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Phase II Study of Cetuximab and Bevacizumab in Esophageal Carcinoma That Failed First Line Therapy

Phase 2
18 Years
Not Enrolling
Esophageal Carcinoma

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Trial Information

Phase II Study of Cetuximab and Bevacizumab in Esophageal Carcinoma That Failed First Line Therapy

Cancer of the esophagus often has a poor outcome since many patients have advanced disease
when they are diagnosed. The average survival rate after five years has increased from 4% in
the 1970s to around 14% currently.

Surgery to remove the tumor or treatment with radiotherapy alone has led to disappointing
results for patients. Chemotherapy has some activity in patients with advanced disease,
although responses are usually short. New strategies are trying to combine these three
treatment approaches to improve survival for these patients.

This study will test the combination of cetuximab and bevacizumab in patients with locally
advanced esophageal cancer. This is a group of patients with usually poor outcomes from
treatment with surgery, radiotherapy or chemotherapy alone. Scientifically, this study will
help assess the value in combining these two different types of drug.

Inclusion Criteria:

1. Patients must have histologically or cytologically confirmed squamous cell carcinoma
or esophageal adenocarcinoma.

2. The disease must be recurrent after first line systemic therapy, with or without
radiation, with or without surgery.

3. Patients must be at least 1 month from prior chemotherapy or radiation therapy.

4. ECOG performance status ≤ 1 (Karnofsky > 60%)

5. Life expectancy of greater than 12 weeks.

6. Age > 18.

7. Patients must have normal bone marrow and other organ function or defined below:

- Absolute neutrophil count, > 1, 500/μL

- Platelet counts, > 100, 00/μL

_ Hemoglobin, > 8.0 gm/dL-

- Creatinine(< 1.5mg/dL)

8. No significant intercurrent medical illness (including NYHA class II, III or IV heart
disease, significant arrhythmias requiring medication, symptomatic coronary artery
disease, myocardial infarction within the previous 6 months.

9. Women of childbearing potential must have a negative pregnancy test.

10. Ability to understand and willingness to sign a written informed consent document.

Exclusion Criteria:

I. Disease-specific Exclusions

1. All histologic types other than squamous cell carcinoma or adenocarcinoma.

2. Patients currently receiving other investigational agents, or who have received
cetuximab previously.

3. Patients with known brain metastases.

4. History of severe allergic reactions attributed to compounds of similar chemical or
biologic composition to Cetuximab or Bevacizumab.

5. Patients with history of any other malignancy (except non-melanomatous skin cancer or
CIS of cervix) are ineligible unless a period of 5 years has lapsed since treatment
of the previous cancer and the patient has remained continuously disease free.

6. Patients who are felt to be poorly compliant.

7. Women who are breast-feeding.

II. General Medical Exclusions

Subjects meeting any of the following criteria are ineligible for study entry:

1. Inability to comply with study and/or follow-up procedures.

2. Life expectancy of less than 12 weeks.

3. Current, recent (within 4 weeks of the first infusion of this study), or planned
participation in an experimental drug study other than a Genentech-sponsored
bevacizumab cancer study.

III. Bevacizumab-Specific Exclusions

1. Inadequately controlled hypertension (defined as systolic blood pressure >150 and/or
diastolic blood pressure >100 mmHg on antihypertensive medications).

2. Any prior history of hypertensive crisis or hypertensive encephalopathy.

3. New York Heart Association (NYHA) Grade II or greater congestive heart failure

4. History of myocardial infarction or unstable angina within 6 months prior to study

5. History of stroke or transient ischemic attack within 6 months prior to study

6. Known CNS disease.

7. Significant vascular disease (e.g., aortic aneurysm, aortic dissection).

8. Symptomatic peripheral vascular disease.

9. Evidence of bleeding diathesis or coagulopathy.

10. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to study enrollment or anticipation of need for major surgical procedure during
the course of the study.

11. Core biopsy or other minor surgical procedure, excluding placement of a vascular
access device, within 7 days prior to study enrollment.

12. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within 6 months prior to study enrollment.

13. Serious, non-healing wound, ulcer, or bone fracture.

14. Proteinuria at screening as demonstrated by either

- Urine protein: creatinine (UPC) ratio ≥ 1.0 at screening OR

- Urine dipstick for proteinuria ≥ 2+ (patients discovered to have ≥ 2+
proteinuria on dipstick urinalysis at baseline should undergo a 24 hour urine
collection and must demonstrate ≤ 1g of protein in 24 hours to be eligible)

15. Known hypersensitivity to any component of bevacizumab.

16. Pregnant (positive pregnancy test) or lactating. Use of effective means of
contraception (men and women) in subjects of child-bearing potential.

17. History of myocardial infarction or unstable angina within 6 months of study

Type of Study:


Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-free survival

Outcome Time Frame:

Every 3 months

Safety Issue:


Principal Investigator

Nabil Saba, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Emory University Winship Cancer Institute


United States: Institutional Review Board

Study ID:




Start Date:

October 2008

Completion Date:

March 2012

Related Keywords:

  • Esophageal Carcinoma
  • esophageal carcinoma
  • cancer of the esophagus
  • locally advanced or metastatic esophageal cancer
  • Carcinoma
  • Esophageal Diseases
  • Esophageal Neoplasms