Skip to main content
Top
Published in: Investigational New Drugs 6/2014

01-12-2014 | PHASE II STUDIES

Phase 2, open-label, 1:1 randomized controlled trial exploring the efficacy of EMD 1201081 in combination with cetuximab in second-line cetuximab-naïve patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN)

Authors: A. Ruzsa, M. Sen, M. Evans, L. W. Lee, K. Hideghety, S. Rottey, P. Klimak, P. Holeckova, J. Fayette, T. Csoszi, J. Erfan, U. Forssmann, T. Goddemeier, A. Bexon, C. Nutting, NA EMD 1201081 Study Group

Published in: Investigational New Drugs | Issue 6/2014

Login to get access

Summary

Aim: to determine whether EMD 1201081, a TLR9 agonist, added to cetuximab had antitumor activity in second-line recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) Methods: this was a phase 2, open-label, randomized trial of EMD 1201081 0.32 mg/kg subcutaneously weekly plus cetuximab (combination) vs cetuximab monotherapy (control) in cetuximab-naïve patients with R/M SCCHN who progressed on 1 cytotoxic regimen. Crossover to combination was permitted after progression Results: objective response rate in both arms was 5.7 % (95 % CI 1.2–15.7 %) by independent assessment. Disease control was 37.7 % for patients on combination (24.8–52.1 %) and 43.4 % on control (29.8–57.7 %). Neither independent nor investigator assessments showed significant differences between study arms. Median progression-free survival was 1.5 months (1.3–2.6) for patients on combination, and 1.9 months (1.5–2.9) on control.
The most frequent adverse events in the combination arm were rash (29.6 %), acneiform dermatitis (22.2 %), and injection site reactions (20.4 %). Grade 3/4 dyspnea and hypokalemia were more frequent with cetuximab monotherapy (7.5 % and 5.7 % vs 1.9 % each, respectively), and grade 3/4 respiratory failure and disease progression were more frequent with combination (5.6 % each vs 1.9 % each) Conclusion: EMD 1201081 was well tolerated combined with cetuximab, but there was no incremental clinical efficacy.
Literature
1.
go back to reference Ahmed SM, Cohen EEW (2007) Treatment of squamous cell carcinoma of the head and neck in the metastatic and refractory settings: advances in chemotherapy and the emergence of small molecule epidermal growth factor receptor kinase inhibitors. Curr Cancer Drug Targets 7:666–73CrossRefPubMed Ahmed SM, Cohen EEW (2007) Treatment of squamous cell carcinoma of the head and neck in the metastatic and refractory settings: advances in chemotherapy and the emergence of small molecule epidermal growth factor receptor kinase inhibitors. Curr Cancer Drug Targets 7:666–73CrossRefPubMed
2.
go back to reference Globocan 2012: http://globocan.iarc.fr/old/bar_sex_site_prev.asp?selection=11100&selection=13010&selection=21030&title=Larynx%2C+Lip%2C+oral+cavity%2C+Other+pharynx&statistic=1&populations=6&window=1&grid=1&info=1&color1=5&color1e=&color2=4&color2e=&submit=%C2%A0Execute; downloaded 13 April 2014 Globocan 2012: http://​globocan.​iarc.​fr/​old/​bar_​sex_​site_​prev.​asp?​selection=​11100&​selection=​13010&​selection=​21030&​title=​Larynx%2C+Lip%2C+oral+cavity%2C+Other+pharynx&statistic=1&populations=6&window=1&grid=1&info=1&color1=5&color1e=&color2=4&color2e=&submit=%C2%A0Execute; downloaded 13 April 2014
3.
go back to reference Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952. doi:10.1056/NEJMoa032641 CrossRefPubMed Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952. doi:10.​1056/​NEJMoa032641 CrossRefPubMed
4.
