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Erlotinib Prevention of Oral Cancer (EPOC)

Erlotinib Prevention of Oral Cancer (EPOC)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00402779
Enrollment
303
Registered
2006-11-22
Start date
2006-11-03
Completion date
2018-06-04
Last updated
2020-04-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Oral Cancer

Keywords

Oral Cancer, Oral IEN Lesion with LOH, Loss of Heterozygosity, Intraepithelial Neoplasia, Placebo, Erlotinib, Tarceva, OSI-774

Brief summary

The goal of this clinical research study is to learn if erlotinib hydrochloride (Tarcevaâ (OSI-774 ) can prevent cancer in the mouth of people with a high risk of developing cancer in the mouth. The safety of this drug will also be studied, as well as the drug's effect on different cells in the body.

Detailed description

Erlotinib hydrochloride is designed to block the activity of an enzyme found on the surface of many tumor cells that may control tumor growth and survival. This may keep tumors from growing. If you are found to be eligible to participate in the study, you will be randomly assigned (as in the toss of a coin) to receive either erlotinib hydrochloride or placebo. A placebo is a substance that looks like the study drug but has no active ingredients. Neither you nor the investigators will know which treatment group you have been assigned to. However, in the event of a medical emergency, the study chair can find out which group you are in, if necessary. You can be informed which of the groups you were assigned to, after the study has ended. There is no certainty that you will have an effect from the treatment, or if you will be placed in a group with the active study drug. While on study, you will take the study dose (either erlotinib hydrochloride or placebo) by mouth, in tablet form, once a day. Tablets should be taken in the morning 1 hour before or 2 hours after a meal, other medications, vitamins, and iron supplements, with no more than 7 ounces of water. You should take the study dose around the same time every day. Every attempt should be made to keep from vomiting the dose, for at least 30 minutes after taking it. For example, if you feel nauseated before or after taking the study dose, anti-nausea medications should be used. If you vomit after taking the study dose, the dose can be taken again only if the tablet(s) can actually be seen and counted (in other words, they have not dissolved yet). You will need to note the time you take each dose of medication throughout the study on a calendar that the study nurse will give to you. At Months 1, 3, 6, 9, and 12, you will return to clinic. You will have a physical exam including measurement of vital signs. You will have a careful examination of the inside of your mouth.You will have blood (about 2 teaspoons) drawn for routine tests and to check your liver function (about 1-2 teaspoons). At Months 3, 6, and 12, you will have blood (about 2 teaspoons) drawn for research testing and to measure the level of study drug in the body. Your study doctor will ask you about any medications you are taking, how you are feeling (symptoms), and your current smoking and alcohol usage. The nurse or study coordinator will collect the medication you did not take, as well as your completed pill diaries, at every clinic visit. At Months 1, 3, 6, and 9, you will also be given new study medication and pill diaries. You may also have another small biopsy performed from the inside of your mouth in the area where the cells that might become cancerous are located. The biopsy will be performed by your doctor and will be sent to a lab for testing. At months 3 and 12, the doctor will also count and measure any red or white patches on the inside of your mouth. Biopsies will be taken after 3 months of treatment and at the end of 12 months of treatment. The tissue will be tested to see if there are any cells that might become cancerous. Following the end of treatment, you will return to the clinic every 6 months for 2 years. You will have a complete physical exam, including measurement of vital signs. You will have a careful examination of the inside of your mouth. You will have blood drawn (about 2 teaspoons) for routine tests, to check your liver function, and for research testing. Your study doctor will ask you about any medications you are taking and how you are feeling (symptoms), and your current tobacco and alcohol use. In addition, at the final clinic visit, you will also take part in a personal interview. During the interview, you will be asked questions regarding socio-demographic information (such as age and race), nutrition habits, current and earlier tobacco use, alcohol use habits, family history of cancer, use of medications, and how you are feeling. The interview will take about 90 minutes to complete. The purpose of the interview is to collect information to learn if there is a relationship between certain factors and your risk of developing cancer of the mouth. You may be contacted in the future in order to collect more information. You may be taken off study if you are not able to follow the doctors' instructions, serious side effects occur, or the doctor thinks it is in your best interest to leave the study. If you are taken off study for any reason, you will be asked to return to the clinic for a final clinic visit, preferably within 14 days after leaving the study. This is an investigational study. Erlotinib hydrochloride is approved by the FDA for treatment of NSCLC. Its use in this study is considered investigational. Approximately 491 patients will be screened for this study. Up to 120 will be enrolled at MD Anderson.

