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A Double Blind Randomised Study of Lapatinib and Placebo in Metastatic TCC of the Urothelium (LaMB)

14. april 2015 opdateret af: Queen Mary University of London

A Phase II/III, Randomised, Two-Arm, Comparison of Maintenance Lapatinib Versus Placebo After First-Line Chemotherapy in Patients With HER1 and/or HER2 Overexpressing Locally Advanced or Metastatic Bladder Cancer [LaMB]

RATIONALE: Lapatinib ditosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether lapatinib ditosylate is more effective than a placebo in killing tumor cells.

PURPOSE: This randomized phase II/III trial is studying how well lapatinib ditosylate works compared to a placebo in treating patients with stage IV bladder cancer.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

OBJECTIVES:

Primary

  • Compare progression-free survival in patients with HER1- and/or HER2-overexpressing stage IV bladder cancer who have been randomized to maintenance therapy with lapatinib ditosylate or placebo following first-line chemotherapy.

Secondary

  • Compare overall survival between these patient groups.
  • Evaluate the safety and tolerability of the regimens in these patients.
  • Assess and compare quality of life between these patient groups.

OUTLINE: This is a multicenter study. Patients are stratified according to ECOG performance status and response to first line chemotherapy (complete or partial response vs stable disease). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral lapatinib ditosylate once daily in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity.

Patients undergo quality of life assessment by EORTC QLQ-C30 at baseline and every 4 weeks during study treatment.

After completion of study treatment, patients are followed up periodically for up to 5 years.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

204

Fase

  • Fase 2
  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Det Forenede Kongerige
      • Aberdeen, Det Forenede Kongerige
        • NHS Grampian - Aberdeen Royal Infirmary
      • Basildon, Det Forenede Kongerige
        • Basildon and Thurrock University Hospital NHS Trust - Basildon Hospital
      • Birmingham, Det Forenede Kongerige
        • University Hospitals Birmingham NHS Foundation Trust - Birmingham University Hospital
      • Bournemouth, Det Forenede Kongerige
        • Royal Bournemouth and Christchurch NHS Foundation Trust - Royal Bournemouth Hospital
      • Bristol, Det Forenede Kongerige
        • University Hospitals Bristol NHS Trust - Bristol University Hospital
      • Cambridge, Det Forenede Kongerige
        • Cambridge University Hospitals NHS Trust - Addenbrooke's Hospital
      • Chelmsford, Det Forenede Kongerige
        • Mid Essex NHS Trust - Broomfield Hospital
      • Colchester, Det Forenede Kongerige
        • Colchester University Hospitals NHS Trust
      • Coventry, Det Forenede Kongerige
        • University Hospitals Coventry & Warwickshire NHS Trust
      • Derby, Det Forenede Kongerige
        • Derby Hospitals NHS Trust - Royal Derby Hospital
      • Glasgow, Det Forenede Kongerige
        • NHS Greater Glasgow and Clyde - The Beatson
      • Huddersfield, Det Forenede Kongerige
        • Calderdale and Huddersfield NHS Trust - Huddersfield Royal Infirmary
      • Ipswich, Det Forenede Kongerige
        • Ipswich Hospital NHS Trust
      • Leicester, Det Forenede Kongerige
        • University Hospitals Of Leicester Nhs Trust
      • Liverpool, Det Forenede Kongerige
        • Clatterbridge Centre for Oncology NHS Trust
      • London, Det Forenede Kongerige
        • Imperial Healthcare NHS Trust
      • London, Det Forenede Kongerige
        • Guys & St Thomas' Hospital NHS Trust - Guys Hospital
      • London, Det Forenede Kongerige
        • Royal Marsden NHS Trust
      • Middlesborough, Det Forenede Kongerige
        • South Tees NHS Trust - James Cook University Hospital
      • Newcastle, Det Forenede Kongerige
        • Newcastle Upon Tyne Hospitals NHS Trust
      • Northampton, Det Forenede Kongerige
        • Northampton General Hospitals NHS Trust
      • Nottingham, Det Forenede Kongerige
        • Nottingham University Hospitals NHS Trust
      • Nottingham, Det Forenede Kongerige
        • Sherwood Forest Hospitals NHS Trust - Kings Mill Hospital
      • Portsmouth, Det Forenede Kongerige
        • Portsmouth Hospitals NHS Trust - Queen Alexandra Hospital
      • Romford, Det Forenede Kongerige
        • Barking, Havering and Redbridge NHS Trust - Queens Hospital
      • Taunton, Det Forenede Kongerige
        • Taunton and Somerset NHS Trust - Musgrove Park Hospital
    • England
      • London, England, Det Forenede Kongerige, EC1M 6BQ
        • Barts and The London NHS Trust

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

DISEASE CHARACTERISTICS:

  • Histologically confirmed transitional cell carcinoma of the bladder

    • Stage IV disease
    • Metastatic or locally advanced disease

  • HER1- and/or HER2-positive disease, defined by the following criteria:

    • 2+ or 3+ intensity on IHC
  • Able to commence the study treatment within 10 weeks of completing chemotherapy

  • Must have achieved objective response or stable disease following 4-8 courses of first-line chemotherapy

    • No progression with first-line chemotherapy for metastatic disease
    • Any widely accepted chemotherapy regimen for bladder cancer allowed
    • Patients who did not receive cisplatin are eligible

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-3
  • ANC ≥ 1.0 x 10^9/L
  • Hemoglobin ≥ 8.0 g/dL
  • Platelet count ≥ 75 x 10^9/L
  • ALT/AST < 2 times upper limit of normal (ULN)
  • Bilirubin < 1.5 times ULN
  • Serum creatinine ≤ 3.0 ULN AND/OR creatinine clearance ≥ 30 mL/min
  • LVEF ≥ 50% (as assessed by quantitative echocardiogram or MUGA)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

  • No current active hepatic or biliary disease, except for any of the following:

    • Gilbert's syndrome
    • Asymptomatic gallstones
    • Liver metastases
    • Stable chronic liver disease per investigator assessment
  • No known hypersensitivity to the study medication

  • No history of prior or concurrent other neoplasms, except for:

    • Any non life-threatening tumours that have been curatively treated.
    • Prostate cancer isolated to the prostate gland

  • No significant cardiac disease, including any of the following:

    • Angina pectoris
    • Severe cardiac arrhythmia requiring medication
    • Severe conduction abnormalities
    • Clinically significant valvular disease
    • Cardiomegaly
    • Prior myocardial infarction
    • Ventricular hypertrophy
    • Congestive heart failure
    • Poorly uncontrolled hypertension (resting diastolic blood pressure > 115 mm Hg)
    • Other cardiomyopathy
  • No serious intercurrent medical or psychiatric illness
  • No serious active infection

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No more than 1 line of prior chemotherapy for metastatic or locally advanced disease (neoadjuvant/adjuvant chemotherapy allowed)
  • No more than 10 weeks since first-line chemotherapy
  • No prior lapatinib ditosylate
  • No prior radiotherapy to the indicator lesion(s) (newly arising lesions in previously irradiated areas allowed)

  • At least 14 days since prior and no concurrent CYP3A4 inducers, including but not limited to, any of the following:

    • Antibiotics (all rifamycin class agents [e.g., rifampicin, rifabutin, rifapentine])
    • Anticonvulsants (phenytoin, carbamazepine, barbiturates [e.g., phenobarbital])
    • Oral glucocorticoids (cortisone [> 50 mg], hydrocortisone [> 40 mg], prednisone [> 10 mg], methylprednisolone [> 8 mg], dexamethasone [> 2 mg²])
    • St. John's wort or modafinil

  • At least 7 days since prior and no concurrent CYP3A4 inhibitors, including but not limited to, any of the following:

    • Antibiotics (clarithromycin, erythromycin, troleandomycin)
    • Antifungals (itraconazole, ketoconazole, fluconazole [>150 mg daily], voriconazole)
    • Antiretrovirals/protease inhibitors (delavirdine, nelfinavir, amprenavir, ritonavir, indinavir, saquinavir, lopinavir)
    • Calcium channel blockers (verapamil, diltiazem)
    • Antidepressants (nefazodone, fluvoxamine)
    • Gastrointestinal agents (cimetidine, aprepitant)
    • Grapefruit, grapefruit juice
  • At least 6 months since prior and no concurrent amiodarone
  • No concurrent radical or curative therapy (radiotherapy or surgery) at the end of first-line treatment (palliative radiotherapy allowed)
  • No other concurrent experimental or investigational drugs
  • No other concurrent anticancer treatment, including cytotoxic or specific immune therapy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Arm I
Patients receive oral lapatinib ditosylate once daily in the absence of disease progression or unacceptable toxicity.
Medicin: lapatinib ditosylat
Gives oralt
Andre navne:
  • Tykerb
  • Tyverb
Placebo komparator: Arm II
Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity.
Andet: Placebo
Gives oralt

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Progression free survival
Tidsramme: Disease Progression - at least 20% increase in the sum of longest diameters of target lesions.
Disease Progression - at least 20% increase in the sum of longest diameters of target lesions.

Sekundære resultatmål

Resultatmål
Samlet overlevelse

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Queen Mary University of London

Samarbejdspartnere

GlaxoSmithKline

Efterforskere

  • Ledende efterforsker: Thomas Powles, MD, MRCP, Queen Mary University of London

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2009

Primær færdiggørelse (Forventet)

1. juli 2015

Datoer for studieregistrering

Først indsendt

29. juli 2009

Først indsendt, der opfyldte QC-kriterier

29. juli 2009

Først opslået (Skøn)

30. juli 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

15. april 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. april 2015

Sidst verificeret

1. april 2015

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CDR0000640393
  • OCTG-LaMB
  • BL-2007-02
  • EUDRACT-2007-001826-28
  • EU-20929

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med lapatinib ditosylat

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