go back to reference Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944. doi:10.1056/NEJMoa032646 CrossRefPubMed Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944. doi:10.​1056/​NEJMoa032646 CrossRefPubMed
6.
go back to reference Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK (2010) Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 11(1):21–28CrossRefPubMed Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK (2010) Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 11(1):21–28CrossRefPubMed
8.
go back to reference Vermorken JB, Trigo J, Hitt R, Koralewski P, Diaz-Rubio E, Rolland F (2007) Open-label, uncontrolled, multicenter phase II study to evaluate the efficacy and toxicity of cetuximab as a single agent in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck who failed to respond to platinum-based therapy. J Clin Oncol 25:2171–2177CrossRefPubMed Vermorken JB, Trigo J, Hitt R, Koralewski P, Diaz-Rubio E, Rolland F (2007) Open-label, uncontrolled, multicenter phase II study to evaluate the efficacy and toxicity of cetuximab as a single agent in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck who failed to respond to platinum-based therapy. J Clin Oncol 25:2171–2177CrossRefPubMed
9.
go back to reference Damiano V, Caputo R, Bianco R, D’Armiento FP, Leonardi A, De Placido S (2006) Novel toll-like receptor 9 agonist induces epidermal growth factor receptor (EGFR) inhibition and synergistic antitumor activity with EGFR inhibitors. Clin Cancer Res 12:577–583CrossRefPubMed Damiano V, Caputo R, Bianco R, D’Armiento FP, Leonardi A, De Placido S (2006) Novel toll-like receptor 9 agonist induces epidermal growth factor receptor (EGFR) inhibition and synergistic antitumor activity with EGFR inhibitors. Clin Cancer Res 12:577–583CrossRefPubMed
10.
12.
go back to reference Wang D, Li Y, Yu D, Song SS, Kandimalla ER, Agrawal S (2004) Immunopharmacological and antitumor effects of second-generation immunomodulatory oligonucleotides containing synthetic CpR motifs. Int J Oncol 24:901–908PubMed Wang D, Li Y, Yu D, Song SS, Kandimalla ER, Agrawal S (2004) Immunopharmacological and antitumor effects of second-generation immunomodulatory oligonucleotides containing synthetic CpR motifs. Int J Oncol 24:901–908PubMed
13.
go back to reference Damiano V, Caputo R, Garofalo S, Bianco R, Rosa R, Merola G et al (2007) TLR9 agonist acts by different mechanisms synergizing with bevacizumab in sensitive and cetuximab-resistant colon cancer xenografts. PNAS 104(30):12468–12473PubMedCentralCrossRefPubMed Damiano V, Caputo R, Garofalo S, Bianco R, Rosa R, Merola G et al (2007) TLR9 agonist acts by different mechanisms synergizing with bevacizumab in sensitive and cetuximab-resistant colon cancer xenografts. PNAS 104(30):12468–12473PubMedCentralCrossRefPubMed
14.
15.
go back to reference Moore DJ, Hwang J, McGreivy J, Park S, Malik S, Martin RR et al (2005) Phase I trial of escalating doses of the TLR9 agonist HYB2055 in patients with advanced solid tumors. J Clin Oncol 23(16S):2503 Moore DJ, Hwang J, McGreivy J, Park S, Malik S, Martin RR et al (2005) Phase I trial of escalating doses of the TLR9 agonist HYB2055 in patients with advanced solid tumors. J Clin Oncol 23(16S):2503
16.
go back to reference Kuzel T, Dutcher J, Ebbinghaus S, Gordon, M, Grubbs, S, Khan, K, et al. (2009) A phase 2 multicenter, randomized, open-label study of two dose levels of IMO-2055 in patients with metastatic or recurrent renal cell carcinoma. Poster presented at the 8th International Kidney Cancer Symposium, Sep 25–26 2009, Chicago, IL, USA Kuzel T, Dutcher J, Ebbinghaus S, Gordon, M, Grubbs, S, Khan, K, et al. (2009) A phase 2 multicenter, randomized, open-label study of two dose levels of IMO-2055 in patients with metastatic or recurrent renal cell carcinoma. Poster presented at the 8th International Kidney Cancer Symposium, Sep 25–26 2009, Chicago, IL, USA
