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Study Of Lapatinib In Patients With Relapsed Or Refractory Inflammatory Breast Cancer

24 de septiembre de 2015 actualizado por: GlaxoSmithKline

A Phase II Study to Evaluate the Efficacy, Safety and Pharmacodynamics of Lapatinib in Patients With Relapsed or Refractory Inflammatory Breast Cancer

This study was designed to determine how effective and safe a new investigational drug, lapatinib, is in treating patients with treatment refractory or relapsed inflammatory breast cancer. Tumor tissue collected pre-treatment and at Day 28 will be examined for biologic activity by IHC (immunohistochemistry). Treatment will consist of daily oral therapy with lapatinib. A patient may continue treatment as long as they are receiving benefit. Blood samples for hematology and chemistry panels, MUGA/ECHO (multigated acquisition/echocardiogram) exams and physical exams will be performed throughout the study to monitor safety.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

This Phase II open label, multicenter study is designed to evaluate the efficacy, safety, and pharmacodynamic effects of oral lapatinib administered as a single agent therapy to patients with relapsed or refractory inflammatory breast cancer. Eligible patients must have a diagnosis of inflammatory breast cancer based on clinicopathologic criteria, tumor that is readily accessible for biopsy, and must have previously received treatment with an anthracycline and taxane-containing regimen (30 patients) plus trastuzumab (90 patients). Patients enrolled must have tumors that overexpress ErbB2, with or without co-expression of ErbB1. The primary objective for this study is to evaluate the objective response rate (defined as complete response plus partial response). Secondary objectives are to evaluate clinical benefit including quality of life parameters, progression-free survival, overall survival, time-to-response, response duration, safety and tolerability, pharmacodynamic effects on intracellular mediators that regulate tumor cell growth and survival, as well as effects on proteomic profile, and circulating levels of extracellular domains of ErbB1 and ErbB2 in peripheral blood.

Tipo de estudio

Intervencionista

Inscripción (Actual)

126

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Bélgica
      • Bruxelles, Bélgica, 1000
        • GSK Investigational Site
  • Canadá
    • Ontario
      • Toronto, Ontario, Canadá, M4N 3M5
        • GSK Investigational Site
  • España
      • Barcelona, España, 08036
        • GSK Investigational Site
      • Barcelona, España, 08035
        • GSK Investigational Site
      • Girona, España, 17007
        • GSK Investigational Site
      • Madrid, España, 28041
        • GSK Investigational Site
  • Estados Unidos
    • Florida
      • Miami, Florida, Estados Unidos, 33136-1002
        • GSK Investigational Site
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60637
        • GSK Investigational Site
      • Zion, Illinois, Estados Unidos, 60099
        • GSK Investigational Site
    • Maryland
      • Bethesda, Maryland, Estados Unidos, 20892-1201
        • GSK Investigational Site
    • Michigan
      • Detroit, Michigan, Estados Unidos, 48201
        • GSK Investigational Site
    • Missouri
      • St. Louis, Missouri, Estados Unidos, 63110
        • GSK Investigational Site
    • North Carolina
      • Durham, North Carolina, Estados Unidos, 27710
        • GSK Investigational Site
    • Washington
      • Seattle, Washington, Estados Unidos, 98109
        • GSK Investigational Site
  • Francia
      • Bayonne, Francia, 64100
        • GSK Investigational Site
      • Lyon Cedex 08, Francia, 69373
        • GSK Investigational Site
      • Marseille Cedex 09, Francia, 13273
        • GSK Investigational Site
      • Paris Cedex 20, Francia, 75970
        • GSK Investigational Site
      • Paris Cedex 5, Francia, 75248
        • GSK Investigational Site
      • Saint-Herblain, Francia, 44805
        • GSK Investigational Site
  • Israel
      • Ramat Gan, Israel, 52621
        • GSK Investigational Site
      • Zrifin, Israel, 70300
        • GSK Investigational Site
  • Reino Unido
      • London, Reino Unido, SW3 6JJ
        • GSK Investigational Site
  • Túnez
      • Sfax, Túnez, 3000
        • GSK Investigational Site
      • Sfax, Túnez, 3029
        • GSK Investigational Site
      • Tunis, Túnez, 1007
        • GSK Investigational Site
      • Tunis, Túnez, 1004
        • GSK Investigational Site

