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Entinostat, Lapatinib Ditosylate and Trastuzumab in Treating Patients With Locally Recurrent or Distant Relapsed Metastatic Breast Cancer Previously Treated With Trastuzumab Only

17 de mayo de 2019 actualizado por: National Cancer Institute (NCI)

Phase I and Phase I Trastuzumab Cohort Study of Entinostat, Lapatinib and Trastuzumab in Patients With HER2-Positive Metastatic Breast Cancer in Whom Trastuzumab Has Failed

This phase I trial studies the side effects and best dose of entinostat when given together with lapatinib ditosylate and trastuzumab in treating patients with breast cancer that has spread from the original (primary) tumor to distant organs or distant lymph nodes or has recurred (come back) at or near the same place as the original (primary) tumor, usually after a period of time during which the cancer could not be detected. Entinostat and lapatinib ditosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as trastuzumab, may interfere with the ability of tumor cells to grow and spread. Giving entinostat together with lapatinib ditosylate and trastuzumab may kill more tumor cells.

Descripción general del estudio

Descripción detallada

PRIMARY OBJECTIVES:

I. To determine the recommended phase II dose (RP2D) for entinostat in combination with lapatinib (lapatinib ditosylate) in patients whom trastuzumab has failed for human epidermal growth factor receptor 2+ (HER2+) metastatic breast cancer (Phase I).

II. To determine the maximum tolerated dose (MTD) for entinostat in combination with lapatinib and trastuzumab in patients whom trastuzumab has failed for HER2+ metastatic breast cancer (Phase I Trastuzumab Cohort).

SECONDARY OBJECTIVES:

I. To determine the toxicity of combination therapy with entinostat and lapatinib in patients whom trastuzumab has failed for HER2+ metastatic breast cancer (Phase I).

II. To determine the toxicity of entinostat in combination with lapatinib and trastuzumab in patients whom trastuzumab has failed for HER2+ metastatic breast cancer (Phase I Trastuzumab Cohort).

EXPLORATORY OBJECTIVES:

I. Determine whether the 2-drug combination modulates the expression of HER2, phosphorylated HER2 (pHER), epidermal growth factor receptor (EGFR), phosphorylated EGFR (pEGFR), v-akt murine thymoma viral oncogene homolog 1 (Akt), and phosphorylated Akt (pAkt) in breast tumors and/or circulating tumor cells (CTCs).

OUTLINE: This is a dose-escalation study of entinostat.

Patients receive entinostat orally (PO) on days 1 and 15 and lapatinib tosylate PO on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients in the Phase I trastuzumab cohort also receive maintenance dose of trastuzumab intravenously (IV) over 30-90 minutes every 3 weeks.

After completion of study treatment, patients are followed up for 28 days or until toxicities are resolved.

Tipo de estudio

Intervencionista

Inscripción (Actual)

37

Fase

  • Fase 1

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

    • Texas
      • Houston, Texas, Estados Unidos, 77030
        • M D Anderson Cancer Center

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:

  • Patients have histological confirmation of invasive breast carcinoma
  • Patients have locally recurrent or distant relapsed metastatic disease
  • Patients have positive HER2 expression by immunohistochemistry (IHC) (3+) or fluorescence in situ hybridization (FISH) testing (> 2.0 ratio)
  • Patients are able to swallow and retain oral medication (i.e., no uncontrolled vomiting, inability to swallow, or diagnosis of chronic malabsorption)
  • Patients have Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Patients must have received prior trastuzumab for > 2 month period before disease recurrence or recurrence or progression while on trastuzumab-based therapy
  • Patients have ability and willingness to sign written informed consent
  • Female patients of childbearing potential (a female not free from menses > 2 years or not surgically sterilized) must be willing to use an adequate barrier method of contraception to prevent pregnancy or agree to abstain from heterosexual activity throughout the study; male patients who are able to father children must use an adequate barrier method of contraception
  • Female patients of childbearing potential must have negative serum pregnancy test within 14 days of starting protocol therapy
  • Patients with brain metastasis have no signs of progressive disease 4 months after the completion of brain metastasis treatment (radiation therapy, surgery, etc.) do not require anticonvulsants or corticosteroids, and have been off such drugs for at least 7 days
  • Both men and women and members of all races and ethnic groups are eligible for this trial

Exclusion Criteria:

  • Patients are receiving concurrent anti-cancer therapy (chemotherapy, immunotherapy, biological therapy and hormonal therapy) while taking study medication
  • Serum bilirubin >= 1.5 x upper limit of normal (ULN)
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) >= 3 x ULN (with or without liver metastasis [mets])
  • Absolute neutrophil count (ANC) < 1.5
  • Hemoglobin =< 9
  • Platelet =< 140,000
  • Patients have an active infection and require intravenous (IV) or oral antibiotics
  • Cardiac arrhythmia requiring maintenance medication
  • History of gastrointestinal disorders (medical disorders or extensive surgery) which may interfere with the absorption of the study drug
  • Patients have a concurrent disease or condition that would make them inappropriate for study participation, or any serious medical disorder that would interfere with patients' safety
  • Serum creatinine > 2.0 mg/dL