17.
go back to reference Malik S, Hwang J, Cotarla I, Sullivan T, Karr R, Marshall J et al (2007) Initial phase 1 results of gemcitabine, carboplatin and IMO-2055, a toll like receptor 9 (TLR9) agonist, in patients (pts) with advanced solid tumors. J Thor Oncol 2(8):S726–S727. doi:10.1097/01.JTO.0000284088.13204.12 CrossRef Malik S, Hwang J, Cotarla I, Sullivan T, Karr R, Marshall J et al (2007) Initial phase 1 results of gemcitabine, carboplatin and IMO-2055, a toll like receptor 9 (TLR9) agonist, in patients (pts) with advanced solid tumors. J Thor Oncol 2(8):S726–S727. doi:10.​1097/​01.​JTO.​0000284088.​13204.​12 CrossRef
18.
go back to reference Smith DA, Conkling P, Richards DA, Flores MR, Nemunaitis JJ, Boyd TE et al. (2012) Efficacy and safety of IMO-2055, a novel T LR9 agonist, in combination with erlotinib (E) and bevacizumab (bev) in patients (pts) with advanced or metastatic non-small cell lung cancer (NSCLC) who have progressed following prior chemotherapy. J Clin Oncol 30, (suppl; abstr e18047) Smith DA, Conkling P, Richards DA, Flores MR, Nemunaitis JJ, Boyd TE et al. (2012) Efficacy and safety of IMO-2055, a novel T LR9 agonist, in combination with erlotinib (E) and bevacizumab (bev) in patients (pts) with advanced or metastatic non-small cell lung cancer (NSCLC) who have progressed following prior chemotherapy. J Clin Oncol 30, (suppl; abstr e18047)
19.
go back to reference Machiels JP, Kaminsky MC, Keller U, Brümmendorf TH, Goddemeier T, Forssmann U, et al.. (2013) Phase Ib trial of IMO-2055 in combination with 5-FU, cisplatin and cetuximab as first-line palliative treatment in patients with recurrent/metastatic squamous cell carcinoma of the head and neck. Invest New Drugs: Feb 10 [Epub ahead of print] Machiels JP, Kaminsky MC, Keller U, Brümmendorf TH, Goddemeier T, Forssmann U, et al.. (2013) Phase Ib trial of IMO-2055 in combination with 5-FU, cisplatin and cetuximab as first-line palliative treatment in patients with recurrent/metastatic squamous cell carcinoma of the head and neck. Invest New Drugs: Feb 10 [Epub ahead of print]
20.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al (2000) New Guidelines to evaluate the response to treatment in solid tumors (RECIST Guidelines). J Natl Cancer Inst 92:205–216. doi:10.1093/jnci/92.3.205 CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al (2000) New Guidelines to evaluate the response to treatment in solid tumors (RECIST Guidelines). J Natl Cancer Inst 92:205–216. doi:10.​1093/​jnci/​92.​3.​205 CrossRefPubMed
21.
go back to reference CTCAE (Common Terminology Criteria for Adverse Events) (2003), Version 3.0, 12 December 2003 CTCAE (Common Terminology Criteria for Adverse Events) (2003), Version 3.0, 12 December 2003
22.
go back to reference Manegold C, van Zandwijk N, Szczesna A, Zatloukal P, Au JS, Blasinska-Morawiec M et al (2012) A phase III randomized study of gemcitabine and cisplatin with or without PF-3512676 (TLR9 agonist) as first-line treatment of advanced non-small-cell lung cancer. Ann Oncol 23(1):72–77. doi:10.1093/annonc/mdr030 CrossRefPubMed Manegold C, van Zandwijk N, Szczesna A, Zatloukal P, Au JS, Blasinska-Morawiec M et al (2012) A phase III randomized study of gemcitabine and cisplatin with or without PF-3512676 (TLR9 agonist) as first-line treatment of advanced non-small-cell lung cancer. Ann Oncol 23(1):72–77. doi:10.​1093/​annonc/​mdr030 CrossRefPubMed