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion criteria:

  • Must have a life expectancy of at least 12 weeks.
  • Has a left ventricular ejection fraction (LVEF) ≥ 50%, or ≥ lower limit of normal for the institution, based on ECHO or MUGA.
  • Aspartate and alanine transaminase (AST or ALT) ≤ 3 times the upper limit of the reference range (patients with liver metastases may have AST and ALT ≤ 5 times the upper limit of the reference range and may be enrolled).
  • Total bilirubin ≤ 3.0 mg/dL.
  • Serum creatinine ≤ 2.0 mg/dL or calculated creatinine clearance (CrCl) ≥ 30 mL/min
  • Adequate bone marrow function. Hemoglobin ≥ 9 gm/dL. Absolute granulocyte count ≥ 1,500/mm³ (1.5 x 10^9/L). Platelets ≥ 75,000/mm³ (100 x 10^9/L).
  • Recovered or stabilized sufficiently from side effects associated with previous chemotherapy, surgery or radiotherapy.
  • Provided written informed consent.
  • ECOG (Eastern Cooperative Oncology Group) performance status 0 to 2.
  • Able to swallow and retain oral medication.
  • Male or female, if female:

A female is eligible to enter and participate in the study if she is of:

  1. Non-childbearing potential (i.e., women with functioning ovaries who have a current documented tubal ligation or hysterectomy, or women who are postmenopausal); or
  2. Childbearing potential (i.e., women with functioning ovaries and no documented impairment of oviductal or uterine function that would cause sterility. This category includes women with oligomenorrhoea (severe), women who are perimenopausal, and young women who have begun to menstruate), has a negative serum pregnancy test at screening, and agrees to one of the following where considered acceptable to the local IRB/IEC: Double-barrier contraception (condom with spermicidal jelly, foam suppository, or film; diaphragm with spermicide; or male condom and diaphragm).

Abstinence from sexual intercourse from 2 weeks prior to administration of the investigational product, throughout the active study treatment period, and through the post-treatment follow-up visit (to occur 28 days after last dose of investigational product).

Male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female subject.

Implants of levonorgestrel. Injectable progestogen. Any intrauterine device (IUD) with a documented failure rate of less than 1% per year.

Oral contraceptives (either combined or progestogen only). Barrier methods including diaphragm or condom with a spermicide.

  • At least 18 years of age.
  • Has either measurable disease by Response Evaluation Criteria in Solid Tumors (RESIST) or clinically evaluable skin disease. Measurable lesions may be in the field of prior adjuvant irradiation; however, there must be at least an 8 week period between the last radiation treatment and the baseline scan documenting disease status for the lesion to be measurable.
  • Tumor that is accessible for biopsy.
  • Tumor that overexpresses ErbB2 defined as 3+ by IHC or FISH +. The ErbB 2 overexpression must be documented prior to dosing.
  • Documented disease progression or relapse following treatment, which must have contained a taxane and anthracycline-containing regimen in the adjuvant or metastatic setting (30 patients) plus trastuzumab (90 patients)
  • Histological diagnosis of breast carcinoma with a clinical diagnosis of IBC based on the presence of inflammatory changes in the involved breast, including diffuse erythema and edema (peau d'orange), with or without an underlying palpable mass involving the majority of the skin of the breast. Pathologic evidence of dermal lymphatic invasion should be noted but is not required for diagnosis.

