Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer

Completed · Phase 3

Conditions studied: Head and Neck Cancer, Precancerous Condition

In brief

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells and shrink tumors. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. It is not yet known whether radiation therapy is more effective with cisplatin or cetuximab in treating oropharyngeal cancer. PURPOSE: This phase III trial is studying radiation therapy with cisplatin or cetuximab to see how well it works in treating patients with oropharyngeal cancer.

Key facts

Study ID

NCT01302834

Run by

Radiation Therapy Oncology Group

People needed

987

Starts

2011-06-01

Expected to finish

2025-09-04

Last updated by the study team

2026-07-20

Who can join

Age: 18 and older, up to 120. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Pathologically (histologically or cytologically) proven diagnosis of squamous cell carcinoma (including the histological variants papillary squamous cell carcinoma and basaloid squamous cell carcinoma) of the oropharynx (tonsil, base of tongue, soft palate, or oropharyngeal walls).
• Patients must be positive for p16, determined by central review prior to randomization.
• Patients must have clinically or radiographically evident measurable disease at the primary site or at nodal stations. Tonsillectomy or local excision of the primary without removal of nodal disease is permitted, as is excision removing gross nodal disease but with intact primary site. Limited neck dissections retrieving ≤ 4 nodes are permitted and considered as non-therapeutic nodal excisions. Fine needle aspirations of the neck are insufficient due to limited tissue for retrospective central review. Biopsy specimens from the primary or nodes measuring at least 3-5 mm are required.
• Clinical stage T1-2, N2a-N3 or T3-4, any N (AJCC, 7th ed.; see Appendix III), including no distant metastases, based upon the following minimum diagnostic workup:
• General history and physical examination by a radiation oncologist and medical oncologist within 8 weeks prior to registration;
• Examination by an ear, nose, and throat (ENT) or head and neck surgeon, including laryngopharyngoscopy (mirror and/or fiberoptic and/or direct procedure) within 8 weeks prior to registration;
• One of the following combinations of imaging is required within 8 weeks prior to registration:
• A computerized tomography (CT) scan of the neck (with contrast) and a chest CT scan (with or without contrast);
• or a magnetic resonance imaging (MRI) scan of the neck (with contrast) and a chest CT scan (with or without contrast);
• or a CT scan of neck (with contrast) and a positron emission tomography (PET)/CT of neck and chest (with or without contrast);
• or an MRI of the neck (with contrast) and a PET/CT of neck and chest (with or without contrast).
• Note: A CT scan of neck and/or a PET/CT performed for radiation planning and read by a radiologist may serve as both staging and planning tools.
• Zubrod Performance Status 0-1 within 2 weeks prior to registration
• Age ≥ 18;
• Complete blood count (CBC)/differential obtained within 2 weeks prior to registration on study, with adequate bone marrow function, defined as follows:
• Absolute neutrophil count (ANC) > 1,500 cells/mm3;
• Platelets > 100,000 cells/mm3;
• Hemoglobin (Hgb) > 8.0 g/dl; Note: The use of transfusion or other intervention to achieve Hgb > 8.0 g/dl is acceptable.
• Adequate hepatic function, defined as follows:
• Bilirubin < 2 mg/dl within 2 weeks prior to registration;
• Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3 x the upper limit of normal within 2 weeks prior to registration;
• Adequate renal function, defined as follows:
• Serum creatinine < 1.5 mg/dl within 2 weeks prior to registration or creatinine clearance (CCr) ≥ 50 ml/min within 2 weeks prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula:
• CCr male = [(140 - age) x (wt in kg)] [(Serum Cr mg/dl) x (72)] CCr female = 0.85 x (CCr male)
• Patients must provide their smoking history (for stratification) via the computer-assisted self interview (CASI) head and neck risk factor survey tool.

You may not qualify if…

• Cancers considered to be from an oral cavity site (oral tongue, floor mouth, alveolar ridge, buccal or lip), nasopharynx, hypopharynx, or larynx, even if p16 positive, are excluded. Carcinoma of the neck of unknown primary site origin (even if p16 positive) are excluded from participation.
• Stage T1-2, N0-1;
• Distant metastasis or adenopathy below the clavicles;
• Gross total excision of both primary and nodal disease; this includes tonsillectomy, local excision of primary site, and nodal excision that removes all clinically and radiographically evident disease.
• Simultaneous primaries or bilateral tumors;
• Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years (For example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible);
• Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable;
• Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields;
• Severe, active co-morbidity, defined as follows:
• 9.1 Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months;
• 9.2 Transmural myocardial infarction within the last 6 months;
• 9.3 Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration;
• 9.4 Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days of registration;
• 9.5 Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol.
• 9.6 Acquired Immune Deficiency Syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition with immune compromise greater than that noted in Section 3.1.13; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive. Protocol-specific requirements may also exclude immuno-compromised patients.
• Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic.
• Prior allergic reaction to cisplatin or cetuximab;
• Prior cetuximab or other anti-EGFR therapy.

Where it is running

• Auburn Radiation Oncology — Auburn, California, United States
• Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center — Burbank, California, United States
• Radiation Oncology Centers - Cameron Park — Cameron Park, California, United States
• Mercy Cancer Center at Mercy San Juan Medical Center — Carmichael, California, United States
• Enloe Cancer Center at Enloe Medical Center — Chico, California, United States
• City of Hope Comprehensive Cancer Center — Duarte, California, United States
• Rebecca and John Moores UCSD Cancer Center — La Jolla, California, United States
• Kaiser Permanente - Division of Research - Oakland — Oakland, California, United States
• Rohnert Park Cancer Center — Rohnert Park, California, United States
• Radiation Oncology Center - Roseville — Roseville, California, United States
• Radiological Associates of Sacramento Medical Group, Incorporated — Sacramento, California, United States
• Mercy General Hospital — Sacramento, California, United States
• UCSF Helen Diller Family Comprehensive Cancer Center — San Francisco, California, United States
• Study site — Santa Clara, California, United States
• Kaiser Permanente Medical Center - South San Francisco — South San Francisco, California, United States
• Solano Radiation Oncology Center — Vacaville, California, United States
• Rocky Mountain Cancer Centers - Aurora — Aurora, Colorado, United States
• Boulder Community Hospital — Boulder, Colorado, United States
• Penrose Cancer Center at Penrose Hospital — Colorado Springs, Colorado, United States
• Porter Adventist Hospital — Denver, Colorado, United States
• Swedish Medical Center — Englewood, Colorado, United States
• McKee Medical Center — Loveland, Colorado, United States
• North Suburban Medical Center — Thornton, Colorado, United States
• George Bray Cancer Center at the Hospital of Central Connecticut - New Britain Campus — New Britain, Connecticut, United States
• Providence Cancer Center — Anchorage, Alaska, United States

Full record on ClinicalTrials.gov

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