23.
go back to reference Hirsh V, Boyer M, Rosell R, Rosell R, Middleton G, Eberhardt WE, et al. (2008) Randomized phase III trial of paclitaxel/carboplatin with or without PF-3512676 as first line treatment of advanced non-small cell lung cancer (NSCLC). J Clin Oncol 26: (May 20 suppl; abstr 8016) Hirsh V, Boyer M, Rosell R, Rosell R, Middleton G, Eberhardt WE, et al. (2008) Randomized phase III trial of paclitaxel/carboplatin with or without PF-3512676 as first line treatment of advanced non-small cell lung cancer (NSCLC). J Clin Oncol 26: (May 20 suppl; abstr 8016)
24.
go back to reference Manegold C, Gravenor D, Woytowitz D, Mezger J, Hirsh V, Albert G et al (2008) Randomized phase II trial of a toll-like receptor 9 agonist oligodeoxynucleotide, PF-3512676, in combination with first-line taxane plus platinum chemotherapy for advanced-stage Non–small-cell lung cancer. J Clin Oncol 26(24):3979–3986CrossRefPubMed Manegold C, Gravenor D, Woytowitz D, Mezger J, Hirsh V, Albert G et al (2008) Randomized phase II trial of a toll-like receptor 9 agonist oligodeoxynucleotide, PF-3512676, in combination with first-line taxane plus platinum chemotherapy for advanced-stage Non–small-cell lung cancer. J Clin Oncol 26(24):3979–3986CrossRefPubMed
25.
go back to reference Hirsh V, Paz-Ares L, Boyer M, Rosell R, Middleton G, Eberhardt WE et al (2011) Randomized phase III trial of paclitaxel/carboplatin with or without PF-3512676 (Toll-like receptor 9 agonist) as first-line treatment for advanced non-small-cell lung cancer. J Clin Oncol 29(19):2667–2674. doi:10.1200/JCO.2010.32.8971 CrossRefPubMed Hirsh V, Paz-Ares L, Boyer M, Rosell R, Middleton G, Eberhardt WE et al (2011) Randomized phase III trial of paclitaxel/carboplatin with or without PF-3512676 (Toll-like receptor 9 agonist) as first-line treatment for advanced non-small-cell lung cancer. J Clin Oncol 29(19):2667–2674. doi:10.​1200/​JCO.​2010.​32.​8971 CrossRefPubMed
26.
go back to reference Rodriguez-Torres M, Ghalib RH, Gordon SC, E Lawitz, Patel K, Pruitt R, et al. (2010) IMO-2125, A TLR9 Agonist, Induces Immune Responses Which Correlate With Reductions In Viral Load In Null Responder HCV Patients. Hepatology, 52 (4 - Suppl), October abstr 33, 336A Rodriguez-Torres M, Ghalib RH, Gordon SC, E Lawitz, Patel K, Pruitt R, et al. (2010) IMO-2125, A TLR9 Agonist, Induces Immune Responses Which Correlate With Reductions In Viral Load In Null Responder HCV Patients. Hepatology, 52 (4 - Suppl), October abstr 33, 336A
27.
go back to reference Dynavax–FDA advisory committee briefing materials provided prior to the 15 November 2012 meeting of the Vaccines and Related Biological Products Advisory Committee Dynavax–FDA advisory committee briefing materials provided prior to the 15 November 2012 meeting of the Vaccines and Related Biological Products Advisory Committee
Metadata
Title
Phase 2, open-label, 1:1 randomized controlled trial exploring the efficacy of EMD 1201081 in combination with cetuximab in second-line cetuximab-naïve patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN)
Authors
A. Ruzsa
M. Sen
M. Evans
L. W. Lee
K. Hideghety
S. Rottey
P. Klimak
P. Holeckova
J. Fayette
T. Csoszi
J. Erfan
U. Forssmann
T. Goddemeier
A. Bexon
C. Nutting
NA EMD 1201081 Study Group
Publication date
01-12-2014
Publisher
Springer US
Published in
Investigational New Drugs / Issue 6/2014
Print ISSN: 0167-6997
Electronic ISSN: 1573-0646
DOI
https://doi.org/10.1007/s10637-014-0117-2

Other articles of this Issue 6/2014

Investigational New Drugs 6/2014 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine