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A Phase I Trial Of Vorinostat In The Treatment Of Advanced Laryngeal, Hypopharyngeal, Nasopahryngeal And Oropharyngeal Squamous Cell Carcinoma Of The Head And Neck.

Phase 1
18 Years
Open (Enrolling)
Stage III Squamous Cell Carcinoma of the Oropharynx, Stage IV Squamous Cell Carcinoma of the Oropharynx

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Trial Information

A Phase I Trial Of Vorinostat In The Treatment Of Advanced Laryngeal, Hypopharyngeal, Nasopahryngeal And Oropharyngeal Squamous Cell Carcinoma Of The Head And Neck.


I. To determine the maximally tolerated dose of Vorinostat in combination with concurrent
chemoradiotherapy for the treatment of advance stage OPSCC.


l. To determine the complete response rate, overall survival and progression free survival
using the maximally tolerated dose of Vorinostat.


I. To assess treatment related acute and late toxicities when combining Vorinostat with
chemoradiation and correlate these toxicities to molecular markers of apoptosis in tumor and
normal oral mucosa.

II. To evaluate the effect of Vorinostat on tumor immune surveillance, particularly in HPV
positive patients.

III. To illustrate that Vorinostat alters the methylation status of commonly methylated
genes in OPSCC.

OUTLINE: This is a dose-escalation study of vorinostat. Patients receive oral vorinostat on
days 0-2 and cisplatin IV on days 7, 21, and 35. Patients undergo radiotherapy 5 days a week
beginning on day 7. Patients also receive concurrent oral vorinostat along with the
radiotherapy to be given 3 days per week (Monday, Tuesday, and Wednesday). Treatment
continues for 7 weeks in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically.

Inclusion Criteria

Inclusion Criteria:

- Patients with histologically confirmed unresectable or borderline resectable squamous
cell carcinoma of the oropharynx will be eligible for enrollment to the clinical

- Oropharyngeal sites of tumor include tonsil, soft palate, base of tongue, lateral and
posterior pharyngeal wall

- Patient must be AJCC Stage III (T3N0, T1-2N1) or Stage IVa (T1-4N2-3M0, T4N0-1 M0)
and be either unresectable or borderline resectable

- No prior therapy for the tumor, including extensive surgery, radiation therapy,
chemotherapy, immunotherapy, targeted therapy or any other investigational agents;
surgical biopsy prior to beginning the study is allowable

- Prior malignancies at sites other than the head and neck are allowable if there has
been greater than or equal to a 3 year disease free interval; basal cell carcinoma of
the skin and in-situ cervix dysplasias are allowable within this 3 year interval if
completely resected

- There must be documentation of evaluable tumor within four weeks of beginning therapy

- ECOG Performance Status 0-2, (Karnofsky > 60%)

- Ability to understand and the willingness to sign a written informed consent

- Patient must have normal liver and bone marrow function

- Absolute neutrophil count (ANC) >= 1,500/mcL

- Platelets >= 100,000/mcL

- Hemoglobin >= 9 g/dL

- Prothrombin Time or INR =< 1.5x upper limit of normal (ULN) unless receiving
therapeutic anticoagulation

- Partial thromboplastin time (PTT) =< 1.2 times the ULN unless the patient is
receiving therapeutic anticoagulation

- K levels preferred normal limits with no clinical abnormalities

- Mg levels preferred normal limits with no clinical abnormalities

- Creatinine =< ULN OR Calculated creatinine clearance >= 50 mL/min

- Serum total bilirubin =< 1.5 X ULN

- AST (SGOT) and ALT (SGPT) =< 2.5 X ULN

- Alkaline Phosphatase =< 2.5 X ULN

- No known malabsorption syndrome

- Female patients of childbearing potential must be willing to use birth control; the 2
birth control methods can be either 2 barrier methods or a barrier method plus a
hormonal method to prevent pregnancy, used throughout the study starting with visit 1

- The following are considered adequate barrier methods of contraception: diaphragm,
condom (by the partner) or sponge; other methods of contraception such as copper
intrauterine device or spermicide may be used

- Appropriate hormonal contraceptives will include any registered and marketed
contraceptive agent that contains an estrogen and/or a progestational agent
(including oral, subcutaneous, intrauterine, or intramuscular agents); female patient
of childbearing potential has a negative serum pregnancy test β-hCG within 7 days
prior to receiving the first dose of vorinostat

- Male patients agree to use an adequate method of contraception for the duration of
the study

- The patient must have a life expectancy of at least 12 weeks

- Patients on coumadin therapy are eligible for study

Exclusion Criteria:

- Major surgery or trauma occurring within 28 days of starting the trial

- History of allergic reactions attributed to compounds similar in chemical or
biological composition to Vorinostat or other agents used in this study

- Gastrointestinal tract disease or previous surgical procedures resulting in an
inability to take oral or enteral medication or a requirement for IV alimentation

- Pregnant women; breast feeding should be discontinued during treatment

- Active peptic ulcer disease

- Uncontrolled comorbid illness including but not limited to ongoing or active
infection, symptomatic congestive heart failure, unstable angina, untreated or new
cardiac arrhythmia, psychiatric or social condition which would limit the patient's
understanding of and compliance with the study

- Prisoners and other vulnerable populations

- Patients who have had prior treatment with an HDAC inhibitor (e.g., romidepsin
(Depsipeptide), NSC-630176, MS 275, LAQ-824, belinostat (PXD-101), LBH589, MGCD0103,
CRA024781, etc)

- Patients who have received compounds with HDAC inhibitor-like activity, such as
valproic acid, as anti-tumor therapy should not enroll in this study; patients who
have received such compounds for other indications, e.g. valproic acid for epilepsy,
may enroll after a 30-day washout period

- Patient is currently participating or has participated in a study with an
investigational compound or device within 30 days of initial dosing with study

- Patients with known active viral hepatitis or known HIV infection

Type of Study:


Study Design:

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

Outcome Measure:

Maximum tolerated dose of vorinostat in combination with concurrent chemoradiation therapy

Outcome Time Frame:

Weekly during treatment; Every 2 weeks for the first month after treatment completion; Then every 4 weeks until day 153

Safety Issue:


Principal Investigator

Theodoros Teknos, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Ohio State University


United States: Institutional Review Board

Study ID:




Start Date:

February 2010

Completion Date:

Related Keywords:

  • Stage III Squamous Cell Carcinoma of the Oropharynx
  • Stage IV Squamous Cell Carcinoma of the Oropharynx
  • oropharyngeal cancer
  • recurrent squamous cell carcinoma of the oropharynx
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Oropharyngeal Neoplasms



Ohio State University Medical Center Columbus, Ohio  43210