Exclusion criteria:

  • Is clinically assessed to have inadequate venous access for protocol-related blood draws.
  • Has a clinically significant electrocardiogram (ECG) abnormality.
  • Has Class II to IV heart failure as defined by the New York Heart Association (NYHA) functional classification system.
  • Has physiological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.
  • Is currently receiving oral steroid treatment (inhaled steroids are permitted), or any other medication on the prohibited medications list
  • Is currently receiving amiodarone or has received amiodarone in the 6 months prior to screening.
  • Has received chemotherapy, immunotherapy, biologic therapy or hormonal therapy within the past 14 days, with the exception of mitomycin C within the past 6 weeks.
  • Has received treatment with any investigational drug in the previous 4 weeks.
  • Has a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the investigational product. These include other anilinoquinazolines, such as gefitinib [Iressa], erlotinib [Tarceva], or other chemically related compounds.
  • Is considered medically unfit for the study by the investigator as a result of the medical interview, physical exam, or screening investigations.
  • Has evidence of symptomatic or uncontrolled brain metastases or leptomeningeal disease. Patients with brain metastases treated by surgery and/or radiotherapy are eligible if neurologically stable and do not require steroids or anticonvulsants.
  • Has malabsorption syndrome, a disease affecting gastrointestinal function, or resection of the stomach or small bowel.
  • Is a pregnant or lactating female.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: No aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Lapatinib
Single arm study of lapatinib with no comparator arm.
Droga: lapatinib
Tyrosine kinase inhibitor administered daily at 1500 mg/kg

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Periodo de tiempo
Objective Response rate (complete response plus partial response)
Periodo de tiempo: Week 84
Week 84

Medidas de resultado secundarias

Medida de resultado
Periodo de tiempo
Clinical benefit (progression free survival, time to progression, response duration)
Periodo de tiempo: week 84
week 84
Assessment of clinical benefit, defined as CR or PR for at least 4 weeks, or SD for at least 6 months
Periodo de tiempo: week 84
week 84
Calculation of progression-free survival, defined as the time between the first dose of investigational product and the first documented sign of disease progression or death.
Periodo de tiempo: week 84
week 84
Calculation of time-to-response, defined as the time between the first dose of investigational product and the first documented CR or PR.
Periodo de tiempo: week 84
week 84
Calculation of duration of response, defined as the time from initial documented CR or PR to the first documented sign of disease progression.
Periodo de tiempo: week 84
week 84
Evaluation of changes in QoL and pain scale measurements collected on Day 1 and every 4 weeks while receiving study treatment.
Periodo de tiempo: week 84
week 84
Evaluation of adverse events (AEs), changes in laboratory values and echocardiogram (ECHO) or multiple gated acquisition scan (MUGA) results from pre-dose, during dosing and post-dose assessments
Periodo de tiempo: week 84
week 84
Comparison of the effects of lapatinib on biomarkers that are involved in regulating tumor cell proliferation and survival (e.g., phosphorylated forms of Erk1/2 and Akt, STAT3, S6 Kinase, Bad, truncated ErbB2 and potentially other downstream mediators of
Periodo de tiempo: Day 28
Day 28
tumor cell growth and survival) by quantitative IHC and by direct and genome-wide methods (e.g., direct sequencing and DNA microarray) in tumor tissue collected prior to and following 28 days of lapatinib monotherapy.
Periodo de tiempo: Day 28
Day 28
Examination of the effects of lapatinib therapy on the levels of circulating ErbB1 and ErbB2 ECD and the proteomic profile of peripheral blood. Investigation of the use of FDG-PET to predict early response to treatment with lapatinib.
Periodo de tiempo: Day 28
Day 28

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

GlaxoSmithKline

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de marzo de 2005

Finalización primaria (Actual)

1 de septiembre de 2007

Finalización del estudio (Actual)

1 de mayo de 2010

Fechas de registro del estudio

Enviado por primera vez

18 de marzo de 2005

Primero enviado que cumplió con los criterios de control de calidad

18 de marzo de 2005

Publicado por primera vez (Estimar)

21 de marzo de 2005

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

28 de septiembre de 2015

Última actualización enviada que cumplió con los criterios de control de calidad

24 de septiembre de 2015

Última verificación

1 de mayo de 2015

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • EGF103009

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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