Patient case: 64-year-old male with head and neck squamous cell carcinoma; genetic feature: CDKN2A

Clinical trial: Saracatinib in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

Summary: This phase II trial is studying the how well saracatinib works in treating patients with metastatic or recurrent head and neck cancer. Saracatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth

Detailed description: PRIMARY OBJECTIVES:
  I. To determine the median progression-free survival for patients with advanced or recurrent squamous cell carcinoma of the head and neck (HNSCC) treated with AZD0530 (saracatinib).
  SECONDARY OBJEC TIVES:
  I. To determine overall survival for patients with advanced or recurrent HNSCC treated with AZD0530.
  II. To determine objective response rate for patients with advanced or recurrent HNSCC treated with AZD0530.
  III. For patients with accessible tumors, to perform pre and post-treatment biopsies to assess the pharmacodynamic effects of AZD0530 on c-Src and downstream signaling molecules STAT3 and STAT5.
  OUTLINE:
  Patients receive saracatinib orally (PO) or by percutaneous endoscopic gastrostomy (PEG) tube once daily (QD) on days 1-56. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity.
  After completion of study treatment, patients are followed up for 12 weeks and then periodically thereafter.

Eligibility: Inclusion Criteria:
  -  Histologically or cytologically confirmed squamous cell carcinoma of the head and neck
  -  Persistent, recurrent, or metastatic disease that is not amenable to curative-intent therapy with surgery or radiation
  -  Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) ≥ 20 mm with conventional techniques or ≥ 10 mm with spiral computed tomography (CT) scan
  -  Karnofsky performance status ≥ 60%
  -  White blood cell (WBC) ≥ 3,000/mcL
  -  Absolute neutrophil count ≥ 1,500/mcL
  -  Platelets ≥ 100,000/mcL
  -  Hemoglobin > 9 g/dL
  -  Total bilirubin within upper institutional limits of normal (ULN)
  -  Aspartate aminotransferase (AST) /alanine aminotransferase (ALT) ≤ 2.5 x ULN
  -  Creatinine within ULN OR creatinine clearance ≥ 60 mL/min
  -  Patients must agree to use adequate birth control for the duration of study participation and for at least 8 weeks after discontinuation of study drug
  -  May have received 1 prior cytotoxic chemotherapy regimen for recurrent or metastatic disease
  Exclusion Criteria:
  -  Known brain metastases
  -  History of allergic reactions attributed to compounds of similar chemical or biological composition to AZD0530
  -  Urine protein: creatinine ratio ≥ 1.0 OR 24-hour urine protein ≥ 1,000 mg
  -  QTc prolongation ≥ 480 msecs
  -  Intercurrent symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia
  -  History of myocardial infarction within the past year
  -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements
  -  Pregnant or breastfeeding women
  -  Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy
  -  Pulmonary fibrosis ≥ grade 2, pleural effusion (non-malignant) ≥ grade 2, or pneumonitis/pulmonary infiltrates ≥ grade 2
  -  Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study
  -  Patients who have not recovered from adverse events due to agents administered more than 4 weeks earlier
  -  Use of specifically prohibited cytochrome P450 3A4 (CYP3A4)-active agents or substances
  -  Prohibited drugs should be discontinued 7 days prior to the administration of the first dose of AZD0530 and for 7 days following discontinuation of AZD0530
  -  Patients receiving any other investigational agents

Relevance to patient case: not relevant