Interventions

DRUGErlotinib

150 mg by mouth daily

DRUGPlacebo

Tablet by mouth daily

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Astellas Pharma US, Inc.
CollaboratorINDUSTRY
M.D. Anderson Cancer Center
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Male or female patients with one of the following: (a) loss of heterozygosity (LOH) at 3p14 and/or 9p21 in the oral IEN of patients with a history of curatively treated oral cancer or (b) LOH at 3p14 and/or 9p21 plus at one other chromosomal region in the IEN of patients with no oral cancer history. 2. Participants must have confirmed diagnosis of oral IEN lesion with LOH. (Note:The initial screening biopsy of oral IEN lesion with LOH must be obtained within 12 months of study enrollment. If initial diagnostic biopsy for LOH is \> 3 months prior to study enrollment, investigators may use clinical judgment to order an additional screening biopsy to assess histopathological changes). 3. Age \>/= 18 years 4. ECOG performance status \<2 5. Participants must have normal organ & marrow function as defined below w/in 30 days of randomization:CBC w/ differential white cell count-acceptable results must include:WBC \>3,000ul, hemoglobin\>10 g/dl, platelet count \> 125,000ul, LFTs-total bilirubin & alkaline phosphatase, AST (SGOT) & ALT (SPGT) all w/in \<1.5xULN.Note:At the discretion of the attending physician,participants w/ Gilbert's disease may still be eligible to participate in the event the total bilirubin value is \>1.5xULN. Kidney function-serum creatinine\< 1.5xULN Chemistry-Sodium & potassium all w/in normal institutional limits. 6. The effects of the study agent on the developing human fetus are unknown.For this reason,WOCBP & men must agree to use adequate contraception (hormonal or barrier method of birth control;abstinence)prior to study entry& for the duration of active treatment.Neg.serum pregnancy test in WOCBP.Childbearing potential will be defined as women who have had menses w/in the past 12 mths,who have not had tubal ligation or bilateral oophorectomy.Should a woman become pregnant or suspect she is pregnant while participating in this study,she should inform her study physician immediately 7. Ability to understand and the willingness to sign a written informed consent document

Exclusion criteria

1. Patients with active cancer or any cancer within the previous two years, excluding oral and non-melanoma skin cancer. 2. Patients with acute intercurrent illness or who have had surgery, radiation therapy, or chemotherapy within the preceding 4 weeks unless they have fully recovered. 3. Patients with a documented history of coagulopathy and/or those taking warfarin or warfarin-derivative anticoagulants 4. Women who are pregnant (confirmed by b-HCG if applicable) or breastfeeding 5. Any medical or psychological condition or any reason that, according to the investigator's judgment, makes the patient unsuitable for participation in the study 6. Patients who have participated in other experimental therapy studies within 3 months of enrollment to this trial 7. Patients with a history of inflammatory bowel disease 8. Patients with a documented history of interstitial lung disease

Design outcomes

Primary

MeasureTime frameDescription
Oral Cancer-free Survival in Participants Receiving Erlotinib as Compared With the Control Arm or Placebo Group.3 yearsCancer-free survival defined as time from randomization to the development of histologically confirmed oral cancer.

Countries

United States

Participant flow

Recruitment details

Patients seen at the following sites exhibiting oral leukoplakia we approached and enrolled if interested. These include MD Anderson Cancer Center, Memorial Sloan-Kettering, Emory University,the University of Chicago, and the University of Maryland.

Pre-assignment details

Patients with leukoplakia were screened and, once eligibility was confirmed, patients willing to proceed were randomized to erlotinib or placebo in a double-blinded manner.

Participants by arm

ArmCount
Erlotinib
Erlotinib 150 mg PO daily x 12 months
75
Placebo
Placebo PO daily x 12 months
75
Total150

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyScreen Failure7776

Baseline characteristics

CharacteristicErlotinibPlaceboTotal
Age, Customized
21-30 years
3 Participants2 Participants5 Participants
Age, Customized
31-40 years
6 Participants9 Participants15 Participants
Age, Customized
41-50 years
14 Participants13 Participants27 Participants
Age, Customized
51-60 years
21 Participants25 Participants46 Participants
Age, Customized
61-70 years
20 Participants22 Participants42 Participants
Age, Customized
71-80 years
10 Participants4 Participants14 Participants
Age, Customized
81-90 years
1 Participants0 Participants1 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants5 Participants10 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
70 Participants70 Participants140 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
2 Participants0 Participants2 Participants
Race (NIH/OMB)
Black or African American
1 Participants2 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants6 Participants9 Participants
Race (NIH/OMB)
White
68 Participants67 Participants135 Participants
Region of Enrollment
Europe
2 participants0 participants2 participants
Region of Enrollment
United States
73 participants75 participants148 participants
Sex: Female, Male
Female
32 Participants33 Participants65 Participants
Sex: Female, Male
Male
43 Participants42 Participants85 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
6 / 756 / 75
other
Total, other adverse events
68 / 7532 / 75
serious
Total, serious adverse events
10 / 754 / 75

Outcome results

Primary

Oral Cancer-free Survival in Participants Receiving Erlotinib as Compared With the Control Arm or Placebo Group.

Cancer-free survival defined as time from randomization to the development of histologically confirmed oral cancer.

Time frame: 3 years

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
ErlotinibOral Cancer-free Survival in Participants Receiving Erlotinib as Compared With the Control Arm or Placebo Group.55 Participants
PlaceboOral Cancer-free Survival in Participants Receiving Erlotinib as Compared With the Control Arm or Placebo Group.18 Participants

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026