- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00380029
Erlotinib Before and After Surgery in Treating Patients With Muscle-Invasive Bladder Cancer
A Phase II Study of Erlotinib (Tarceva®) in Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy
RATIONALE: Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving erlotinib before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving erlotinib after surgery may kill any tumor cells that remain after surgery.
PURPOSE: This phase II trial is studying how well erlotinib works when given before and after surgery in treating patients with muscle-invasive bladder cancer.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
OBJECTIVES:
Primary
- Determine the effect of neoadjuvant erlotinib hydrochloride on histopathological, molecular, and genetic correlates in patients undergoing radical cystectomy for muscle-invasive bladder cancer.
Secondary
- Determine the pathological complete response rate in surgical specimens from patients treated with this drug.
- Determine recurrence and progression rates after cystectomy (up to 2 years after surgery) in patients treated with neoadjuvant and adjuvant erlotinib hydrochloride.
- Determine 2- and 5-year disease-free, disease-specific, and overall survival rates in patients treated with this drug.
- Determine the safety of this drug in these patients.
OUTLINE: This is an open-label study.
Patients receive oral erlotinib hydrochloride once daily for 4 weeks. Patients then undergo radical cystectomy with curative intent. Within 12 weeks after surgery, patients resume oral erlotinib hydrochloride* once daily for up to 2 years in the absence of disease progression or unacceptable toxicity.
Note: *Patients who are candidates for adjuvant chemotherapy (e.g., found to have pathologic stage T3 (pT3), Node positive (N+) disease) do not receive erlotinib hydrochloride after surgery.
Tumor tissue is obtained at baseline (at the original or confirmatory transurethral resection of the bladder tumor) and at the time of cystectomy for analysis of drug-specific and tissue-based biomarkers by western blot, immunohistochemistry, and gene array techniques. Histopathological, molecular, and genetic correlates are analyzed to better understand the potential effects of the epidermal growth factor receptor (EGFR) inhibition in transitional cell carcinoma and to determine the effect of neoadjuvant erlotinib on gene expression. Tumor tissue is also evaluated by real-time polymerase chain reaction to confirm drug effects on expected targets and on EGFR expression, activity, and affected signaling pathways in the disease state and by microarray analysis to define expression phenotypes correlating with outcome, distinguish responders from nonresponders, and determine effects of drug treatment on gene expression in disease.
Patients are followed periodically for up to 5 years after surgery.
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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North Carolina
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Chapel Hill, North Carolina, États-Unis, 27599-7295
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
DISEASE CHARACTERISTICS:
Histologically confirmed muscle-invasive bladder cancer, meeting the following criteria:
- Clinical stage T2 disease
- No locally-extensive clinical stage T3 or T4 disease
- No metastatic disease (N+, M+) by physical exam or radiologic evaluation
- Must have undergone prior initial or confirmatory transurethral resection of the bladder tumor (TURBT)
- Candidate for and has agreed to undergo radical cystectomy with curative intent
- No non-transitional cell carcinoma histologies
PATIENT CHARACTERISTICS:
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Granulocyte count > 1,500/mm³
- Platelet count > 100,000/mm³
- Bilirubin normal
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2 times upper limit of normal
- Creatinine normal
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No contraindication to erlotinib hydrochloride or other tyrosine kinase inhibitors
PRIOR CONCURRENT THERAPY:
No prior radiotherapy or systemic chemotherapy for bladder cancer
- Prior single-dose mitomycin C allowed at the time of TURBT
- Prior 6- or 12-week course of adjuvant intravesical Bacillus Calmette-Guerin (BCG) therapy with or without recombinant interferon alfa-2a allowed
- At least 4 weeks since other prior or concurrent radiotherapy, chemotherapy, or hormonal therapy
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: Erlotinib
erlotinib given before and after transurethral resection of a bladder tumor, TURBT
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Erlotinib will be given at a dose of 150 mg per day for 4 weeks before undergoing planned radical cystectomy.
In addition, patients will continue on erlotinib daily at a dose of 150 mg per day (qd dosing) for up to 2 years after surgery (beginning within 12 weeks of surgery) or until evidence of disease recurrence or progression
Autres noms:
Will occur 4 weeks prior to dosing with erlotinib
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
EGFR Activation Signal (AKT2) Expression to Predict Sensitivity to Erlotinib
Délai: 4 weeks before treatment and 4 weeks post treatment
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Determine the effect of neoadjuvant erlotinib hydrochloride on histopathological, molecular, and genetic correlates in patients undergoing radical cystectomy for muscle-invasive bladder cancer.
Gene expression of pre-treatment and post-treatment tumor samples were analyzed to define molecular determinants of response or resistance to epidermal growth factor receptor (EGFR) inhibition.
Both in vitro and in vivo EGFR-associated signatures were evaluated on pre-treatment bladder tumors.
Candidate molecular determinants of sensitivity to EGFR inhibition were characterized and examined for their ability to predict sensitivity to EGFR inhibitors in vitro.
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4 weeks before treatment and 4 weeks post treatment
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Pathological Complete Response Rate
Délai: 4 weeks
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Determine the pathological complete response rate (P0 rate) after undergoing radical cystectomy (RC).
Evaluated using Response Evaluation Criteria In Solid Tumors (RECIST).
Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
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4 weeks
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Disease Recurrence and Progression Rates After Cystectomy
Délai: 2 years
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To determine disease recurrence/progression rates after cystectomy in patients treated with erlotinib
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2 years
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Overall Survival Rate
Délai: 25 months
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The number of patients who remained alive and with no evidence of disease at the mean (range) follow-up of 24.8 months (3.0-36.6).
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25 months
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Number of Subjects Experiencing Adverse Events
Délai: 4 weeks - 2 years following surgery
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The incidence of all toxicities observed during neoadjuvant and adjuvant treatment phase.Toxicity will be graded per the Common Terminology Criteria for Adverse Events (CTCAE) 2.0.
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4 weeks - 2 years following surgery
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Collaborateurs et enquêteurs
Les enquêteurs
- Chercheur principal: Raj S. Pruthi, MD, UNC Lineberger Comprehensive Cancer Center
Publications et liens utiles
Liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Tumeurs
- Tumeurs urologiques
- Tumeurs urogénitales
- Tumeurs par site
- Maladies urologiques
- Maladies de la vessie urinaire
- Tumeurs de la vessie urinaire
- Mécanismes moléculaires de l'action pharmacologique
- Inhibiteurs d'enzymes
- Agents antinéoplasiques
- Inhibiteurs de protéine kinase
- Chlorhydrate d'erlotinib
Autres numéros d'identification d'étude
- LCCC 0521
- P30CA016086 (Subvention/contrat des NIH des États-Unis)
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
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