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: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Treatment (entinostat, lapatinib ditosylate and trastuzumab)
Patients receive entinostat PO on days 1 and 15 and lapatinib tosylate PO on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients in the Phase I Trastuzumab Cohort also receive maintenance dose of trastuzumab IV over 30-90 minutes every 3 weeks.
Estudios correlativos
Dado IV
Otros nombres:
  • Herceptina
  • ABP 980
  • Anti-c-ERB-2
  • Anticuerpo monoclonal anti-c-erbB2
  • Anti-ERB-2
  • Anti-erbB-2
  • Anticuerpo monoclonal anti-erbB2
  • Anticuerpo monoclonal anti-HER2/c-erbB2
  • Anti-p185-HER2
  • Anticuerpo monoclonal c-erb-2
  • Anticuerpo monoclonal HER2
  • Herceptin biosimilar PF-05280014
  • Herceptin Trastuzumab Biosimilar PF-05280014
  • MoAb HER2
  • Ogivrí
  • PF-05280014
  • rhuMAb HER2
  • RO0452317
  • Trastuzumab Biosimilar ABP 980
  • Trastuzumab Biosimilar HLX02
  • Trastuzumab Biosimilar PF-05280014
  • Trastuzumab-dkst
Orden de compra dada
Otros nombres:
  • Inhibidor de HDAC SNDX-275
  • MS 27-275
  • MS-275
  • SNDX-275
Orden de compra dada
Otros nombres:
  • Tykerb

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Periodo de tiempo
RP2D for entinostat in combination with lapatinib ditosylate defined as the highest dose level in which 6 patients have been treated with at most 1 patient experiencing dose limiting toxicity
Periodo de tiempo: Up to 28 days
Up to 28 days

Medidas de resultado secundarias

Medida de resultado
Periodo de tiempo
Incidence of grade III or IV toxicities, graded according to Common Terminology Criteria for Adverse Events version 4
Periodo de tiempo: Up to 28 days
Up to 28 days

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Changes in CTCs levels before and after the combination treatment of entinostat, lapatinib ditosylate and trastuzumab
Periodo de tiempo: Baseline up to 28 days after completion of study treatment
Summary statistics (mean, standard deviation, median, quartiles) will be summarized for these changes in CTCs and biomarkers by patient tumor response status (yes vs. no). Changes will be compared between the two groups of patients (yes vs. no tumor response) using the two-sample t-test. If the data is skewed, Wilcoxon rank-sum test will be used.
Baseline up to 28 days after completion of study treatment
Changes in phosphorylated Akt levels before and after the combination treatment of entinostat, lapatinib ditosylate and trastuzumab.
Periodo de tiempo: Baseline up to 28 days after completion of study treatment
Summary statistics (mean, standard deviation, median, quartiles) will be summarized for these changes in CTCs and biomarkers by patient tumor response status (yes vs. no). Changes will be compared between the two groups of patients (yes vs. no tumor response) using the two-sample t-test. If the data is skewed, Wilcoxon rank-sum test will be used.
Baseline up to 28 days after completion of study treatment
Changes in phosphorylated HER2 levels before and after the combination treatment of entinostat, lapatinib ditosylate and trastuzumab
Periodo de tiempo: Baseline up to 28 days after completion of study treatment
Summary statistics (mean, standard deviation, median, quartiles) will be summarized for these changes biomarkers by patient tumor response status (yes vs. no). Changes will be compared between the two groups of patients (yes vs. no tumor response) using the two-sample t-test. If the data is skewed, Wilcoxon rank-sum test will be used.
Baseline up to 28 days after completion of study treatment
Changes in phosphorylated EGFR levels before and after the combination treatment of entinostat, lapatinib ditosylate and trastuzumab
Periodo de tiempo: Baseline up to 28 days after completion of study treatment
Summary statistics (mean, standard deviation, median, quartiles) will be summarized for these changes biomarkers by patient tumor response status (yes vs. no). Changes will be compared between the two groups of patients (yes vs. no tumor response) using the two-sample t-test. If the data is skewed, Wilcoxon rank-sum test will be used.
Baseline up to 28 days after completion of study treatment

Colaboradores e Investigadores

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

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 (Actual)

10 de enero de 2012

Finalización primaria (Actual)

16 de febrero de 2016

Finalización del estudio (Actual)

16 de febrero de 2016

Fechas de registro del estudio

Enviado por primera vez

13 de septiembre de 2011

Primero enviado que cumplió con los criterios de control de calidad

13 de septiembre de 2011

Publicado por primera vez (Estimar)

14 de septiembre de 2011

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

20 de mayo de 2019

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

17 de mayo de 2019

Última verificación

1 de mayo de 2019

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • NCI-2011-03222 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • P30CA016672 (Subvención/contrato del NIH de EE. UU.)
  • UM1CA186688 (Subvención/contrato del NIH de EE. UU.)
  • U01CA062461 (Subvención/contrato del NIH de EE. UU.)
  • 8871 (Otro identificador: CTEP)
  • NCI 8871
  • 2010-0842 (Otro identificador: M D Anderson Cancer Center)
  • CDR0000710891

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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