated with worse patient outcomes. Thus, the application of GSK1120212 to target OCSCC is a specific translational application of our laboratory findings.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Trametinib (GSK1120212) is a selective MEK1 and MEK2 inhibitor with selective activity towards BRAF and RAS mutant cancer cell lines and hematopoietic cancer cells from AML and CML origins.
Washington University School of Medicine
St Louis, Missouri, United States
Number of Participants With Changes in Putative Tumor Initiating Cell Populations as Defined by Cell Surface CD44 and Intracellular Phospho-ERK1/2 Staining After Treatment With GSK1120212.
Pre-post measure of p-EKP expression was measured by change in staining intensity and quartile distribution.
Time frame: Baseline and Day 15
Number of Participants With Changes in TumorCell Surface CD44 Expression After Treatment With GSK1120212.
Pre-post measure of CD44 expression using IHC.
Time frame: Baseline and Day 15
Tumor Specific Findings for Pathologic Changes Including Proliferation (Ki-67 Staining), Tumor Vasculature Staining (Microvessel Density), ERK1/2 Mediated Changes in p27 (Kip1) & Flow Cytometric Analysis of the Peripheral Blood & Tumor.
Time frame: Baseline and Day 15
Percentage of Participants With Clinical Response Induced by GSK1120212, as Determined by Change in Tumor Size.
Clinical Response was evaluted by quantitative changes in tumor size based on clinical examination of area of tumor at baseline and after GSK1120212 based on two dimensional measurements.
Time frame: Baseline and Day 15
Flow Cytometric Analysis of the Peripheral Blood and Tumor.
Peripheral blood - baseline and Day 14 Tumor - baseline and Day 15
Time frame: Baseline, Day 14, and Day 15
Percent Change in Maximum Standard Uptake Value in Oral Cavity Saqumous Cell Carcinoma (OCSCC) Using F18-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT).
Time frame: Baseline and Day 14
Safety of GSK1120212
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Number of adverse events were monitored for 30 day following last dose of GSK1120212
Time frame: 1st 4-6 week follow-up visit
Percent Change in Tumor Size Area
Time frame: Baseline and Day 15
Percent of Participants With Metabolic Changes in OCSCC Using FDG-PET/CT Imaging.
Intratumarol metabolic changes were evaluated by changes in in SUVmax in the primary tumor; quantitative analysis SUVmax with the primary tumor site was determined within a volume of interest around the tumor using a Siemens eSoft workstation.
Time frame: Baseline and Day 14