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

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

Summary: Phase II trial to study the effectiveness of perifosine in treating patients who have recurrent or metastatic head and neck cancer. Drugs used in chemotherapy such as perifosine use different ways to stop tumor cells from dividing so they stop growing or die.

Detailed description: OBJECTIVES:
  I. Determine the antitumor activity of perifosine in patients with recurrent or metastatic squamous cell head and neck cancer.
  II. Determine the time to progression and overall survival of patients treated with this drug.
  III. Determine the toxicity of this drug in these patients. IV. Determine the pharmacodynamics of this drug in these patients. V. Assess the usefulness of biomarkers in predicting response and other outcome parameters in patients treated with this drug.
  VI. Assess the quality of life of patients treated with this drug.
  OUTLINE: This is a multicenter study.
  Patients receive oral perifosine 4 times daily on days 1 and 2 and once daily on days 3-28 during course 1. Patients receive oral perifosine once daily on days 1-28 for all subsequent courses. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  Quality of life is assessed at baseline, weekly during the first month, every 28 days after the first month, and then at study withdrawal.
  Patients are followed every 3 months.
  PROJECTED ACCRUAL: A total of 22-46 patients will be accrued for this study within 2 years.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically or cytologically confirmed squamous cell cancer of the head and neck
  -  Metastatic or recurrent disease
  -  Not amenable to surgery or radiotherapy
  -  Unidimensionally measurable disease
  -  At least 1 lesion at least 20 mm by conventional techniques OR at least 10 mm by CT scan
  -  No known brain metastases
  PATIENT CHARACTERISTICS:
  Age
  -  18 and over
  Performance status
  -  ECOG 0-2 OR
  -  Karnofsky 60-100%
  Life expectancy
  -  More than 3 months
  Hematopoietic
  -  WBC at least 3,000/mm^3
  -  Absolute neutrophil count at least 1,500/mm^3
  -  Platelet count at least 100,000/mm^3
  Hepatic
  -  Bilirubin normal
  -  AST/ALT no greater than 2.5 times upper limit of normal
  Renal
  -  Creatinine normal OR
  -  Creatinine clearance at least 60 mL/min
  Cardiovascular
  -  No symptomatic congestive heart failure
  -  No unstable angina pectoris
  -  No cardiac arrhythmia
  Other
  -  Not pregnant or nursing
  -  Negative pregnancy test
  -  Fertile patients must use effective contraception
  -  No history of allergic reaction attributed to compounds of similar chemical or biological composition to perifosine
  -  No ongoing or active infection
  -  No other concurrent uncontrolled illness
  -  No psychiatric illness or social situation that would limit compliance with study requirements
  PRIOR CONCURRENT THERAPY:
  Biologic therapy
  -  No more than 1 prior biologic/targeted regimen for recurrent or metastatic disease
  Chemotherapy
  -  No more than 1 prior adjuvant or neoadjuvant chemotherapy and/or concurrent chemoradiotherapy regimen
  -  No more than 1 prior chemotherapy regimen for recurrent or metastatic disease
  -  At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
  Radiotherapy
  -  At least 4 weeks since prior radiotherapy
  Other
  -  Recovered from prior therapy
  -  No concurrent combination antiretroviral therapy for HIV-positive patients
  -  No other concurrent investigational agents
  -  No other concurrent anticancer agents or therapies

Relevance to patient case: not relevant