Targeted therapy for advanced salivary gland carcinoma based on molecular typing

A Phase II Study of Advanced Salivary Gland Carcinoma Based on Molecular Typing

This study is testing if personalized treatments based on specific tumor markers can help people with advanced salivary gland cancer feel better and live longer.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 88 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Fudan University (Academic / other)
• Drugs / interventions: chemotherapy
• Locations: 1 site (Shanghai)
• Trial ID: NCT05924256 on ClinicalTrials.gov

What this trial studies

This phase II study evaluates the efficacy and safety of targeted therapies for patients with relapsed or metastatic salivary gland carcinoma, utilizing molecular typing to assign patients to different treatment arms. Patients will be categorized based on specific biomarkers, such as HER2 and androgen receptor status, and receive tailored therapies including anti-HER2 ADC and anti-androgen therapy. The study aims to determine the effectiveness of these targeted treatments in improving patient outcomes. It is conducted at a single center and involves a comprehensive assessment of tumor characteristics.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 to 75 with histologically confirmed locally advanced or metastatic salivary gland carcinoma and specific molecular alterations.

Not a fit: Patients with salivary gland carcinoma who do not meet the molecular criteria for the treatment arms or have a poor performance status may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide personalized treatment options that significantly improve outcomes for patients with advanced salivary gland carcinoma.

How similar studies have performed: Other studies have shown promising results with targeted therapies in similar cancer types, suggesting potential for success in this approach.

Eligibility criteria

Inclusion Criteria:

1. Patients volunteered to participate in this study and signed informed consent;
2. Aged ≥ 18 but ≤ 75 years, male or female;
3. Histologically confirmed to be locally advanced or metastatic salivary gland carcinoma;
4. Arm1: salivary gland carcinoma patients with HER-2 alteration including HER-2 positive or mutation/amplification; Arm 2: salivary gland carcinoma patients with AR-positive; Arm 3: salivary gland carcinoma patients without HER-2 alteration or AR-positive; Arm 4: salivary gland carcinoma patients with low HER2 expression;
5. At least one measurable lesion (according to RECIST v1.1, long diameter of measurable lesion scanned by spiral CT should be ≥ 10 mm or short diameter of swollen lymph node should be ≥ 15 mm; according to RECIST vl.1 standards, a previously treated lesion with local treatment can be used as target lesions after clear progress);
6. ECOG Perfomance Status: 0\~1;
7. Estimated survival time ≥ 12 weeks;
8. The main organs function are normal, and meet the following requirements (within 7 days before the start of study treatment):

   Blood routine examination(no blood transfusion within 14 days before screening, no granulocyte colony stimulating factor (G-CSF), no medication corrected):1) Hemoglobin (HB)≥ 90g / L;2) Neutrophil count (ANC) ≥ 1.5 × 109 / L;3) platelets (PLT) ≥ 80 × 109 / L; Blood biochemical tests are subject to the following criteria (no albumin is delivered 14 days prior to screening):1) Serum total bilirubin (BIL) ≤ 1.5 times the upper limit of normal (ULN); 2) alanine aminotransferase (ALT), aspartate aminotransferase (AST\])\< 2.5 × ULN; if liver metastasis, ALT and AST ≤ 5 × ULN;3) Serum creatinine (Cr) ≤ 1 × ULN or endogenous creatinine clearance \> 50ml / min (Cockcroft-Gault formula); International normalized ratio (INR) ≤ 2.3 or prothrombin time (PT) exceeds the range of normal controls ≤ 6 seconds; Urine protein \<2+ (if urine protein ≥ 2+, 24-hour urine protein can be quantified, 24-hour urine protein quantitation \<1.0g can be included);
9. Women of childbearing age must have a negative pregnancy test (serum or urine) within 7 days prior to enrollment and volunteer to use appropriate methods during the observation period and within 8 weeks after the last study drug administration; for men, sterilization surgery should be performed, or agree to use appropriate methods of contraception during the observation period and within 8 weeks after the last administration of the study drug;
10. Patient who are expected to have good compliance and can accept follow-up visit for the efficacy and adverse reactions according to the program requirements.

Exclusion Criteria:

1. Have other active malignancies within 5 years or at the same time. Localized tumors that have been cured, such as cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma, superficial bladder cancer, prostate carcinoma in situ, cervical carcinoma in situ, and breast carcinoma in situ, can be enrolled.
2. Other anti-tumor treatments (including but not limited to chemotherapy, radiotherapy, etc.) were used within 28 days prior to the first use of the study drug. if the last dose of anti-tumor drug had been stopped ≥ 5 half-life can be allowed.
3. There are clinical symptoms or diseases of the heart that are not well controlled, such as:

   According to the New York Heart Association (NYHA) standard, level II or higher cardiac dysfunction or echocardiography: left ventricular ejection fraction\<50%; unstable angina; Myocardial infarction occurred within 1 year before the start of treatment; Clinically significant supraventricular or ventricular arrhythmia that requires treatment or intervention; corrected QT interval(QTc) \> 450ms (male); QTc \> 470ms (female) (Calculation of QTc interval with Fridericia formula; if the QTc is abnormal, it can be detected three times at an interval of 2 minutes, and the average value is taken);
4. Patients with high blood pressure who cannot be reduced to normal range by antihypertensive medication (systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg) (average of BP based on ≥2 measurements), allowing the use of antihypertensive treatment to achieve the above parameters.
5. A variety of factors that affect the absorption of oral medications (such as inability to swallow, nausea and vomiting, chronic diarrhea and intestinal obstruction) (Only apply for Arm 2 patients);
6. Patients with a risk of gastrointestinal bleeding may not be enrolled, including the following: (1) active digestive ulcer lesions, and fecal occult blood (++); (2) those with a history of melena and hematemesis within 3 months;
7. Abnormal coagulation function (INR\>1.5×ULN,activated partial thromboplastin time\>1.5×ULN), with bleeding tendency.

Where this trial is running

Shanghai

• Dongmei Ji — Shanghai, China (Recruiting)

Study contacts

• Principal investigator: Dongmei Ji, Doctor — Fudan University
• Study coordinator: Dongmei Ji, Doctor

Conditions Advanced Salivary Gland Carcinoma