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Erlotinib Hydrochloride in Preventing Cancer in Patients With Precancerous Lesions of the Lung

17. februar 2015 opdateret af: National Cancer Institute (NCI)

A Phase I Study of Erlotinib in Patients With Premalignant Lesions of the Lung

This phase I trial studies the side effects and best dose of erlotinib hydrochloride in preventing cancer in patients with precancerous lesions of the lung. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Studieoversigt

Detaljeret beskrivelse

PRIMARY OBJECTIVES:

I. To determine the lowest dose of erlotinib (erlotinib hydrochloride) that will decrease the ratio of phosphorylated to total epidermal growth factor receptor (EGFR) (phosphorylated EGFR [pEGFR]/EGFR) by at least 20% in subjects with premalignant lesions of the lung. This will be accomplished by implementing a dose de-escalation trial of erlotinib (i.e., 75, 50, and 25 or 100 mg by mouth daily for a 3-month period), and determining the pEGFR/EGFR ratio in premalignant lesions of the lung epithelium by immunohistochemistry. Changes in the pEGFR/EGFR ratio will be assessed by comparing the pre-treatment (baseline) ratio to that of the post-treatment (3 month) ratio, measured in paraffin embedded biopsy specimens.

SECONDARY OBJECTIVES:

I. To determine the effect of erlotinib on the following biomarkers of potential biological relevance in paraffin embedded lung biopsies, p-v-akt murine thymoma viral oncogene homolog 1 (Akt), p-mitogen-activated protein kinase 1 (Erk), and marker of proliferation Ki-67 (Ki67).

II. To characterize the toxicity profile of erlotinib in this cohort of subjects.

III. To analyze and model erlotinib's pharmacokinetic/pharmacodynamic (PK/PD) profile. Serial blood samples will be drawn at the beginning and at the end of erlotinib treatment, and pharmacokinetic parameters will be determined. The status of EGFR genotype (and that of others genes linked to erlotinib PK/PD) clinical toxicity, and dose will be examined as possible other influential covariates by comparing them to experimentally measured PK profiles, and PD profiles (in particular, the pEGFR/EGFR ratio). The goal of these studies will be to determine the optimal biologic concentration (OBC) of Erlotinib that is associated with the lowest toxicity and highest effect, for a given subject's pharmacogenomic profile.

OUTLINE:

Patients receive erlotinib hydrochloride orally (PO) once daily (QD) for 90 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 days.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

60

Fase

  • Fase 1

Kontakter og lokationer

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

Studiesteder

    • Illinois
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02118
        • Boston University School of Medicine
    • New York
      • Buffalo, New York, Forenede Stater, 14263
        • Roswell Park Cancer Institute

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

40 år til 79 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Diagnosis of a premalignant lung lesion (metaplasia or dysplasia) on autofluorescent bronchoscopy (AFB) within 1 month
  • Participants must have a >= 10 pack year lifetime smoking history; current and former smokers only are eligible for this trial
  • No contraindications for treatment with erlotinib or additional bronchoscopies
  • Absolute neutrophil count (ANC) of >= 1.5 x 10^9/L
  • Platelet count of >= 100 x 10^9/L
  • Creatinine level of less than 1.5 mg/dL
  • Total bilirubin =< 2.0 mg/dl
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 1.5 x upper limit of normal (ULN)
  • Alkaline phosphatase =< 2.5 x ULN
  • Must meet Eastern Cooperative Oncology Group (ECOG) performance status criteria of 0-1
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) throughout the duration of the study and for 1 month following cessation of study drug; females must begin adequate contraception immediately following screening pregnancy test; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately; if she is pregnant, she will be immediately withdrawn from the study
  • Ability to understand and the willingness to sign a written institutional review board (IRB) approved informed consent document

Exclusion Criteria:

  • Subjects with life-threatening medical conditions that would preclude the treatment intervention and bronchoscopy, including, but not limited to, unstable pulmonary function, acute cardiac failure, which is unstable despite medication use; uncontrolled hypertension; uncontrolled diabetes mellitus; unstable coronary artery disease; acute or chronic liver disease, ongoing or active infection; or psychiatric illness/social situations that would limit compliance with study requirements
  • Participants with evidence of an active cancer or carcinoma in situ, are not eligible
  • Participants currently taking medications that induce or inhibit the cytochrome P450, family 3, subfamily A, polypeptide 4-7 (CYP3A4-7) enzymes
  • Participants may not be receiving any other investigational agents within 3 months
  • Participants taking warfarin
  • History of allergic reactions attributed to erlotinib, a known hypersensitivity to erlotinib, or agents with a similar chemical or biological composition to erlotinib
  • Women who are pregnant or lactating are excluded from the study because based on the proposed mechanism of tyrosine kinase inhibition of erlotinib; erlotinib should be assumed to cause fetal harm when administered to a pregnant woman; there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with erlotinib
  • History of interstitial lung disease (ILD)

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Prevention (erlotinib hydrochloride)
Patients receive erlotinib hydrochloride PO QD for 90 days in the absence of disease progression or unacceptable toxicity.
Givet PO
Andre navne:
  • Cp-358.774
Korrelative undersøgelser
Korrelative undersøgelser
Andre navne:
  • farmakologiske undersøgelser

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Change in the ratio of p-EGFR to total EGFR
Tidsramme: Baseline up to 90 days
Baseline up to 90 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in the expression of p-Akt
Tidsramme: Baseline up to 90 days
Analyzed using an analysis-of-variance (ANOVA) on the change from baseline expression level with a factor for dose (75, 50, 25 or 100). All tests will be two-sided and tested at level alpha=0.05. If the overall comparison is significant, pairwise comparisons will be done using straight Bonferroni adjustments.
Baseline up to 90 days
Change in the expression of p-Erk
Tidsramme: Baseline up to 90 days
Analyzed using an ANOVA on the change from baseline expression level with a factor for dose (75, 50, 25 or 100). All tests will be two-sided and tested at level alpha=0.05. If the overall comparison is significant, pairwise comparisons will be done using straight Bonferroni adjustments.
Baseline up to 90 days
Change in the expression of Ki67
Tidsramme: Baseline up to 90 days
Analyzed using an ANOVA on the change from baseline expression level with a factor for dose (75, 50, 25 or 100). All tests will be two-sided and tested at level alpha=0.05. If the overall comparison is significant, pairwise comparisons will be done using straight Bonferroni adjustments.
Baseline up to 90 days
Incidence of toxicities, graded according to Common Toxicity Criteria, version 3.0
Tidsramme: Up to 30 days
Up to 30 days

Andre resultatmål

Resultatmål
Tidsramme
PK/PD parameters
Tidsramme: Up to 90 days
Up to 90 days
Pharmacogenomic profile
Tidsramme: Up to 90 days
Up to 90 days

Samarbejdspartnere og efterforskere

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

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. oktober 2009

Primær færdiggørelse (Faktiske)

1. februar 2012

Studieafslutning (Faktiske)

1. juni 2013

Datoer for studieregistrering

Først indsendt

13. november 2009

Først indsendt, der opfyldte QC-kriterier

13. november 2009

Først opslået (Skøn)

16. november 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

18. februar 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. februar 2015

Sidst verificeret

1. april 2014

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • NCI-2013-00750 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • P30CA060553 (U.S. NIH-bevilling/kontrakt)
  • N01CN35157 (U.S. NIH-bevilling/kontrakt)
  • RPCI-I-121507
  • NU-NWU08-11-01
  • STU00012618
  • NCI 08-11-01 (Anden identifikator: Northwestern University)
  • NWU08-11-01 (Anden identifikator: DCP)

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 Erlotinib hydrochlorid

Abonner